 Okay, so we'll just go over the answers and then through the Jeopardy game we'll kind of review more in depth a lot of this stuff but all right number one besides the CNS findings what other systemic findings of tuberous sclerosis are potentially life-threatening or is potentially life-threatening. Yeah, B, so cardiac grab to myoma. Perfect. What non-CNS cutaneous or ocular manifestations are not associated with ataxiatlantric atasia? C. We're really killing it. Lim-length discrepancy is not associated with ataxiatlantric atasia. That's not a standardized question. It's a not. C. Ataxiatlantric atasia is kind of hard because it does have a lot of different manifestations so with ataxiatlantric atasia you have a mutation in a gene that helps like maintain many different things so including like telomere length you have angiogenesis glucose metabolism so many different things so these kids who get this have like a like a really low life expectancy how long do you think they live if you throw us in the first after 20 years 25 years is like the expectancy for these kids and when they get um cancers uh age when they're younger than 20 usually get hematological malignancies solid organ cancer is a little bit more common in adults so they have a much more increased risk of breast cancer in this population about five times the risk in general population and then they have thymocypoplasia and also like um IgG IgG IgM IgA abnormally all kinds of um infection risk um including especially like pulmonary infections is usually what they die of and so there's a lot of different findings here and we'll go over even more of them but it's it's one of those things where it's just like you're not really sure and they have increased risk of mortality because the cancer it's usually ataxiatlantric among the okay number number three was maybe a little confusing so but what are the diagnostic criteria for neurofibromatosis one just the parentheses abbreviated version just meant you don't have to be really specific about it but does anybody have a list or a good mnemonic to remember yeah so bone bony abnormalities there's seven there's three that affect the orbit or the eye you think of what else you just said one that's actually that's that's actually I don't include iris iris yeah so these nodules how many others do you have to have two two neurofibromas right so yeah neurofibromas is another one catholic spots yeah it's like five or seven or something right there six okay say it again yeah axillary freckling optic pathway glioma yes optic pathway glioma and then there's one more what are the criteria really um it's uh like someone in your family yeah relative perfect so kind of a mnemonic i've seen before is calborn so cal b or n so the c is oh sorry the c is cathol a a is axillary freckling l is least nodules b is bony abnormalities including especially sphenoid bone dysplasia o is optic pathway glioma r is relative and then n is neurofibroma more right yeah so i guess i just have to remember it based on like what's in the eye first like any hallucinodules optic pathway glioma or uh plexiform neurofibroma and then i think of all other things so that's three things that affect the eye and then you have a sphenoid wing dysplasia or long bone abnormalities there's two things that affect the skin either axillary freckling or inguinal freckling or cafe or lay spots and then you have a relative so like skin i found them just gotta try harder okay all right what are the renal and adrenal masses associated with fontanipulin now good and then there's one more renal cell nailed it and then last one what faking mitosis presents with uh race most angioma or retinal AVM yeah okay so next we're going to go over some cranial nerve seven actually i'm not going to go over the anatomy because you guys had this review sheet i wanted to give this to you so you have an idea maybe like one way to approach trying to understand or learn anatomy it took me a long time to like put it all together because it feels like the bcsc has some information and then you have to look up your own sources and things like that to really understand anatomy and especially the clinical anatomy so i'm going to scroll through this but we'll go to the actual questions um the quiz question is not the worksheet i'm filling in the blank about the anatomy you guys all have a copy of this yeah or you can put up on a computer and bring this kind of news together okay the most common cause of damage to the upper motor neuron of the facial nerve is so when you have um when you see uh cranial nerve seven palsy and we know that it's due to an upper motor neuron lesion rather than the lower motor neuron lesion what is the most likely cause going to be a stroke and near plasma or infection stroke yeah stroke is the most common um and these are all from the bcsc in like main points i guess uh this so if there's a stroke to the left paracentral gyrus um it would result in what facial muscle deficit so if you have an upper motor neuron stroke would you have upper face lower face which side would be affected if if there's a stroke on the left side we're right so why is it lower right yeah so you have um uh yeah let's blow up a picture here so okay so could you explain this mic basically you have dual innervation and so unless you stroke out the lower motor neuron you're still gonna have innervation from like it's a lateral side to that upper upper right so the upper motor neuron um provides yes uh input into the uh the lower motor neuron cell body here in the ponds um and both of them do the both upper motor neurons do and then with the lower motor neuron there's only only goes to one side so you have dual innervation from upper motor neuron for the upper face and then for the lower motor it only comes from the contralateral side one here for nuclear a right cranial nerve seven nuclear or in for nucleation would result in what facial muscle deficit so if you had the other issue so not upper motor neuron issue but more like a lower motor neuron issue so um right side for lower motor on affects the same side upper and lower so if you know that someone can't raise their brow you know they have like a male or seven palsy having facial weakness they can't raise their brow um and their lower face is weakened it's almost like the lower motor neuron condition rather than upper motor neuron okay this is trying to have like some questions we had in med school actually damage to the nerve that supplies the stapedius can result in what kind of hearing problem can you hear too well like too any noises or too little too much too much dip it's almost like hyperacusis because what does the state bees do dampen sounds yeah it's a stapedia supplies the state bees muscle and muscle supplies the the bone with the more stability and dampens the sound um so you have all these conditions decreased hearing dry mouth decreased taste hearing impairment I stag must vertical taxia you have involved in multiple cranial nerves five uh six and eight as well and cerebellar signs kind of like pointing towards a certain region in the brain could be affected here what do you guys think see a dry mouth decreased taste hearing impairment those things could be what cranial nerve or decreased hearing all these things and then um stag was in vertigo and ataxia can happen from cranial nerve eight or cerebellar issues right and if you have five and six also involved in addition to other cerebellar signs kind of think this is a lot of real estate in a very important area called the cerebral apontine angle um what what two tumors could affect that area yeah because you know well what you get in an obscene or other one that's what you think about in the meningioma yeah so those are the two main things that we see in that area um Bell's Palsis Diagnostic Exclusion but what do you if someone if your patient comes to you and says well why does this happen to me why do I have Bell's Palsis what do you know about it like what can you say probably viral could be viral no autoimmune right why are autoimmune inflammation of the nerve temporarily um and what do you use to treat it acutely yeah steroids and then some people do antivirals but that's not necessarily particularly any guidelines what's the term used to describe the co-contraction of face facial muscles after incomplete recovery from a Bell's Palsis so you might see like yeah in kinesis right you also see that in other cranial nerve Palsis too you can see in cranial nerve three what is a pattern of facial apresis would you what pattern would you expect in Bell's Palsis it's kind of like same side or same session yeah so you know a lot of upper and lower face all right um let's go around and have maybe you guys read some of these so Jeff do you want to read the next one number one um what tick-borne illness can result in bilateral or unilateral cranial nerve seven Palsis um this could be line what's the bug that comes in right generate this one sure so this is a hd of cranial seven is called uh is there a Ramsey hunt and diagnosed for vesicles found along the course of iteration of the cluster regular nerve which includes what structures are we talking about like which nerves so um so auricular nerves uh actually supposed to auricular nerve supplies certain structures on our head with innervation like sensory innervation and when I scroll back up here so you can see exactly where it is so somewhere in that posterior auricular that gives you a clue yeah yeah so you're going for pina extra ulterior right yeah so you can look in the ear and he's and I mean if there's obvious vesicles you can see these you can see them getting better over time um and you have the muscular innervation too as well to muscles around the ear and the occipitalis most commonly affected cranial nerve and sarcoidosis is cranial nerve seven due to infatuation of the parotid gland the second most commonly affected is cranial nerve eight um so actually found cranial nerve two okay I didn't see it here I found like a range for eight and then two was sort of in that right yeah it's not very common to have other ones and cranial nerve involvement anyway in sarcoidosis it's pretty weird to have nervous sarcoidosis right but um I found two as the most second most common so you can get vision loss and not do neuropathy from this um which childhood disorders characterized by bilateral facial paralysis chronic facial swelling and legal placata furring of the tongue um Melkerson rosin balsam yeah right so what are they um what what what part of their face usually gets swollen like do you guys see any pictures look it up see what it looks like the classic that you can get a cheek or their lips actually that seems to get um affected it's really weird that it's on the caps because there's only like hundreds of people affected with this that have been reported it's not even so uncommon but is that it's actually yeah yeah it was on there yeah let's go over a few more things real quick and then we'll move on to debris um all right so let's do this as a team so the rest of you guys who haven't answered the question yet um on the board uh you guys want to go through this together and kind of fill in the blanks to shout it out so for um blood for spasm by not essential blood for spasm versus hemifacial spasm it's important to know the distinction and there's often also other conditions that cause um muscle contraction type uh presentations that will go over as well that affect cranial nerve seven so what muscles are involved in uh blood for spasm versus hemifacial spasm where you have like hemifacial spasm which is like cranial nerve seven muscles so it's like these are the whole upper and lower yes yeah great um and as far as laterality which which what is uh blood for spasm and hemifacial spasm so blood for spasms usually well hemifacial spasm as it says as the name is yep so what where is the pathology or pathophysiology of buffer spasm like what do we think causes it yeah so it could be we don't really know this is currently I think it could even be like extra pair middle maybe or it could be like stress because it's like stress related sometimes with some people um there are other conditions that can like dry eye right can also be one of the things that can cause blood for spasm people's helping to control that will help as well so maybe the surface of that is can be listed here how about for hemifacial spasm you know the seventh nerve typically yeah and what's compressing it usually like a I think the book says like a dolicoactatic vessel which is what does that mean uh it's just a weird ship vessel I guess yeah so dolicoactatic it's like this twisty dilated vessels like this tortuous vessel that's dilated sort of from uh from hypertension just that's interesting so let me kind of tell you that we should probably see we should probably do some imaging to see what's going on there because what else could be there not a vessel but yeah it could be an aneurysm it could be a tumor or something else that is compressing the nerve there um in the in the brainstem so uh which one is present during sleep yeah hemifacial spasm yeah um what would you do as part of the work up other than imaging for hemifacial spasm yeah I mean we do it yeah open MRI and I mean what type of imaging sorry yeah spasm imaging um and then for spuffer spasm what work up would you do like what kind of questions would you ask the patient you know it's isn't that one of the things to like um I think it's more in kids like with glaucoma like they could have like blood for a spasm that could be a sign of it or no am I thinking of something else I think I'm sure there's some kids who have that I don't I don't think that's commonly seen in kids as much yeah I think like sensitivity I don't know is it's like yeah yeah like they congenital I'm not talking about like for yeah um we can uh we can also ask about like you know maybe caffeine intake stress things like that anything else going on in their lives that could be related to the timing of onset what would you do for like what are like one or two medications for each of these that you could try medication surgery for hemivacial yeah you do surgery um real quick for medication for left first spasm oh there's sorry yeah I'm like out of here at all artificial tears artificial tears yes I thought 41 um okay so what surgery would you do for left first spasm you asked her to take the muscles and how much really it's pretty surprising um so if you what are the what are the three components of our obruculars uh if you had a list of the three parts of our obruculars in orbital yeah so um so if you have if you have all three components you would think that you maybe leave a lot of it but actually you take out the majority of it and people just usually live a strip of the pre-tarsal muscle apparently so a lot of it's gone these are varieties of that surgery um your patients have to order yeah so sometimes they'll probably leave more of the pain on how severe it is too there's a lot of plastic student because I've never seen that surgery but it's really the last resort it's quite a uh in face changing people look very different after surgery but it's very mechanic very effective I have one patient who's had that by a different surgeon and she still needs Botox but a lot of them they're good but they've cost have chronic tryout and what surgery can you do for any patients spasm it's sponge sponge where in between where like the nerve is and whatever it is it's compared the weird vessel that Chris said yeah who does that yeah all right so for the last I'm going to give you guys I'm just going to give you that I don't want to take too much time because I want to do everything but um I'm going to show you one video and I'm not going to go over these questions I'm a facial malchem is another bit different and I want you to tell me how this these these movements are different from left first as the sort of the seventh nerve but in this case probably due to brainstem involvement this is a patient with multiple sclerosis and what you can see are continuous undulating fasciculation like contractions in the distribution of the seventh nerve now this disorder is different than the benign obicularis myocardia which I think all of you this one's more like undulating it's different from spasm it's like it's fast you know it's not continuous like this it's more like undulating it's rip and also lovers as well compared to this where are we looking at right now well yeah this is the all of a sudden although you can get myocardia without having to be the whole face yep you can have you can have just like what you can have like a certain extrafiler muscle probably myocardia or even this individual muscles as well in the face right so in this condition with the space you have multiple sclerosis or sometimes adults or kids who have haunting gliomas you can have and then I will just send this rest this out to you and we'll move on do you get at both point of the last few questions is that for six and seven um with uh facial myocardia and this spastic you know lateral facial contracture these conditions anytime you have these conditions it's really important to consider that it could be something malignant and consider really consider getting next part we're gonna go over if they come in oh why don't we do um okay so it's Jeff and I'm sorry tell me Trevor Trevor why don't we do trying to do like a pgy three and two in each class and then we'll split up Trevor Ali and Jeff okay that's why we have three teams yeah sounds good we are two here I know I was well I guess all right so Marshall or Ariana need to move away from Brad pgy two and a three right so either you or Ariana need to go over there all right then Chris okay so Rachel's coming here so Ariana you go over there okay so so the way that we're gonna do this um is just everybody's gonna answer every question so just write down your answer on the whiteboard and then we'll just hold it up so there are there is a lot of repeat information but it's kind of coming out from different angles so just also pay attention because one question might give you the answer to a later question and there there is basically one benefit to choosing the question so if you get it right so kind of try and pay attention to like who put their board up first but um because there is a double jeopardy question so only that person can double their money whoa all right so we'll just start Brad why don't your team go pick first like a boss I knew you would be I should have said this category is kind of the harder question all right so quickly and we first I think you were definitely there is no question about that all right that was quick that's quick that's right so NF1 is the most common and then just for kind of by way of information those are the incidents it's just it's it's it's it's it's I everyone got it we have team names oh man is winning okay our team name is team like a boss we're gonna be team like their boss all teams got like their boss I believe you were first so but but they held their thing up first I know it's like it's the only way anyway can we still get the first one I'm going to just use one benefit in choosing double jeopardy but let's do okay ready and you have to answer no penalty for answering incorrectly so I just want everybody to answer I will point out that it says these chromosomes oh oh oh so there's two correct you got 10 more seconds guess I should put one this one in like a boss all right five seconds okay okay all right this is a tough one six oh god that was close yeah so kind of two jump question right so what's the condition so tuberous sclerosis and then chromosome nine and 16 and just in in a few charts actually in bcsc it specifically talks about how these genes are also so tsc one is also called hammerton tsc two is called tuber and and then just I tried to full pictures I tried to get them from bcsc just because I guess that's where they always talk about the unwolf right bro yeah which is like not it's not what yeah that's true all right uh so back to like their boss since everybody got wrong and keep it do ocular findings for 300 ataxia tell good so ataxia telegenitasia yeah also known as so I really like how strong I've talked about this there's so many systemic symptoms systemic things that can go on with like or ataxia telegenitages so just another example so super nuclear gaze palsies so these kids like they have ocular apraxia or variation of that sort of they can initiate movements so what can they do to help all right I think it was I think that was me what was it okay great like like like their boss I'm like I see you Dr. Warner's keeping tracks so watch it all right go ahead like their boss again it names for 400 400 oh and the one daily double so only you guys can double your money but everybody else still answers so 800 for you 400 for you guys all right you guys have 600 everyone has 600 points okay you're ready and we still have to get it fastest though if we want to right okay no if you get it right you get it okay but if you want to pick again all right here we go so specifically the less common name if you list both I guess that'll work all right 15 seconds how many how much did you guys waste here what is it double yeah it's worth double because we're not chasing away we're not taking away points I'm making it up as we go okay all right five seconds you've seen the oh yeah all right time's up team winning what did you say I saw what it says as long as you want to keep it all right here we go oh nice I'm getting tired of this ataxi I told you there's repeat information but repetition right repetition all right so again I mean it's all these a lot of systemic things so and Strav already mentioned that respiratory infection is a common cause of mortality and these younger patients who die with ataxi atlantication all right like their boss let's do sorry so name the that's maybe a little confusing name the neurocutaneous disease not the finding but I think that says it's very close angiom is that okay maybe it's just someone else right don't give it to Chris all right so everybody got it right that's right so wyburn mason or race most angioma there anyway there's yeah uh just as a side note because this is not considered an inherited disease it's most common sporadic mutation as well as sturch weather so this just bonus tidbit thing that's not sturch weather correct no it's just that that's also a non-inherited all right like their boss okay let's do miscellaneous for 400 eight ten seconds a little bigger getting old all right we're good so again the wyburn mason race most so so due to the intracranial arterial venous malformations just they can have spontaneous rupture and intracranial hemorrhage this is the same condition that um Kamansky talked about at that last deputy game with retina he has number one what are you talking about um the reason why this disease uh became as popular in ophthalmic literature apparently is because at wills there was a patient with wyburn mason who had who's getting dental work done had an avm in the mouth and then it ruptured blood to death all right like her boss let's do alternative names for 200 10 seconds all right five seconds all right anything team winning live up to your name winning winning winning okay this is this is what i'm talking about oh Ben hang on now we'll take that oh yeah i couldn't remember what it was so do they get points if they wrote the other name uh so what's so von hebel lindau is kind of i guess the more common name i i would say but it's actually also known as retinal cerebellar angiomatosis so that specific lesion what are what are we talking about with the description album you do bless right oh sorry yeah retinal hemangioblastoma a couple pictures all right like a boss uh 200 we have to raise it up right i mean do we don't get points if we get there's no benefit if we didn't get no everybody gets points if you get right oh you're all getting points oh yeah i didn't know this i know it's been a while since you have been first so all right that was they all got it um also known as encephalofacial angiomatosis but sturge wearer syndrome and i think this so this picture is from bcsc yeah like a boss let's do uh genetics for 200 you have to tell okay okay they they told me that that's the top ones i crossed out yeah yeah thank you thank you extra points for writing big thank you i know you're struggling out there but all right good so 22 so i think he's too good yeah so nf2 22 like a boss on a roll um let's go for our did we do for 100 ocular no all right ocular fight so what's the lesion sorry what's the name of the lesion okay can you be more specific than that okay all right so we'll still take it but we're just like that's what we meant is like being more specific okay all right uh team winning all right team winning like a boss for 500 all right here we go like a boss 500 okay we had it reviewed that was we already reviewed this but that's good all right uh team like a boss all right here we go a lot of growing on this one i need multiple choice i don't want to pay out just think about all the things that this condition has and like three you think might work you're gonna get all three that's why this is like boss was it was that it probably was in a mixture yeah there is a lot to repeat all right let's do that sure i don't think anyone got them all i'd like to tell you faces i'm just trying to read it yeah read it sorry what it's actually astrocytic hamertoma and intracranial lesion okay so i don't yeah i don't think anyone got them all i think you guys but uh adnoma sebacea did was that on your seizure hamertoma oh hamertoma okay all right so yeah so the classic triad so cognitive impairment seizures and then facial angio fibromas also also called adnoma sebacea so it's like these these triads sort of came about when all we had was like we can look at the patient and see what they have right all right uh everybody had nobody got it so were you guys last yeah fine you gotta keep track of that mark or T wait yeah good so NF1 right where the where the lesion is and what the shape of it is is the left eye. And it's known as a, like a, what is it? The tram tracks is a meningeal one, right? Yeah. So you can have that glioma, it's an optic pathway glioma that this patient has. These can go all the way back. So I, I always would get the two mixed up, like tram track and fusiform. This is maybe like a result, but so I actually think it's really helpful to, I think, turn off, to think about what part of the optic nerve it's affecting. And then that's why it looks like that, right? Because as the meningioma it's affecting the, the meninges are like the dural sheets. So you get this, you know, thickening of the outside. So it's going to look like that tram track. Whereas this is kind of the glial cells of the optic nerve. So it's just going to blow it up. That picture, is this really asymmetric temporal lobes? I don't know if that's the, it's called out on that slide, but it looks like the right spheroid wing is different than the left. Yeah. It can be very lumpy, like fully. Okay. Thanks. All right. Um, let's go for, let's do genetics for 100. Brad knows what it is. I just heard a big sigh. Okay. Five seconds. Pick a number between, all right. 11. No half credit for one on that one. It's the gene for this. The gene that's mutated. ATM. And I, the only way I can remember this is actually, I looked at like why do they have telling dictages? And it's actually because again, the ATM genes associated with like angiogenesis. So these people have dysregulation of the hypoxia inducible factor, HIF1 and VEGF actually. So those are, there's extra levels of hypoxia inducible factor and VEGF floating around. And they have telling dictations of their congenital vessels and also their skin, their superficial skin. You can also see those vessels. If that helps to remember, just, I feel like anything helps with these things. No, so back to you guys. You could think of 11 as like two little legs and there's a little bit of a tax if you're what to do. Oh. I like it. I will forever. Do they, do they usually know? Like, do they usually have family members like that? Like, are they aware of that? Yeah. It's, so are we going to go over inheritance? I actually, I don't think I have questions on inheritance. Yeah. So what do you think the inheritance pattern is? It's recessive. It's recessive. Yeah. I was a little recessive actually. So yeah, you can have family members with it. But usually, part of the inheritance. Whereas most of these neuro-facumatoses are what? How are they inherited? Dom dom. Well, I do. There is one question on genetics, but we didn't spoil it. All right. You told us we had to pay attention. I mean, I don't always. So I wrote it down right here. So Robin, what are you thinking about? This is the list of elements. Okay. So Tuber Sclerosis is right, but the less common name is Bornville Disease. Bornville. And then just, just to go over some of these findings. So ash leaf spots, facial angiofibromas, or adenomysibatium, chagrin patch, and then angolfibromas. What's their intracranial lesion? Our tumors have to calcify tumors. Oh yeah. Okay. What is it? You didn't mention the, mentioned the vodka? It's their, um, right there. I know, right? Thank you. I'm just here to admit about facial or uh. What are the tumors there? I can do a good picture of a seizure. I mean, they're like. They're like. They're like talking. Yeah. She's talking in a parody. You know, like. Oh my god. Brachemole. Brachemole. And it's also a sub-pandamole, uh. That's what it is. Yeah. They asked that. And then it's going to be calcified. Wait, wait, wait. What lesion? Yeah. I'm sorry. What's the, what's in your stuff with this one? Astrocele. So Rachel just said. Calcified. That's okay. They don't have to be calcified though. So the ones that look like the mulberry lesions, those are the ones that are typically calcified. If they're non-calcified, then they tend to be a little more flat. And then they're often associated right around, they're often placed like right around the optic. Are you going to set this up, by the way? These are really good. Uh, we'll, we'll put it in box. Proprietary. Yeah. Well. Yeah, we can put it in box. Me and some of them up real quick. And then can we review what the votes try out? Vote try out is again real quick. This one. Seizures. Seizures. Proprietary seizures in the facial and different from us. Nailin. All right. Oh yeah. Team winning. Lurries. Lurries. Short-term ratio. Short-term ratio. Team winning. Team winning. Team winning. We had a points update here. Team winning. Like your boss has... Team winning. Yeah. Yeah. 1,950. Like a boss has 3,350. Wait, sorry, sorry. What? You ready, Brad? Yeah. Like their boss has 3,950. Like a boss has 3,350. And winning has 2,500. Yeah. Winning. Yeah. You're insane. That's not... So we're like... We're like... We're like you. We're like you. We're like you. We're like you. We're like you. We're like you. Dang it. I'm trying not to make it. I'm trying not to make it. I'm trying not to make it. This is getting real. All right. Um... I think it was... Okay. Yeah, we got it. Let's team winning. Alternate in age 500. Okay. Here we go. Let's do a jump there quick. No, I want the alternate in age 500. I saw it. It's awesome. It's awesome. It's awesome. Yeah. I remember that. I'm pretty sure. Okay. Five seconds. Just to start. Mike cheated. You know, we were talking about why we're Mason. We're going to give the three-person name. Yeah, yeah. Yay! So you're right. It's the last one. It's the last three-person... Yep. There's another one. Blank. Blank. Blank. So it's Bonet de Chamblank. What? Long syndrome. Blank. Oh, Blank! I got Blank right. But we're taking Wyburn Mason. But Strav pointed out that there is an even lesser well-known name. Although I couldn't find it in the neuro-BCSC, so I don't know if it's in the Pied section. Anyway. We're supposed to name them. Everyone just tries to get their freaking name on everything. We're names. But we're taking Wyburn Mason. Like an arm, an arm, an arm. Blank. All right. Team winning. So we're going to get them too. Sorry. We want Miscellaneous for $500. Yeah. Yeah. It's gone. Yeah. Yeah. Yeah. Because even though... Yay! Oh, shoot. I haven't been putting what are. Okay. We'll just go to Final Jeopardy. It's a day or two. Sorry. Oh, crap. This is so much fun. Oh, but we only have a couple of them. Weager, right? What's that? We have to Weager, right? Yes, you have to Weager. But only Weager. Yeah, but I didn't give a topic, but you need to Weager. I don't remember. I have to look at the question. Oh, no. I do remember. The topic is treatment. Treatment? Yes. Treatments for fakeomatosis. Okay. We're wagering everything. Okay. What's the price? There's no price. A potential pie is the price. Yes. It goes towards the pie. What do we have? What are our points? Oh, what are your points? You guys, Winning has 3,000. Like a boss has 3,850. How much are you guys wagering? I gave a half credit for there was one that was like partially in order. Making this up as we're going after work. We have a viral video. All right. Are you ready? Wagering everything. All but 254. 256. Okay. All right. Here's the question. I didn't. It was 0. Okay. No, no, it wasn't 0. No, there's one. Okay, all right. It was 0 and how much? Anyway, let's just do the question. All right, guys. Ooh. Wagered everything. That is correct though. Weird. Nice. Yes. Good job. So double your money. Unfortunately, team like their boss wagered everything but 25 cents. So I think they still came out on the top. You guys did great though. Awesome comeback though. Say for what it is. Say for what it is. Say for what it is. Say for what it is. We're going to talk about same role then. We're going to talk about same role then. We're going to talk about same role then. We're going to talk about same role then. And up here. Up here. Up here. Up here. At least we're waiting for the right amount. Have your quiz then. And can you show evidence that you completed the worksheet? Evidence? Evidence.