Visual problem in pituitary tumor compressing optic chiasm (10x) - ANSWERSBITEMPORAL HEMIANOPSIA
Unsteady gait, appendicular ataxia in lower-extremity only and normal eye movement. Walks with lurching broad-based gait. (8x) - ANSWERSCEREBELLAR DEGENERATION (ALCOHOLIC)
Severe occipital HA, BL ...
Ninja Prite 2020 Neurology Questions &
Answers
Visual problem in pituitary tumor compressing optic chiasm (10x) -
ANSWERSBITEMPORAL HEMIANOPSIA
Unsteady gait, appendicular ataxia in lower-extremity only and normal eye movement.
Walks with lurching broad-based gait. (8x) - ANSWERSCEREBELLAR
DEGENERATION (ALCOHOLIC)
Severe occipital HA, BL papilledema and no other abnormalities. Chronic acne treated
with isotretinoin. Lumbar puncture elevated opening pressure with no cells, 62 mg/dl
glucose, and 22mg/dl protein. CT is normal. (7x) - ANSWERSPSEUDOTUMOR
CEREBRI
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: (7x) -
ANSWERSprogressive supranuclear palsy
79 y/o pt with a deteriorating mental state over a 3-week period has an exaggerated
startle response with violent myoclonus that is elicited by turning on the room lights,
speaking loudly, or touching the pt. Myoclonic jerks are also seen. Diagnosis: (5x) -
ANSWERSSPONGIFORM ENCEPHALOPATHY
Pt presents with a slowly progressive gait disorder, followed by impairment of mental
function, and sphincteric incontinence. No papilledema or headaches are reported.
Likely diagnosis? (4x) - ANSWERSNORMAL PRESSURE HYDROCEPHALUS
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) -
ANSWERSPROGRESSIVE SUPRANUCLEAR PALS
28y/o with emotional lability and impulsivity. LFT's elevated. Close relative had similar
sx and died at 30y/o from hepatic failure. Which blood level would be diagnostic? (3x) -
ANSWERSCERULOPLASMIN
Pt w/ acute onset of pain and decreased vision in the R eye. Colors look faded when
viewed through the R eye. On exam, has a R afferent pupillary defect and a swollen
, right optic disc. Pt spontaneously recovers over the next 6 wks. Likely to develop later:
(3x) - ANSWERSMULTIPLE SCLEROSIS
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) - ANSWERSHYPOTHALAMIC
HAMARTOMA
5 yo w/ 4 month history of morning HA, vomiting, and recent problems with gait, falls,
and diplopia: (2x) - ANSWERSMEDULLOBLASTOMA
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: (2x) -
ANSWERSCENTRAL 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) -
ANSWERSPREVENT BLINDNESS
Superior homonymous quadratic defects in the visual fields result from lesions to which
of the following structures? (2x) - ANSWERSTEMPORAL OPTIC RADIATIONS
Tremor with a frequency of around 3 Hz, irregular amplitude, most evident towards the
end of reaching movements: (2x) - ANSWERSCEREBELLAR TUMOR
Pt with several days of fever & severe headaches presents to ED d/t generalized
seizure. Pt is confused & somnolent. Also reported been irritable and c/o foul smells. T2
MRI displayed (hyperintensity of left temporal): (4x) - ANSWERSHERPES
ENCEPHALITIS
Acute onset of fever, sore throat, diplopia, & dysarthria. Exam reveals an inflamed
throat, left adductor nerve palsy w/ impairment of vertical pursuit, diffuse hyperreflexia
w/ bilateral clonus, lower ext spasticity, & mild right hemiparesis. CT is uninformative.
Spinal fluid has protein of 24, 10 mononuclear cells, and glucose of 70. Dx? (2x) -
ANSWERSMULTIPLE SCLEROSIS
Which is the most reliable finding from CSF analysis for a pt with multiple sclerosis in
the chronic progressive phase of the dz? (2x) - ANSWERSPRESENCE OF
OLIGOCLONAL BANDS
Benign intracranial HTN etiology: (2x) - ANSWERSHYPERVITAMINOSIS A
Gait abnormality, slow movement, asymmetric UE rigidity. Difficulty in voluntary vertical
upward/downward gaze. Slowness/rigidity improved slightly with levodopa. Later has
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