kaplan nervous pathophys

Question 1

type of hematoma resulting from trauma to the head and laceration of what artery?

Answer 1

Epidural hematoma; laceration of the middle meningeal artery

Question 2

Epidural hematoma is followed by a 1-48 hour ______ period

Answer 2

lucid/asymptomatic

Question 3

Unlike subdural hematomas, epidural hematomas (caused by blunt force to the head) do or do not cross the midline because

Answer 3

Epidural hematomas don’t cross the midline because they are limited by cranial sutures

Question 4

The laceration of middle meningeal artery in an epidural hematoma can cause faster or slower bleeds and why?

Answer 4

Faster bleed because the arterial pressure is greater than the pressure of bridging veins.

Question 5

Non-traumatic Subarachnoid hemorrhage usually due to rupture of

Answer 5

berry aneurysm

Question 6

Someone complaining of the worst headache of their lives could be experiencing rupture of a

Answer 6

berry aneurysm (this could be a subarachnoid hemorrhage

Question 7

what testing do you do to confirm a subarachnoid hemorrhage?

Answer 7

Lumbar puncture (more sensitive than imaging)

Question 8

Classic lens-shaped (biconvex) hematoma on head CT indicative of

Answer 8

Epidural hematoma

Question 9

Rupture of the bridging veins between the meningeal dura and the superficial cerebral veins can cause

Answer 9

Subdural hematoma (in elderly usually)

Question 10

Loss of large myelinated axons in peripheral nerves sparing unmyelinated fibers

Answer 10

Friedreich ataxia

Question 11

Demyelination in Friedreich ataxia is evident in

Answer 11

Dorsal (posterior) columns

corticospinal tracts

spinocerebellar tracts

Question 12

Friedreich ataxia is the first known recessive genetic disease caused by (genetics)

Answer 12

Trinucleotide Repeat expansion (GAA) which are usually auto dominant but FA isn’t it’s
auto recessive

Question 13

Friedreich ataxia is a defect in

Answer 13

Frataxin gene

Question 14

A young boy with loss of reflexes, spasticity, extensor plantar responses, impaired vibration and position sense

Answer 14

Friedreich ataxia

Question 15

Loss of vision in right eye, swinging flashlight test shows dilation in the right eye and dilation of the left indicates what that is secondary to demyelination of the optic nerve

Answer 15

Optic neuritis (Marcus-Gunn pupil) relative afferent pupillary defect caused by decreased sensitivity of the affected eye to light due to demyelination so when light is shined into the affected eye, both eyes dilate because the message to constrict doesn’t travel fast enough to cause bilateral constriction.

Question 16

in a patient with abnormally brisk patellar reflex arc what structure if responsible for the hyperreflexia?

Answer 16

spindle afferents and other sensory fibers innervate the intrafusal fibers and detect changes in the muscle stretch tendons. They are the first fibers that are activated and enter the spinal cord through dorsal root then synapse on alpha motorneurons innervating homonymous muscle.. This is known as the myotatic reflex

Question 17

Choreoathetosis and dementia

Answer 17

Huntington Disease

GABAerigic neurons of caudate degenerates (and putamen)

makes lateral ventricles appear very large when imaged

Question 18

a patient present with word salad from impairment in language comprehension due to damage to

Answer 18

Wenicke area located in the temporal lobe which often contains portion of the optic radiation fibers from the left lateral geniculate nucleus projecting to the left primary visual cortex in the occipital lobe (Meyer’s loop)

Question 19

What type of visual deficits often present with Wernicke area destruction?

Answer 19

Homonymous inferior Quadrantanopia

Question 20

cataracts occur on the

Answer 20

lens (white lens opacifications)

Question 21

Diseases that can present with cataracts

Answer 21

Diabetes Mellitus
Long-term steroid use
UV light or radiation exposure
Intrauterine infections