- Sudden focal loss of neurological function with complete recovery within 24 hours. - Caused by inadequate perfusion in the partial or complete distribution of the carotid or vertebro-basilar arteries.

High yield questions Flashcards by David Bnd

what type of mutation occurs in a Glioblastoma multiforme?

mutation in IDH1

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What is T1 weighted MRI?

Makes Grey matter light and White matter dark

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Name 3 clinical uses of ultrasounds?

Suspected meningitis
perinatal ischaemia
Hydrocephalus
pregnancy

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what is a Glioblastoma Multiforme?

It is a fast-growing type of tumour of the brain or spinal cord. It is the most common primary malignant brain tumour in adults.
- effects multiple glial brain cells ( astrocytes, oligodendrocytes, microglia and cells of the blood vessels.) and almost never spreads outside of the central nervous system

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what is anaplastic oligodendroglioma?

A type of brain tumour Grade 3 that occurs primarily in adults but also found in children.
These tumours effect the neuroepithelium of the nervous system.
There is a chromosome deletion of 1p19q

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What is T2 weighted MRI?

Makes Grey matter dark, and White matter light

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what is the cause of Extradural Haemorrhage?

Commonly caused by traumatic rupture of the middle meningeal artery following a temporal Bone fracture.

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what is the clinical use of MRI angiography?

Atherosclerosis
Sternosis
Aneurysms

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Describe the structure of the Organ of Corti

Tectorial membrane
Outer hair cell with hair Stereocilia
Reticular lamina
Outer hair cells + Inner hair cells
Each connected to a nerve fibre
Connected to Modiolus (bony structure in cochlea)
Rods of Corti
Basilar membrane
Vestibulocochlear nerve

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How does the Cochlea work?

Vibration of stapes (caused by the other ocicles) causes wave in perilymphatic fluid to travel through the Scala vestibuli.
At a specific frequency, when a vibration is set up in the Basillar membrane they cross into the Scala tympani to round window.
Causes displacement of basilar membrane and Organ corti
4.Basillar membrane most stiff nearest to base of cochlea and least stiff at helicotrema – only high frequency sounds can displace basilar membrane at the base, lower frequencies must travel further along

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How does the inner hair cells send information to the brain?

Via spiral ganglion and the vestibulocochlear nerve

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How does the medial superior olivary nuclei compare to the lateral?

Medial SON detects differences in the time that sounds reach each ear – Low frequency
Lateral SON detects differences in sound intensity reaching each ear – High frequency

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If the sterocillia move in the direction towards the kinocilium what happens?

Displacement in the direction of the kinocillium stimulates hair cells.

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what is the perilymph layer?

fluid with high Na+ conc

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Where is the Auditory cortex?

Temporal lobe
Brodmann areas 41 and 42
Tonotopic – Different areas correspond to different frequency of sound

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what solute is in high concentration in the labyrinth?

potassium

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How does lacunar anterior circulation stroke present ?

ataxic hemipariesis
- Pure motor hemiplegia
- Pure sensory loss

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what are the 4ps when imaging for stroke or TIA?

P- parenchyma: Assess early signs of acute stroke, rule out haemorrhage and some stroke mimics
P- pipes including collaterals: Assess extracraial and Intracranial circulation
P- perfusuion: Assess cerebral blood volume, cerebral blood flow and transit time
P- penumbra: Assess tissue at risk of dying if ischaemia continues without repercussion.

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what are the clinical clues that a patient is experiencing a peripheral vestibulopathy?

New tinnitus/hearing loss
No other neurological symporoms/signs
No vertical or bidirectional nystagmus
dix-hallpike positive

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what are the functions of temporal lobe?

Auditory cortex
Learning and memory
Olfactory sensation
Emotional behaviour

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what hospital tools can be used for TIA and stroke assessment?

Rosiers

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what is a TIA?

Sudden focal loss of neurological function with complete recovery within 24 hours.
Caused by inadequate perfusion in the partial or complete distribution of the carotid or vertebro-basilar arteries.

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what is Metabolic encephalopathy?

Flucturating onset
Attention deficits/confusion
Often pre-existing cognitive problems
Accompanying metabolic derangement

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What is the most common type of ischaemic stroke?

Lacunar stroke – occlusion of small penetrating arteries that provide blood to the brains deep structures

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What is the treatment for an ischaemic stroke?

- Tissue plasminogen activator (tPA) - Thrombolysis - ( within 4 hours from onset of symptoms) - Then aspirin and statin

What kind of occlusion can cause brain stem syndromes?

- Branch occlusion

what pre hospital assessment tools for stroke or TIA?

- Fast ( face and speech) - Be fast ( balance eyes face and speech)

4 types of posterior stroke syndromes?

Basilar artery occlusion Anterior inferior cerebellar artery Wallenberg's syndrome Weber's syndrome/medial midbrain syndrome

how does the posterior stroke syndrome of basilar artery occlusion commonly present?

Basilar artery occlusion is more likely to present with locked in syndrome (quadriparesis with preserved consciousness and ocular movements), loss of consciousness, or sudden death.

how does the posterior stroke syndrome of anterior inferior cerebellar artery occlusion commonly present?

Anterior inferior cerebellar artery results in lateral pontine syndrome, a condition similar to the lateral medullary syndrome but with additional involvement of pontine cranial nerve nuclei.

How does the posterior stroke syndrome Wallenberg's syndrome?

Wallenberg's syndrome (lateral medullary syndrome) causes ipsilateral Horner's syndrome, ipsilateral loss of pain and temperature sensation on the face, and contralateral loss of pain and temperature sensation over the contralateral body.

How does the posterior stroke syndrome, Weber's syndrome present?

Weber's syndrome/medial midbrain syndrome (paramedian branches of the upper basilar and proximal posterior cerebral arteries): causes an ipsilateral oculomotor nerve palsy and contralateral hemiparesis

How does an Total anterior circulation infarct present?

- Contralateral hemiplegia - Contralateral homologous Hemianopia - Higher cerebral dysfunction

what are deficits cerebellar signs? ( DANISH)

D- Dysdiachonkinesia A - Ataxia N- Nystagmus I - intention tremor S- Slurred Speech H - Hypotonia

what are the 3 types of ischemic strokes?

- Thrombotic - Embolic - Hypoxic

On CT, a crescent-shaped haematoma is diagnostic of what? what are risk factors?

Subdural haemorrhage - head injury - age - alcoholism

On CT, a biconvex haematoma is diagnostic of what? When does it commonly occur?

Extradural haemorrhage- Commonly caused by trauma to the pterion

what drugs are given to prevent vasculospams in haemorrhagic strokes ?

Calcium channel blockers: Nimodipine Betablockers : Labetalol

symptoms commonly presented in lacunar strokes?

Hemiparesis Ataxia Dysarthria Numbness in contralateral face, arm and leg

where would focal neurological deficits present if there was an occlusion in the middle cerebral artery?

- Hands, Arms and Face

where would focal neurological deficits present if there was an occlusion in the Anterior cerebral artery?

Feet and Legs

where would focal neurological deficits present if there was an occlusion in the posterior cerebral artery?

- Visual cortex

what is the function of the dorsal column pathway (DON’T, VICTIMISE, PEACEFUL, PEOPLE)

DON’T- Discriminative touch (fine touch) VICTIMISE- Vibration PEACEFUL- proprioception PEOPLE- Pressure

what is the function of the Lateral spinothalamic tract?

pain and temperature

what is the function of the spinothalamic tract? ( Trust, Crude, People)

Trust- Temperature Crude- Crude touch People- Pain

what is the Function of the Tectospinal tract?

head turning in response to visual stimulus Coordination of head and eye movement

What is the function of the ventromedial pathway?

It’s function relates to the positioning of the head and neck. It’s also responsible for balance (movement in response to sudden postural change).

what is the reticular spinal tract pathway responsible for?

Alterness and consciousness

What the function of the Rubrospinal tract(dorsolateral pathway)?

Control of muscle tone in flexor muscles group and coordination of movement (cerebellum).

where do afferent primary nerve fibres A delta and C fibres enter the spinal cord and which neurones do they innervate?

dorsal horn - innervate neurones in laminae I AND laminae II(substantia gelatinosa)

where does the spinothalamic pathway deccusate

travel 1/2 segments and decussate in the spinal cord then ascend ipsilaterally

Which nerve fibres are usually anaesthetised?

Alpha delta and c fibres

which neurotransmitter chemicals are released in by pain neurones?

Glutamate and substance p

which primary afferent fibres are responsible for pain and temperature ?

Alpha delta nerve fibres

which primary afferent fibres are responsible for pain and temperature, itch but are slower?

c fibres

which sensory neurones innervate the Cuneate Fasciculus? ( T 6 landmark)

Above T6 Thoracic and Cervical sensory neurones inervate the cuneate fasciculus

which sensory neurones innervate the Gracile Fasciculus? ( T 6 landmark)

Below T6 sacral and lumbar sensory neurones

How is the progression of labour monitored ?

The primigravid labour record

How long should active labour last in mums that have had children before?

Should last around 6 hours

How long should active labour roughly last in new mums?

9.5 hours

what are 3 preventable causes of death during child birth?

Bleeding Infection Pre-eclampsia

What are the 4 pelvic types? (G-GO, A-Away, A-And, P-Push)

Gynecoid Android Anthropoid Platypellpoid

What are the 5 types of analgesia that could be used?

Simple oral analgesics TENS Entenox Syetmic opiates- pethidine , emptied, morphine , diamorphne

What are the 7 cardinal movements of labour? ( Every, Dad, Forces, Ideas regarding, Education, Regularly, Everyday )

Engagement Decent Flexion Internal rotation Extension Restitution External rotation

What are the three mechanisms of labour ?

Passage Power Passenger

what contributes to the high number of intrapartum stillbirths per year?

Inadequate fetal heart rate monitoring and partogram use

What factors cause retention of baby during labour?

Oestrogen Oxytocin Vasopressin Cortisol Prostaglandins Uterine distension CRH

What happens during the first stage of labour?

regular contractions 3-4 cm dilatation —> full dilatation at 10 cm

What happens during the latent phase of labour?

onset of contractions Regular contraction 3-4 cm dilatation Muscle toning Cervix fully effaced ( thinning of the cervix)

What happens during the second stage of labour?

passive - no pushing Active - maternal pushing (push during contraction) Theres full dilation → delivery of the baby

What happens during the third stage of labour?

Delivery of the baby + placenta and membranes Contraction and Haemostasis

What cells produce milk ?

Lactocytes

what is fibroadenoma (breast) ?

benign breast lump that is commonly seen in young women. Typically presnting as smooth, firm and highly moble, painless and slowly growing

what is fibrocystic disease and how does it present?

caused by the cumulative effect of cyclical hormones such as oestrogen and progesterone (among many others) which leads to chronic changes in the breast including multiple small cysts and proliferative changes. Symptoms: Breast Pain and cyclical lumpiness that normally occurs before a menstrual cycle and resolves before the period.

what is the name of the epithelium that surrounds the lactocytes?

Myoepithelial cells

What triggers prolactin to be released after birth?

drop in oestrogen and progesterone

what is the function of the Tentorium Cerebelli?

In terms of function, the tent shape of the tentorium cerebelli ensures that the cerebellum and underlying brainstem are protected from the pressure caused by the heavier upper part of the brain.

High yield questions Flashcards

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