A 52-year-man is brought to the physician because of a 2-week history of memory loss. Three weeks ago, he had a cardiac arrest that required cardiopulmonary resuscitation and intravenous epinephrine. On mental status examination, he cannot recall objects shown to him 20 minutes earlier but vividly recalls memories from before the incident. The remainder of the examination shows no abnormalities. Which of the following structures of the brain is most likely affected?
AInternal pyramidal layer of the amygdala
BMicroglial cells of dorsal midbrain
CPurkinje cells of the cerebellum
DPyramidal cells of the hippocampus
EAstroglial cells of the putamen
A 61-year-old man is brought to the emergency room with slurred speech. According to the patient's wife, they were watching a movie together when he developed a minor headache. He soon developed difficulty speaking in complete sentences, at which point she decided to take him to the emergency room. His past medical history is notable for hypertension and hyperlipidemia. He takes aspirin, lisinopril, rosuvastatin. The patient is a retired lawyer. He has a 25-pack-year smoking history and drinks 4-5 beers per day. His father died of a myocardial infarction, and his mother died of breast cancer. His temperature is 98.6°F (37°C), blood pressure is 143/81 mmHg, pulse is 88/min, and respirations are 21/min. On exam, he can understand everything that is being said to him and is able to repeat statements without difficulty. However, when asked to speak freely, he hesitates with every word and takes 30 seconds to finish a short sentence. This patient most likely has an infarct in which of the following vascular distributions?
AProximal middle cerebral artery
BInferior division of the middle cerebral artery
CMiddle cerebral artery and posterior cerebral artery watershed area
DSuperior division of the middle cerebral artery
EAnterior cerebral artery and middle cerebral artery watershed area
A 60-year-old man is brought to the emergency department by police officers because he was acting strangely in public. The patient was found talking nonsensically to characters on cereal boxes in the store. Past medical history is significant for multiple hospitalizations for alcohol-related injuries and seizures. The patient’s vital signs are within normal limits. Physical examination shows a disheveled male who is oriented to person, but not time or place. Neurologic examination shows nystagmus and severe gait ataxia. A T1/T2 MRI is performed and demonstrates evidence of damage to the mammillary bodies. The patient is given the appropriate treatment for recovering most of his cognitive functions. However, significant short-term memory deficits persist. The patient remembers events from his past such as the school and college he attended, his current job, and the names of family members quite well. Which of the following is the most likely diagnosis in this patient?
ASchizophrenia
BKorsakoff's syndrome
CWernicke encephalopathy
DDelirium
EDelirium tremens
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