Exam 2 CH. 22 KIdney

Question 1

What is Polycystic Kidney Disease

Answer 1

Enlarges kidneys, palpable mass, asymptomatic until 30s

Flank pain, headaches

75% develop HTN possible upper UTI

Question 2

Polycystic kidney disease is autosomal ___________. And is caused by what gene

Answer 2

Dominant, PKD1 or 2 gene

Eventual renal failure

Question 3

Saccular aneurysm mc occurs where

Answer 3

In anterior circulation, Anterior communicating artery is MC.

Question 4

What results in worm like arteries and veins?

Answer 4

Ateriovenous Malformation

Is MC cerebrovascular malformation

Question 5

Who’s most at risk for ateriovenous Malformation (AVM)

Answer 5

Males 2x, MC age 10-30 years old

Headaches in 50% of all cases

Question 6

What is an occlusion of single artery

Answer 6

Lacunar infarct

It is silent and devastating

Question 7

When a small cerebral vessel is ruptured and resorbed

Answer 7

Slit Hemorrhage

A “slit like cavity” remains

Question 8

What occurs when diastolic BP>130 and sever ICP and global cerebral dysfunction

Answer 8

Hypertensive Encephalopathy

Question 9

This is systemic autoimmune vasculitis, fibrinoid necrosis, small heart and arteries

Answer 9

Polyarteritis Nodosa

Question 10

What is primary Angiitis of the CNS

Answer 10

chronic inflammation in the multiple parenchyma and subarachnoid vessels

Involves the brain and spinal cord

Question 11

Who is most at risk for Primary Angiitis of the CNS

Answer 11

Males age 30-60

Injury from aneurysm, hemorrhage, ischemia

Treatment is Immunosuppression

Question 12

Who is more at risk for CNS trauma

Answer 12

Males 2x more likely

The Assessment is ABCD

Question 13

What is punch drunk?

Answer 13

Chronic Traumatic Encephalopathy CTE

Question 14

What is most susceptible during a contusion

Answer 14

Gyri!!!!!!!!!

Coup injury- at impact site

Contrecoup injury- Opposite site of impact

Question 15

What is it called when movement of one brain region relative to another

Answer 15

Diffuse Axonal Injury (DAI)

Severe dysfunction 50% of causes post traumatic comas

Disrupts white matter, shaking

Question 16

How long does it take to recover from a Concussion

Answer 16

80% in 10 days without treatment

Question 17

What is post concussive syndrome

Answer 17

When symptoms last for weeks to months

15-20% of all concussions

Fatigue/low energy= 37% MC

Question 18

Whats so bad about second impact syndrome

Answer 18

Second concussion can occur and is LETHAL

Question 19

This is dural ARTERY damage, compresses brain tissue, my be lucid during bleed

Answer 19

Epidural Hematoma

Question 20

Rapid tear movements of VEIN, subdural bleed, compresses brain

Answer 20

Subdural Hematoma

Question 21

WHich one has the dura still attached to the skull epidural or subdural

Answer 21

Subdural

Question 22

What is the most common artery effected by an epidural hematoma

Answer 22

Middle meningeal artery

Very aggressive lethal within hours

Question 23

What is more common subdural or epidural hematoma

Answer 23

Subdural

MC self limited but still an emergency

Clot lysis 1 week, Fibrosis 1-3 months

Question 24

What is the MC CNS malformation

Answer 24

Neural tube defects 1/1000

Risks= decreased folate, previous child

Question 25

Spina Bifida Occulta is

Answer 25

Bony defect, asymptomatic

Question 26

Myelomeningocele is

Answer 26

Extension of CNS through vertebral defect (lumbosacral)

Question 27

Anencephaly is

Answer 27

Absence of brain, roster all apsect

Question 28

Encephalocele is

Answer 28

CNS diverticulum through cranium

Question 29

Look at slide

Answer 29

80

Question 30

What is Hydromyelia

Answer 30

Cavity, connected to 4th ventricle

Question 31

Syringomyelia is

Answer 31

Aka (syrinx) Is a cyst within cord in adults Developmental or traumatic, Arnold Chiari Malf

Question 32

What causes a "Shaw-like" distribution in the upper trunk/arms

Answer 32

Syringomyelia Loss of pain/temp sensation Possible tissue atrophy or areflexia

Question 33

What is intraparenchymal hemorrhage

Answer 33

Prematurity, near ventricles, possible hydrocephalus

Question 34

Infarct is

Answer 34

Prematurity, Supratentorial white matter, chalky plaques/necrosis, possible cysts

Question 35

Whats cerebral Palsy

Answer 35

Non progressive motor neuron defects Prematurity, hypoxia, infection damage during development

Question 36

What are symptoms of cerebral palsy

Answer 36

Spasticity, dystonia, ataxia, tremors 1/3 have decreased cognition or seizures

Question 37

What is the MC CNS infection

Answer 37

Hematogenous, direct implant or local infection Retrograde from PNS

Question 38

What is a Epidural Abscess

Answer 38

Infection in the epidural space Occurs from adjacent infection aka osteomyelitis Cord compression results is a Neurosurgical emergency

Question 39

Whats a subdural Empyema

Answer 39

Infection in the subdural space Pyrexia, HA, cervicalgia Neurologic dysfunction, lethargy, coma

Question 40

Whats meningitis

Answer 40

Subarachnoid inflammation of leptomeninges CSF examination helps to distinguish the type

Question 41

what is Acute pyogenic meningitis

Answer 41

Rapid onset, HA, NUCHAL RIGIDITY, PHOTOPHOBIA CSF=bacteria, increased pressure, neutrophils, proteins (exudate) Fatal if untreated

Question 42

Whats Kernig sign

Answer 42

Pain when moving the legs due from Meningitis

Question 43

Whats the Brudzinski sign

Answer 43

When patient lays down and knees are bent they have pain when the head is lifted

Question 44

What causes meningitis is neonates

Answer 44

E. Coli Group B Strep.

Question 45

What causes meningitis in young children

Answer 45

Haemophilus INfluenzae

Question 46

What causes meningitis in young adult

Answer 46

Neisseria meningitidis

Question 47

What causes meningitis in older adult

Answer 47

Strep. Pneumoniae Listeria monocytogenes

Question 48

What is aseptic meningitis

Answer 48

Viral, relatively acute onset, pyrexia, decreased consciousness, unchallenged rigidity, edema CSF= Increased Lymphocytes

Question 49

Tuberculous meningitis is

Answer 49

"Tuberculoma", HA, malaise, confusion, vomiting CSF= Moderate increase in WBC's and proteins

Question 50

Whats spirochetal meningitis

Answer 50

3 degree of syphilis or Lyme disease Neuronal loss, progressive loss of neuro function. Ataxia, anesthesia, Encephalopathy