Clinical examination Flashcards
What is a non-invasive perfusion MRI methodology used to quantify cerebral blood flow?
Arterial spin labelling
What is a statement of respect?
Affirmative statements that are genuine and appropriate indicating respect and dignity which offer positive reinforcement
What are T1 images on MRI most useful for?
Assessment of normal brain structure
Which MRI image closely resembles CT?
T1
Which MRI image is the only one that allows for contrast with gadolinium?
T1
What colour is blood on CT scan and T1 MRI?
White
Blood oxygen level dependent measurement is a technique used in which imaging study?
Functional MRI - can be detected in T2 sequence
Examples of tests for visuospatial functioning
Judging line orientation
Ray Osterrieth test
Clock drawing test
What can be used to measure the concentration of different metabolites in the brain?
Magnetic resonance spectroscopy
How long after occasional cannabis use can it be detected in the urine?
3 days
How long after regular cannabis use can it be detected in the urine?
Up to 4 weeks
If a patient can follow commands and repeat phrases but has non-fluent speech, what is the problem?
Transcortical motor aphasia
What improves with amobarbital infusion?
Organic muteness
What is confrontation technique useful for in clinical interview?
Help the patient face a difficult aspect of their problems
What is visual agnosia?
Failure to recognise objects despite adequate perception
If primitive reflexes are present, what does it suggest?
Significant damage to frontal lobe
What is digital subtraction angiography?
Visualises blood vessels in a bony or dense soft tissue area
Which component is better seen on CT than MRI?
Calcification - this may be invisible on MRI
BMI equation
Weight/height squared
What does diffusion tensor imaging measure?
Measures at macroscopic level the extent of myelination of white matter fibres using fractional anisotropy - a measure of the degree and directionality of water molecules
If urine and plasma osmolality is low, what is the diagnosis?
Psychogenic polydipsia
If urine osmolality is high, what is the diagnosis?
SIADH
In schizophrenia, which anatomical structure in the brain is most consistently reduced in size?
Insula
Other structures affected include - anterior cingulate cortex, dorsolateral prefrontal cortex, thalamus
What are intracytoplasmic inclusion bodies?
Lewy bodies
Which metabolic abnormalities can lengthen QTc?
Hypokalaemia
Hypocalcaemia
Hypomagnesaemia
How does acute intermittent porphyria often present?
Abdominal pain, constipation and neuropathy
AIP - do not tend to have cutaneous manifestation
How is acute intermittent porphyria inherited?
Autosomal dominant
Which medications can trigger AIP?
Oestrogens
Barbituates
Benzodiazepines
Diclofenac
Investigation of choice for AIP
Urinary porphyrins
Management of AIP
Aims to reduce haem synthesis by administration of haemin
Constructional apraxia is typically caused by lesion in which hemisphere
Right
Alexia without agraphia is seen in lesions of which vessel
Posterior cerebral
What finding on SPECT is seen in Alzheimer’s disease?
Decrease in temporal perfusion
Which symptom of wernicke’s encephalopathy responds earliest when thiamine is replaced?
Opthalmoplegia
What is anomic dysphasia?
Where patient shown an object the patient cannot tell its name
Lesion in which area causes anomic dysphasia?
Dominant temporo-parietal junction - language cortex
On MMSE, how many points are awarded for orientation in time?
5
On MMSE, how many points are awarded for recall?
3
Balint’s syndrome triad
Simultanagnosia
Optic ataxia
Oculomotor apraxia
Which scan uses a synthetic radionucleotide to obtain brain images?
PET
When performing tasks, which area of the brain is highlighted on fMRI?
Primary motor cortex
In Ray Osterreich Complex figure test, what do patients with right hemisphere lesion do?
Fail to reproduce global pattern but copy isolated details
In Ray Osterreich Complex Figure test, what do people with left hemisphere lesions do?
Capture global picture but not finer details
EEG in metabolic encephalopahthy
Generalised diffuse delta and theta waves
Characteristic of senile pupil
Sluggish light and accommodation reaction
When might you see REM in daytime?
Sleep deprivation
Narcolepsy
Withdrawal from stimulants
How long can amphetamines be detected in urine for?
48 hours
How long can codeine & morphine be detected in urine for?
48 hours
Visuospatial ability is the function of which lobe?
Parietal
Which brain regions are crucial for non-declarative memory?
Basal ganglia
Limbic system
Somatosensory cortices
What is the most common opportunistic infection in AIDS?
Toxoplasmosis
MRI findings of toxoplasmosis
Multiple ring-shaped contrast enhancing lesions
