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NMSP Exam I > Cerebrovascular Disease & Infections (Martin) > Flashcards

Cerebrovascular Disease & Infections (Martin) Flashcards

1
Q

Symptoms of an ACA injury

A

anterior cerebral artery - c/l leg more than the arm or face and “alien hand” syndrome - semiautomatic movements of the c/l arm NOT under voluntary movement

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2
Q

Which vessel injury is associated with “alien hand” syndrome?

A

anterior cerebral artery (ACA)

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3
Q

Symptoms of an MCA injury

A

middle cerebral artery - aphasia and face/arm motor loss face preference toward side of lesion

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4
Q

Where would the gaze preference be for a MCA injury?

A

toward the side of the lesion

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5
Q

What are the 3 main categories of cerebrovascular disease?

A
  1. thrombosis
  2. embolism
  3. hemorrhage
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6
Q

What is a major risk factor for focal ischemia?

A

atherosclerosis in hypertension

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7
Q

Watershed infarcts

A

region between 2 vessels that is the MOST susceptible to ischemia and infarction; will see sickle-shaped band of necrosis

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8
Q

What should you think if you see a sickle-shape band of necrosis?

A

a watershed infarct

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9
Q

What are the two common sites of a water-shed infarct?

A
  1. ACA - MCA: arm and leg weakness and language issues
  2. MCA - PCA: visual processing
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10
Q

Atherosclerosis typically leads to stenosis of which artery?

A

internal carotid artery - just beyond the carotid bifurcation

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11
Q

Which vessel is most affected by an embolic infarction?

A

MCA

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12
Q

Transient Ischemic attacks (TIA’s)

A

<24 hrs neurological deficit caused by temporary brain ischemia; typically a warning sign and a neurological emergency

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13
Q

At what time are ischemic deficit most probably to produce permanent cell death?

A

> 10 mins

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14
Q

What are the two types of strokes?

A
  1. hemorrhagic (red) - emboli associated
  2. ischemic (pale) - thrombus associated
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15
Q

Hypertensive cerebrovascular disease produces which type of infarcts?

A

lacunar infarcts via lenticulostriate arteries

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16
Q

Malignant hypertension is most commonly associated with what type of hemorrhage?

A

deep brain parenchymal hemorrhages

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17
Q

Chronic hypertension is associated with what?

A

Charcot-Bouchard microaneurysms

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18
Q

What is the most common cause of a subarachnoid hemorrhage (SAH)

A

rupture of a saccular (berry) aneurysm (dilation)

19
Q

A saccular aneurysm typically involves which vessel?

A

the anterior circulation via the anterior communicating artery

20
Q

“THE WORST HEADACHE I’VE HAD” should make you think what?

A

subarachnoid hemorrhage (SAH); 25-50% die; repeat bleeding is common in survivors

21
Q

What is the most common site for a arteriovenous malformation (AVM)?

A

subarachnoid space

22
Q

What is the most common route of CNS infection?

A

hematogenous - primarily arteries but facial veins possible

23
Q

herpes simplex and zoster

A

latent infection of sensory ganglia in Schwann cells and ASCEND to the CNS in SENSORY nerves

24
Q

Rabies

A

acetylcholine receptos at the NMJ and ASCENDS to the CNS via MOTOR nerves

25
Q

What is a major complication of bacterial meningitis?

A

meningococcemia with rash and b/l adrenal hemorrhage that leads to death (Waterhouse-friderichsen syndrome)

26
Q

Waterhouse-friderichsen syndrome

A

b/l adrenal hemorrhage that leads to death following a Nisseria infection (bacterial meningitis)

27
Q

A gram negative diplococci organism that causes bacterial meningitis?

A

N. meningitidis

28
Q

A gram positive diplococci organism that causes bacterial meningitis?

A

S. pneumoniae

29
Q

A gram negative pleomorphic organism that causes bacterial meningitis?

A

H. influenzae

30
Q

A gram positive cocci organism that causes bacterial meningitis?

A

S. aureus or S. epidermis

31
Q

A gram negative bacilli organism that causes bacterial meningitis?

A

E. coli

32
Q

What is the most common cause of bacterial meningitis in a newborn (0-6 months)”

A

Group B Strep

33
Q

What is the most common cause of bacterial meningitis in a child (6month-6 yrs)?

A

Strep pneumoniae

34
Q

What is the most common cause of bacterial meningitis in adolescents/young adults?

A

N. meningitidis; gram negative diplocci; watch for those in crowded populations; can cause Waterhous-Friderichsen syndrome

35
Q

What is the most common cause of bacterial meningitis in the elderly?

A

Strep pneumoniae

36
Q

CSF findings in a person with a abscess?

A

high WBCs
high proteins
normal glucose (unlike bacterial)

37
Q

Neurosyphilis can cause which type of hydrocephalus?

A

communicating hydrocephalus

38
Q

In viral meningitis viruses may reach the CNS through which nerves?

A

olfactory and trigeminal nerves

39
Q

Herpes simplex virus (HSV-1) typically involves which lobes?

A

necrotizing and hemorrhagic damage in inferior and medial temporal lobes

40
Q

What is diagnostic for rabies?

A

local paresthesias around the wound; infections ascends along MOTOR nerves; can see “foaming at the mouth”

41
Q

Subacute Sclerosing Panencephalitis (SSPE)

A

caused by the paramyxovirus; non immunized children following infection with measles; will have cognitive decline, spasticity of limbs and seizures

42
Q

Nonimmunized children are at risk for developing what after an acute measles infection?

A

Subacute Sclerosing Panencephalitis (SSPE); cognitive decline, spasticity of limbs and seizures

43
Q

In which population do you typically see toxoplasmosis gondii infections?

A

HIV or immunospressed; will see brain abscess and free tachyzoites and encysted bradyzoites

44
Q

Creutzfeldt-Jackob Disease (CJD)

A

prion disease rapidly progressive; PrP protein; will see spongiform change (intracellular vacuoles)

NMSP Exam I (18 decks)

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