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29 Cards in this Set

  • Front
  • Back
Character of memory loss in patient with dissociative amnesia.

Visual problem in pituitary tumor compressing optic chiasm.

Bitemporal Hemianopsia
60yoM, R handed, gets lost and only writes on R half of paper. L sided hemineglect. Lesion?

R Parietal

66yo c/o frequent falls, months of anxiety, unwillingness to leave home. Mild impairment of vertical gaze on smooth pursuit/saccades. Mild axial rigidity of UE w/ mild slowness of movement on finger tapping, hand opening, and wrist opposition. Pt is slow in arising from chair. Dx?

Progressive Supranuclear Palsy

65yo patient fell several times in the past 6 months. MSE wnl, smooth pursuit and saccades impaired and worse with vertical gaze. Full ROM on head, mild symmetric rigidity, no tremor. MRI/CSF/labs unremarkable. Dx?
Progressive Supranuclear Palsy
26yo with headache, clumsiness of R hand for weeks. Struggles with rapid alternating movements of R hand, overt intention tremor with finger-to-nose. CNs wnl, no papilledema. Lesion?


9yoF has a 3 months history of unprovoked laughter. Worse when not sleeping well. Patient is not happy during laughing episodes. Started menstruating 6 months ago. Tanner 4. Dx?

Hypothalamic Hamartoma/Gelastic Seizure

5yo with 4 month h/o morning HA, emesis, ataxia, falls, diplopia. Lesion?


70yo develops flaccid paralysis following severe H2O intoxication. Dysphagia + dysarthria w/o other cranial nerve involvement. Sensory exam limited but grossly normal. DTR symmetric. Cognition intact. Dx?

Central Pontine Myelinolysis

Which term describes a state of immobility that is constantly maintained?


62yoM with 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 phrases but fails to execute any instruction. Dx?

Wernicke's Aphasia

66yo with HTN develops vertigo, diplopia, n/v, hiccups, L face numbness, nystagmus, hoarseness, ataxia of limbs, staggering gait, tendency to fall to the left. Dx?
Lateral Medullary Stroke

Patient with chronic Afib develops aphasia and R hemiparesis at noon. ER exam notes weakness of R extremities and severe dysfluent aphasia, but CT at 1330 has no acute lesion. Most appropriate TX?


Rapid onset of R facial weakness, left limb weakness, diplopia. Dx?

Brain Stem Infarct

A life threatening complication of cerebellar hemorrhage.
Acute hydrocephalus

72yo with embolic infarct in MCA. Cardiac US shows no structural abnormalities. Carotid Doppler shows <50% occlusion of either side. EKG reveals AFib. Which strategy has the best likelihood of reducing strokes in this patient?


Young adult gained 70lbs in last year and complains of daily severe HA sometimes associated with grayed out vision. Papilledema present. CT + MRI show ventricles smaller than usual. Goal of tx?

Prevent blindness
68yo with HTN develops rapidly progressing RUE + RLE weakness w/ deviation of eyes to left. W/in 30 min of onset, pt becomes sleepy. 2h after onset patient is unresponsive. Dense R hemiplegia, eyes deviated to left. PERRL. R facial weakness to grimace. Cough and gag present. CT finds?

L Putaminal Hemorrhage

Superior homonymous quadrantic defects in visual fields result from lesions to which structure?
Temporal Optic Radiations
78yo h/o ischemic stroke w/ residual mild hemiplegia. Unaware that there's a problem of weakness. When asked to raise the weak arm, patient raises normal arm. Neglects weak side of the body. Where is the lesion?

Parietal Lobe

Patient has multiple stroke-like sx of short duration over several days. New-onset sx for last 90 min. CT is negative for hemorrhage. Appropriate tx?

IV Thrombolytics

MRI scan of head reveals an infarct in distribution of L ACA. Patient most likely exhibits?
Contralateral LE weakness
72yo w/ recent behavior/memory problems. Disrobing, not sleeping, irritable. Waxing/waning consciousness. Dx?


79yo with decreasing mental state over 3 weeks has an exaggerated startle w/ violent myoclonus. Myoclonic jerks occur spontaneously, ataxia. EEG shows sharp waves. Dx?
Subacute Spongiform Encephalopathy

52yo with h/o depression, HTN. Severe HA, "has not been himself" for 10d. Poor eye contact, inattentive, muttering, picking at clothes, occasionally dozes off even at mid-day. Dx?


Mild confusion, lethargy, thirst, polydipsia. Dx?


Multifocal myoclonus in a comatose patient indicates?

Metabolic encephalopathy

70yo with mild Alzheimer's lives with family, prescribed an SSRI for MDD. H/O HTN, DM, RA. Acute confusion w/o other med/psych sx. Which lab do you order first?


65yoM with 6mo h/o confusion episodes, disorientation, VH of children playing in his room. VH are fully formed, colorful, vivid. Pt has little insight into VH. Normal between episodes. Mild difficulty with serial subtraction, mild symmetric rigidity, bradykinesia. MRI, CSF, labs, UDS neg. Dx?

Lewy Body Dementia