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NBME 24 Answers

nbme24/Block 4/Question#46

A 22-year-old woman comes to the physician because ...

Pineal gland

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tumor of Pineal Gland (Pinealoma) causes Parinaud Syndrome (vertical gaze palsy)

neonem  Due to compression of the superior colliculus in the tectum, I believe +4  
wowo  FA2019 p516 +3  

some fun facts 4 u hoes to rule out the wrong answers:

Arcuate nucleus aka “infundibular nucleus” = hypothalamic nucleus. Projects dopaminergic neurons to anterior pituitary gland --> inhibits PRL. One of the 4 main dopamine pathways of the brain. Prolactin also gives feedback and inr dopamine secretion via this pathway [p 487 FA 2019]

Frontal cortex = oligodendrioma [p 514 FA 2019] rare, slow growing, fried egg appearance, may present with seizures

pituitary adenoma [p 514 FA 2019] - Bitemporal hemianopia - Most commonly a prolactinoma (hyperplasia of lactotrophs) - Male: decr libido, infertility - Female: galactorrhea, amenorrhea (PRL negative feedback on hypothalamic GnRH) - Can also see hyperplasia of somatotrophs (GH) --> acromegaly, gigantism or corticotrophs --> Cushing disease

PPRF = in charge of eye movements/conjugate gaze [p 503 FA 2019] - A stroke by the basilar artery of circular willis will lead to loss of horizontal, but not vertical eye movements