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Which of the following areas, if selectively lesioned, would cause an error with voluntary vertical saccades with spared horizontal saccades and sparred occulocephalic vertical reflex?
A patient presents to the emergency room with sudden onset weakness and dysphagia. On exam, the patient’s tongue deviates to the left, and there is right hemiparesis and right-sided loss of position and vibratory sensation. Pain and temperature sensation is intact. Which of the following arteries supplies blood to the damaged area?
Of the following, which region of the adult brain is most susceptible to hypoperfusion injury and ischemia?
You are evaluating a patient in the clinic for loss of light touch, pain, and body position in the left upper and lower limbs. Within which of the following thalamic nuclei do these signals synapse to third-order neurons?
An 87-year-old male presents with a 2-year history of worsening cognitive decline and speech difficulties. Brain MRI reveals multiple chronic cerebral infarcts. The neurological exam reveals adequate comprehension and fluency but naming was impaired. What is the most likely diagnosis?
Which of the following arteries supplying the thalamus provides supply to the lateral geniculate nucleus (LGN)?
A 55-year-old male presents with progressive worsening new headache over several months. He did not wish to seek medical attention but now presents because his family reports his facial expressions “look different”. On exam, he has impaired upgaze, light near dissociation, and convergence retraction nystagmus. An MRI is done and shows a lesion. Where is the lesion likely located?
Which of the following best describes the clinical features seen in transcortical motor aphasia?
Paraphasic and semantic errors in speech can occur secondary to a lesion in which of the following regions?
Which synapsed of the peripheral nervous system is acetylcholine the primary neurotransmitter?
Which of the following blood vessels that supply the thalamus is the only one to branch off of the posterior communicating artery (PCOM) instead of the posterior cerebral artery (PCA)?
Vasogenic edema would be best appreciated on which of the following MRI sequences?
Which of the following is the primary source of norepinephrine in the brain?
A lesion to which of the following neuroanatomical structures causes dysphagia, decreased gag reflex, and hoarseness?
A 45-year-old man presents to the clinic with a disc of the following MRI. Which symptom is the patient likely experiencing?
Lesion to which area of the brain causes impairment in naming, fluency, and repetition with intact comprehension?
Which of the following can not cross the blood-brain barrier via channel-mediated transport?
A 24-year-old patient had a severe unhelmeted motorcycle accident and despite best efforts by medication providers, he passed away two days later. An autopsy was performed. Identify the structure marked by the white arrow.
Which of the following can not passively diffuse across the blood-brain barrier?
Cerebral amyloid angiopathy would be best appreciated on which of the following MRI sequences?
An 80-year-old woman with uncontrolled HTN presents to the ED with symptoms upon awakening of left hemi-sensory loss, last seen well 8 hours prior. MRI is done and shows a lateral thalamic lacunar stroke. The small branch affected in this lacune is most often a branch of which major artery?
A 77-year-old male presents with a 1-year history of worsening bradykinesia, recurrent falls, and a shuffling gait. Past medical history is significant for REM-sleep behavior disorder and diet-controlled hypertension. Neurologic examination reveals a tremor at rest that improves with movement, along with bilateral upper-limb spasticity. Impaired dopaminergic signaling is most likely to be found in which of the following locations?
Based on the histopathologic findings shown below, how long ago did this patient experience an ischemic stroke?
What is the anatomical structure labeled “C” below?
Which of the following anatomic structures is responsible for the perception of superficial light touch?
Initiation of urination involves which of the following physiologic processes?
Cytotoxic edema would be best appreciated on which of the following MRI sequences?
A young infant is found after birth to have an abnormality of the left arm. The arm is held down by the infant’s side, adducted and medially rotated, and the forearm is extended and pronated. What is the anatomic location of the injury causing the deficits?
Which of the following is the first branch of the internal carotid artery once it enters the skull?
A 37-year-old male presents with sudden onset of tachycardia and hypertension, followed shortly by unilateral rhythmic facial and then arm jerking. The autonomic symptoms of tachycardia and hypertension are most likely to reflect the involvement of which region of the brain during a seizure?
Which of the following occurs at point “4” on this diagram of an action potential?
Which of the following can be appreciated on histopathologic analysis of ischemic tissue five hours after an ischemic injury to the cortex?
What is the anatomical structure marked by the blue arrow?
Match the phase of the Valsalva maneuver with its associated physiology.
A 32-year-old obese and pregnant female in her third trimester presents to the clinic with pain and tingling of the lateral thigh with occasional aching in the groin. It is worsened by moving to a standing or sitting position and by wearing tight underwear. She has numbness on the right anterolateral thigh up to the level of the hip. The strength exam is normal. Which nerve is likely affected?
A 78-year-old patient with a history of multiple system atrophy (MSA) presents to your clinic for falls. The patient states that while standing he initially experiences feelings of lightheadedness and tunnel vision before a loss of consciousness. While on the ground he will be “twitching” for 30 seconds before he regains consciousness. Which of the following tests is the most likely to be diagnostic in this case?
Which of the findings are most likely to be found on examination in a patient with the lesion appreciated in the image below?
A 23-year-old female with a history of optic neuritis presents with a 1-week history of left leg weakness. Neurologic examination reveals decreased strength of the left lower extremity. A lumbar puncture reveals oligoclonal bands with lymphocytic pleocytosis. What stain can be used to identify the dysfunctional cells in this condition?
A 55-year-old was recently diagnosed with breast cancer. She required a right mastectomy, lymph node resection, and local radiation. She presents to your clinic with right arm pain and weakness. On exam, she has weakness only to forearm pronation, and flexion at the wrist and biceps. She also has numbness of the lateral hand and the first 3 digits.
Which cord or nerve was likely injured from the surgery or radiation?
Which of the following nuclei of the hypothalamus is involved in temperature regulation?
Which of the following structures is not primarily involved in the processing and relay of auditory information in the central nervous system?
Uncal herniation compressing on the structure marked below (black arrow) would lead to which of the following symptoms?
A pure sensory stroke is most likely to damage which structure?
Immunohistochemical staining with GFAP is particularly useful in identifying which of the following cell types?
Which of the following is the chemoreceptor trigger zone for vomiting?
Identify the structures labeled in the image below:
A 45-year-old female presents as a trauma for an unhelmeted motorcycle accident. She has sustained significant blunt head trauma, and CTH shows hydrocephalus caused by edematous mass effect compressing the fourth ventricle. Which of the following shows the correct directional flow of CSF in a normal individual?
Which of the following structures has an intact blood-brain barrier?
A 75-year-old woman with HTN presents with sudden memory deficits and a change in emotional regulation. She is found to have a lacunar infarct, and you feel a disconnection of the Papez circuit may explain her symptoms. Which of the following is not considered a part of the Papez circuit?