Ninja PRITE Part 1
26 y.o. w/HA and R-hand clumsiness for weeks. Exam
shows difficulty w/rapid alternating movements of
hand, overt intention tremor on finger-to-nose, and
mildly dysmetric finger tamping. CNS intact and no
papilledema. Where will damage show on MRI? - ANS CEREBELLUM
Mesolimbic DA pathway includes which structure? - ANS VENTRAL STRIATUM
In addiction, dopaminergic neurons project to nucleus
accumbens. Cell bodies of these neurons reside in
which area of brain? - ANS VENTRAL TEGMENTAL AREA
Neural plasticity largely mediated through the capacity
to rapidly change in number and morphology which fo
the following? - ANS DENDRITIC SPINES
The uncinated fasciculus connects which of the
following brain areas? - ANS ANTERIOR TEMPORAL AND VENTRAL PRE-FRONTAL
REGIONS
What are cortical columns? - ANS FUNCTIONAL UNITS FOR INFORMATION
PROCESSING
Abnormal emotional expressions such as pathological
laughter or crying caused by lesions affecting cortical-
subcortical circuits linking frontal cortex, pons and
what? - ANS CEREBELLUM
Exposure to light effects which brain structure? - ANS SUPRACHIASMATIC NUCLEUS
When does synaptogenesis peak? - ANS FIRST 4 YEARS OF LIFE
Where does the neuron morphology in the brain
change the most? - ANS PREFRONTAL CORTEX
threatening objects produce startle response prior to
person becoming consciously aware. Connection of
thalamus to what? - ANS AMYGDALA
Huntington's disease characterised by loss of neurons
,producing which NT - ANS GABA
Adult neurogenesis in which area of the brain? - ANS HIPPOCAMPUS
17y/o is evaluated for binge eating associated with a
60 lb weight gain over the past four months. CT shows
a craniopharyngioma that likely disrupts what
structure? - ANS VENTROMEDIAL HYPOTHALAMUS
What is an accurate statement about the brain's default
mode network? - ANS IS INVOLVED IN REPROCESSING PREVIOUSLY
EXPERIENCED STIMULI
The most likely reason that adults are superior to
adolescents in abstract thinking. The brain undergoes: - ANS SYNAPTIC PRUNING
Dorsal-lateral-pre-frontal cortext plays important role in
what activity? - ANS WORKING MEMORY
Drug abuse activates neuro circuits. Generates signals
in the ventral tegmental area and to where? - ANS DOPAMINE INTO THE NUCLEUS
ACCUMBENS
Ninety-five percent of right-handed people develop
left hemispheric dominance for language. What
percentage of left handed people develop left
hemispheric dominance for language? - ANS 75%
Prostaglandin D2 increases extracellular levels of... - ANS ADENOSINE
Which is a retrograde neurotransmitter? - ANS ENDOCANNABINOIDS
Characteristics of Ach receptors in cerebral cortex - ANS BOTH INHIBITORY AND
EXCITATORY
Neurohormone for social bonding - ANS OXYTOCIN
28 y.o. hospitalized with paranoid delusions, AH, and
agitation, tx w/Haldol 5, pt becomes rigid & mute, in
days gets choreoform mvmt, has seizures, gets resp
problems leading to ICU admit. Exam shows ovarian
mass, CSF will show antibodies to: - ANS NMDA RECEPTORS
Neurotransmitter from responsible for rewarding
,nature of drug abuse - ANS DOPAMINE
Role of glycine at NMDA receptor - ANS OBLIGATE COAGONIST
Low CSF levels of this neurotransmitter metabolites is
associated with suicidality? - ANS 5-HYDROXYINDOLE ACETIC ACID (5-HIAA)
What is the 5HT3 receptor classification? - ANS LIGAND GATED
Pain by neurogenic inflammation mediated by? - ANS SUBSTANCE P
Decreased level of what NT is most associated with
depressed mood, poor sleep, and poor impulse
control - ANS SEROTONIN
Psych stress increases cortisol and prolonged cortisol is
associated with bad outcomes. Stress also affects other
hormones. Increase in which hormone is correlated
with decreased PTSD severity most likely due to
hormone's anti-glucocorticoid properties: - ANS DHEA
Unsteady gait, appendicular ataxia in LE only and
normal eye movement. Walks with lurching broad-
based gait. (8x) - ANS CEREBELLAR DEGENERATION (ALCOHOLIC)
Visual problem in pituitary tumor compressing optic
chiasm (10x) - ANS BITEMPORAL HEMIANOPSIA
60 y/o right-handed M, getting lost, only writes on
right half of paper. Left-sided hemi-neglect. Where is
the lesion? (8x) - ANS RIGHT PARIETAL LOBE
Which cancer has the highest likelihood of going to
brain? - ANS LUNG
66 y/o c/o frequent falls, several-month hx of anxiety,
unwillingness to leave home. On exam, mild
impairment of vertical gaze on smooth pursuit/
saccades, mild axial rigidity & minimal rigidity of
upper extremities, along w mild slowness of
movement on finger tapping, hand opening & wrist
opposition. Posture nml. Gait tentative/awkward, but
w/o shuffling, ataxia, tremor. Pt is slow in arising from
a chair. Most likely dx: (6x) - ANS PROGRESSIVE SUPRANUCLEAR PALSY
, 65 y/o pt fell several times past 6 mos. MSE nml.
Smooth pursuit, saccadic movements impaired. Worse
w vertical gaze. Full ROM w doll head maneuver. Mild
symmetric rigidity/bradykinesia, no tremor. MRI/CSF/
labs unremarkable. Dx? (4x) - ANS PROGRESSIVE SUPRANUCLEAR PALSY
26 y/o w HA, clumsiness of right hand x weeks.
Struggles with rapid alternating movements of R
hand, overt intention tremor w finger-to-nose, mildly
dysmetric finger-tapping. CNs nml, no papilledema.
Damage to what is seen on MRI? (3x - ANS CEREBELLUM
9 y/o F has 3 month h/o seemingly unprovoked bouts
of laughter. Worse when not sleeping well. Pt does
not feel happy during these episodes. Started
menstruating 6 months ago, and at Tanner stage 4.
Dx? (2x) - ANS HYPOTHALAMIC HAMARTOMA
5 y/o with 4 month history of morning HA, vomiting,
and recent problems with gait, falls, and diplopia: (2x) - ANS MEDULLOBLASTOMA
70 y/o develops flaccid paralysis following severe
water intoxication. He develops dysphagia and
dysarthria without other cranial nerve involvement.
Sensory exam is limited but grossly normal, DTR's are
symmetric, and cognition is intact. Likely dx: (X2) - ANS CENTRAL PONTINE MYELINOLYSIS
Elderly pt with confusion, lethargy, generalized tonic-
clonic seizure & serum sodium 95 mEq/L may develop
this complication if excessively correcting metabolic
problem. - ANS CENTRAL PONTINE MYELINOLYSIS
Young adult gained 70 lbs in last year c/o daily severe
headaches sometimes associated with graying out of
vision. Papilledema present. CT and MRI brain no
abnormalities but ventricles smaller than usual. Goal
of treatment in this case: (2x) - ANS PREVENT BLINDNESS
Superior homonymous quadrantic defects in the visual
fields result from lesions to which of the following
structures? (2x) - ANS TEMPORAL OPTIC RADIATIONS
Severe occipital HA, BL papilledema and no other
26 y.o. w/HA and R-hand clumsiness for weeks. Exam
shows difficulty w/rapid alternating movements of
hand, overt intention tremor on finger-to-nose, and
mildly dysmetric finger tamping. CNS intact and no
papilledema. Where will damage show on MRI? - ANS CEREBELLUM
Mesolimbic DA pathway includes which structure? - ANS VENTRAL STRIATUM
In addiction, dopaminergic neurons project to nucleus
accumbens. Cell bodies of these neurons reside in
which area of brain? - ANS VENTRAL TEGMENTAL AREA
Neural plasticity largely mediated through the capacity
to rapidly change in number and morphology which fo
the following? - ANS DENDRITIC SPINES
The uncinated fasciculus connects which of the
following brain areas? - ANS ANTERIOR TEMPORAL AND VENTRAL PRE-FRONTAL
REGIONS
What are cortical columns? - ANS FUNCTIONAL UNITS FOR INFORMATION
PROCESSING
Abnormal emotional expressions such as pathological
laughter or crying caused by lesions affecting cortical-
subcortical circuits linking frontal cortex, pons and
what? - ANS CEREBELLUM
Exposure to light effects which brain structure? - ANS SUPRACHIASMATIC NUCLEUS
When does synaptogenesis peak? - ANS FIRST 4 YEARS OF LIFE
Where does the neuron morphology in the brain
change the most? - ANS PREFRONTAL CORTEX
threatening objects produce startle response prior to
person becoming consciously aware. Connection of
thalamus to what? - ANS AMYGDALA
Huntington's disease characterised by loss of neurons
,producing which NT - ANS GABA
Adult neurogenesis in which area of the brain? - ANS HIPPOCAMPUS
17y/o is evaluated for binge eating associated with a
60 lb weight gain over the past four months. CT shows
a craniopharyngioma that likely disrupts what
structure? - ANS VENTROMEDIAL HYPOTHALAMUS
What is an accurate statement about the brain's default
mode network? - ANS IS INVOLVED IN REPROCESSING PREVIOUSLY
EXPERIENCED STIMULI
The most likely reason that adults are superior to
adolescents in abstract thinking. The brain undergoes: - ANS SYNAPTIC PRUNING
Dorsal-lateral-pre-frontal cortext plays important role in
what activity? - ANS WORKING MEMORY
Drug abuse activates neuro circuits. Generates signals
in the ventral tegmental area and to where? - ANS DOPAMINE INTO THE NUCLEUS
ACCUMBENS
Ninety-five percent of right-handed people develop
left hemispheric dominance for language. What
percentage of left handed people develop left
hemispheric dominance for language? - ANS 75%
Prostaglandin D2 increases extracellular levels of... - ANS ADENOSINE
Which is a retrograde neurotransmitter? - ANS ENDOCANNABINOIDS
Characteristics of Ach receptors in cerebral cortex - ANS BOTH INHIBITORY AND
EXCITATORY
Neurohormone for social bonding - ANS OXYTOCIN
28 y.o. hospitalized with paranoid delusions, AH, and
agitation, tx w/Haldol 5, pt becomes rigid & mute, in
days gets choreoform mvmt, has seizures, gets resp
problems leading to ICU admit. Exam shows ovarian
mass, CSF will show antibodies to: - ANS NMDA RECEPTORS
Neurotransmitter from responsible for rewarding
,nature of drug abuse - ANS DOPAMINE
Role of glycine at NMDA receptor - ANS OBLIGATE COAGONIST
Low CSF levels of this neurotransmitter metabolites is
associated with suicidality? - ANS 5-HYDROXYINDOLE ACETIC ACID (5-HIAA)
What is the 5HT3 receptor classification? - ANS LIGAND GATED
Pain by neurogenic inflammation mediated by? - ANS SUBSTANCE P
Decreased level of what NT is most associated with
depressed mood, poor sleep, and poor impulse
control - ANS SEROTONIN
Psych stress increases cortisol and prolonged cortisol is
associated with bad outcomes. Stress also affects other
hormones. Increase in which hormone is correlated
with decreased PTSD severity most likely due to
hormone's anti-glucocorticoid properties: - ANS DHEA
Unsteady gait, appendicular ataxia in LE only and
normal eye movement. Walks with lurching broad-
based gait. (8x) - ANS CEREBELLAR DEGENERATION (ALCOHOLIC)
Visual problem in pituitary tumor compressing optic
chiasm (10x) - ANS BITEMPORAL HEMIANOPSIA
60 y/o right-handed M, getting lost, only writes on
right half of paper. Left-sided hemi-neglect. Where is
the lesion? (8x) - ANS RIGHT PARIETAL LOBE
Which cancer has the highest likelihood of going to
brain? - ANS LUNG
66 y/o c/o frequent falls, several-month hx of anxiety,
unwillingness to leave home. On exam, mild
impairment of vertical gaze on smooth pursuit/
saccades, mild axial rigidity & minimal rigidity of
upper extremities, along w mild slowness of
movement on finger tapping, hand opening & wrist
opposition. Posture nml. Gait tentative/awkward, but
w/o shuffling, ataxia, tremor. Pt is slow in arising from
a chair. Most likely dx: (6x) - ANS PROGRESSIVE SUPRANUCLEAR PALSY
, 65 y/o pt fell several times past 6 mos. MSE nml.
Smooth pursuit, saccadic movements impaired. Worse
w vertical gaze. Full ROM w doll head maneuver. Mild
symmetric rigidity/bradykinesia, no tremor. MRI/CSF/
labs unremarkable. Dx? (4x) - ANS PROGRESSIVE SUPRANUCLEAR PALSY
26 y/o w HA, clumsiness of right hand x weeks.
Struggles with rapid alternating movements of R
hand, overt intention tremor w finger-to-nose, mildly
dysmetric finger-tapping. CNs nml, no papilledema.
Damage to what is seen on MRI? (3x - ANS CEREBELLUM
9 y/o F has 3 month h/o seemingly unprovoked bouts
of laughter. Worse when not sleeping well. Pt does
not feel happy during these episodes. Started
menstruating 6 months ago, and at Tanner stage 4.
Dx? (2x) - ANS HYPOTHALAMIC HAMARTOMA
5 y/o with 4 month history of morning HA, vomiting,
and recent problems with gait, falls, and diplopia: (2x) - ANS MEDULLOBLASTOMA
70 y/o develops flaccid paralysis following severe
water intoxication. He develops dysphagia and
dysarthria without other cranial nerve involvement.
Sensory exam is limited but grossly normal, DTR's are
symmetric, and cognition is intact. Likely dx: (X2) - ANS CENTRAL PONTINE MYELINOLYSIS
Elderly pt with confusion, lethargy, generalized tonic-
clonic seizure & serum sodium 95 mEq/L may develop
this complication if excessively correcting metabolic
problem. - ANS CENTRAL PONTINE MYELINOLYSIS
Young adult gained 70 lbs in last year c/o daily severe
headaches sometimes associated with graying out of
vision. Papilledema present. CT and MRI brain no
abnormalities but ventricles smaller than usual. Goal
of treatment in this case: (2x) - ANS PREVENT BLINDNESS
Superior homonymous quadrantic defects in the visual
fields result from lesions to which of the following
structures? (2x) - ANS TEMPORAL OPTIC RADIATIONS
Severe occipital HA, BL papilledema and no other
