Ninja PRITE Most Asked Questions &
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60 yo right-handed M, getting lost, only writes on right half of paper. Left-sided hemi-neglect. Where
is the lesion? - ANSWERRIGHT PARIETAL LOBE
66 yo with HTN develops vertigo, diplopia, nausea, vomiting, hiccups, L face numbness, nystagmus,
hoarseness, ataxia of limbs, staggering gait, and tendency to fall to the left. Dx? - ANSWERLATERAL
MEDULLARY STROKE
26 yo w/HA and R-hand clumsiness for weeks. Exam shows difficutty 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? - ANSWERCEREBELLUM
78 yo pt had an ischemic stroke that left him with a residual mild hemiplegia. Pt appeared to be
unaware that there was a problem of weakness on one side of this body. When asked to raise the
weak arm, the patient raised his normal arm. When the failure to raise the paralyzed arm was
pointed out to pt, he admitted that the arm was slightly weak. He also neglects the side of the body
when dressing and grooming. Pt did not shave one side of his face, had difficulty putting a shirt on
when it was turned inside out. Area of the brain likely affected by stroke? - ANSWERRIGHT PARIETAL
LOBE
Adult neurogenesis happens in which area of the brain? - ANSWERHIPPOCAMPUS
Previously pleasant mom becomes profane and irresponsible over 6 months. Most likely a pathology
in: - ANSWERFRONTAL LOBE
In addiction, dopaminergic neurons project to nucleus accumbens. Cell bodies of these neurons
reside in which area of the brain? - ANSWERVENTRAL TEGMENTAL AREA
Orexin is made in what part of the brain? - ANSWERLATERAL HYPOTHALAMIC NUCLEI
Which dopaminergic pathway includes the nucleus accumbens and also mediates addiction and
associated behaviors/ reinforcing? - ANSWERMESOLIMBIC
Neural plasticity is largely mediated through the capacity to rapidly change in number and
morphology of what cell structure? - ANSWERDENDRITIC SPINES
Which cell type secretes innate pro-inflammatory cytokines TNF - alpha and Il -1 B in pts with
inflammatory conditions that affect the brain? - ANSWERMICROGLIA
Cortical synaptic remodeling characteristic of normal adolescence is also believed to be associated
with what neurobiological change? - ANSWERPREFERENTIAL LOSS OF EXCITATORY SYNAPSES
DA release in what structure represents common final event associated w/ reinforcing effects of
opiates, cocaine, amphetamines, nicotine, PCP, and alcohol? - ANSWERNUCLEUS ACCUMBENS
In addiction, dopaminergic neurons project to nucleus accumbens. Cell bodies of these neurons
reside in which area of the brain? - ANSWERVENTRAL TEGMENTAL AREA
Neurohormone for social bonding: - ANSWEROXYTOCIN
, 35 yo M awakens frequently in the middle of night with severe HAs, which sometimes occurs nightly
and lasts approx 1-2 hrs, so severe that pt is afraid to go to sleep, located around L eye and assoc
with lacrimation, ptosis, & miosis. Likely dx is: - ANSWERCLUSTER HEADACHES
Young pt with new onset severe HAs associated with periods of visual obscuration. Neuro exam is
normal except for papilledema. MRI: normal and shows no mass effect. Next test? -
ANSWERLUMBAR PUNCTURE TO MEASURE PRESSURE
35 yo reports episodes of flashing lights traveling slowly from L to R in the left visual field, symptoms
persisting for about 30 minutes, followed by difficulty expressing self and concentrating. After about
30 minutes, these neurologic symptoms seem to subside, and pt develops a pounding headache
associated with nausea. Both the physical exam and MRI are normal. Dx? - ANSWERMIGRAINE WITH
AURA
30 yo with intermittent HAs, each attack lasting approx 1 hour. Attacks w/ sharp, stabbing pain
around eye, tearing, and nasal congestion. Most effective abortive treatment? - ANSWEROXYGEN
On the way to the airport for vacation, 58 yo F begins to behave in a very strange way. Husband
notices when he talks to her she answers appropriately w fluent speech but seems to have no ability
to retain any new information. She repeatedly asks where they are going, even after he has told her
many times. The episode lasts for about 6 hours. The following day she is back to normal but has no
recollection of the prior day events. This episode is most consistent with a diagnosis of: -
ANSWERTRANSIENT GLOBAL AMNESIA
Myasthenia gravis associated w/ which EMG finding: - ANSWERDECREASED AMPLITUDE WITH
REPETITIVE MOTOR NERVE STIMULATION
22 yo with pain in the right hand that radiates into the forearm and bicep muscle. Paresthesia in the
palm of the hand, thumb, index, middle ring finger. Sensory systems in the ring finger split the ring
finger longitudinally. Dx? - ANSWERMEDIAN NERVE ENTRAPMENT AT THE WRIST
Atrophy of the intrinsic muscles of the right arm and forearm. Reflexes are generally brisk, plantar
reflexes are extensor. Electrophysiology shows widespread fasciculations, fibrillation and sharp
waves, normal sensation, muscle spasticity. Positive sharp waves on EMG. Dx -
ANSWERAMYOTROPHIC LATERAL SCLEROSIS
A 54- year-old patient had a viral upper respiratory infection 2 weeks ago and now presents with a 3-
day episode of progressive, symmetric weakness in the legs, and tingling in the toes and fingers. On
exam, achilles and patellar deep tendon reflexes are diminished. Nerve conduction studies
demonstrate decreased conduction velocity and decreased amplitude of action potentials. The most
likely Dx: - ANSWERACUTE INFLAMMATORY DEMYELINATING POLYNEUROPATHY (or GBS)
Myasthenia gravis can be diagnosed in 80-90% of cases by identification of serum antibodies against
what? - ANSWERACETYLCHOLINE RECEPTORS
Which drug for the tx of parkinsonism has been associated with sudden sleep attacks? -
ANSWERROPINIROLE
Most effective treatment for 25 yo with daytime sleepiness, needs several short naps, fell asleep
while driving once, decreased REM latency: - ANSWERMODAFINIL
