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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
Q

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

A

SSPE, Creutzfeldt-Jakob disease, cerebral lipidoses

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26
Q

The presence of this wave test the integrity of the auditory nerve

A

wave I and its absolute latency test

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27
Q

Delay between the stimulus site and the Erb point or lumbar spine in SSEP indicates what disease?

A

Peripheral nerve disease

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28
Q

Temporal artery biopsy is indicated when?

A

when giant cell arteritis is suspected

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29
Q

Main intracellular constituents of the neural tissue

A

K, Mg, P

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30
Q

Main extracellular constituents of the neural tissue

A

Na, Ca, Cl

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31
Q

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.

A

True

32
Q

The serum enzyme other than CK that is derived predominantly from skeletal muscle

A

Aldolase

33
Q

How many grams of muscle must be destroyed to color the urine visibly?

A

200g

34
Q

The values of the conduction velocity reaches the adult range by what age?

A

2-4 yo

35
Q

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.

A

True

36
Q

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

A

H reflex

37
Q

A decrement of how many percent in repetitive motor nerve stimulation denotes a failure of a proportion of the neuromuscular junction.

A

10%

38
Q

Lambert-Eaton myasthenic syndrome is associated with what type of carcinoma?

A

Oat cell carcinoma of the lung

39
Q

Up to how many percent of normal motor unit potential consist of four or more phases?

A

up to 10%

40
Q

Refers to the activity when individual motor unit potentials can no longer be distinguished during maximal voluntary contraction?

A

Complete interference pattern

41
Q

In cases of advanced denervation or myopathy, the insertional activity may be ___________.

A

Decreased

42
Q

Refers to the irregular firing of a number of motor units seen as a rippling of the skin

A

myokymia

43
Q

T/F: Complex repetitive discharges marks chronicity of the lesion (>6 months)

A

True

44
Q

A phenomenon which denotes a failure of voluntary relaxation of muscle because of sustained firing of the muscle membrane

A

Myotonia

45
Q

It refers to the variability of the inter potential interval of successive discharges of two single muscle fibers belonging to the same motor unit

A

Jitter

46
Q

Most often cause of “dry tap”

A

Improperly placed needle

47
Q

Most common complication of lumbar puncture

A

Headache

48
Q

Normal CSF opening pressure

A

100-180 mmH2O (8-14 mmHg)

49
Q

Test for rapid rise in CSF pressure within a few seconds after application of the pressure on the vein

A

Queckenstedt test

50
Q

T/F: RBCs undergo rapid hemolysis in the CSF because of the osmotic differences in plasma and CSF.

A

False (osmolarity of plasma and CSF is essentially the same)

51
Q

T/F: Not all xanthochromia of the CSF is caused by hemolysis of RBCs.

A

True

52
Q

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.

A

True

53
Q

Syndrome characterized by CSF block, deeply yellow CSF with presence of clots.

A

Froin Syndrome

54
Q

T/F: Gray matter appears denser than white matter in CT scan due to its lower lipid content

A

True

55
Q

It is the most abundant element in tissue and yields the strongest magnetic signal.

A

Hydrogen

56
Q

The favored configuration of electrode pairs in EEG

A

International 10-20

57
Q

T/F: The normal EEG recording shows symmetry.

A

False (slightly asymmetrical)

58
Q

The most pathologic finding in EEG

A

Absence of EEG activity or electrocerebral silence

59
Q

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

A

Herplex simplex encephalitis

60
Q

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.

A

Alpha coma

61
Q

BAER wave correlated with the transmission of sound at the level of superior olivary nucleus?

A

III

62
Q

Contraindications in hyperventilation

A

Heart and lung disease, sickle cell disease, moyamoya disease, recent stroke, high grade cerebral stenosis, intracranial hemorrhage, increased intracranial pressure

63
Q

Most common seizure type induced by photic stimulation

A

Myoclonic seizures

64
Q

T/F: motor responses are less affected by background noise and other technical factors than sensory responses

A

True

65
Q

T/F: Fibrillation potentials originate from single muscle fibers.

A

True

66
Q

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.

A

Conduction block

67
Q

T/F: F response is evoked by a supramaximal stimulus of a mixed motor-sensory nerve.

A

True

68
Q

T/F: The combination of fibrillations and fasciculations indicates active denervation combined with more chronic reinnervation of muscles.

A

True

69
Q

T/F: In CJD, there is increased T2 signal in neocortex, thalamus, caudate and putamen but not in the globus pallidus.

A

True

70
Q

This wave test the integrity of the auditory nerve

A

Wave I

71
Q

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.

A

Joubert syndrome

72
Q

Most commonly used silver stain

A

Bielschowsky stain

73
Q

It is when the electric impulse travel in the same direction as normal physiologic conduction

A

Orthodromic

74
Q

A decrement of how many percent denotes a failure of a proportion of the NMJ in RNS

A

10%

75
Q

The presence of this wave and its absolute latency in BAER test the integrity of the auditory nerve

A

Wave 1

76
Q

T/F: Impaired visual acuity has little effect on the latency but does correlate well with the amplitude of the PSVER.

A

True

Adams Principles of Neurology (19 decks)

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