PRITE Ninja 2024 Review Questions and Correct Answers

Amnesia preceded by epigastric sensation and fear are associated with electrical abnormality where? Temporal lobe Memory loss pattern in dissociative amnesia Memory loss occurs for a discrete period of time Amnesia characterized by loss of memory of events that occur after onset of etiologic condition or agent Anterograde What psychoactive drug produces amnesia? Alcohol Visual problem in pituitary tumor compressing optic chiasm Bitemporal Hemianopsia 32 y/o pt 1-month history of worsening headaches, episodic mood swings and occasional hallucinations with visual, tactile and auditory content. CT head reveals tumor where: Temporal lobe Syndrome characterized by fluent speech, preserved comprehension, inability to repeat, w/o associated signs. Location of lesion in the brain? Supramarginal gyrus or insula Acute onset of hemiballismus of LUE & LLE. MRI is most likely to show lesion located where? Subthalamic nucleus Left sided hemi-neglect is associated with lesion located where? Right Parietal Lobe 60M right-handed, getting lost, only writes on right half of paper. Where is lesion Right parietal Which hormone secreted in functional pituitary adenoma: Prolactin CT & MRI show ventriculomegaly are out of proportion to sulcal atrophy. This is suggestive of what diagnosis? Normal Pressure Hydrocephalus 5 y/o with 4 month history of morning HA, vomiting, and recent problems with gait, falls, and diplopia Medulloblastoma 20 y/o with 1 yr of bitemporal headaches, polydipsia, polyuria, bulimia. For 2 months emotional outburst aggressive and transient confusion neuro exam normal. What will MRI of brain show? Hypothalamic tumor Location of lesion: previously pleasant person becomes profane and irresponsible over 6 months: Frontal lobe Unilateral hearing loss with vertigo, unsteadiness with falls and headaches, mild facial weakness and ipsilateral limb ataxia is most commonly associated with tumors in what locations: Cerebellopontine angle 52 y/o with h/o unipolar depression is brought to ED with a first episode of catatonia. Patient is on no meds, UDS is neg. Further w/u should initially focus on what factor? Metabolic disorders Which term describes state of immobility that is constantly maintained? Catalepsy Ability of catatonic pt to hold same position Catalepsy Chronic Afib develops aphasia and R hemiparesis at noon. ER exam notes weakness of R extremities and severe dysfluent aphasia, but CT at 1:30 PM has no acute lesion. Most appropriate treatment: TPA Young adult gained 70 lbs in last year c/o daily severe headaches sometimes assoc with graying out of vision. Papilledema present. CT and MRI brain no abnormalities but ventricles smaller than usual. Goal of treatment in this case: Prevent blindness Patient with hypertension develops vertigo, nausea, vomiting, hiccups, left sided face numbness, nystagmus, hoarseness, ataxia of the limbs, staggering gait, and is falling to the left. Dx? Lateral medullary stroke Rapid onset of right facial weakness, left limb weakness, diplopia Brain Stem Infarction Transient symptom associated with carotid stenosis: *** Monocular blindness 62 y/o M w DM is not making sense, saying "thar szing is phrumper zu stalking". Normal intonation but no one in the family can understand it. He verbally responds to questions with similar utterances but fails to successfully execute any instruction. **** Wernicke's aphasia 58 y/o M h/o HTN, cig smoking and sudden inability to speak. Face drooping on R and dragging R leg. In ER examined within 40 mins of onset: Aphasic, unable to understand or repeat verbal commands. Unintelligable sounds for speech. Alert but appeared frustrated. R hemiplegia with arm and face weaker than leg. CT head showed no hemorrhage. Pathology type and area: Thromboembolic stroke L MCA (middle cerebral artery)