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ANSB Review > Metabolic > Flashcards

Metabolic Flashcards

1
Q

Which of the following is a most common complication of septic emboli?

A. Mycotic Aneurysm
B. Ischemic Stroke
C. Brain Abscess
D. Meningoencephalitis

A

B. Ischemic Stroke

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2
Q

Which of the following is not included in the PENTAD of Thrombotic Thrombocytopenic Purpura?

A. Microangioparhic Hemolytic Anemia
B. Low platelet count
C. Liver Dysfunction
D. Fever
E. Neurologic Manifestation
A

C. Liver dysfunction —> RENAL Dysfunction

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3
Q

Which vitamin deficiency is involved in Celiac Disease?

A. Vitamin A Deficiency
B. Vitamin B Deficiency
C. Vitamin C Deficiency
D. Vitamin D Deficiency
E. Vitamin E Deficiency
A

E. Vitamin E Deficiency

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4
Q

Which cranial nerve is usually involved in Celiac Disease? (Clue: Found in Melkersson-Rosenthal Syndrome)

A. CN II
B. CN III
C. CN IV
D. CN VI
E. CN VII
A

E. CN VII

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5
Q

Which cranial nerve is least likely involved in patients with Osteopetrosis?

A. CN II
B. CN III
C. CN VII
D. CN VIII

A

B. CN III

Osteopetrosis is a sclerosis disorder characterized by increased bone mass due to impaired bone resorption by osteoclasts.

Result to narrowing of cranial nerve foramina in the base of the skull.

Result to optic atrophy with blindness and irreversible hearing loss.

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6
Q

Which is not associated with Pheochromocytoma?

A. Neurofibromatosis
B. Sturge-Weber Syndrome
C. Von-Hippel Lindau Disease
D. Osler-Weber-Rendu Syndrome
E. Tuberous sclerosis
A

D. Osler-Weber-Rendu Syndrome

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7
Q

Hippocampus (CA1 and CA4)

A. Resistant to Anoxia
B. Vulnerable to Anoxia

A

B. Vulnerable to Anoxia

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8
Q

Hippocampus (CA2 and CA3)

A. Resistant to Anoxia
B. Vulnerable to Anoxia

A

A. Resistant to Anoxia

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9
Q

Betz Cells of Motor Cortex

A. Resistant to Anoxia
B. Vulnerable to Anoxia

A

A. Resistant to Anoxia

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10
Q

Deep Folia of Cerebellum

A. Resistant to Anoxia
B. Vulnerable to Anoxia

A

B. Vulnerable to Anoxia

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11
Q

Nucleus of Brainstem and Spinal Cord

A. Resistant to Anoxia
B. Vulnerable to Anoxia

A

A. Resistant to Anoxia

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12
Q

Which has higher affinity to hemoglobin, oxygen or carbon monoxide?

A

Carbon Monoxide (200x more affinity with hemoglobin)

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13
Q

At 20-30% of hemoglobin mixed with carboxyhemoglobin, which of the following signs and symptoms do you usually observed?

A. EEG: Generalized slowing
B. Seizures
C. Coma
D. Cyanosis of the skin (skin changes)

A

D. Cyanosis of the skin (skin changes)

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14
Q

At 20-30% of hemoglobin mixed with carboxyhemoglobin, which of the following signs and symptoms is not observed?

A. Headache
B. Seizures
C. Confusion
D. Cyanosis of the skin (skin changes)

A

B. Seizures

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15
Q

At 50-60% of hemoglobin mixed with carboxyhemoglobin, which of the following signs and symptoms is not observed?

A. Coma
B. Seizures
C. Decerebrate posturing
D. EEG: Slowing of background activity
E. Confusion
A

E. Confusion

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16
Q

Which of the following is correct regarding carbon monoxide poisoning?

A. Cherry-Red color is the most common skin manifestation
B. At 50% level of carboxyhemoglobin, you may observe headache, confusion, nausea and vomiting
C. Oxygen has higher affinity with carboxyhemoglobin
D. Visual field defects and papilledema may be observed at higher level of carboxyhemoglobin
E. MRI or CT is usually abnormal and never appears normal.

A

D. Visual field defects and papilledema may be observed at higher level of carboxyhemoglobin

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17
Q

In acute mountain sickness, at 8,000ft, which of the following will be observed in a patient?

A. Headache
B. Ataxia
C. Drowsiness
D. Tremor
E. Mild Confusion
A

A. Headache

18
Q

In acute mountain sickness, at 8,000ft, which of the following should not be observed in a patient?

A. Headache
B. Insomnia
C. Anorexia
D. Tremor
E. Weakness
A

D. Tremor

19
Q

When would you expect the presentation of long term CO poisoning?

A: <1 week
B: 1-3weeks
C: 4-6 weeks
D: 6-8 weeks
E: >8 weeks
A

B: 1-3weeks

20
Q

Which of the following is not a chronic manifestation of mountain sickness?

A. mental dullness
B. nocturnal headache
C. hallucinations
D. papilledema
E. burning of hands and feet
A

C. Hallucinations

21
Q

Which of the following is true regarding high altitude sickness?

A. There is over-expression of glutamate that would explain presence of vascular edema
B. Other term for acute mountain sickness is Monge disease
C. Best preventive treatment for acute mountain sickness is acclimatization of 2-4days prior to ascent
D. At 8,000ft, patient may present with tremor, headache, nausea and vomiting, anorexia and insomnia
E. Chronic mountain sickness patient usually presents with anemia

A

C. Best preventive treatment for acute mountain sickness is acclimatization of 2-4days prior to ascent

22
Q

Initial symptoms of hypoglycemia appear at what level of blood glucose..

A

30mg/dL

23
Q

Glucose reserve is about _____ and can sustain cerebral activity for ___ minutes.

A

1-2grams

30minutes

24
Q

At level of 30mg/dL, which of the following is not expected symptom of hypoglycemia?

A. Focal Cerebral Deficits
B. Seizure
C. Headache
D. Coma
E. Confusion
A

D. Coma

25
Q

At level of 10mg/dL, which of the following is not expected symptom of hypoglycemia?

A. Seizure
B. Dilation of pupils
C. Hypotonia
D. Coma
E. Slow pulse
A

A. Seizure

At 10mg/dL
“Medullary phase of hypoglycemia”

  • Dilatation of pupils
  • hypotonia
  • coma
  • shallow respiration
  • slow pulse
26
Q

Which of the following is an MRI finding of osmotic demyelination?

A. Hemorrhage and necrosis of the mamillary bodies
B. Symmetrical Hyperintensities of Globus Pallidus
C. Enhancing lesion in the pulvinar of hypothalamus
D. Restricted diffusion of the putamen and head of caudate nucleus
E. Hyperintensity in the center of the pons and sparing corticospinal tract

A

E. Hyperintensity in the center of the pons and sparing corticospinal tract

27
Q

Myopathy is only observed in Hyperthyroidism.

True or False?

A

False.

Aside from hypothyroidism, thyrotoxic myopathy is also present in Grave disease.

28
Q

Which of the following is not observed in hypercalcemia?

A. Psychosis
B. Ataxia
C. Coma
D. Numbness

A

D. Numbness

29
Q

Which of the following is the most common neurologic manifestation of Sickle Cell Disease?

A. Watershed Infarcts
B. Moya-moya syndrome
C. Intracranial anuerysm
D. Tortuous intracranial arteries
E. Hemorrhages
A

A. watershed Infarct

30
Q

Which of the following is not true of Vitamin A?

A. Bitot spots may be observed in Vit A deficiency
B. Idiopathic Intracranial Hypertension may be observed in Vitamin A deficiency
C. VAD is the leading cause of preventable childhood blindness
D. VAD is observed in poorer countries like Africa and Southeast Asia
E. Vitamin A excess results to headache and transient episodes of visual loss

A

B. Idiopathic Intracranial Hypertension may be observed in Vitamin A deficiency

31
Q

Which of the following is not included in the triad of Wernicke-Korsakoff Syndrome?

A. Delirium
B. Hypoglycemia
C. Ataxia
D. Ophthalmoplegia
E. None of the above
A

B. Hypoglycemia

32
Q

Which of the following is true of central pontine myelinolysis?

A. Symptoms are usually observed within 24hours of rapid sodium correction
B. Parkinsonism cannot be observed in this kind of illness
C. >50% of cases may present with extrapontine myelinolysis
D. Extrapontine myelinolysis may present with MRI findings of hyperintensities of putamen and head of caudate nucleus

A

Answer: D. Extrapontine myelinolysis may present with MRI findings of hyperintensities of putamen and head of caudate nucleus

A. Symptoms are usually observed within 24hours of rapid sodium correction - (48-72Hours)

B. Parkinsonism cannot be observed in this kind of illness (Parkinsonism, Quadriparesis, Locked-in Syndrome and Bulbar symptoms and Coma are observed)

C. >50% of cases may present with extrapontine myelinolysis (10% ONLY)

33
Q

Where can you find long-segment hyperintensities on T2 weighted images in the dorsal column of spinal cord? Patient presents with slowly progressive gait ataxia and paresthesias of the hands and feet

A. Lead toxicity
B. Copper deficiency myelopathy
C. Mercury Toxicity
D. Vitamin B12 deficiency

A

B. Copper deficiency myelopathy

34
Q

Which nerve roots are commonly involved in Diabetic Amyotrophy?

A. C4-C6
B. L2-L4
C. S1-S3
D. T12-L1

A

B. L2-L4

patient presents with weakness and severe pain on the thigh and hip. Followed by atrophy of these muscles

35
Q

Which of the following medications is approved by FDA for management of pain associated with diabetic peripheral neuropathy?

A. Gabapentin
B. Steroids
C. Duloxetine
D. Amitriptyline
E. Tramadol
A

C. Duloxetine

Duloxetine and Pregabalin are FDA approved medications for diabetic neuropathy

36
Q

Which of the following is an MRI finding of Chronic Portal-Systemic Encephalopathy?

A. Hemorrhage and necrosis of the mamillary bodies
B. Symmetrical T1 Hyperintensities of Globus Pallidus
C. Enhancing lesion in the pulvinar of hypothalamus
D. Restricted diffusion of the putamen and head of caudate nucleus
E. Hyperintensity in the center of the pons and sparing corticospinal tract

A

B. Symmetrical T1 Hyperintensities of Globus Pallidus

37
Q

Which of the following is an MRI finding of Acute Portal-Systemic Encephalopathy?

A. Hemorrhage and necrosis of the mamillary bodies
B. Symmetrical Hyperintensities of Globus Pallidus
C. Enhancing lesion in the pulvinar of hypothalamus
D. Restricted diffusion of the putamen and head of caudate nucleus
E. T2 hyperintensity throughout cerebral hemisphere (insula, thalamus, and cingulate)

A

E. T2 hyperintensity throughout cerebral hemisphere (insula, thalamus, and cingulate)

38
Q

Which of the following is an MRI finding of Carbon Monoxide Poisoning?

A. Hemorrhage and necrosis of the mamillary bodies
B. Symmetrical T1 Hyperintensities of Globus Pallidus
C. Enhancing lesion in the pulvinar of hypothalamus
D. Restricted diffusion of the putamen and head of caudate nucleus
E. T2-hyperintensity of bilateral globus pallidus with associated necrosis

A

E. T2-hyperintensity of bilateral globus pallidus with associated necrosis

39
Q

Which of the following is true of Wilson Disease?

A. It is due to deficiency of copper-carrying protein, transferrin.
B. Manifestation is usually at late-adulthood, inherited via autosomal recessive
C. Accumulation of lead in multiple areas of the body (liver, cornea, basal ganglia)
D. One of the classic manifestation is wing beating tremor
E. Dysphagia and dysarthria cannot be observed in these patients

A

D. One of the classic manifestation is wing beating tremor

Explanation

A. It is due to deficiency of copper-carrying protein, transferrin. (CERULOPLASMIN)
B. Manifestation is usually at late-adulthood, inherited via autosomal recessive pattern (late childhood and early adolescence, autosomal recessive pattern)
C. Accumulation of lead in multiple areas of the body (liver, cornea, basal ganglia) (accumulation of copper)
E. Dysphagia and dysarthria cannot be observed in these patients (dysphagia and dysarthria may be observed)

40
Q

What is the characteristic ocular finding in Wilson Disease? At which layer is copper accumulated?

A

Kayser-Fleischer Ring

copper is deposited around periphery of cornea’s Descemet Membrane

41
Q

Which is not true with the laboratory manifestations of Wilson Disease?

A. Low serum ceruloplasmin (<200ng/L)
B. Elevated 24hr urine copper (>50mcg/day)
C. Elevated Liver function test
D. Low copper concentration on liver biopsy

A

D. Low copper concentration on liver biopsy

ELEVATED COPPER CONCENTRATION ON LIVER BIOPSY. —> Gold standard

ANSB Review (18 decks)

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