BRS

Chapter 21 Neurotransmitters and Pathways

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25. A 78-year-old woman presents to her pri mary care physician with progressively worsen ing symptoms of Alzheimer disease, particularly memory loss. Previous imaging revealed degen eration of the basal nucleus of Meynert, leading to low levels of which neurotransmitter in this patient? (A) Acetylcholine

Match each of the cases with the disorder it best describes.

20. A 60-year-old man presents to his primary care physician for ongoing evaluation of a resting tremor in his right upper limb that has progres sively worsened over the past 3 years. He recently had a positron emission tomography scan using a radioactive marker, which showed a reduction of levodopa metabolism. This reduction was likely caused by dopaminergic neuronal death. What is the most likely diagnosis for this patient? 21. A 25-year-old woman presents to her pri mary care physician with a chief complaint of difficulty swallowing and weakness in her hands and fingers. A blood test reveals antibodies to the nicotinic ACh receptor. What is the most likely diagnosis for this patient? 22. A brain autopsy of an 85-year-old woman re veals neurofibrillary tangles and neuritic plaques. What is the most likely diagnosis for this patient? 23. A 53-year-old man presents to his primary care physician with a complaint of weakness in his arms and legs but notes that his muscle strength seems to improve when exercising. He is a long-time smoker and also complains of dry mouth and constipation. A chest radiograph reveals a mass in the left lung. What is the most likely diagnosis for this patient? 24. A 45-year-old man presents to his primary care physician with a chief complaint that he has been experiencing jerky, uncontrollable move ments. He reports having noticed similar symp toms for the past few years but notes that the symptoms seem to be getting worse. His family history reveals that his father had some of the same symptoms prior to his death in an automo bile accident. The magnetic resonance imaging scan shows cell loss in the caudatoputamen. What is the most likely diagnosis for this patient?

(B) Dopamine (C) Glutamate (D) Norepinephrine (E) Serotonin

26. A 30-year-old woman with previously diag nosed multiple sclerosis presents to her primary care physician to address new and worsening symptoms. Patient interview reveals that the patient has been feeling more depressed and le thargic as of late and reports feeling dizzy when standing from a seated position. Based on the patient’s symptoms, imaging is most likely to reveal a sclerotic plaque affecting which of the following? (A) Basal nucleus of Meynert 27. _______________ is the major excitatory neu rotransmitter in the brain. (A) Ach (B) Aspartate (C) GABA (D) Glutamate (E) Glycine 28. The major inhibitory neurotransmitter in the brain is _____________________. (A) GABA (B) nitric oxide (C) serotonin (B) Globus pallidus (C) Locus ceruleus (D) Pontine raphe nuclei (E) Substantia nigra

(D) somatostatin (E) substance P

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