The intricate process of neurotransmitter release at the synapse involves a precise sequence of molecular events. Which of the following accurately depicts the critical steps in this process, beginning with the arrival of an action potential and culminating in vesicle fusion?
A) Action potential -> calcium influx -> synaptotagmin activation -> vesicles docked by SNARE protein
complex -> vesicle fusion
B) Vesicles docked by SNARE protein complex -> action potential -> calcium influx -> synaptotagmin
activation -> vesicle fusion
C) Action potential -> vesicles docked by SNARE protein complex -> calcium influx -> synaptotagmin
activation -> vesicle fusion
D) Calcium influx -> synaptotagmin activation -> vesicles docked by SNARE protein complex -> vesicle
fusion 

Long-term potentiation (LTP) is a complex synaptic phenomenon implicated in the formation of long-term memories. It involves persistent strengthening of synapses between neurons. Which of the following best characterizes LTP?
A) Removal of the magnesium block from NMDA receptors, followed by repeated activation of AMPA receptors, initiating a cascade of intracellular signaling events that lead to synaptic enhancement.
B) Repeated activation of AMPA receptors, leading to the removal of the magnesium block from NMDA receptors which leads to synaptic enhancement.
C) A form of long-term inhibitory synaptic plasticity that temporarily suppresses competing neural pathways, ultimately leading to enhanced overall network activity.
D) None of these answer choices are correct.

Which statement accurately describes a feature of CaM kinase II and its regulation?
A) Binding of Ca2+-calmodulin to CaM kinase II displaces the autoinhibitory segment, activating the kinase, which then autophosphorylates Thr-286 to maintain activity independent of Ca2+-calmodulin.
B) CaM kinase II remains active in the basal state due to the autoinhibitory segment enabling substrate access.
C) The phosphorylation of Thr-286 by CaM kinase II inactivates the kinase by allowing the autoinhibitory segment to block the active site again.
D) CaM kinase II isoforms are exclusively found in the nucleus, with no association with postsynaptic densities or synaptic vesicles.

Neurons in the auditory cortex with ________ characteristics tend to have receptive fields that are large and encompass both contralateral and ipsilateral sides due to their bilateral excitatory input.
A) Inhibitory
B) Summation
C) Suppression
D) Excitatory

In sound localization, why do neurons in the medial superior olive (MSO) respond best when they receive coincident input from both ears?
A) Neurons in the MSO are designed to detect high-frequency sounds, which require simultaneous input to be processed effectively.
B) Neurons in the MSO integrate phase-locked spikes to determine the direction of sound but only respond to signals coming from the ipsilateral side.
C) Neurons in the MSO are tuned to particular interaural time differences (ITDs) and thus respond optimally when the sound input from both ears arrives simultaneously, corresponding to their best ITD.
D) Neurons in the MSO use interaural level differences (ILDs) to determine sound localization, so coincident input is not relevant for their function.

A patient walks into the clinic with dry mouth, blurred vision, difficulty swallowing, constipation, and urinary retention. Further analysis reveals the malfunction of a specific neurotransmitter receptor. Which type of receptor is most likely impaired?
A) Muscarinic acetylcholine receptors
B) Nicotinic acetylcholine receptors
C) Adrenergic receptors
D) Dopaminergic receptors

What is the role of clock-controlled genes in the circadian rhythm mechanism?
A) They are necessary for the rhythmicity of the circadian clock by feeding back on the core oscillatory mechanism.
B) They regulate rhythmic gene expression through additional regulatory elements but do not directly impact the core oscillatory mechanism.
C) They compete with core clock genes for E-box elements, thus disrupting the transcriptional activation of core clock genes.
D) They exclusively control the rhythmic synthesis and secretion of arginine vasopressin (AVP) in the cerebrospinal fluid.

Which statement accurately reflects the role of the auditory cortex (AI) in sound localization?
A) Neurons with suppression characteristics in AI tend to have wide, omnidirectional receptive fields.
B) Lesions in the posterior auditory field and areas near the anterior ectosylvian sulcus affect sound localization on the ipsilateral side.
C) The auditory cortex has an organized spatial map that corresponds to a sound's position in external space.
D) Behavioral studies show that lesions in AI lead to deficits in sound localization, with deficits being frequency-specific and more pronounced when the task involves moving toward the sound source.

In a study of fear conditioning, researchers want to examine the role of the basolateral amygdala. Which of the following techniques would be most appropriate for temporarily inactivating this region in mice?
A) Optogenetic inhibition using halorhodopsin
B) Pharmacological inactivation with muscimol
C) Lesioning with ibotenic acid
D) RNA interference targeting NMDA receptors

A patient with damage to the ventromedial prefrontal cortex would most likely show deficits in:
A) Working memory
B) Emotional decision-making
C) Visual object recognition
D) Motor coordination




Case Study: Dr. Lee, a neurologist, is evaluating Mr. Thompson, a 55-year-old male presenting with progressive muscle weakness, dysarthria, and dysphagia. The patient reports fasciculations and muscle cramps. Symptoms began 12 months ago with left hand weakness, gradually progressing to involve both arms and legs. Examination reveals widespread fasciculations, increased muscle tone in affected limbs, and hyperreflexia. Diagnostic workup includes:
1. EMG showing active denervation in multiple body regions.
2. Nerve conduction studies with reduced compound muscle action potentials.
3. MRI revealing mild cortical atrophy.
4. Genetic testing negative for common ALS-associated mutations.

Discursive Question: Discuss the most likely diagnosis based on Mr. Thompson's clinical presentation and diagnostic results. Explain the pathophysiological mechanisms for the observed upper and lower motor neuron signs.

Case Study: Dr. Witherspoon, a neurologist, is evaluating Mrs. Kanken, a 62-year-old female presenting with gradually worsening gait instability, tremors, and bradykinesia. She also reports difficulty beginning movements and frequently stumbles upon herself and falls. Symptoms started 18 months ago with a resting tremor in her right hand, progressively involving both sides of her body. The doctor conducts an examination and notices cogwheel rigidity, a shuffling git, and a masked facial expression. Diagnostic workup includes:
1. DaTscan revealing reduced dopamine transporter uptake in the basal ganglia
2. Blood tests within normal limits, excluding secondary-associated mutations
3. MRI showing mild brainstem atrophy with no significant cortical abnormalities
4. Genetic testing negative for Parkinson's disease-associated mutations

Discursive Question: Based on the clinical presentation and diagnostic results of Mrs. Kanken discuss the most likely diagnosis. Explain the pathophysiological mechanisms that could account for the observed motor symptoms and neurological findings.

Case Study: Dr. Perelman, a neurologist is evaluating Mr. Kumar, a 44-year-old male who presents with intermittent episodes of severe stabbing facial pain localized to the right side of his head. Mr. Kumar reports the pain arises whenever he talks, chews, or lightly brushes the area. He reports they first started 6 months ago and added they were initially brief episodes lasting anywhere from 10-15 seconds and have now progressed to longer and more frequent episodes ranging from 3-5 minutes. Mr. Kumar reports no history of trauma or prior neurological conditions. Physical examination reveals no sensory deficits or muscle weakness in the face. (The patient is visibly distressed during an episode). Diagnostic workup includes:
1. MRI of the brain reveals a loop of the superior cerebellar artery close to the right trigeminal nerve root
2. MR angiography confirms neurovascular compression at the root entry zone of the trigeminal nerve
3. A complete blood count (CBC) is conducted and reveals no abnormalities
4. Electroencephalography is conducted and shows no significant abnormalities in facial nerve conduction

Discussion Questions:
A. What is the most likely diagnosis for Mr. Kumar based on his clinical presentation and diagnostic findings? Provide a rationale for your diagnosis.
B. Explain the underlying pathophysiological mechanism that accounts for the pain experienced. Explain the role of neurovascular compression in the development of his symptoms.
C. Given the diagnosis, provide a treatment option, and note the treatment can include both pharmacological and surgical approaches. Discuss the indications for the treatment chosen