First aid, bootcamp, pathoma

Question 1

Syringomyelia is associated with chiari type _

Answer 1

Syringomyelia is associated with chiari type 1

Question 2

Guillain-Barre syndrome involves injury to _ cells

Answer 2

Guillain-Barre syndrome involves injury to schwann cells

Question 3

MS, PML, and leukodystrophies involve injury to _ cells

Answer 3

MS, PML, and leukodystrophies involve injury to oligodendrocytes

Question 4

_ and _ sensory receptors adapt quickly

Answer 4

Meissner and Pacinian sensory receptors adapt quickly
* Meissner = light tough
* Pacinian = vibration, pressure

Question 5

_ and _ sensory receptors adapt slowly

Answer 5

Merkel and Ruffini sensory receptors adapt slowly
* Merkel = deep static touch
* Ruffini = stretch

Question 6

Depression is associated with _ REM sleep time, _ REM latency, _ N3, repeated awakenings and terminal insomnia

Answer 6

Depression is associated with increased REM sleep time, decreased REM latency, decreased N3, repeated awakenings and terminal insomnia

Question 7

Narcolepsy is associated with _ REM latency

Answer 7

Narcolepsy is associated with decreased REM latency

Question 8

The inhibitory output of the cerebellum travels from the purkinje cells –> the deep nuclei of cerebellum —> contralateral cortex via the _ peduncle

Answer 8

The inhibitory output of the cerebellum travels from the purkinje cells –> the deep nuclei of cerebellum —> contralateral cortex via the superior peduncle

Question 9

Dopamine binds to [receptor] when stimulating the excitatory pathway and [receptor] when inhibiting the inhibitory pathway

Answer 9

Dopamine binds to D1 when stimulating the excitatory pathway and D2 when inhibiting the inhibitory pathway
* D1 = direct
* D2 = indirect

Question 10

Hypoxemia increases CPP only if PO2 < _

Answer 10

Hypoxemia increases CPP only if PO2 < 50 mm Hg

Question 11

CPP is directly proportional to PCO2 until PCO2 > _

Answer 11

CPP is directly proportional to PCO2 until PCO2 > 90 mm Hg

Question 12

ID the anterior corticospinal tract

Answer 12

Question 13

ID the anterior spinothalamic tract

Answer 13

Recall that the anterior spinothalamic is responsible for crude touch, pressure

Question 14

Lesion of the subthalamic nucleus can cause _

Answer 14

Lesion of the subthalamic nucleus can cause contralateral hemiballismus

Question 15

Decerebrate posturing is a worse prognosis compared to decorticate; it is a result of lesion at [location]

Answer 15

Decerebrate posturing is a worse prognosis compared to decorticate; it is a result of lesion at or below red nucleus

Question 16

Diagnosis?

Answer 16

Epidural hematoma

Question 17

Most likely cause?

Answer 17

Rupture of the middle meningeal artery; often secondary to pterion skull fracture

Question 18

Diagnosis?

Answer 18

Subdural hematoma

Question 19

Etiology/cause?

Answer 19

Rupture of bridging veins (can be acute or chronic)
* Hemorrhage crosses suture lines; poor prognosis

Question 20

Diagnosis?

Answer 20

Subarachnoid hemorrhage

Question 21

Etiology/cause?

Answer 21

Bleeding due to trauma or rupture of aneurysm or AV malformation

Question 22

Diagnosis?

Answer 22

Intraparenchymal hemorrhage

Question 23

Most common etiology/cause?

Answer 23

Most commonly caused by systemic hypertension

Question 24

Shaken baby sydrome is associated with [hemotoma]

Answer 24

Shaken baby sydrome is associated with subdural hematoma –> rupture of bridging veins

Question 25

[Hematomas] can present as transient loss of consciousness followed by lucid interval before deterioration

Answer 25

**Epidural hematoma** can present as transient loss of consciousness followed by lucid interval before deterioration

Question 26

Patients with [hemorrhage] may complain of "worst headache of their lives"

Answer 26

Patients with **subarachnoid hemorrhage** may complain of "worst headache of their lives" * Rapid time course

Question 27

Diffuse axonal injury will show _ on MRI

Answer 27

Diffuse axonal injury will show **multiple punctate hemorrhages** *involving white matter tracts* on MRI * This is caused by traumatic shearing forces during rapid acceleration or deceleration of the brain (like MVA)

Question 28

Dihydroergotamine is (abortive/preventative) for migraines

Answer 28

Dihydroergotamine is **abortive** for migraines

Question 29

_ is painful unilateral visual loss associated with marcus gunn pupil and is a common presentation for MS

Answer 29

**Acute optic neuritis** is painful unilateral visual loss associated with marcus gunn pupil and is a common presentation for MS

Question 30

Oligoclonal bands and increased IgG and myelin basic protein on CSF is diagnostic for _

Answer 30

Oligoclonal bands and increased IgG and myelin basic protein on CSF is diagnostic for **MS**

Question 31

Both MS and guillain barre can cause sensory and motor deficits; however _ affects UMNs and _ affects LMNs

Answer 31

Both MS and guillain barre can cause sensory and motor deficits; however **MS** affects UMNs and **GB** affects LMNs * MS = spasticity * GB = absent DTRs

Question 32

Increased CSF protein with normal cell count is associated with [demyelinating disease]

Answer 32

Increased CSF protein with normal cell count is associated with **Guillain Barre** * *This is called albuminocytologic dissociation*

Question 33

Sturge weber syndrome = problem with _ gene

Answer 33

Sturge weber = **GNAQ**

Question 34

What two manifestations are seen here?

Answer 34

1. **Port-wine stain** in V1/V2 distribution 2. **Ipsilateral leptomeningeal angioma** *Due to capillary vascular malformations*

Question 35

What manifestation is shown?

Answer 35

**Hamartoma** on skin (these also occur in CNS) * Result of tuberous sclerosis

Question 36

NF1 tumor supressor gene is on [chromosome] while NF2 tumor supressor gene is on [chromosome]

Answer 36

NF1 tumor supressor gene is on **17** while NF2 tumor supressor gene is on **22**

Question 37

Medulloblastoma originates from [cells]

Answer 37

Medulloblastoma originates from **primitive neuroectoderm**

Question 38

In addition to bilateral schwannomas, NF2 is associated with [tumor] and [tumor]

Answer 38

In addition to bilateral schwannomas, NF2 is associated with **meningioma** and **ependymoma**

Question 39

Elevated levels of tau and 14-3-3 proteins in CSF are associated with _ disease

Answer 39

Elevated levels of tau and 14-3-3 proteins in CSF are associated with **Creutzfeldt-Jakob disease**

Question 40

Reactive gliosis typically occurs [time period] after injury and is characterized by the proliferation of glial cells (i.e., astrocytes)

Answer 40

Reactive gliosis typically occurs **1 to 2 weeks** after injury and is characterized by the proliferation of glial cells (i.e., astrocytes)

Question 41

The [brain cells] are particularly susceptible to hypoxia and typically are the first to experience ischemic damage during global cerebral hypoperfusion

Answer 41

The **CA1 pyramidal neurons of the hippocampus** are particularly susceptible to hypoxia and typically are the first to experience ischemic damage during global cerebral hypoperfusion

Question 42

Acute onset of painful, unilateral visual field loss (scotoma) and a relative afferent pupillary defect likely indicate _

Answer 42

Acute onset of painful, unilateral visual field loss (scotoma) and a relative afferent pupillary defect likely indicate **optic neuritis** * *Think MS*

Question 43

_ radiculopathy presents as pain that radiates to the posterior leg and as motor weakness of plantar flexion, hip extension, and/or knee flexion

Answer 43

**S1** radiculopathy presents as pain that radiates to the posterior leg and as motor weakness of plantar flexion, hip extension, and/or knee flexion

Question 44

[Hemorrhage] usually occurs in premature infants or those of low birth weight. Symptoms, if present, include seizure, flaccid weakness, hypoventilation, and cranial nerve abnormalities

Answer 44

**Intraventricular hemorrhage** usually occurs in premature infants or those of low birth weight. Symptoms, if present, include seizure, flaccid weakness, hypoventilation, and cranial nerve abnormalities

Question 45

Diagnose the brain tumor

Answer 45

**Meningioma**: psammoma bodies * There are derived from arachnoid cells

Question 46

_ is an anti-Parkinsonian medication that may cause orthostatic hypotension, dizziness, and livedo reticularis

Answer 46

**Amantadine** is an anti-Parkinsonian medication that may cause orthostatic hypotension, dizziness, and livedo reticularis

Question 47

[NT] in the reticular formation induces REM sleep. Natural aging is associated with lower levels of this and decreased sleep (rapid eye movement and overall) duration

Answer 47

**Acetylcholine** in the reticular formation induces REM sleep. Natural aging is associated with lower levels of acetylcholine and decreased sleep (rapid eye movement and overall) duration