CNS patho 2

Question 1

Cingulate (subfalcine) herniation under falx cerebri:

Can compress ____

Answer 1

anterior cerebral artery.

Question 2

Central/downward transtentorial herniation

Answer 2

rupture of paramedian basilar artery branches → Duret hemorrhages.

Question 3

Uncal transtentorial herniation

Answer 3

Early herniation: ipsilateral blown pupil (unilateral CN III compression), contralateral hemiparesis (cerebral peduncle compression - Crus cerebri)

Question 4

Uncal herniation sequence

Answer 4

CN III compression

Further progression → loss of vestibular-occular reflexes and decorticate followed by decerebrate posturing

Question 5

UMN lesion

weakness in lower limb _____ and upper limb _____ and _______

Answer 5

LL: Flexors

UL: Extensors and supinators

Question 6

Spinal motor atrophy: Defect and mutation?

Answer 6

mutation in SMN1 → defective snRNP assembly → degradation of anterior horn cells
LMN lesion symptoms only

Question 7

SMA type 1 is called

Answer 7

Werdnig-Hoffmann disease

Question 8

Amyotrophic lateral sclerosis Can be caused by defect in____

Answer 8

superoxide dismutase 1.

Question 9

Amyotrophic lateral sclerosis Also called

Answer 9

Lou Gehrig disease.

Question 10

Amyotrophic lateral sclerosis: macroscopic findings

Answer 10

Thin anterior root

Mild atrophy of precentral gyrus

Question 11

Amyotrophic lateral sclerosis: most common cause of death

Answer 11

Respiratory complication i.e aspiration pneumonia

Question 12

___________ supplies ASA below T8

Answer 12

artery of Adamkiewicz

Question 13

Frataxin is a _________ encoded by _____ nucleotide repeats on chromosome number ______

Answer 13

Iron-binding protein, GAA

9

Question 14

Mesial temporal sclerosis is associated with _____

Answer 14

childhood febrile seizures

Question 15

Auras are ______

Answer 15

simple, partial seizures

Question 16

________ differentiates seizure from cardiac syncope

Answer 16

Post-ictal state

Question 17

Myoclonic jerks on awakening from sleep is a hallmark of ______

Answer 17

Juvenile myoclonic epilepsy

Question 18

_____ is used for refractory epilepsy

Answer 18

Ketogenic diet

Question 19

Causes of seizures by age:
Children
Adults
Elderly

Answer 19

Children—genetic, infection (febrile)
ƒ Adults—tumor, trauma, stroke
ƒ Elderly—stroke, tumor, trauma,

Question 20

Absence seizure treatment according to onset

Answer 20

Early onset: Ethosuxamide
Later onset (10-12): Valproic acid

Question 21

> 42.2’C (108 F) _____

Answer 21

Oxidative phosphorylation stops

Question 22

Distortion in patient’s sense of position (eg feeling of floating, changes in position) or visual interpretation (eg size of objects) due to damage of _________

Answer 22

Non-dominant parietal lobe

Question 23

Cluster headache treatment
acute
prophylaxis

Answer 23

Acute: sumatriptan, 100% O2.
Prophylaxis: verapamil.

Question 24

Migraine treatment
acute
prophylaxis

Answer 24

Acute: TEN NSAIDs, triptans, dihydroergotamine. Prophylaxis: BBAT VA lifestyle changes (eg, sleep, exercise, diet), β-blockers, amitriptyline, topiramate, valproate, botulinum toxin, anti-CGRP monoclonal antibodies

Question 25

Tension headache treatment
acute
prophylaxis

Answer 25

Acute: analgesics, NSAIDs, acetaminophen. Prophylaxis: TCAs (eg, amitriptyline), behavioral therapy.

Question 26

Horner syndrome in which type of headache

Answer 26

Cluster

Question 27

Patients with medically intractable essential tremor treated with ____

Answer 27

High frequency stimulation of ventral intermediate nucleus (VIN) of thalamus

Question 28

Subthalamic nucleus lesion (contralateral):

High frequency Deep brain stimulation suppression of subthalamic nucleus is done in _____

Answer 28

Hemiballismus

Parkinson disease

Question 29

Rubral tremors

Answer 29

At rest and goal directed activity

Combined lesion of midbrain, substantia nigra and superior cerebellar peduncle

Question 30

Restless leg syndrome: pathology

Associated with

Answer 30

Functional iron deficiency: Low iron concentration in substantia nigra even in absence of systemic iron deficiency
Iron deficiency and CKD