NINJA PRITE – Questions & Complete Solutions
What characterizes the memory loss in patients with dissociative amnesia?
Right Ans - Episodic
Amnesia preceded by epigastric sensation and fear are associated with
electrical abnormality where? Right Ans - Temporal lobe
Memory loss pattern in dissociative amnesia Right Ans - 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 Right Ans - Anterograde
What psychoactive drug produces amnesia? Right Ans - Alcohol
Pt w/ strange behavior answers appropriately w/ fluent speech but no ability
to retain new info. Episode lasts 6 hr then back to normal. No recollection of
events. Dx? Right Ans - Transient global amnesia
Visual problem in pituitary tumor compressing optic chiasm Right Ans -
Bitemporal Hemianopsia
Pt reports hearing voices of someone not present; stops moving, stares
blankly, repetitively picks at clothing, does not respond to Qs/commands x
several min. The confusion resolves after 15 mins but pt has no recollection of
events. Likely what? Right Ans - Complex Partial Seizure
55 y/o pt BIB family after episode of amnesia/bewilderment lasting several
hrs. CVA ruled out. Pt keeps asking what is happening. What med to
administer at this point? Right Ans - Observation with no pharmacological
intervention
Which of the following diagnoses involves a sense of loss of identity, often
following a traumatic experience and associated with inability to recall one's
past? Right Ans - Dissociative Fugue
,Contralateral leg weakness with sparing of face and arms. Urinary
incontinence and abulia. Where is the lesion? Right Ans - Anterior Cerebral
Artery
(Abulia = an absence of willpower or an inability to act decisively, as a
symptom of mental illness.)
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: Right Ans - Temporal lobe
Syndrome characterized by fluent speech, preserved comprehension, inability
to repeat, w/o associated signs. Location of lesion in the brain? Right Ans -
Supramarginal gyrus or insula
Acute onset of hemiballismus of LUE & LLE. MRI is most likely to show lesion
located where? Right Ans - Subthalamic nucleus
Left sided hemi-neglect is associated with lesion located where? Right Ans -
Right Parietal Lobe
60M right-handed, getting lost, only writes on right half of paper. Where is
lesion Right Ans - Right parietal
Which hormone secreted in functional pituitary adenoma: Right Ans -
Prolactin
CT & MRI show ventriculomegaly are out of proportion to sulcal atrophy. This
is suggestive of what diagnosis? Right Ans - Normal Pressure
Hydrocephalus
5 y/o with 4 month history of morning HA, vomiting, and recent problems
with gait, falls, and diplopia Right Ans - 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? Right Ans - Hypothalamic tumor
,Location of lesion: previously pleasant person becomes profane and
irresponsible over 6 months: Right Ans - 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: Right Ans - 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? Right Ans - Metabolic disorders
Which term describes state of immobility that is constantly maintained?
Right Ans - Catalepsy
Ability of catatonic pt to hold same position Right Ans - 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: Right Ans - 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:
Right Ans - 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? Right Ans - Lateral medullary stroke
Rapid onset of right facial weakness, left limb weakness, diplopia Right Ans
- Brain Stem Infarction
Transient symptom associated with carotid stenosis: *** Right Ans -
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. **** Right Ans - 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: Right
Ans - Thromboembolic stroke L MCA (middle cerebral artery)
Abulia refers to impairment in ability to: Right Ans - Spontaneously move
and speak
Sudden-onset left hemiparesis with deviation of eyes to the right Right Ans
- Right putaminal hemorrhage
Sudden onset vertigo/nausea, hoarseness/dysphagia, right sided face
numbness, diminished gag reflex on right, decreased pinprick and temp
sensation on left Right Ans - Right medullary infarction
65 y/o diabetic presents to ED c/o acute L sided weakness, deviation of gaze
to R, L hemiplegia and hemisensory deficit, and L homonymous hemianopsia.
12 hrs later, pt is unconscious, L pupil enlarged and unreactive. CT will show
what? Right Ans - R MCA infarct w/ edema and uncal herniation
Pt with acute onset vertigo, what will suggest R lateral medullary infarct?
Right Ans - R facial loss of touch + temp sensation
46 y/o M w/ double vision + pain R eye. Exam: ptosis R eyelid, inability to
elevate or adduct R eye + R pupillary dilation. This is caused by: Right Ans -
Post. Communicating artery aneurysm
Aphasia w/ effortful fragmented, dysfluent, telegraphic speech, is seen in a
lesion where? Right Ans - Post frontal lobe
39 year old with h/o of multiple miscarriages develops an acute left sided
hemiparesis. Work up revels elevated anticardiolipin titers and no other risk
factors for stroke. Appropriate intervention at this point is? Right Ans -
Plasmapheresis