Neuro: Test 1 : Taube : Greatest Hits-For D

Front 1

T1 or T2?
What 4 things are black on this type of image?

Back 1

T1

Cortical bone
Bone
Moving blood
Fluid

Front 2

T1 or T2

Back 2

T2

Front 3

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

Back 3

CT (no contrast)

Cranial bone will be white

Front 4

What happens in shear injuries?

Back 4

diffuse axonal injury

can be due to rotational injury (not necessarily blow to a head)

Front 5

path?

will it cross sutural lines?

what blood vessel causes it?

Back 5

epidural hematoma

DOESN'T CROSS SUTURAL LINES

assoc with skull fracture

due to arterial tear (middle meningeal artery)

Front 6

SDH more common with ____ while

EDH more common with _____

(cause of injury)

Back 6

SDH more common with falls
EDH more common with MVA

Front 7

Back 7

Intraparenchymal hemorrhage from shear injuries

Front 8

Back 8

MRI showing
intra parenchymal
hemorrrhage

Front 9

vasogenic edema is found where?

cytogenic?

causes?
***

Back 9

vasogenic edema: CONFINED TO WHITE MATTER (tumor or infection)

where cytogenic could be in white or gray (infarct or stroke)

Front 10

What is the difference btw catatonia, catalepsy, and cataplexy?

***

Back 10

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

Front 11

Describe Tangential thought

*

Back 11

Front 12

Describe flight of ideas

*****

Back 12

Front 13

what is the difference between hypnagogic and hypnopompic hallucinations? are these pathological or non pathological?

***

Back 13

Nonpathological: hypnagogic (when you go to sleep), hypnopompic (when you wake up)

Pathological: Auditory, visual, tactile, olfactory, gustatory, somatic

Front 14

what are
Perceptual disturbances? (4)

****

Back 14

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

Front 15

Recognize the difference between the Folstein MMSE and the mental status examination

(o)

note: answer extrapolated from Wiki

Back 15

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

Front 16

Identify the domains of psychiatric illness (6)

(o)

Back 16

Some People Can Eat Bad Eggs

Front 17

SUMMARY SLIDE FOR LECTURE 2 OF PSYCH

Back 17

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

Front 18

The student will be able to explain and account for differences in brain-injury patterns caused by high- and low-velocity missiles.

(o)

Back 18

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)

Front 19

what is the difference between a neurotransmitter and a neuromodulator?

(o)

Back 19

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)

Front 20

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?

*

Back 20

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

Front 21

differentiate between ionotropic and metabotrophic receptors.

(o)

Back 21

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.

Front 22

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

Back 22

have to be at least a week of no symptoms before they can resume play

Front 23

in-between epileptic seizures, what is a common finding on EEG?

Back 23

Spikes

Front 24

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!!!!!!!!!!!!!!!!!!!!!!!!!

Back 24

ONLY THING SHARED: STARING AND DECREASED RESPONSIVENESS

Front 25

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)

Back 25

Front 26

flip for a comparison of dementia with Lewy Bodies, Alzheimer's Disease, Parkinson's

Back 26

Front 27

T1 “Black Holes” and brain atrophy can be seen in what?

Back 27

Multiple Sclerosis

note: Gilenya ™ - Fingolimod is the first oral pill tx for MS

Front 28

midline tumors and tumors of cerebellar lobes are more common in adults or kids?

Back 28

kids

Front 29

2 of the most common primary cancers in existence are what? so what can this lead to?

(o)

Back 29

breast and Lung

can lead to brain (intermediate tenancy to go to the brain)

Front 30

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)

Back 30

Prostate: DOES NOT go to brain

Melanoma: GOES TO BRAIN (very high propensity)

Front 31

what is the concept of ischemic penumbra?

*

Back 31

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.

Front 32

in stroke, what effect can blood sugar have on acute stoke management?

Back 32

Too high can be damaging!!

Front 33

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?

Back 33

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

Front 34

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

Back 34

ASPIRIN has small benefit acutely

note: heparin would be good to prevent DVT from bed rest

Front 35

what is Spasticity...what is it associated with (upper or lower mn)

(o)

Back 35

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

Front 36

What is Rigidity? what is it seen in?

(o)

Back 36

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

Front 37

What is Paratonia? commonly seen in?

(o)

Back 37

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

Front 38

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?

Back 38

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.

Front 39

Werdnig-Hoffman is a motoneuron disease affecting what population?

*

Back 39

NEONATES

you will see characteristic FROG LEG position and floppy baby
(other thing that causes floppy baby? Botulin toxin)

BABIES WILL NOT HAVE REFLEXES

Front 40

The student will be able to grade muscular strength according to the MRC (Medical Research Council) scale.

(o)

Back 40

Front 41

functions of the insular lobe

Back 41

emotions, drives, drug addiction etc

Front 42

consider the locations of white and gray matter in the spinal cord and brain (which is deep and which is superficial in each)

Back 42

spinal cord: gray matter deep

brain: gray matter superficial

Front 43

please diagram out the DCML pathway...what info does this carry?

Back 43

Front 44

please diagram out the Anterior Lateral System, and list what it carries

Back 44

Front 45

Please diagram out fine touch and vibration of the face

Back 45

Front 46

please diagram orofacial pain and temp

Back 46

Front 47

The left optic tract carries info from what visual field?

Back 47

right visual field

Front 48

a pituitary tumor causes pressure on the optic chiasm...what will this lead to?


****TEST

Back 48

Bitemporal hemianopia

Will only be able to see info from medial visual fields (peripheral vision lost-->tunnel vision)

Front 49

diagram out the corticospinal and corticobulbar tracts

Back 49

Front 50

FIRST AID REVIEW QUESTION

abdominal pain radiating to the back, weight loss, migratory thrombophlebitis and obstructive jaundice should make you think what?

Back 50

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

Front 51

FIRST AID REVIEW QUESTION

What are some of the causes of aplastic anemia?

Back 51

Radiatoin and drugs (Benzene, chloramphenicol, alkylating agents, antimetabolites)

Viral agents (B19 parvo, EBV, HIV, HCV)

Fanconi's anemia

Idiopathic