clinical aspects, dimensions, other

Question 1

MRI findings of carbon monoxide poisoning

Answer 1

lesions in globus pallidus and deep cerebral matter.

Question 2

functional MRI

Answer 2

changes in blood flow in brain,

measures oxygenation in brain

Question 3

adenoleukodystrophy

Answer 3

x linked peroxismal disorder

peroxisome is unable to degrade saturated unbranched long chain fatty acids, especially hexacosanoate

mc presentation:
behavioal changes, intellecutal decline in early years, spastic quadriparesis, coma, seizures

dx: elevated hexacosanoate in lipids

Question 4

Lesch-nyhan

Answer 4

x linked

hypoxanthine-guanine phosphoribosyltransferase (HGPRT) mutation

1st year of life

psychomotor retardation, choreoathetosis, spacicity , self-mutilation

excess uric acid as result of deficiency of hypoxanthine-guanine phosphoribosyltransferase

Question 5

wilson DZ

Answer 5

autoreccessive
dec copper excretion,

50% present initially with liver failure

elevatrd transaminases, depressed ceruloplasminm elevated copper excretion in urine, kayser-fleischer rings in iris,

mood swings, personality changes, hepatomegaly, tremors

Question 6

Fragile x

Answer 6

trinucleotide repeat on CGG X chormosome

FMR1 gene

MC form of MR

hyperactivity, large ears, macroorchidism, long face

Question 7

homocysteinuria

Answer 7

deficient cystathionine B synthase

increased methionine in blood

IDD, dislocated ocular lenses, malar flushing, scoliosis, pectus excavatum, gemu valgum

Question 8

how hyperthyroidism presents

Answer 8

GAD or panic

goiter, exophthalmos, anxiety, restlessness
proximal muscle wasting

Question 9

odds ratiom

Answer 9

odds that individual with dz has been exposed to possible risk factor / odds that control without the dz has been exposed.

> 1 OR means odds of exposure in pts iwth condition are greater than odds of exposure in unaffected individual.

OR<1 may mean exposure may be protective

Question 10

neuropsych tests..

Answer 10

cognitive factors

intelligence
spatial analysis,
language
executive function

psychological test evaluates emotional personality factors.

Question 11

Binswangers disease

Answer 11

dementia plus 2 of the following:

hypertension or vascular DZ

cerebral vascular DZ

subcortical dysfunction (neurogenic bladder, muscular rigidity, gait abnormalities)

BL abnormalities of MRI/CT, attenuation of white matter on CT or MRI

neuro sx: rigidity, limb gait ataxia, syncope, psudobulbar palsy- affective lability, dysarthria, crying,

SPECT can distinguish deficits of cerebral blood flow unique to binswangers dz

Question 12

hyperparathyroidism
and elevated calcium

Answer 12

can cause delirium

stones (kidney stones)
groans (bone pain)
psych overtones
are sx of hypercalcemia

correcting calcium will prevent delirium

Question 13

reduces fall risk

Answer 13

exercise

Question 14

schizophrenia and sleep structure

Answer 14

REM latency decreased during exacerbation

dec sleep time

decreased slow wave slep-correlated with age, severeity of negative sx and duration of illness

Question 15

semantic memory

Answer 15

long term memory- understanding meaning and conceptual facts of the world.

Question 16

childhood mc dz in order

Answer 16

ADHD
behavioral (ODD, CD)
anxiety
depressive

Question 17

panic do sleep issues

Answer 17

paroxysmal awakenings during stage 3 and 4

Question 18

rabies

Answer 18

bats account for most cases

67% get aggressive/furious type: psychosis, bizarre behavior, biting, anxiety, agitation, hydrophobia,, autonomic dysfuntion
33% get paralytic

vocal cord paralysis common

Question 19

cushing dz

Answer 19

high dose cortisol suppresion helps distinguish pituitatry adenoma as cause

psych sx often precede it so can delay diagnosis

need brain imaging.

Question 20

percentage of EEGs normal in epilepsy

Answer 20

40%

partial seizures are 60% of nonconvulsive seizures

Question 21

dronabinol

Answer 21

treats anorexia in AIDS and antiemetic for chemotherapy pts

synthetic delta-9-THC

Question 22

lab abormality seen in serotonin syndrome

Answer 22

hypocalcemia

due to calcium being deposited into damaged muscle cells

can also see hyperphostphatemia, elevated CK, myoglobinuria, leukocytosis, elevated transaminases

can see hyponatremia and hypomagnesia due to electrolyte abnormalities

Question 23

post Lyme DZ syndrome

Answer 23

within 6 mo of treated dz

cognitive difficulties, muscloskeleatl pain, fatigue within 6 mo of treatment.

target shaped rash

spirochyte target heart, eyes, joints, muscles, peripheral nervous system, central nervous system

sx of lyme dz: myalgia, fatigue, HA,

tx: doxycylne, amoxicillin, ceftiaxone

Question 24

Beriberi aka thiamine deficiency (b1)

Answer 24

neuropathy, weakness, muscle wasting, cardiomegaly, ophtalmoplegia, confabulation.

mc cause is alcoholism.

Question 25

WErnickes encephalopathy

Answer 25

thiamine deficiency

nystagmus, confusion, ataxia

triad of confusion, ophtalmoplegia, ataxia

glucose administration worsens condition bc pyruvate (made from glucose) cannot enter TCA cycle so it is shifted to create lactic acid, causing cell death.

thiamine is a required enzyme in this process

Question 26

central pontine myelinolysis

Answer 26

correcting hyponatremia too rapidly

Question 27

Dhat syndrome

Answer 27

southeast asia/indian anxiety, depression somatic complaints attributed to semen loss

koro syndrome: men believe their genetilia may retract in their abdomen

Question 28

susto

Answer 28

mexican belief that soul left the body, similar to PTSD, after trauma

fatalismo: belief that illness is occuring bc of destiny.

coraje: belief that illness is result of long term social struggle

Question 29

persistent vegetative state

Answer 29

normal sleep wake cycles, arousable but no awareness or apparent cognitive function.
can be transition between coma and recovery

coma: unresponsiveness, cannot be aroused. GCS of 3 is severe