more path/phys

Question 1

lifetime risk CNS tumor

Answer 1

.6%

Question 2

glioma progen tumors

Answer 2

astrocytoma, ependymoma, oligodend

Question 3

neuronal progen tumors

Answer 3

neuronal tumors

Question 4

MC brain neoplasia primary

Answer 4

GBM 40% and infiltrative astrocytoma 42%

Question 5

when giving anticonvulsants for brain tumor

Answer 5

use non hepatic enzyme inducing drugs - levet, lacos, gabapentin

Question 6

meningioma hist

Answer 6

spindle shaped cells arranged in sheet and whorls

Question 7

chemo for meningioma

Answer 7

no effective chemo at this time

Question 8

pituitary tumors are mostly from

Answer 8

ant pituitary

Question 9

microadenoma

Answer 9

<1cm - most often hormone secreting - fxnal

Question 10

sx pit adenoma

Answer 10

ha, endo dysfxn, visual field def, facial numbness

Question 11

bitemp hemianop in pit tumor

Answer 11

begins in upper quads

Question 12

tx primary cns lymphoma

Answer 12

steroids after bx, high dose mtx, vincrist or procarb, radiotherapy

Question 13

primary cns lymphoma hist

Answer 13

round blue cells

Question 14

superiors

Answer 14

intort

Question 15

inferiors

Answer 15

extort

Question 16

cn 4 palsy

Answer 16

nasal upshoot

Question 17

the more anterior the lesion

Answer 17

the more incongruous the field defect

Question 18

altitudinal hemianopsia common

Answer 18

loss of visual fields either sup or inf - dz in eye

Question 19

meyer’s loop

Answer 19

in temp lobe superior contralateral quadrant of visual field “pie in the sky”

Question 20

anterior spinal artery

Answer 20

supplies everything except dorsal columns

Question 21

CSF glucose is ___ of serum

Answer 21

2/3

Question 22

associate medulloblast with

Answer 22

drop mets

Question 23

VLPO

Answer 23

single nuc stimulating sleep

Question 24

craniopharyng associated with

Answer 24

diabetes insipidus

Question 25

myelopathy

Answer 25

any dz that affects the SC

Question 26

acute sc lesion bladder

Answer 26

urinary retention. Chronic is spastic and urinary frequency

Question 27

acute and subacute myelopa are

Answer 27

neuro emergencies - therapy is usually IV steroids

Question 28

epidural lesion early

Answer 28

motor sx early UMN, sensory, urinary urgency

Question 29

epidural lesion progression

Answer 29

motor weakness, root area numb, like a brown-sequard, definite sphincter dysfxn

Question 30

epidural lesion final

Answer 30

flaccid arreflexive due to sc shock, spastic paraparesis if more chronic, complete sensory level to all modalities at level of lesion

Question 31

some epidural lesions

Answer 31

abscess, tumor, disc disease

Question 32

intradural lesions

Answer 32

neurinoma, meningioma

Question 33

intramedullary lesions

Answer 33

syringomyela, glioma, myelitis

Question 34

tx disc disese

Answer 34

steroids and surgery

Question 35

acute sc injury

Answer 35

IV methylprednisolone over 1 hr, and lower dose over next 23 hrs

Question 36

most met cancer begins in

Answer 36

the vertebral body

Question 37

most spinal abscess begins in

Answer 37

disc space

Question 38

if suspect abscess

Answer 38

spinal MRI, probably staph Aureus

Question 39

clinical of epidural abscess

Answer 39

fever, pain on percuss, elevated WBC, elevated ESR, risks include IV drug, HIV, immunosupp

Question 40

spinal meningioma is common in

Answer 40

thoracic spine

Question 41

dumbbell shape mass

Answer 41

nerve sheath tumor - schwannoma or neurofibroma

Question 42

central cord lesion early

Answer 42

pain in shoulders, loss of pain and temp across chest, crossing spinothalamic tracts are involved early.

Question 43

central cord lesion progression

Answer 43

reflexes are lost in arms, loss of pain and temp severe, Horner's syndrome, touch and joint position are intact, legs develop spastic paraparesis, + Babinski

Question 44

central cord lesion final progress

Answer 44

all symptoms worsen, sacral sparing because these fibers are most lateral.

Question 45

acute non compressive myelopathies

Answer 45

transverse myelitis, NMO

Question 46

subacute combined degeneration

Answer 46

B12 def - spastic weakness of lower extrem, decreased sens to vib and pos, rombergs, ataxia, babinski, per neuropathy possible

Question 47

Infection with HTLV1

Answer 47

paraparesis and sc dz - HAM/tropical spastic paraparesis. CNS infiltrated by monocytes, demy and axonal degen - esp corticospinal tract, CSF shows oligoclonal bands and IgG

Question 48

vacuolar myelopathy

Answer 48

neuro complication of HIV, progressive spastic paraparesis, sens ataxia and incontinence, vacuolization and myelin pallor, resembles B12 def

Question 49

tabes dorsalis

Answer 49

complication of neurosyphilis. post column dysfxn, loss of vibration and joint sense, + romberg

Question 50

lesion limited to 1-2 vertebral bodies length

Answer 50

transverse myelitis

Question 51

tx transverse myelitis

Answer 51

IV steroids

Question 52

% chance of developing MS after an episode of trans my

Answer 52

30%

Question 53

neuromyelitis optica

Answer 53

NMO- severe thoracis pain, optic neuritis bouts, acute paraparesis and urinary retention

Question 54

Ab associated with NMO

Answer 54

anti-aquaporin 4

Question 55

lesion of sc more than 3 vert bodies long

Answer 55

NMO

Question 56

neutrophils in CSF and normal brain MRI

Answer 56

NMO - also neg oligoclonal bands

Question 57

path of NMO

Answer 57

eosins, neuts, hyalinized vessels, complement deposition - rimmed and rosette

Question 58

median age onset MS

Answer 58

29

Question 59

median age onset NMO

Answer 59

39

Question 60

hiccups in pt with myelopathy

Answer 60

think NMO