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Radiology > CNS > Flashcards

CNS Flashcards

1
Q

On a CT what color is CSF?

A

dark

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2
Q

Which has more bony detail- CT or MRI?

A

CT scan

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3
Q

Which is more expensive, CT or MRI?

A

MRI

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4
Q

Which takes longer, MRI of brain or CT of brain?

A

MRI

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5
Q

Which has better soft tissue detail- MRI or CT?

A

MRI

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6
Q

Which scan should you use to rule out a bleed- MRI/ CT?

A

CT

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7
Q

What does MRI use to create images?

A

Magnets and radio waves

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8
Q

What are some risks of iodine?

A

Allergic rx
serious rxn
renal failure
extravasation (iodine not in blood)

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9
Q

What does CT contrast in the brain allow you to see?

A

Evaluate blood vessels and integrity of the BBB

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10
Q

What are some known causes of contrast induced nephrotoxicity?

A 
Renal insufficiency (Cr >1.5) 
Diabetes
Dehydration
CV disease
>70 years old
Myeloma, hypertension, Hyperuricemia
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11
Q

If an individual is taking ______ you need to change their dosage for a CT with contrast.

A

Metformin

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12
Q

What does a history of “kidney disease” include?

A

Tumor, solitary kidney and transplant

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13
Q

________ in huge amounts can be nephrotoxic.

A

NSAID’s

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14
Q

If an individual has an allergy to iodinate contrast what can you give?

A

Prednisone 50 mg PO 13, 7, and 1 hour before IV contrast injection
Benadryl 50 mg 1 hour before injection

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15
Q

Gadolinium can cause what (rare disease)?

A

Nephrogenic systemic fibrosis

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16
Q

What are some absolute contraindications of an MRI?

A

cardiac pacemakers and implantable defibrillators
implantable drug pumps
vagal and boen growth stimulators
metal in eye

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17
Q

What is a fibrosing disease of the skin and SQ tissues that has an association between gadolinium and severe chronic renal disease?

A

Nephrogenic systemic fibrosis

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18
Q

It a patient has renal disease what should you get within 6 weeks of an anticipated contrast MRI?

A

Glomerular filtration rates

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19
Q

if someone had a stroke what should you order?

A

non-contrast CT or MRI

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20
Q

If someone has a “worst headache of their life”

A

non-contrast CT to rule out subarachnoid hemorrhage

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21
Q

For seizures what should you order?

A

CT w/ and w/o contrast. MRI for intractable seizures

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22
Q

for cranial nerve issues what should your order?

A

MRI with contrast

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23
Q

For dementia what should you order?

A

Non-contrasted MRI

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24
Q

For trauma what should you order?

A

Non contrasted CT then get MRI for patients who don’t improve as expected

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25
Q

For a person with vertigo and dizziness what should you order?

A

MRI with contrast

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26
Q

For hemorrhage what should you order?

A

Non contrasted CT

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27
Q

For atypical hemorrhage what should you order?

A

MRI w/ and w/o contrast

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28
Q

Why white matter lighter than grey?

A

white matter has axons with a little more fluid

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29
Q

What is better, 1.5 or 3 Tesla?

A

3 Tesla- better detail

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30
Q

For head trauma, what test is best to order?

A

CT w/o contrast

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31
Q

Patients with what other symptoms should undergo CT?

A 
Headache
Vomiting
>60 y/o
Drug/alcohol intoxication
Deficits in short term memory
presence of trauma above clavicles
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32
Q

How do most epidural hematomas occur?

A

With a skull fracture

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33
Q

how does epidural hematoma occur on CT?

A

Biconvex hemorrhage

34
Q

If you hear a classic history of “temporary loss of consciousness followed by a lucid period then rapid clinical deterioration” what should you think?

A

Epidural hematoma

35
Q

What artery is usually lacerated w/ epidural hematoma?

A

Middle meningeal artery

36
Q

What does an epidural hematoma look like?

A

A lens

37
Q

What does an subdural hematoma look like?

A

A crescent, tracks along the inner wall of the skull

38
Q

What causes a subdural hematoma?

A

Occurs secondary to torn bridging cortical veins

39
Q

Is a skull fracture common with subdural hematoma?

A

No

40
Q

Where does a subdural hematoma occur?

A

Between arachnoid and dura mater

41
Q

What causes the white in acute hemorrhage?

A

Methemoglobin

42
Q

Someone who is very anemic (not a lot of met hemoglobin) can have what type of hematoma?

A

Isodense sub dural hematoma

43
Q

What is blood in the cortical sulci, fissures and basilar cisterns?

A

Subarachnoid hemorrhage

44
Q

What is the biggest thing that causes subarachnoid hemorrhage?

A

Aneurysm has ruptured

45
Q

What can a subarachnoid hemorrhage cause?

A

hydrocephalus

46
Q

what type pattern does subarachnoid hemorrhage have?

A

Branching pattern

47
Q

What is a catheter directed procedure that is invasive and runs into carotid vessels and x-ray dye is injected and you take a picture of the brain?

A

Cerebral angiography

48
Q

What are some non-invasive ways to do cerebral angiography?

A

CTA

MRA

49
Q

What is like an x-ray but you are seeing it live?

A

Fluoroscopy (continuous beam)

50
Q

What are some common causes of non traumatic intra parenchymal hemorrhage?

A 
Hypertension
Ruptured aneurysm or vascular malformaton
Venous thrombosis
Amyloidosis (patients older than 60)
Collagen vascular disorders
Anticoagulation therapies
Tumors
Cocaine use
51
Q

What dose a basilar skull fracture opacify?

A

Sinus and mastoid air cells with blood

52
Q

How can basilar skull fracture present clinically?

A

Otorrhea or rhinorrhea

53
Q

What type fractures can present with pneumocephalus (air within cranial wall)

A

Sinus fracture or penetrating skull trauma

54
Q

What happens in subfalcine herniation?

A

One side of brain moves over to the other (past the falx)

55
Q

What is uncular herniation?

A

the innermost part of the temporal lobe, the uncus, can be squeezed so much that it moves towards the tentorium and puts pressure on the brainstem, most notably the midbrain

56
Q

What happens with tonsillar herniation?

A

cerebellar tonsils move downward through foramen magnum

57
Q

When you hear “blown pupil” what should you think?

A

increased intracranial pressure

58
Q

Where does the 3rd cranial nerve run?

A

b/w posterior cerebral artery and posterior communicating artery

59
Q

What is a problem where there is too much CSF coming in and not enough coming out?

A

hydrocephalus

60
Q

How should you evaluate hydrocephalus in babies?

A

US

61
Q

how can you fix hydrocephalus?

A

With shunts

62
Q

Most of the time strokes are what?

A

Embolic

63
Q

how long will cell viability be maintained w/o the available energy source needed?

A

2-3 minutes

64
Q

You can only give thrombolytic therapy within how many hours of stroke onset?

A

3 hours

65
Q

What type CT should you order with a stroke?

A

Non-contrast

66
Q

What is TPA?

A

Tissue plasminogen activator

67
Q

What is more sensitive to signs of stroke- CT or MRI?

A

MRI (due to diffusion)

68
Q

How long does it take to see changes of acute ischemia on MRI?

A

within minutes on onset

69
Q

How long does it take to see loss of cortical ribbon on CT?

A

Can occur as early as 3 hours, takes 4-6 hours

70
Q

When will there be a normal CT with a stroke?

A

In the acute phase, within 12 hours of the stroke

71
Q

What are the most common emboli origins for infarcts in the middle cerebral artery?

A

common carotid artery, internal carotid artery

72
Q

What does a CT look like in the subacute (2-21 days) after stroke?

A

wedge-shaped area, low density. Loss of cortical ribbon

73
Q

________ increase in the first 3 days after a stroke?

A

Mass effect

74
Q

What are symptoms of normal pressure hydrocephalus.

A

Ataxia
dementia
urinary incontinence

75
Q

What is treatment for normal pressure hydrocephalus?

A

Shunting

76
Q

What is a vascular malformation w/ a risk of hemorrhage?

A

Arteriovenous malformations

77
Q

What are 2 vascular malformations that are almost always asymptomatic?

A

Capillary telangiectasias

Cavernous angiomas

78
Q

What is an intra-axial tumor with edema

A

vasogenic edema

79
Q

What is the primary demyelinating disease?

A

Multiple sclerosis

80
Q

If you see a white area at the base of the temporal lobes what should you think?

A

Herpes encephalitis

Radiology (11 decks)

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