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Adams Principles of Neurology > Laboratory Techniques > Flashcards

Laboratory Techniques Flashcards

1
Q

Type of herniation associated with lumbar puncture

A

cerebellar or transtentorial herniation

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2
Q

What is given to produce a sustained reduction in ICP

A

Dexamethasone

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3
Q

Normal Opening CSF pressure

A

Adults - 100-180 mmH2O / 8-14 mm Hg

Children - 30-60 mmH2O

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4
Q

Difference of CSF OP in a sitting versus recumbent position

A

it is approximately doubled in sitting position

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5
Q

At least how many RBCs are needed to detect the presence of blood in the CSF imparting a hazy or ground-glass appearance?

A

200 RBCs/mm3

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6
Q

Pigments that discolor the CSF following SAH

A

Oxyhemoglobin, bilirubin and methemoglobin

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7
Q

Protein content of CSF from the basal cisterns

A

10-25 mg/dL (ventricles: 5-15 mg/dL)

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8
Q

Protein correction in traumatic tap

A

CSF protein increase by about 1mg per 1000 RBCs

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9
Q

Average osmolality of the CSF

A

295 mOsm/L

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10
Q

Normal pCO2 in the CSF

A

45-49 mm Hg

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11
Q

Major catabolite of dopamine which is 5-6x higher in the ventricular fluid than the lumbar CSF

A 
Homovanillic Acid (HVA)
major catabolite of serotonin: 5-hydroxyindoleacetic acid (5-HIAA)
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12
Q

Intravenous contrast is generally withheld if the glomerular filtration rate is ______?

A

<30ml/min/1.73 m2

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13
Q

MRI technique that measures the free diffusion of water molecules within the tissue

A

Diffusion-weighted imaging

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14
Q

Severe cutaneous sclerosing disease linked to the administration of gadolinium

A

Nephrogenic systemic fibrosis

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15
Q

Special imaging technique in which a time-intensity curve is produced from which measurements of cerebral blood flow, cerebral blood volume and transit time can be derived.

A

Perfusion imaging

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16
Q

Marker of neuronal integrity

A

N-acetyl aspartate (NAA)

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17
Q

Marker of membrane turnover

A

Choline

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18
Q

This imaging technique produces images that reflect the regional concentration of systemically administered radioactive compounds

A

Positron emission tomography

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19
Q

Alpha rhythm appears by what age?

A

6 years

adult frequency is reached by the age of 10-12 years

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20
Q

The most pathologic finding of all in EEG recording?

A

absence of EEG activity or electrocerebral silence

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21
Q

Between seizures, a single EEG recording will show a normal pattern in how many patients with absence seizures?

A

30%

50% in those with generalized tonic-clonic seizures

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22
Q

Characterized by periodic high-voltage sharp waves and slow-wave complexes at intervals of 1-3 per second in the temporal regions

A

Herpes Simplex Encephalitis

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23
Q

Refers to a unique EEG pattern in which an apparent alpha activity in the 8-12 Hz range is distributed widely over the hemispheres rather than in its normal location posteriorly

A

alpha coma

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24
Q

Characterized by paroxysms of bilaterally synchronous large, sharp triphasic waves

A

Hepatic Coma

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25
Characterized by relatively slight degrees of diffuse slow-wave abnormality in the theta range with periodic bursts of high-amplitude sharp waves, usually bisynchronous and symmetrical
SSPE, Creutzfeldt-Jakob disease, cerebral lipidoses
26
The presence of this wave test the integrity of the auditory nerve
wave I and its absolute latency test
27
Delay between the stimulus site and the Erb point or lumbar spine in SSEP indicates what disease?
Peripheral nerve disease
28
Temporal artery biopsy is indicated when?
when giant cell arteritis is suspected
29
Main intracellular constituents of the neural tissue
K, Mg, P
30
Main extracellular constituents of the neural tissue
Na, Ca, Cl
31
T/F: The interior of the cell is some 30 times richer in K than the extracellular fluid and the concentration of Na is 10-12 times greater in extracellular fluid.
True
32
The serum enzyme other than CK that is derived predominantly from skeletal muscle
Aldolase
33
How many grams of muscle must be destroyed to color the urine visibly?
200g
34
The values of the conduction velocity reaches the adult range by what age?
2-4 yo
35
T/F: Disease processes that preferentially injure the fastest-conducting, large diameter fibers in peripheral nerves reduce the maximal conduction velocity because the remaining thinner fibers conduct slowly.
True
36
It is the electrical representation of the tendon reflex circuit and is a useful measure because the impulse traverses both the anterior and posterior spinal roots
H reflex
37
A decrement of how many percent in repetitive motor nerve stimulation denotes a failure of a proportion of the neuromuscular junction.
10%
38
Lambert-Eaton myasthenic syndrome is associated with what type of carcinoma?
Oat cell carcinoma of the lung
39
Up to how many percent of normal motor unit potential consist of four or more phases?
up to 10%
40
Refers to the activity when individual motor unit potentials can no longer be distinguished during maximal voluntary contraction?
Complete interference pattern
41
In cases of advanced denervation or myopathy, the insertional activity may be ___________.
Decreased
42
Refers to the irregular firing of a number of motor units seen as a rippling of the skin
myokymia
43
T/F: Complex repetitive discharges marks chronicity of the lesion (>6 months)
True
44
A phenomenon which denotes a failure of voluntary relaxation of muscle because of sustained firing of the muscle membrane
Myotonia
45
It refers to the variability of the inter potential interval of successive discharges of two single muscle fibers belonging to the same motor unit
Jitter
46
Most often cause of "dry tap"
Improperly placed needle
47
Most common complication of lumbar puncture
Headache
48
Normal CSF opening pressure
100-180 mmH2O (8-14 mmHg)
49
Test for rapid rise in CSF pressure within a few seconds after application of the pressure on the vein
Queckenstedt test
50
T/F: RBCs undergo rapid hemolysis in the CSF because of the osmotic differences in plasma and CSF.
False (osmolarity of plasma and CSF is essentially the same)
51
T/F: Not all xanthochromia of the CSF is caused by hemolysis of RBCs.
True
52
T/F: the amount of protein in the CSF is proportional to the length of time it is in contact with the blood-CSF barrier.
True
53
Syndrome characterized by CSF block, deeply yellow CSF with presence of clots.
Froin Syndrome
54
T/F: Gray matter appears denser than white matter in CT scan due to its lower lipid content
True
55
It is the most abundant element in tissue and yields the strongest magnetic signal.
Hydrogen
56
The favored configuration of electrode pairs in EEG
International 10-20
57
T/F: The normal EEG recording shows symmetry.
False (slightly asymmetrical)
58
The most pathologic finding in EEG
Absence of EEG activity or electrocerebral silence
59
Characterized by periodic high voltage sharp waves and slow-wave complexes at intervals of 1-3 per second in the temporal regions.
Herplex simplex encephalitis
60
A unique EEG pattern in which an apparent alpha activity in the 8- to 12- Hz range is distributed widely over the hemispheres rather than its normal location posteriorly.
Alpha coma
61
BAER wave correlated with the transmission of sound at the level of superior olivary nucleus?
III
62
Contraindications in hyperventilation
Heart and lung disease, sickle cell disease, moyamoya disease, recent stroke, high grade cerebral stenosis, intracranial hemorrhage, increased intracranial pressure
63
Most common seizure type induced by photic stimulation
Myoclonic seizures
64
T/F: motor responses are less affected by background noise and other technical factors than sensory responses
True
65
T/F: Fibrillation potentials originate from single muscle fibers.
True
66
It is demonstrated by a reduction in the amplitude of the CMAP elicited from the proximal site along the motor nerve compared to stimulation at a distal site.
Conduction block
67
T/F: F response is evoked by a supramaximal stimulus of a mixed motor-sensory nerve.
True
68
T/F: The combination of fibrillations and fasciculations indicates active denervation combined with more chronic reinnervation of muscles.
True
69
T/F: In CJD, there is increased T2 signal in neocortex, thalamus, caudate and putamen but not in the globus pallidus.
True
70
This wave test the integrity of the auditory nerve
Wave I
71
MRI has a characteristic configuration of a molar tooth sign that reflects a deep invagination caused by vermian hypoplasia with a narrow cleft separating the cerebellar hemispheres and thickening of the superior cerebellar peduncles.
Joubert syndrome
72
Most commonly used silver stain
Bielschowsky stain
73
It is when the electric impulse travel in the same direction as normal physiologic conduction
Orthodromic
74
A decrement of how many percent denotes a failure of a proportion of the NMJ in RNS
10%
75
The presence of this wave and its absolute latency in BAER test the integrity of the auditory nerve
Wave 1
76
T/F: Impaired visual acuity has little effect on the latency but does correlate well with the amplitude of the PSVER.
True

Adams Principles of Neurology (19 decks)

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