Question 1

Damage to the subthalamic nucleus would result in which of the following motor disturbances?&#10;A) Choreiform&#10;B) Hemiballismus&#10;C) Bradykinesia&#10;D) Hemiplegia&#10;E) Athetoid

Accepted Answer

Hemiballismus is a motor disturbance characterized by violent, flinging movements of the limbs, typically on one side of the body, and is most commonly associated with damage to the subthalamic nucleus.

Question 2

A 48-year-old woman has a history of schizophreniform disorder that is controlled by daily administration of clozapine. After being transferred to a new facility, the woman is switched from clozapine to risperidone and subsequently develops frequent and forceful blinking of her eyelids. When the condition is exacerbated by light, the woman blinks her eyes nearly 40 times in one minute. An ophthalmological consultation was unremarkable for any eye pathology contributing to this presentation and the neurological examination did not reveal any other abnormal movements. Which of the following most specifically describes the motor symptoms experienced by this woman?

A) Intention tremor
B) Hypokinetic
C) Dystonia
D) Asterixis tremor
E) Hypertonia

C

Accepted Answer

The motor symptoms experienced by the woman are best described as dystonia, which is a movement disorder characterized by involuntary muscle contractions that cause repetitive or twisting movements. The frequent and forceful blinking, known as blepharospasm, is a form of focal dystonia. The change in medication from clozapine, which has a lower risk of extrapyramidal side effects, to risperidone, which has a higher risk, likely precipitated this condition.

Question 3

A magnetic resonance image of a patient with Wilson's disease would most likely reveal which of the following?&#10;A) Brain sand&#10;B) Cavitation in the lenticular nucleus&#10;C) Aqueductal stenosis&#10;D) Arteriovenous malformations&#10;E) Hemorrhagic lesion

Accepted Answer

Wilson's disease is characterized by the accumulation of copper in tissues, leading to neurological and psychiatric symptoms. The lenticular nucleus, particularly the putamen and globus pallidus, is often affected, showing cavitations or changes in MRI scans due to copper deposition.

Question 4

An autopsy is performed at the request of the family after the death of an 89-year-old man. During sectioning of the brain, the substantia nigra is noted to have significant degeneration in the area of the pars compacta. This man most likely suffered from which of the following?

A) Foville's syndrome
B) Tourette's syndrome
C) Wilson's disease
D) Parkinson's disease
E) Huntington's disease

Accepted Answer

Degeneration of the substantia nigra, particularly in the pars compacta region, is a hallmark pathological feature of Parkinson's disease. This condition leads to a deficiency in dopamine, contributing to the classic symptoms of bradykinesia, resting tremor, rigidity, and postural instability.

Question 5

A 12-year-old girl experiences acute onset of rapid, flowing, movements of her extremities and facial grimacing. Her parents report to the emergency physician that the girl had been diagnosed with rheumatic fever 3 months earlier and treated with antibiotics. This girl is most likely suffering from which of the following?

A) Parkinson's disease
B) Cerebellar degeneration
C) Sydenham's chorea
D) Wilson's disease

Accepted Answer

The girl's symptoms of rapid, flowing movements of her extremities and facial grimacing, combined with a recent history of rheumatic fever, suggest Sydenham's chorea. This condition is a neurological disorder associated with rheumatic fever and is characterized by these types of involuntary movements.

Question 6

Cortical projections that excite striatal cells participating in the direct pathway lead to inhibition of the&#10;A) Globus pallidus internus and substantia nigra, pars reticulata&#10;B) Globus pallidus internus and substantia nigra, pars compacta&#10;C) Globus pallidus externus and substantia nigra, pars compacta&#10;D) Globus pallidus externus and substantia nigra, pars reticulata

Accepted Answer

The direct pathway of the basal ganglia involves the excitation of striatal neurons that project to and inhibit the globus pallidus internus (GPi) and the substantia nigra pars reticulata (SNr). This inhibition leads to a decrease in the inhibitory output from these nuclei to the thalamus, ultimately facilitating movement.

Question 7

Progressive loss of medium spiny neurons throughout the striatum is a pathophysiological characteristic of which of the following?&#10;A) Hypertonia&#10;B) Dystonia&#10;C) Hemiballismus&#10;D) Wilson's disease&#10;E) Huntington's disease

Accepted Answer

Huntington's disease is characterized by the progressive loss of medium spiny neurons throughout the striatum, leading to the clinical symptoms associated with the disease.

Question 8

Which of the following most characteristically describes the tremor seen in patients with Wilson's disease?&#10;A) Choreiform&#10;B) Ballismus&#10;C) Asterixis&#10;D) Resting&#10;E) Intention

Accepted Answer

The answer of Which of the following most characteristically describes...

Deck 2: Development of the Nervous System