Unit 2 Formative 8

Front 1

Embolic; clot on the move from another location

Back 1

A patient presents with stroke like symptoms without fluctuation or progressive deficits. The patient complains of headache and seizures. What is the likely cause?

Front 2

Thrombosis; clot at the site of damage

Tx by dissolving clog but must give within 3 hrs of onset to minimize damage

Back 2

A patient presents with fluctuating, progressively worsening stroke like symptoms. The patient has a history of prior TIA in the same distribution and intra cranial atherosclerosis What is the likely cause?

Front 3

Embolic; comes from embolism "shower" released from places like heart

Back 3

A patient presents with multifocal stroke like symptoms. What is the likely cause?

Front 4

Watershed zones

Back 4

A patient presents with severe arterial hypotension. Where is the infarct likely to occur?

Front 5

Atherosclerosis

Back 5

A patient presents with stroke like symptoms and a history of peripheral vascular disease, hypertension, hypercoagulation. Carotid pulses are absent, reduced, and asymmetric. What type of thrombotic stroke is it?

Front 6

Dissection or dysplasia

Back 6

A patient shows up in the ER with stroke like symptoms after a fight and a car accident while driving away from the fight. What is the likely mechanism of action for the thrombotic stroke?

Front 7

Posterior Communicating Artery

Back 7

An MRI shows a subarachnoid hemorrhage with characteristic spider like appearance. What artery is most likely ruptured?

Front 8

The delicate vessels off of main arterial branches

Back 8

A patient with a history of diabetes and hypertension has an MRI that shows a intracerebral hemmoragic attack. Which vessels are likely compromised?

Front 9

Stroke in the white matter that "spilled in" to the ventricles

Back 9

A patient MRI reveals an intraventircular hemmorhage. What is the likely mechanism by which this occured?

Front 10

Vasculitis

Back 10

An immunosuppressed patient presents with a history of lupus and stroke like symptoms. What is the likely etiology?

Front 11

Unimodal Association Area

Back 11

A patient presents with language difficulties and has impaired comprehension. However the patient can hear, see, recognize symbolic input and repeat. Where is the infarct?

Front 12

Anomic Aphasia

Back 12

A patient presents with fluent language, intact comprehension, and can repeat. The patient complains of having difficulty recalling words or a "tip of the tongue" sensation with remembering objects. What is the diagnosis?

Front 13

Conduction Aphasia

Back 13

A patient presents with fluency, intact comprehension, but can't repeat. What is the diagnosis?

Front 14

Transcortical sensory aphasia

Back 14

A patient presents with fluency, impaired comprehension, but can repeat. You notice the patient using incorrect words in similar categories. (For example, saying pear when talking about an apple) What is the diagnosis?

Front 15

Wernick'e Aphasia

Back 15

A patient presents with fluency, impaired comprehension, and can't repeat simple words. Their sentences have the correct rhythm but do not contain sensible words. What is the diagnosis?

Front 16

Transcortical motor aphasia

Back 16

A patient presents with nonfluent speech, intact comprehension, and can repeat, though his repetition is delayed. What is the diagnosis?

Front 17

Broca's aphasia

Back 17

A patient presents with nonfluent speech, intact comprehension, but can't repeat simple sentences. What is the diagnosis?

Front 18

Mixed transcortical aphasia

Back 18

A patient presents with nonfluent speech, impaired comprehension, but can repeat words.

Front 19

Global perisylvian aphasia

Back 19

A patient presents with nonfluent speech, impaired comprehension, and can't repeat. What is the diagnosis?

Front 20

Episodic Memory

Back 20

What kind of long term memory involves personal experiences?

Front 21

Semantic Mmory

Back 21

What kind of long term memory involves facts?

Front 22

Non declarative (Procedural)

Back 22

What kind of long term memory involves skill learning?

Front 23

Hippocampal Sclerosis or lobotomy

Back 23

What neural structure is most associated with declarative memory impairment?

Front 24

Propranolol - Beta blocker

Back 24

A norepinephrine blocking drug you can give to inhibit the emotional impact of a traumatic event.

Front 25

Autobiographical, semantic

Back 25

What two types of memory are not effected with age?

Front 26

Long Term Potentiation Cascade

Back 26

Glutamate binds to NMDA; kicks Mg block off; calcium enters; binds CAMKII; which phosphorylates AMPA receptors and shuttles more AMPAR to surface of cell; sodium enters; activates protein kinases; begins proein synthesis via CREB which retroactively signals to increase transmitter release

Front 27

Long Term Memory at critical junctures

Back 27

If you inhibit protein synthesis 1 hr after training and 5-8 hrs after training what kind of memory are you inhibiting?

Front 28

Semantic Dementia

Back 28

A patient presents with PROGRESSIVE difficulty in the production and comprehension of language, prosopagnosia, visual agnosia, and reading/writing impairment. What is the diagnosis?

Front 29

Autobiographical and Semantic memory

Back 29

What types of memory are not affected by age?

Front 30

The formation of a memory involves first a brief transient memory storage process, then a stable change in the nervous system.

Back 30

What is the Hebbs dual trace hypothesis?

Front 31

Anterior Spinal Arteries

Back 31

A rupture here causes medial medullary syndrome (also called alternating hypoglossal hemiplegia)

Front 32

Posterior Inferior Cerebellar Artery

Back 32

A rupture here causes medial medullary syndrome of Dejerine

Front 33

Thalamic Infarct (Dejerine Roussy)

Back 33

A patient presents with contralateral hemisensory loss and distressing spontaneous pain; where is the stroke

Front 34

Occipital Infarct

Back 34

A patient presents with homonymous hemianopsia with mascular sparing. Where is the infarct?

Front 35

Weber's Syndrome; Paramedian branches of the posterior cerebral artery

Back 35

A patient presents with ipsilateral third nerve palsy and contralateral hemiparesis. Where is the infarct?

Front 36

Visual cortex or optic radiation; macular or central vision is preserved if striate area is spared

Back 36

A patient presents with contralateral homonymous hemianopia. Where is the lesion?

Front 37

Dominant calcarine lesion and posterior part of corpus callosum

Back 37

A patient presents with dyslexia without agraphia (trouble reading but can still write); where is the lesion?

Front 38

Thalamic Syndrome (of Dejerine-Roussy); infarct in posterolateral and postereomedial ventral nucleus of thalamus in the territory of the thalamogeniculate artery

Back 38

A patient presents with contralateral sensory loss (all modalities), spontaneous pain, contralateral choreoathesosis, contralateral intention tremor

Front 39

Anterior Cerebral Artery; supplies the anteriorinferior limb of the internal capsule, and anterior aspects of the caudate and putamen

Back 39

A patient presents with paralysis and sensory loss in the contralateral leg, lack of initiative (behavior change), urinary incontinence, and extinctino (patient perceives touch only contralateral to the undamaged sensory cortex) Where is the infarct?

Front 40

Superior division of the middle cerebral artery

Back 40

A patient presents with paralysis of the contralateral face, arm, and upper leg as well as Broca's aphasia. Where is the occlusion?

Front 41

Inferior division of the middle cerebral artery

Back 41

A patient presents with paralysis of contralateral face, arm, and leg as well as contralateral homonymous hemianopsia, Wernicke's aphasia, deficient cortical sensory function, and impaired spatial perception. Where is the lesion?

Front 42

Lacunar Infarct

Back 42

A patient presents with only sensory and motor disturbances. Where is the small stroke?

Front 43

Choroidal artery; damage to posterior limb of internal capsule

Back 43

A patient presents with contralateral hemiplegia (ARM=TRUNK=LEG), hemihypesthesia (decreased sensation on opposite of body), and hemianopsia. Where is the lesion?

Front 44

Lacunar Infarct

Back 44

A patient presents with a pure motor or pure sensory deficit.There is a history of hypertension.

Microscopically there is a cystic space

Gross appearance of the caudate and putamen shows normal tissue except for one small area

Front 45

Slit Hemorrhage; rupture of small penetrating vessels resulitng in small hemorrhages which are eventually reabsorbed and a cavity remains

Back 45

A patient with a history of hypertension presents with stroke symptoms.

Microscpically you notice gliosis. (histopathalogical sign of CNS injury)

Front 46

Hypertensive Encephalopathy

Back 46

A patient presents with headaches, CONFUSION, vomiting, convulsions and may even be slipping into a coma!

Gross examination of the brain reveals edema with tonsillar herniation.

Microscopic examination shows fibirinoid necrosis of arteriles and petechiae involving the gray and white matter.

Front 47

Charcot-Bouchard Microaneurysms

Back 47

You notice aneurysms occuring in vessels less than 300 um in diameter (located in the basal ganglia)

Front 48

Cerebral Amyloidangiopathy; can cause intracerebral hemorrhage

Back 48

When looking under the microscope at a blood vessel wall you used a congo-red stain to look for amyloid and under the microscope you see apple green birefringement. Diagnosis?

Front 49

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL); type of intracerebral hemorrhage

Back 49

An elderly patient presents with recurring strokes and dementia.

Histologically you note basophilic, PAS positive material in vessel walls which is OSMOPHILIC on EM Diagnosis?

Front 50

Subarachnoid Hemorrhage

Saccular (berry) aneurysm; sack contains thickened and hyalinized intima; lacks muscualr wall and elastic lamina

or Fusiform aneurysm

Back 50

A patient with a history of smoking, binge drinking, illicit drug use, amphedamines shows up complaining of the WORST HEADACHE OF HIS LIFE. What two common causes might be seen?

Front 51

AV Malformation of the MCA

Back 51

A patient between 10 and 30 years old presents with seizures, intracerebral hemorrhage or subarachnoid hemorrhage.

What is the most common location of the arteriovenous malformation?

Front 52

Global Ischemia; all cells in the border/watershed zones; cortical pyramidal cells and purkinje cells of cerebellum ocated between ACA and MCA
are at risk

Back 52

Patient presents with severe, sustained hypotension. What brain cells are at risk for ischemia?

Front 53

Thrombus in the middle cerebral artery; most occlusions due to atherosclerosis

Back 53

Where is the most common site for focal ischemia in a patient with hypertension and DM? What is its etiology?

Front 54

Collateral Blood Flow

Back 54

During a focal cerebral ischemic attack due to vasculitis in a patient with a history of immunosuppresion what is the most important factor in determining the degree of damage?

Front 55

Gerstmann's Syndrome

Back 55

A patient presents with a parietal fracture that results in dysgraphia, dyslexia, left/right confusion and finger agnosia. What is the diagnosis?

Front 56

Verbal Paraphasia; uses an associated word instead of the correct word

Back 56

A patient is comes in and says spoon instead of fork. What kind of paraphrasia is this?

Front 57

Literal paraphrasia; gets most of the word right

Back 57

A patient comes in and says rain instead of train. What kind of paraphrasia is this?

Front 58

Neologistic paraphrasia; uses made up words

Back 58

A patient comes in and just uses a nonsensicle word instead of the correct word

Front 59

Gerstmann's Syndrome

Back 59

A patient presents with a parietal fracture that results in dysgraphia, dyslexia, left/right confusion and finger agnosia. What is the diagnosis?

Front 60

Verbal Paraphasia; uses an associated word instead of the correct word

Back 60

A patient is comes in and says spoon instead of fork. What kind of paraphrasia is this?

Front 61

Literal paraphrasia; gets most of the word right

Back 61

A patient comes in and says rain instead of train. What kind of paraphrasia is this?

Front 62

Neologistic paraphrasia; uses made up words

Back 62

A patient comes in and just uses a nonsensicle word instead of the correct word