478. A lumbar puncture is performed on a patient with headaches, pho- tophobia, clouding of consciousness, and neck stiffness. If these symptoms are the result of bacterial infection of the meninges, then what would examination of the cerebrospinal fluid (CSF) most likely reveal? Gross Pressure Appearance Protein Glucose Inflammation a. Increased Cloudy Increased Decreased Neutrophils b. Increased Clear Increased Normal Lymphocytes c. Increased Clear Increased Normal Mononuclear cells d. Decreased Clear e. Increased Clear Decreased Normal Increased Normal Lymphocytes Mixed 479. Neuronophagia of anterior horn neurons is characteristic of a. JC virus infection b. Treponema pallidum infection c. Poliovirus infection d. St. Louis encephalitis e. Subacute sclerosing panencephalitis 480. A 51-year-old male presents with rapidly progressive dementia and dies. At autopsy, marked spongiform degeneration of the brain is found. These changes are suggestive of a. A deficiency of galactocerebrosidase b. Abnormal folding of a prion protein c. Decreased activity of superoxide dismutase d. Ingestion of ova of taenia solium e. Neuronal damage due to amyloid deposition 481. Physical examination of a 34-year-old female with the new onset of an intention tremor finds medial rectus palsy on attempted lateral gaze in the adducting eye and monocular nystagmus in the abducting eye with convergence. These findings are highly suggestive of a. An apical lung cancer b. A pituitary adenoma c. Diabetes mellitus d. Multiple sclerosis e. Tertiary syphilis