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Clin Med 3 > E3: Neuro Diagnostics > Flashcards

E3: Neuro Diagnostics Flashcards

1
Q

What is an EEG?

A

-A safe and painless recording of the cortical electrical activity

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2
Q

What are the indications to get an EEG?

A
  • Seizure disorders, may be a normal EEG because seizures are episodic events
  • Metabolic encephelopathy: Distinguish from generalized slowing
  • Distinguish between cortical and subcortical
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3
Q

If a patient is having a seizure, what will you see on EEG?

A

Epileptiform activity

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4
Q

If a patient has a tumor, infarct, or scar tissue, what might you see on EEG?

A

Focal discharges/spikes consistent with focal problem

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5
Q

If a patient has encephelopathy or anoxia, what might you see on EEG?

A

Generalized changes/slowing consistent with metabolic disorders

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6
Q

What is an electromyogram (EMG)?

A
  • A clinical exam of the electrical activity of muscle fibers
  • defines location of problems affecting peripheral nerves and differentiates primary muscle conditions from muscle weakness cause by neurological disorders
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7
Q

What are the indications to get an EMG?

A
  • Lower motor neuron disease: ALS
  • NMJ disease: Myasthenia gravis
  • Muscle disease: myopathy
  • Peripheral nerve disorders: carpal tunnel, peripheral neuropathies
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8
Q

If a patient has Myasthenia gravis, what might their EMG show?

A

Fatigability

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9
Q

If a patient has myopathy, what might their EMG show?

A

EMG consistent with decreased amplitude of motor response

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10
Q

What are nerve conduction studies used for?

A
  • Used to assess the rate of conduction and the amplitude of response of peripheral nerves, used in conjunction with EMG
  • Tests how well and how fast nerves can send electrical signals
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11
Q

What are the indications for nerve conduction studies?

A
  • To differentiate between primary nerve and muscle disorders
  • To differentiate lower motor neuron diseases from peripheral neuropathy
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12
Q

If a patient has spondylolisthesis, what should you order to evaluate for degree of instability?

A

Flexion and extension Lumbar XR

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13
Q

What is first line to evaluate for spinal fractures with or without associated dislocations?

A

XR

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14
Q

What are the indications for a skull XR?

A

Trauma, metabolic disease, or malignancy

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15
Q

What are the indications for a CT?

A
  • LOC
  • Persistent neurologic dysfunction
  • persistent vomiting
  • GCS <8 or deteriorating
  • Retrograde or anterograde amnesia
  • Post traumatic seizures
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16
Q

If a patient has a lens shaped bleed on CT, what should you be concerned about?

A

Epidural hematoma

17
Q

If a patient has a crescent shaped bleed on CT, what should you be concerned about?

A

Subdural hematoma

18
Q

What must you do before giving thrombolytic medications for a stroke?

A

-Non contrast head CT to rule out hemorrhagic stroke

19
Q

What are the indications for MRI?

A

Tumors, vascular disease, inflammation/infection, MS, degenerative disease

20
Q

What is the difference between a T1 and T2 MRI?

A

T1: Reflects uptake of magnetic energy, better for normal anatomy. Fluid is dark
T2: Reflects release of magnetic energy, better for pathology. Fluid is white.

21
Q

What is the study of choice for brain tumors?

A

MRI with gadolinium

22
Q

What is the most sensitive test when you suspect an acute ischemic stroke of the brain and/or spinal cord?

A

Diffusion MR

23
Q

What is a diffusion MRI?

A

Measures the microscopic motion of water

24
Q

What might you see on MRI if the patient has MS?

A

Periventricular plaques are common

25
Q

What is the recommended initial study for a TIA/CVA?

A

CT is recommended initially, especially prior to anticoagulation. If negative, can get MRI.

26
Q

What is the recommended study for new onset seizures?

A

CT

27
Q

What are the indications for MRI spine?

A
  • Radiculopathy
  • high impact trauma
  • new or progressive deficit
  • suspected tumor or infection
  • neurogenic claudication
  • New onset of back pain in a patient with cancer
28
Q

What is a myelography?

A

-Detects spinal cord pathology/compression, such as herniated discs or spinal stenosis

29
Q

When is an LP contraindicated?

A

Papilledema or increased ICP

Clin Med 3 (17 decks)

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