CNS

Question 1

What is the MC cause of primary brain parenchymal hemorrhage, and at what age

Answer 1

Hypertension, 60

Question 2

What is responsible for 15% of deaths in chronic HTN patients

Answer 2

Primary Brain Parenchymal Hemorrhage

Question 3

What is MC from a ruptured saccular aneurysm, has a fatality rate of 25-50% on the first episode (likely to recur), Often described as “Worst headache I’ve ever had”

Answer 3

Subarachnoid Hemorrhage

Question 4

What make up 80-90% of all intracranial aneurysms, and are a risk factor for Polycystic kidney disease

Answer 4

Saccular Aneurysm

Question 5

What is the MC cerebrovascular malformation is a tangle of arteries and veins “worm-like”, and 2x MC in males ages 10-30

Answer 5

Arteriovenous Malformation (AVM)

Question 6

What is occlusion of a single artery, occurs in deep brain tissues: silent which make it devastating

Answer 6

Lucuna infarct

Question 7

What is a ruptured small cerebral vessel, hemorrhage, resorbed, “slit-like cavity” remains

Answer 7

Slit Hemorrhage

Question 8

What is described by global cerebral dysfunction, diastolic BP >130= severe inc. in ICP

Answer 8

Hypertensive Encephalopathy

Question 9

What is vessel wall inflammation

Answer 9

Vasculitis

Question 10

What is systemic autoimmune vasculitis, fibrinoid necrosis, small cerebral arteries and heart

Answer 10

Polyarteritis Nodosa

Question 11

What is chronic inflammation of multiple parenchymal and subarachnoid vessels. MC in males 30-60

Answer 11

Primary Angiitis of the CNS

Question 12

What is the Tx for vasculitis

Answer 12

Immunosuppression

Question 13

CNS Trauma has a high morbidity and mortality, who is at greater risk for it

Answer 13

Males 2x

Question 14

What is trauma that injures neurons and disrupts vessels which leads to hemorrhage (“brain-bruise”)
Gyri are most susceptible

Answer 14

Contusion

Question 15

What is tearing of cerebral parenchyma that disrupts vasculature that leads to hemorrhage

Answer 15

Laceration

Question 16

What is movement of one brain region relative to another. Angular acceleration/shaking. Leads to diffuse disruption of white matter

Answer 16

Diffuse Axonal Injury (DAI)

Question 17

What causes 50% of post-traumatic comas. may not involve direct impact

Answer 17

Diffuse Axonal Injury

Question 18

What is reversible altered consciousness from head injury in the absence of contusion

Answer 18

Concussion

Question 19

What percent of concussions recover in 10 days without Tx

Answer 19

80%

Question 20

Imaging cant ID a concussion, but a CT may be used for what

Answer 20

To rule out hemorrhage

Question 21

What occurs in the minority of all concussions (15-20%) when symptoms may last for weeks to months

Answer 21

Post-concussive syndrome

Question 22

Why does Dx. of a concussion exclude from RTP

Answer 22

Second-impact syndrome: second concussion, lethal

Question 23

What occurs with dural artery damage, compresses brain tissue, lucid during bleed, Associated with Fx, Neurosurgical emergency

Answer 23

Epidural Hematoma

Question 24

What occurs when rapid movements tear the veins, leading to a subdural bleed which compresses the brain

Answer 24

Subdural Hematoma

Question 25

Which is the more rare of the dural hematomas

Answer 25

Epidural ~2%

Question 26

What artery is MC involved with epidural hematoma

Answer 26

Middle meningeal

Question 27

What % of severe head traumas result in a subdural hematoma

Answer 27

5-25%

Question 28

What is the MC cause of neural tube defects

Answer 28

CNS malformation

Question 29

What is an asymptomatic bony defect

Answer 29

Spina bifida occulta

Question 30

What is extension of CNS through vertebral defect (lumbosacral)

Answer 30

Myelomeningocele

Question 31

What is an absence of brain, rostral aspect

Answer 31

Anecephaly

Question 32

What is CNS diverticulum through cranium

Answer 32

Encephalocele

Question 33

Which spinal cord abnormality is a cavity connected to 4th ventricle

Answer 33

Hydromyelia

Question 34

Which spinal cord abnormality is when there is a cyst withing the cord, adults

Answer 34

Syringomyelia (syrinx)

Question 35

What is associated with loss of pain/temp sensation in a "shawl-like" distribution with poss tissue atrophy or areflexia

Answer 35

Syringomyelia

Question 36

What perinatal brain inj. occurs prematurely, near ventricles, may cause hydrocephalus

Answer 36

Intraparenchymal hemorrhage

Question 37

What perinatal brain injury occurs prematurly, supratentorial white matter, chalky plaques, possibly cysts

Answer 37

Infarct

Question 38

What perinatal brain inj. is non-progressive defects in motor neurons (movement disorder

Answer 38

Cerebral palsy

Question 39

What is the MC way CNS infections are spread

Answer 39

Hematogenous

Question 40

What is an infection in the epidural space, typically from an adjacent infection (sinusitis, osteomyelitis)

Answer 40

Epidural abscess

Question 41

What is an infection of the subdural space

Answer 41

Subdural Empyema

Question 42

What disease is associated with HA, nucal rigidity, and photophobia primarily. Fatal if untreated, favorable with Tx

Answer 42

Acute pyogenic (bacterial) meningitis

Question 43

What neurological exam for meningitis involves pain when one knee is brought to the chest

Answer 43

Kernig sign

Question 44

What neurological exam for meningitis involves pain when the heels are brough to the buttocks and head is passively flexed

Answer 44

Brudzinski sign

Question 45

What kind of meningitis is aseptic

Answer 45

Viral

Question 46

What are the 2 types of chronic meningitis

Answer 46

Tuberculous and Spirochetal

Question 47

Parenchymal infections: Localized infection

Answer 47

Bacterial abscess

Question 48

Parenchymal infections: Diffuse infection

Answer 48

Viral Encephalitis

Question 49

Parenchymal infections: Local or diffuse (mixed)

Answer 49

Fungal encephalitis

Question 50

What parenchymal infection is MC among immunosuppressed

Answer 50

Fungal encephalitis

Question 51

What is a type IV hypersensitivity autoimmune attack on white matter

Answer 51

MS

Question 52

What is the MC myelin disorder

Answer 52

MS

Question 53

Who is at greater risk fo rMS

Answer 53

females 2x, familial hx. inc. 15x

Question 54

What happens during active MS

Answer 54

Ongoing myelin breakdown

Question 55

What happens during inactive MS

Answer 55

Little myelin and minimal inflamm

Question 56

What is Wernicke-Korsakoff Syndrome (necrosis of the thalamus) caused by

Answer 56

Thiamine (vit B1.) deficiency

Question 57

What is LE paresthesia/paralysis and nystagmus

Answer 57

Beriberi

Question 58

What can a Cobalamin (B12) deficiency lead to

Answer 58

Cord demyelination

Question 59

What is the MC cause of hypoglycemia

Answer 59

Inappropriate insulin use

Question 60

What is the MC cause of hyper glycemia

Answer 60

Uncontrolled diabetes

Question 61

What is the MC cause of dementia in elderly

Answer 61

Alzheimer's Disease

Question 62

What is a Parkinsonism

Answer 62

Altered motor function

Question 63

What does Parkinson disease damage

Answer 63

Dopaminergic neurons, Substantia nigra

Question 64

What can be seen in Parkinson's

Answer 64

Lewy bodies

Question 65

How is Parkinson's treated

Answer 65

L-DOPA, Deep brain stim (less effective over time)

Question 66

What condition is chorea (dance-like jerking) of entire body seen in

Answer 66

Huntington's Disease

Question 67

What 2 nuclei are effected in huntington's

Answer 67

Caudate and Putamen

Question 68

What kind of astrocytoma is malignant, 80% of adult gliomas, 30-60

Answer 68

Diffuse

Question 69

What kind of astrocytoma is benign, cystic, affect children/youg adults, cerebellum or spinal cord (rarely cerebral

Answer 69

Pilocytic

Question 70

What kind of glioma is MC in pediatrics (periventricular regions) Adults=spinal canal

Answer 70

Ependymoma

Question 71

Medulloblastomas make up what % of pediatric brain tumors

Answer 71

20%

Question 72

Where is Diffuse Large B Cell Lymphoma MC

Answer 72

Among immunosuppressed (AIDS)

Question 73

90% of these are benign, MC affects adult females, and made of transformed arachnoid cells

Answer 73

Meningioma

Question 74

Metastasis into the CNS accounts for what percent of intracranial tumors

Answer 74

25-50% (Lungs, breast, melanoma, kidney, GI)