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[OS 211] Neurology E1 Trans Cluster 4 > Lec 20: Toxic and Metabolic Encephalopathy > Flashcards

Lec 20: Toxic and Metabolic Encephalopathy Flashcards

1
Q

ID: This occurs with reduced blood supply to the entire brain but with normal cerebrovascular flow.

A

hypoxia

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2
Q

Bronchial asthma predisposes to what type of anoxia?

A. anoxic anoxia
B. anemic anoxia
C. histotoxic anoxia
D. ischemia
E. NOTA
A

A.

Anoxic anoxia results from poor O2 tension mainly due to pulmonary diseases.

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3
Q

ID: A focal brain infarct is called a

A

stoke

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4
Q

ID: This gross pathology of hypoxic ischemic encephalopathy is characterized by dropout of cells at a layer of the neocortex.

A

laminar necrosis

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5
Q

Areas that are selectively vulnerable to ischemic injuries EXCEPT

A. 3rd, 5th, 6th layers of neocortex
B. Sommer sector and end folium
C. inner half of caudate and putamen
D. reticular zone of substantia nigra
E. NOTA
A

C.

It is the OUTER HALF that is more vulnerable.

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6
Q

ID: These are areas where the blood supply converges.

A

watershed areas

They are more prone to ischemic injury.

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7
Q

Coma is irreversible after how many minutes of anoxia?

A. 2 minutes
B. 4 minutes
C. 6 minutes
D. 8 minutes
E. 10 minutes
A

B. 4 minutes

Consciousness meanwhile is lost within 8-10 seconds of complete cerebral anoxia / ischemia.

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8
Q

Which is the most likely associated sequelae after hypoxic / ischemic encephalopathy of the cerebellum?

A. intention myoclonus
B. dysmetria
C. tremor
D. impaired cognition
E. AOTA
A

B. dysmetria

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9
Q

This is the most common cause of toxic / metabolic encephalopathy in pediatric patients as per PGH / NPMCC census.

A. sodium hypochlorite
B. silver jewely cleaner
C. hydrochloric acid
D. kerosene
E. metamphetamine
A

D. kerosene (most common in children)

Metamphetamine is the most common cause in adults (200% increase from last census), while alcohol intoxication is the 2nd.

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10
Q

ID: This component of silver jewelry cleaner causes the anoxia.

A

cyanide

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11
Q

What is the primary reason why most silver cleaner deaths occur among the pediatric age group?

A

Accumulated rhodanese enzyme helps in the metabolism of cyanide in adults.

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12
Q

Treatment of cyanide poisoning include

A. high flow oxygen
B. sodium nitrate
C. sodium thiosulfate
D. A & B only
E. AOTA
A

E. AOTA

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13
Q

ID: Serious symptoms of hypoglycemic encephalopathy occurs when blood glucose level dips below

A

30 mg/dL

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14
Q

This encephalopathy is associated with oculomotor paralysis or impaired oculovestibular reflexes.

A. hepatic encephalopathy
B. wernicke's encephalopathy
C. diabetic ketoacidosis
D. guillain-barre encephalopathy
E. NOTA
A

B. Wernicke’s encephalopathy

It is a co-factor deficiency.

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15
Q

ID: Treatment of choice for Wernicke’s encephalopathy.

A

thiamine 50 mg intravenously

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16
Q

T/F: Babinski sign in hepatic encephalopathy is more bilateral.

A

T

17
Q

Asterixis cannot be elicited in patients with hepatic encephalopathy in what stage?

A. 1
B. 2
C. 3
D. 4
E. 5
A

D. Stage 4

The patient is already comatose so you cannot do the test.
There is no stage 5.

18
Q

ID: Myxedema coma is associated with disorder in what organ?

A

thyroid

19
Q

T/F: Ethylene glycol can cause acidosis.

A

T

20
Q

ID: Predisposition to flushing and alcohol intoxication symptoms in certain individuals and races is due to low levels of what enzyme?

A

aldehyde dehydrogenase (This converts aldehyde to acetate. Aldehyde causes the symptoms.)

NOT alcohol dehydrogenase

21
Q

Coma occurs when blood alcohol level reaches

A. 200 mg/dL
B. 300 mg/dL
C. 400 mg/dL
D. 500 mg/dL
E. 600 mg/dL
A

C. 400 mg/dL

22
Q

Characteristics of opiate intoxication EXCEPT

A. dilated reactive pupils
B. respiratory depression
C. bradycardia
D. hypotension
E. NOTA
A

A.

It is characterized by PINPOINT (CONSTRICTED) reactive pupils.

23
Q

ID: The antidote for opiate intoxication is

A

naloxone

24
Q

T/F: Excessive water intake can lead to hypernatremia.

A

T

This leads to frequent urination and hence sodium loss.

25
Q

T/F: Focal motor signs are suggestive of toxic / metabolic encephalopathies.

A

F

Focal signs are characteristic of structural diseases. Diffuse signs are the ones associated with toxic / metabolic conditions.

[OS 211] Neurology E1 Trans Cluster 4 (6 decks)

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