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51 Cards in this Set
- Front
- Back
T1 or T2?
What 4 things are black on this type of image? |
T1
Cortical bone Bone Moving blood Fluid |
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T1 or T2
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T2
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A 26 y/o patient presents to the ED after being struck by a softball bat. You want to rule our intracranial hemorrhage. You order:
A. CT B. MRI |
CT (no contrast)
Cranial bone will be white |
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What happens in shear injuries?
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diffuse axonal injury
can be due to rotational injury (not necessarily blow to a head) |
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path?
will it cross sutural lines? what blood vessel causes it? |
epidural hematoma
DOESN'T CROSS SUTURAL LINES assoc with skull fracture due to arterial tear (middle meningeal artery) |
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SDH more common with ____ while
EDH more common with _____ (cause of injury) |
SDH more common with falls
EDH more common with MVA |
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Intraparenchymal hemorrhage from shear injuries
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MRI showing
intra parenchymal hemorrrhage |
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vasogenic edema is found where?
cytogenic? causes? *** |
vasogenic edema: CONFINED TO WHITE MATTER (tumor or infection)
where cytogenic could be in white or gray (infarct or stroke) |
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What is the difference btw catatonia, catalepsy, and cataplexy?
*** |
Catatonia: motor symptom: Dx by any two of the following: a. motor immobility, b. motor excitement, c. negativism or mutism, d. posturing, stereotypies or mannerism, e. echolalia (parroting) or echopraxia (miming)
Catalepsy: feature of catatonia, waxy flexibility (muscular rigidity and fixity of posture regardless of external stimuli, as well as decreased sensitivity to pain.) Cataplexy: sudden loss of muscle tone leading to collapse, related to narcolepsy |
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Describe Tangential thought
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Describe flight of ideas
***** |
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what is the difference between hypnagogic and hypnopompic hallucinations? are these pathological or non pathological?
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Nonpathological: hypnagogic (when you go to sleep), hypnopompic (when you wake up)
Pathological: Auditory, visual, tactile, olfactory, gustatory, somatic |
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what are
Perceptual disturbances? (4) **** |
include:
hallucinations, derealization (where I am at doesn't feel real, i am floating in the space I am in), depresonalization (feel like you are floating outside of yourself), déjà vu |
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Recognize the difference between the Folstein MMSE and the mental status examination
(o) note: answer extrapolated from Wiki |
The mini–mental state examination (MMSE) or Folstein test is a brief 30-point questionnaire test that is used to screen for cognitive impairment. It is commonly used in medicine to screen for dementia. It is also used to estimate the severity of cognitive impairment at a given point in time and to follow the course of cognitive changes in an individual over time, thus making it an effective way to document an individual's response to treatment.
Mental status is way more in depth |
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Identify the domains of psychiatric illness (6)
(o) |
Some People Can Eat Bad Eggs
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SUMMARY SLIDE FOR LECTURE 2 OF PSYCH
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Psychiatric symptoms can be seen in many conditions
The etiology of most primary psychiatric disorders is not known Diagnosis is based primarily on history and mental status exam Physical exam, neurologic exam, lab, and other studies are performed to rule out possible non-psychiatric causes of psychiatric symptoms The DSM-IV-TR increases reliability of diagnosis |
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The student will be able to explain and account for differences in brain-injury patterns caused by high- and low-velocity missiles.
(o) |
k.e.= ½ m v2
so the faster the traveling bullet (military weapon) will be more likely to kill you than a slow moving bullet (civilian weapon) |
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what is the difference between a neurotransmitter and a neuromodulator?
(o) |
Neurotransmitter – a substance which is released locally and causes a change in post-synaptic potential.
Neuromodulator – a substance which acts to modify the response of the synapse to a neurotransmitter. (make a stimulus stronger or weaker) |
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highschool football player gets hit on the head in the second half of the game and dies. Why did this happen? this is an example of?
* |
You look back and see that the kid got hit on the head in the 1st half but it was dismissed or not realized
the SECOND IMPACT SYNDROME says that the brain is waaayyyy more vulnerable to a 2nd injury this is more common in younger ppl |
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differentiate between ionotropic and metabotrophic receptors.
(o) |
Ionotropic receptors (also known as ligand-gated ion channels) are associated with ion channels, and change ionic conductance.
Mediate fast, short effects. Metabotropic receptors are coupled with enzymes via G-proteins and other intermediates. Mediate slow, long effects. |
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Little Johnny gets hit in the head during a game and gets knocked out. Mom and Dad bring him to you and ask if he can play the next game in 2 days. What do you tell them
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have to be at least a week of no symptoms before they can resume play
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in-between epileptic seizures, what is a common finding on EEG?
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Spikes
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what is common and similar in Absence and Partial Complex Seizures
Consider: brain involvement Age of pt Duration Sx recalled by pt Movements or behaviors After-effects EEG pattern Underlying Cause Effective Tx TEST!!!!!!!!!!!!!!!!!!!!!!!!! |
ONLY THING SHARED: STARING AND DECREASED RESPONSIVENESS
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The student will be able to correlate the age of onset of first seizure with likely underlying causes.
Consider: Idiopathic Febrile Birth Injury Metabolic Infection Trauma Tumor Stroke (o) |
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flip for a comparison of dementia with Lewy Bodies, Alzheimer's Disease, Parkinson's
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T1 “Black Holes” and brain atrophy can be seen in what?
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Multiple Sclerosis
note: Gilenya ™ - Fingolimod is the first oral pill tx for MS |
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midline tumors and tumors of cerebellar lobes are more common in adults or kids?
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kids
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2 of the most common primary cancers in existence are what? so what can this lead to?
(o) |
breast and Lung
can lead to brain (intermediate tenancy to go to the brain) |
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The student will be able to describe more and less common sources of metastatic brain tumors.
aka what are the most and least likely to go to the brain*** (o) |
Prostate: DOES NOT go to brain
Melanoma: GOES TO BRAIN (very high propensity) |
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what is the concept of ischemic penumbra?
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There is a central core of forever-lost brain cells that no treatment can revive surrounded by a larger zone of sick brain cells that may or may not recover – depending on acute management.
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in stroke, what effect can blood sugar have on acute stoke management?
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Too high can be damaging!!
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shortly after stroke it is important to monitor BP. If it is really high what should you do? Should you let a pt walk right away?
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we lost autoregulation, so be careful not to drop BP too aggressively-->can extend the stoke
so if their BP is high, don't worry about it for the immediate time being also, don't let them walk, they may have an unsafe drop in BP |
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if you are going to give a drug for acute treatment of thrombotic stroke, which of the following would you use?
t-PA heparin aspirin |
ASPIRIN has small benefit acutely
note: heparin would be good to prevent DVT from bed rest |
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what is Spasticity...what is it associated with (upper or lower mn)
(o) |
A unidirectional increase in muscular tone
Involves increased tone in “anti-gravity” muscles In the upper extremities, resistance to stretching out biceps, but not triceps In the lower extremities, resistance to stretching out quadriceps but not hamstrings seen in upper motor neuron |
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What is Rigidity? what is it seen in?
(o) |
Seen in Parkinson’s disease and other extrapyramidal disorders
A bi-directional increase in tone to passive range of motion The resistance to passive range of motion is relatively independent of degree of force or rate of speed |
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What is Paratonia? commonly seen in?
(o) |
feels like the pt is trying to stop you from moving the limb
Commonly seen in dementia Also known as gegenhalten (to hold against) A bidirectional resistance to passive range of motion that increases with force and rate of movement, as if voluntary |
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a man presents to you with a seemingly triangular face. On a hunch, you hit their hypothenar eminence with your reflex hammer and it causes their thumb to move towards their pinky. To confirm what you think, you have the pt squeeze your hand and tell them to open it as soon as you tell them. When you say go, their hand stays in a grip...what do they have? What is the genetics going on?
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Myotonic Dystrophy
A gene near the centromere of chromosome 19 codes for myotonic dystrophy protein kinase. In M.D. dozens to hundreds of “CTG” repeats occur in the gene. The transcribed mRNA gets trapped within the cell’s nucleus. |
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Werdnig-Hoffman is a motoneuron disease affecting what population?
* |
NEONATES
you will see characteristic FROG LEG position and floppy baby (other thing that causes floppy baby? Botulin toxin) BABIES WILL NOT HAVE REFLEXES |
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The student will be able to grade muscular strength according to the MRC (Medical Research Council) scale.
(o) |
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functions of the insular lobe
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emotions, drives, drug addiction etc
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consider the locations of white and gray matter in the spinal cord and brain (which is deep and which is superficial in each)
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spinal cord: gray matter deep
brain: gray matter superficial |
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please diagram out the DCML pathway...what info does this carry?
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please diagram out the Anterior Lateral System, and list what it carries
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Please diagram out fine touch and vibration of the face
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please diagram orofacial pain and temp
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The left optic tract carries info from what visual field?
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right visual field
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a pituitary tumor causes pressure on the optic chiasm...what will this lead to?
****TEST |
Bitemporal hemianopia
Will only be able to see info from medial visual fields (peripheral vision lost-->tunnel vision) |
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diagram out the corticospinal and corticobulbar tracts
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FIRST AID REVIEW QUESTION
abdominal pain radiating to the back, weight loss, migratory thrombophlebitis and obstructive jaundice should make you think what? |
Pancreatic adenocarcinoma
more common in pancreatic head aggressive (prognosis is 6 months or less) CEA and CA19-9 tumor markers assoc with Cigarettes and chronic pancreatitis but not EtOH |
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FIRST AID REVIEW QUESTION
What are some of the causes of aplastic anemia? |
Radiatoin and drugs (Benzene, chloramphenicol, alkylating agents, antimetabolites)
Viral agents (B19 parvo, EBV, HIV, HCV) Fanconi's anemia Idiopathic |