Neuro- FC

Question 1

What special staining is needed to see Pick’s body?

Answer 1

silver staining

Question 2

What is progressive supranuclear palsy?

Answer 2

PSP is sort of parkinsonian syndrome, characterized by early gait instability, frequent falls, and progressive ophthalmoplegia.

PSP overlaps with Parkinson’s disease in that bradykinesia, hypophonia, masked facies, and micrographia are frequently present, however, TREMOR IS MUCH LESS COMMON

Unlike primary Parkinson’s disease, PSP classically does NOT respond to treatment with carbidopa/levodopa.

Question 3

Which artery supplies blood to VPM/VPL thalamic nuclei?

Answer 3

thalamogeniculate branches of posterior cerebral artery

Question 4

Heat tilting RIGHT to correct vision. What CN is impaired? Which side?

Answer 4

RIGHT CN4
LEFT superior oblique is messed up. and LEFT superior oblique is innervated by RIGHT CN4

• Head tilting to the SAME SIDE as CN4,
  OPPOSITE SIDE as SUPERIOR OBLIQUE

Question 5

How to treat Bell palsy?

Answer 5

Corticosteroid

• antiviral (acyclovir) is not as effective as corticosteroid
• most patient recover naturally without treatment, but corticosteroid seems to be effective in shortening symptom duration

Question 6

Weakness in foot dorsiflexion, toe extension, foot inversion and/or eversion, and leg abduction. Loss of sensation in dorsal foot. What dermatome?

Answer 6

L5

• I picked S1. but S1 doesn’t cover dorsal foot. It only covers lateral side of foot

Question 7

Diagnostic triad of cauda equina syndrome?

Answer 7

• weakness
• urinary retention
• saddle anesthesia

Question 8

Describe MRI finding in MS

Answer 8

Varying size and age of plaques

most common locations for MS PLAQUE are in the periventricular and juxtacortical white matter, brainstem, and spinal cord.

Regions of active demyelination will also be bright on contrast-enhanced sequences, whereas older plaques will no longer enhance.

Question 9

Pt has seizure with preferential conjugate gaze to right. Which brain lesion? explain

Answer 9

Left frontal cortex

• bottom line: focal seizure= over-activation of that region

Left frontal cortex -> Left frontal eye fields (FEF)

• > Right (contralateral PPRF, paramedian pontine reticular formation)
• > Right CN6
• > over activation of right eye LR and left eye MR
• > Right gaze

Question 10

NF2: defect in what protein?

Answer 10

merlin

Question 11

For what condition is sumatriptan is contraindicated?

Answer 11

history of CAD or MI

=> sumatriptan can cause excessive vasospasm

Question 12

Which muscle of eye is associated pupil dilation? what about pupil contraction? Which nerve innervates each?

Answer 12

• radial muscle: located in peripheral outermost rim, pupillary dilation, innervated by sympathetic nerve (NOT CRANIAL NERVE)
• circular muscle: surrounding rim of pupil, pupillary contraction, innervated by parasympathetic nerve (CN3)

Question 13

Is motor (mastication) affected in trigeminal neuralgia?

Answer 13

NO.

trigeminal neuralgia is due to the compression of the trigeminal nerve by an aberrant loop of artery or vein, often of the superior cerebellar artery. motor is intact

Question 14

elevated CSF levels of protein 14-3-3: what disease is this

Answer 14

Creutzfeldt–Jakob disease

Question 15

What is classic finding of opthalmoscopy in age-related macular degeneration?

Answer 15

multiple small, bright yellow dots

Question 16

Where does pre-ganglionic sympathetic arise from?

Answer 16

intermediolateral cell column (T1-L2) of the spinal cord