Metabolic Encepalopathy

Question 1

Metabolic encephalopathy (ME) is associated with these symptoms aside from cognitive and decreased sensorium

Answer 1

EPS: Tremors
Seizure
Systemic findings
Skin abnormalities
Ophthalmologic findings

Question 2

T/F: Metabolic disorders rarely present as an isolated case involving only one system

Answer 2

T

Question 3

Dark red to brown urine reflect excess ________

Answer 3

porphyrin excretion

Question 4

Pathogenesis of ischemic hypoxic encephalopathy (6)

Answer 4

Global reduction in CBF -> ischemia
Hypoxia from suffocation
Paralysis of respiratory muscles
CO poisoning
Anoxia -> hippocampus and cerebellum affected

Question 5

These parts are more resistant to anoxia

Answer 5

Brainstem and spinal cord

Question 5

T/F: watershed infarcts may present if hypoperfusion dominates

Man in the Barrel Syndrome is due to an infarction between what arteries?

Answer 5

T

MCA and ACA

Question 5

T/F: Hyperthermia reduces cerebral metabolic requirements, thus prevents delayed worsening of ME

Answer 5

F- hypothermia

Question 6

T/F: CO poisoning can present in imaging to have symmetric hyperintensity of the globi pallidi, with sparing of the putamen

Initial treatment of CO poisoning

Answer 6

T

Inspired oxygen

Question 7

T/F: extreme altitude causes cerebral edema

Monge disease is aka

Answer 7

T

Chronic Mountain sSickness

Question 8

In DKA, ___ and ___ are elevated in the blood and urine, and there is marked glycosuria

Nonketotic hyperosmolar states have focal signs or symptoms due to previous _________

Answer 8

Ketone bodies and B hydroxybutyric acid

Silent cerebrovascular events

Question 9

This is caused by using aluminum as a substrate for dialysis

This is caused by the cytotoxic edema due to osmotic shifts in water

Answer 9

Dialysis encephalopathy
Dialysis disequilibrium syndrome

Question 10

T/F: Central pontine myelinolysis is a manifestation of hyponatremia

Answer 10

F- It’s Osmotic demyelination syndrome (d/t rapid rise of serum osmolality)

Question 11

Head trauma with damage to the pituitary stalk usually causes ______

Answer 11

Central diabetes insipidus

Question 12

Histopathology found in Wernicke-Korsakoff syndrome

Answer 12

Mamillary bodies

Question 13

This disease has neurological presentations such as length-deepndent, axonal sensorimotor peripheral neuropathy with distal sensory loss

Answer 13

Beri-beri

Question 14

Although rare, this could be caused by intake of isoniazid, hydralazine, or penicillamine

Answer 14

Pyridoxine Deficiency

Question 15

This causes Lhermitte’s sign, progressing to gait abnormalities due to combination of sensory ataxia

Answer 15

Cobalamin (V12) Deficiency

Question 16

This causes spinocerebellar syndrome, with acanthosis and swollen axons in pathology

Answer 16

Vit E Deficiency

Question 17

This disease is associated with chronic alcoholism and involves the demyelination and necrosis of the corpus callosum

Answer 17

Marchiafava Bignami Disease

Question 18

T/F: Arsenic causes necrosis of the optic nerves and putamina bilaterally

Answer 18

F - methanol

Question 19

This is stored in the reticuloendothelial system and slowly released, causing fatal acute poisoning due to diffuse edema and/or hemorrhagic encephalopathy

Answer 19

Arsenic poisoning

Question 20

The Type II syndrome due to this poisoning can cause cardiac failure

Answer 20

Organophosphate poisoning

Question 20

This is due to inhibited porphyrin metabolism, causing motor neuropathy commonly involving radial nerve (wrist drop)

Answer 20

Inorganic lead poisoning

Question 21

Involves the calcarine cortex, resembling ALS, and causes cognitive impairment (MAD AS A HATTER)

Answer 21

Mercury poisoning

Question 22

This poison causes diffuse proximal weakness resembling MG. It also involves postsynaptic (COBROtoxin) and presynaptic (CROtoxin) inhibition of Ach release

Answer 22

Snake

Question 23

T/F: Amanita mushrooms block both cholinergic and GABA synapses

Answer 23

T