P363-01 PHYSIOLOGICAL PSYCHOLOGY

Spring, 1999

TAKE HOME TEST #2

Please answer the following four (4) questions as completely as possible. You may use your book and notes (other references may also be used, but shouldn't be necessary). While you are encouraged to discuss these questions with others in class, you MUST TURN IN YOUR OWN ANSWERS. Answers that appear to be duplicates of others in the class with be considered cheating- so please do your own work.

Each question is worth a possible 25 points (100 points total). Each answer should be approximately 3/4 to 1 page long (handwritten). Answers need not be typed, however, it is preferred when possible (hard on my eyes, but that will be explained on the next test!).

Answers are due by FRIDAY, April 2nd by 4:30 PM. Oh- and have fun (answers should be factual, but creative license is allowed).

You (yes, you) are a famous neuropsychologist who works at an exclusive faculty/student health center in a midwestern state of your choice. The following patients come into your center with some difficulties. You, being as famous as you are, have been asked to consult on the case and to decide what is going on.

QUESTION 1 and 2:

    You (yes, you), the famous neuropsychologist, have decided to take a belated spring break camping trip in the backwoods of a hick midwestern state of your choice (you work for a state university system, so that vacation in the Bahamas is history- camping is all you can afford!). The other professors you are vacationing with are not the smartest- that is, they are high on academic IQ points, but not in common sense. Remember, they did have that little accident in the lab, but thanks to your soon-to-be Nobel prize winning work on reparative brain surgery, they seem to have recovered from. Oh- both are very nearsighted and don't bother to read warning labels. As a result, they have gotten themselves into a rather unique position:

    Dr. Don Dingbat suffers from hypomotility and ureteral spasms (this is a result of his advancing age, and students taking up too much of his office hours so he could never get to the bathroom!). As a result, his physician has prescribed a drug called Cystospaz, a parasympathetic blocker. Specifically, this drug is the alpha-isomer of atropine, and thus exhibits the same clinical effects as atropine.

    Dr. Dave Do-Little has recently been diagnosed with myasthenia gravis. As a result of this disease, he has difficulty with neuronal synapses at the neuromuscular junctions. His neurologist has prescribed Mestinon tablets, a common orally active cholinesterase inhibitor.

    Now, while out camping, Dr. Dave and Dr. Don each missed a dose of their medication. As a result, they each took 2 doses to "make up" for this. Unfortunately, they mistakenly took EACHOTHER's medication, rather than their own, and have now poisoned themselves. Thus, Dr. Dave is suffering from poisoning by the Cystospaz, while Dr. Don is suffering from poisoning by the Mestinon. Dr. Dave is showing a variety of symptoms, as is Dr. Don.

    Only you have the needed knowledge to treat the incoming victims (no fair calling up the big medical center). Based upon what you know about these medications (and the PDR description, if you need a giant clue) answer the following 2 questions:

1. What symptoms should you look for in Dr. Don and Dr. Dave, and why should you look for these symptoms? How are these symptoms related to one another, that is, explain the mechanism by which each drug is affecting the Dr.'s.

2. What steps should you take to assist them with their little "problem"- oh, and remember, you are 157 miles from the nearest emergency room! HINT: Remember, you are an inventive, and desperate, physician. Between the 2 men you should have the antidotes you need.

Question #3:

     Grandma Paeonia has recently been having some trouble. First, she has developed a bit of a stationary tremor recently. A quick visit to you diagnosed that as probably Parkinson's syndrome, and you started her on a course of L-Dopa. Grandma decided she really needed to get the shaking under control, since soon it will be gardening season, and doubled her dose for about 2 weeks.. Now, Mrs. Paeonia, her daughter, is calling in for a consult. Grandma suddenly developed what appears to be an odd form of dementia. She appears to be very nervous, quite anxious about people trying to harm her, and claims that people (more accurately voices) are telling her to give away all her flower seeds. She is hiding her rakes and hoes all over the house, and appears genuinely afraid. At times she is irrational, her speech is composed of many made-up words, and she appears to have little contact with reality. Grandma has been admitted into a nursing home, and she was started on a nice little course of Thorazine treatment to calm her down and reduce her aggression. Mrs. Paeonia is understandably upset, and wants to know if she has done the right thing. What do you think?

Question #4

    Remember Dr. Don Dingbat? Thank goodness for you he survived both of his most unfortunate accidents. However, he does remain a most puzzling fellow. First, while fixing his latest problems described above, you might have noticed that he still suffers from severely crossed eyes that have not been corrected. (NOW that explains that little medication mixup). As a result, he has more retinal disparity than the brain "prefers". This does not result in good coordination. The other day Dr. Dingbat was riding his bike in the quad and had another slight accident. Given his poor depth perception, he had a little run in with Dr. DoNothing (brother of Dr. DoLittle), who happened to be lecturing on artistic property issues in the quad. Most unfortunately, the good professor's bike helmet got left at home, and he had a great fall. He is now back in your emergency room for a another follow up visit after the fall, and is presenting the following symptoms: First, he appears unable to name objects and says everything just looks like grey blobs, although he is able to react to things being thrown at him (there is a better way to test for this, you know. How sadistic!), and can dodge furniture, etc. when you chase him. Second, Dr. Dingbat is still claiming that all those grey blobs are somewhat "double". Please explain to Dr. Dingbats poor wife what Dr. Dingbat's prognosis is: Specifically, why does he only see grey blobs, and can you fix the "double" problem? Describe the visual system to Mrs. Dingbat, and explain to her how the brain processes form vs depth. Remember to state whether this doubling is due to brain injury, or the crossed eyes. Finally, his wife wants to know if you can straighten his eyes out, so he won't look funny in their daughter's upcoming wedding. What does the evidence suggests about the ability to correct this impairment at his age? Will the actual pathway for depth perception likely be permanently damaged, if not destroyed? Why, or why not.