Central Nervous System

Question 1

Pathology in the frontal lobe of the brain

Answer 1

Anosmia (loss of sense of smell)
Inappropriate emotions
Expressive dysphasia (difficulty putting words together for meaning)
Motor impairment

Question 2

Pathology of the parietal lobe

Answer 2

Receptive dysphasia

Sensory impairment

Question 3

Pathology of the temporal lobe

Answer 3

Cortical deafness

Receptive dysphasia

Question 4

What is cerebrovascular disease

Answer 4

Disease incorporating strokes, TIAs, intracerebral haemorrhage

Question 5

What are the two main pathological processes of cerebrovascular disease?

Answer 5

1. Hypoxia, ischaemia and infarction due to impaired blood supply/oxygenation
2. Haemorrhage from CNS vessels

Question 6

If blood flow is reduced to a portion of the brain, what does tissue survival depend on?

Answer 6

1. Collateral circulation
2. duration of ischaemia
3. magnitude and rapidity of flow reduction

Question 7

What causes generalised neuronal dysfunction?

Answer 7

Global Hypoperfusion (reduced blood flow to whole brain)

Question 8

Definition of Transient Ischaemic Disease (TIA)

Answer 8

Characterised by temporary loss of function that resolves itself within 24hrs “mini stroke”

Question 9

How do you treat TIA?

Answer 9

Anti-platelet therapy: aspirin or clopidgrel
Controlling BP
Lower cholesterol

Question 10

Definition of Stroke

Answer 10

Loss of function lasting greater than 24hrs

Question 11

Causes of Stroke

Answer 11

Ischaemic: hypoxia of brain (due to blockage of blood vessel by atheroma or embolism)
Haemorrhagic: Bleed in brain (hypertensive related, Berry aneurysm)

Question 12

Risk factors of a Stroke

Answer 12

Hypertension, diabetes, heart disease, previous TIA, hyperlipidaemia

Question 13

Management of a Stroke

Answer 13

Thrombolysis, Aspirin/Clopidgrel, Physio, OT, SALT, Supportive Treatment

Question 14

Signs/symptoms of Dementia

Answer 14

Memory loss, slow speed of thought/language/understanding/judgement, people can become disinterested in usual activities, have difficulties controlling emotions.

Question 15

Causes of Haemorrhagic Events (Strokes)

Answer 15

Hypertension, vascular malformation (Berry aneurysm), neoplasia, trauma, drug abuse

Question 16

Intracerabral Haemorrhage definition

Answer 16

“haemorrhagic stroke”

when a diseased blood vessel in the brain bursts

Question 17

Signs/symptoms of Intracerbral Haemorrhage

Answer 17

Presents as headaches with rapid or gradual loss of consciousness

Question 18

What is a Subarachnoid Haemorrhage?

Answer 18

Spontaneous and often catastrophic bleed on the brain. Often occurs during physical effort or straining

Question 19

Signs/Symptoms of a subarachnoid haemorrhage

Answer 19

sudden agonising headache, meningitis-like symptoms/stroke-like symptoms

Question 20

What is a Subdural Haemorrhage?

Answer 20

Blood collection between the dura and arachnoid space. Bleeding from the bridging veins between the cortex and venous sinuses.

Question 21

What is an extradural haemorrhage?

Answer 21

Post head injury, build of blood between the dura mater and the skull. Often with a fractured temporal or parietal bone, typically the middle meningeal artery.

Question 22

Causes of Alzheimer’s Disease?

Answer 22

Neurofibrillary tangles and plaques, and loss of neurones and synpases/

Question 23

Signs and symptoms of Alzheimers?

Answer 23

Defects of visual-spacial skill (gets lost)
Memory loss
Decreasing cognition
Ansognosia (lack of awareness)

Question 24

Definition of epilepsy

Answer 24

A recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain, manifests as seizures.

Question 25

Management of epilespy

Answer 25

Lifestyle changes, drug compliance (Sodium valproate, carbamazepine, phenytoin, lamotrigine

Question 26

Types of Meningitis

Answer 26

Bacterial (Niesseria Meningitides, Pneumococcus, Meningococcus)
Viral
Fungal

Question 27

What is a brain abscess?

Answer 27

Focal infection, which can lead to focal brain damage or mass effect. Can present with headaches, seizures, temperatures.

Question 28

How does a brain abscess spread?

Answer 28

Via blood - embolus from bacterial endocarditis, IV drug user at risk
Or directly - from an infected inner ear

Question 29

What is Parkinson’s Disease?

Answer 29

Movement disease that can be sporadic or familial. Postural instability due to the progressive degeneration of the dopaminergic nigrostriatal system and other neuronal networks.

Question 30

Treatment of Parkinson’s Disease

Answer 30

MDT approach
L-dopa e.g. Madopar
Anticholinergic drugs e.g. orphenarine

Question 31

Clinical presentation of Parkinson’s disease

Answer 31

Rigidity, bradykinesis, resting tremor, postural instability

Question 32

Types of Tumours

Answer 32

Bening tumors - can cause problems depending on location and mass effect.
Malignant
Can affect the skull, the meninges or the brain itself

Question 33

What are meningiomas?

Answer 33

Benign tumour that is generally well circumscribed, and slow growing. Derived from meningothelial cells. They enlarge slowly, don’t often infiltrate the brain and can be removed surgically.