Neuroscience Week 2

_______ do not readily pass through the blood brain barrier due to the presence of _____

• lipophilic molecules, basement membrane

• hydrophilic molecules, tight junctions

• glucose, nonfenestrated capillaries

• leukocytes, astrocyte foot processes

A patient comes to the ER with a fever, headache and nuchal rigidity. They are found to have aseptic meningitis. What is likely the cause of this infection?

• Picornaviridae

• Paramyxoviridae

• H. Influenza

• Enterovirus

Consider two patients. Patient 1 comes to the ER with a fever, nausea and nuchal rigidity. Patient 2 comes to the ER with fever, headache and altered mental status and is diagnosed with encephalitis. Both patients are actually infected by the same type of microorganism. Which of the following could it be?

• HSV

• Paramyxoviridae

• Strep. Agalactiae

• N. Meningitidis

A 23 year-old woman begins experiencing significant hair loss after starting a new medication to prevent frequent headaches. Her cousin has epilepsy and takes the same drug to prevent seizures. What drug are they most likely taking?

• Amitriptyline

• Valproate

• Pronaolol

• Acetaminophen

A friend of yours is overly concerned about getting meningitis and wants to dedicate their research to making the Blood-Brain barrier impermeable. You explain that this may not be a great idea because complete separation may cause:

• an inability to express emotion

• difficulty sleeping

• Problems for the baroreceptors to regulate blood pressure in carotid bodies

• a decrease in heart rate

A 35-year-old patient comes to the emergency room with symptoms of tachycardia, confusion, and nystagmus. She has a history of depression and is currently taking citalopram (a SSRI) daily. She tells you that the symptoms started an hour after she took medication for her severe migraine headaches. What is the mechanism of action of the drug she took?

• Enhances GABA-mediated inhibition and modulates glutamate

• Inhibits the cyclooxygenase enzyme irreversibly blocking the production of prostaglandins

• Stimulates brainstem 5-HT1B and 5-HT1D receptors to reduce excitability of neurons in the trigeminovascular system

• Calcium channel blocker

A 22 y.o. female college student comes to your office concerned about a headache she experienced this morning. She describes the pain as having been severe and pulsating in quality, only having been on one side of her head, and tells you that the headache was accompanied by feelings of nausea. She also tells you that she has experienced similar headaches in the past. The most likely diagnosis is….

• migraine without aura

• Cluster headache

• Tension Headache

• She is probably hungover. Giver her some advil and gatorade

• Broken Arm

A patient with a history of migraine comes into your office. She says the headaches have been much worse lately, and that they are now accompanied by feelings of confusion and impaired alertness, and that her medicine has not been effective in treating them. What is the best course of action?

• Increase the dose of her migraine medication

• Switch her to a different medication that may be more effective

• Lecture her on the consequences of lying

• Get imaging done to rule-out an alternative diagnosis

Upon shining a light into the left eye of a patient, a normal Pupillary Reflex is observed. This suggests that which region of the brain is most likely to be intact?

• Cerebral Hemisphere

• Midbrain

• Pons

• Medulla

You are currently a PGY3 pathology resident, your attending calls you over to look at a specimen slide that you had only ever seen in your textbooks. She asks you what you think the diagnosis is based off the histological slides (pictured below) She tells you that your patient is a 7 y/o male with a chief complaint of intermittent headaches for the past 3 months, abdominal pain, nausea, and vomiting. She states the Emergency Room physician ordered an MRI and it showed a solid mass in the midline of the cerebellum. You suspect the patient has:

• A medulloblastoma

• an astrocytoma

• pseudomotor cerebri

• a vestibular schwannoma