Dr. Planey stands on her right leg for a really challenging yoga pose, keeps her balance, and you wonder how the heck she does it. How does her cerebellum receive input about her proprioception to maintain this stance?

While celebrating the finale of MD1 year, your party-animal best friend develops truncal ataxia, head tilting, wide gait, and nystagmus. Based off your wide array of neuroanatomical knowledge, a lesion in which part of the cerebellum would NOT likely cause any of the following symptoms?

Central tolerance refers to which of the following processes?

Which of the following statements is true regarding microglia?

A 25-year-old female is visiting your clinic for a follow-up visit for her long-standing diagnosis of Friedreich’s Ataxia. Which of the following signs or symptoms would you most likely NOT expect the patient to exhibit?

A 63-year-old male is visiting your clinic for a 2-week follow-up visit from his recent stroke that involved his left Superior Cerebellar Artery. It turns out that at the time, the ischemia was severe enough to create lasting damage but only in the areas of the cerebellum that it supplies. Which of the following signs or symptoms would you most likely NOT expect to find upon exam in this patient?

A 37 year old female patient presents to the ED with shortness of breath, cough, and pitting pedal edema in her legs. You order an EKG, cardiac labs, BMP, and a CBC with differential. Labs are unremarkable except for a low lymphocyte count. You ask about past medical history and current medications, but the patient is so distraught about being in the ED that all she remembers is that she is taking some cancer drug but she is taking it for something wrong with her brain, not for cancer. What medical condition do you suspect she has, and what medication do you suspect she is taking?

A 29 year old pregnant female with no past medical history presents to the neurologist with loss of sensation in her right arm, leg, and face for the past 2 months. Further history reveals that she had an episode of electrical shock sensations upon neck flexion 9 months ago that resolved after 1 week. She did not seek treatment at this time since “it went away on its own.” MRI reveals a lesion in her cervical spinal cord as well as two periventricular lesions, all of which are non-enhancing. What actions do you take next?

A 64-year old woman presents to the clinic with a 2 week history of “dizziness”. She says that the dizzy spells last only a few seconds, but she feels like the room is spinning around her even when she is sitting down. What should you prescribe to help alleviate her symptoms?

After the NBME exam, the entire MD Class of 2022 celebrated at Cooper’s. After consuming many “Blue Hawaii’s” (the drink of the month) some of the class began experiencing unsteadiness on the dance floor, trouble walking, and nausea. Tim thinks they may be experiencing Positional Alcohol Nystagmus (PAN). On careful observation, he notices a nystagmus to the right when the right side of their heads are down. What is happening here?

After watching the avengers, Roshan & D. Fear enthusiastically decide it’s a great idea to inject water into their patient’s ear… The patient's right eye begins to slowly drift to the right. Which ear did these two student doctors inject? What was the water temperature?

Alex M. just got back from a recent fishing trip near his old stomping grounds at PSU. He claims to have caught numerous “massive” brook trout on this trip… he kept stating that when he hooks the big ones, he has to throw his head back in a linear fashion in order to fully “battle it out” with those poor fish. Which of the following is happening within Alex’s vestibular system while he is throwing his head from front to back?

A 60 year old man with a history of hypertension presents to the ER with numbness of the left face and right side of the body, and dysmetria in the left limbs after he fell to the left side. A lesion in which artery is most likely causing these symptoms?

A.M., a 23 year old male, describes a ringing noise in his ear and dizziness that has lasted for the past three months. He also states that he feels pressure in his ear and that he has needed to turn the radio up louder than usual in his car in order to hear it. He has been treated with meclizine, which did not help symptoms. Which of the following should A.M. NOT do?

A 34-year-old female medical student is brought to the ED by a classmate after falling to the ground becoming completely unresponsive. In the ED, the doctor suspects that she may have a central impairment in the brain stem and does a rapid head thrust maneuver to test this hypothesis. If he is correct, what findings would you expect and why?

A 25-year-old male presents to the clinic with a one-week history of diplopia. On physical exam you note that his right eye is unable to move past midline on left horizontal gaze while his left eye exhibits nystagmus on abduction. He is, however, able to abduct the right normally and can move it past midline with convergence. Where would you expect to localize these findings on the given image?

A 35-year-old woman comes to your office with complaints of loss of vision and pain in the left eye, which gets worse with movements. Upon examination, which of the following clinical signs could would you observe in this patient and where would it localize?

A 28-year-old female presents with a one-week history of stumbling gait and ataxia. Upon further examination, you discover that she has been having urinary incontinence that began around the same time. What is the next step to confirm her diagnosis?

A 55-year old patient with a 25-year history of Multiple Sclerosis arrives with complaints of worsening ataxia and dysphagia, lasting for over a year, which is longer than his normal relapse duration. How is his disease most likely characterized?

A 38 y/o male presents to the hospital with numbness and weakness throughout both legs over the past 2 weeks. His symptoms have continued to worsen over time and he also reports urinating more frequently, and some difficulty swallowing and even breathing. He does mention feeling having a stomach bug around the same time his symptoms started, but figured both were related to stress since he works as a farmer. What would be most useful for making a complete diagnosis?

A 69 y/o Male with a history of congestive heart failure, anxiety, well-controlled diabetes, and recurrent upper respiratory infections presents with decreased sensation and mild hyporeflexic weakness in his lower legs over the last 4 weeks. The patient was initially worried that he may be developing diabetic neuropathy, but his diagnosis is relatively new and his blood sugars and A1C levels are within normal limits. You suspect the patient is experiencing neurological issues, and diagnosis is confirmed via spinal tap and nerve conduction studies. What would be an appropriate treatment for this patient?

Which of the following is NOT true about astrocytes?

You are on your ED rotation and an old fella with Leukemia presents with the following complaints:

Numbness of the upper extremities bilaterally (sensory loss/can’t feel anything cause “numbness” is such a vague term), and hand weakness with clumsiness.

On physical exam, you find the patients has a positive Romberg test (he cannot keep his balance with eyes closed) and decreased sensation in his feet bilaterally. The patient notes he a started a new drug for his leukemia a couple of months ago; he cannot remember the name, but he somehow knows it interferes with “M phase” of the cell-cycle (very selective memory). Which drug is he most likely taking?