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Identify the neuronal pigment/inclusion that matches the following statement:
-intranuclear inclusions seen in herpes simplex encephalitis

Cowdry type A inclusions

Identify the neuronal pigment/inclusion that matches the following statement:
-Cytoplasmic inclusions pathognomonic of rabies

Negri bodies

Identify the neuronal pigment/inclusion that matches the following statement:
-Neuronal inclusions characteristic of Parkinson disease

Lewy bodies

Identify the neuronal pigment/inclusion that matches the following statement
-Cytoplasmic inclusion bodies associated with aging

Lipofuscin granules

Identify the neuronal pigment/inclusion that matches the following statement:
-Dark cytoplasmic pigment in neurons of the substantia nigra and locus coeruleus, not seen in patients with parkinson

melanin

Identify the neuronal pigment/inclusion that matches the following statement:
-Eosinophilic, rod-like inclusions in hippocampus of Alzheimer patients

Hirano bodies

Identify the neuronal pigment/inclusion that matches the following statement
-Diagnostic of Alzheimer disease

Neurofibrillary tangles and plaques

Identify the neuronal pigment/inclusion that matches the following statement
-Filamentous inclusions that stain with silver, do not survive neuronal death

Pick bodies

Identify the neuronal pigment/inclusion that matches the following statement
-Filamentous inclusions that stain with PAS and ubiquitin

lewy bodies

What are the usual components of a "dementia work-up"?

• Syphilis screen
• HIV screen
• TSH (to rule out hypothyroidism)
• Vit B12
• Head CT or MRI (to rule out multiple infarct, stroke or normal pressure hydrocephalus)
•MMSE

Which neurodegenerative disease matches the following statement?
-Lou Gehris disease

ALS

Which neurodegenerative disease matches the following statement?
-Senile plaques, neurofibrillary tangles

Alzheimer disease

Which neurodegenerative disease matches the following statement?
-Presents at birth as "floppy baby"

Werdnig-Hoffman disease

Which neurodegenerative disease matches the following statement?
-Lewy bodies

•Parkinson disease
• Alzheimer disease (lewy body type)
• Lewy body dementia

Which neurodegenerative disease matches the following statement?
-Dementia often associated with frequent falls and/or syncope

Lewy body dementia

Which neurodegenerative disease matches the following statement?
-Atrophy of caudate nucleus → chorea

Huntington disease

Which neurodegenerative disease matches the following statement?
-Depigmentation of substantia nigra

Parkinson disease

Which neurodegenerative disease matches the following statement?
-Both upper and lower motor neuron signs (spasticity and weakness)

ALS

Which neurodegenerative disease matches the following statement?
-Dementia + visual hallucinations

Lewy body dementia

Which neurodegenerative disease matches the following statement?
-Dementia + personality changes and/or aphasia

Pick disease

What allele is associated with Alzheimer disease?
Why is Alzheimer disease so common in patients with Down syndrome?

• APP gene on chromosome 21
• APOE4 allele
• Down syndrome: have 3 copies of APP gene on chromosome 21

What is the mechanism of action of the drugs used in the treatment of Alzheimer disease?

Increase acetylcholine

What is the most likely cause of headache based on the following description?
-Made worse by foods containing tyramine

migrain headaches

What is the most likely cause of headache based on the following description?
-Obese female with papilledema

pseudotumor cerebri

What is the most likely cause of headache based on the following description?
-Jaw muscle pain when chewing

temporal arteritis

What is the most likely cause of headache based on the following description?
-periorbital pain with ptosis and myosis

cluster headache

What is the most likely cause of headache based on the following description?
-photophobia and/or phonophobia

migraine headache

What is the most likely cause of headache based on the following description?
-bilateral frontal/occipital pressure

tension headache

What is the most likely cause of headache based on the following description?
-lacrimation and/or rhinorrhea

cluster headache

What is the most likely cause of headache based on the following description?
-elevated ESR

temporal arteritis

What is the most likely cause of headache based on the following description?
-"worst headache of my life"

subarachnoid hemorrhage

What is the most likely cause of headache based on the following description?
-headache + extraocular muscle palsies

cavernous sinus thrombosis

What is the most likely cause of headache based on the following description?
-scintillating scotomata prior to headache

migraine with aura

What is the most likely cause of headache based on the following description?
-headache occurring either before or after orgasm

postcoital cephalgia

What is the most likely cause of headache based on the following description?
-responsive to 100% oxygen supplementation

cluster headache

What is the most likely cause of headache based on the following description?
-trauma to the head → headache begins days after the event, persists for over a week and does not go away

subdural hematoma

What features allow you to distinguish a migraine headache from a cluster headache or a tension headache?

Migraine
• Might have an aura
• N/V photophobia, phonophobia
• Time frame: 24-48 hrs

Cluster
• Might have tearing & rhinorrhea
• Occur on a daily basis in a certain cluster of time (e.g. e.g. every day for 3 months)
• Time frame: 30 mins to 3 hrs

Tension
• Frontal or occipital pain
• Timeframe: long period of time

What is the mechanism of action of sumtriptan?

Serotonin 5-HT1B/1D receptor agonist

What are the contraindications to sumatriptan use?

• CAD
• Prinzmental's angina
• Pregnancy

What is the usual treatment for migraine headaches in pregnancy?

opioids

What would you suspect as a cause of headache in a patient using topical retinoic acid for acne?

Benign intracranial HTN (pseudotumor cerebri)
(due to vit A toxicity)

A 20-year-old woman that has migraine headaches each proceeded by an aura should never be prescribed what medication?

Oral contraceptive pills (because it increases risk of thromboembolic stroke)

What makes Lewy body dementia unique?

• Visual hallucinations
• Repeated falls
• Syncopal episodes

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