Neuro 1 pt4

Question 1

Excellent images of white matter tracts
Good for localizing eloquent areas in relations to the lesion for surgery/RT
complementary with fMRI
can see changes in white matter connectivity p ischemic or traumatic disruptions
also white matter chgs from MS, HIV, schizophrenia, metabolic & degenerative probs

Answer 1

Diffusion Tensor Imaging (DTI)

Question 2

inject nuclear tagged tracer which accumulates in metabolically active sites (what test?)

Answer 2

PET - Positron Emission Tomography

Question 3

PET scan is often performed with CT or MRI to localize: (2)

Answer 3

Cancer

Dementias

Question 4

Approach to the neuro patient starts with:

Answer 4

Neurologic impression - first sight of patient

Question 5

P (of PQRST) of the neuro exam looks to distinguish:

Answer 5

UMN (central) vs. LMN (peripheral)

Question 6

Q of PQRST of neuro exam looks for quality, aka:

Answer 6

“numbness”: anesthesia vs. decr.sensation
“dizzy”:presyncope/vertigo/disequilibrium
weakness; generalized vs. motor

Question 7

Most of the time when patients say they’re weakened, they mean __.

Answer 7

fatigued

Question 8

What are trigger points?

Answer 8

pain along a specific muscle fiber, can cause headaches.

Question 9

Describe a patient with Spontaneous CSF leak

Answer 9

when they lie down they feel okay, but it hurts when they are up and walking around. The more they move, the weaker (motor) they get. When they rest they get stronger.

Question 10

Prof sez: this is most important part of the neuro history.

Answer 10

timing: acute vs. chronic

Question 11

With __, nobody knows who can be “hardly affected” or will be unable to walk in a few years.

Answer 11

MS

Question 12

Mainly concerned with weight __ with cancer, but ask about “change in weight” to keep the patient interview question open-ended.

Answer 12

weight loss

Question 13

Define True incontinence

Answer 13

they can’t feel when they need to use bathroom.

Question 14

1 Question Neurologists ask

Answer 14

Where is the lesion?

Question 15

7 places a neurlogic lesion may be:

Answer 15

Brain
Spinal cord
Nerve root
Plexus
Peripheral nerve
NM junction
end organ (esp.skin and muscle)

Question 16

Mini-Mental Exam is for grading:

How many points on this scale?

Answer 16

For grading dementia

30 point scale. 30/30 = no dementia

Question 17

Motor Grading System, I guess it rates motor abilities. How does its scale work?

Answer 17

5/5 Full strength
*4/5 Better than antigravity, but less than full
3/5 Antigravity strength only; holds posture but not to any resistance
2/5 Movement with gravity removed
1/5 Tone only or flicker of movement
0/5 Completely flaccid

Question 18

r/o meningitis: bacterial, viral, aseptic, carcinomatous
r/o SAH
unexplained coma
tx. pseudotumor cerebri & other communicating hydrocephalus dx

Answer 18

Indications to do a lumbar puncture

Question 19

standard way to do LP (position of patient, where to insert needle)

Answer 19

patient in left lateral decbutitus & fetal position, spinal needle is inserted btwn 3rd and 4th lumbar vertebrae, and access CSF

Question 20

Acute Bacterial Meningitis main CSF lab

Answer 20

Glucose is low, lots of neutrophils

Question 21

Viral Meningitis main CSF lab

Answer 21

Glucose is normal-less low than bacterial

Lot of lymphocytes

Question 22

xanthrochromia is

Answer 22

yellowish appearance of cerebrospinal fluid (which envelops the brain) in particular medical conditions, especially subarachnoid hemorrhage.

xanthrochromia more accurate for SAH detection than CT head if small sentinal bleed 3-4 days ago

Question 23

post LP headache can be treated with:

Answer 23

Blood patch

Question 24

An epidural blood patch is

Answer 24

surgical procedure that uses autologous blood in order to close one or many holes in the dura mater of the spinal cord, usually as a result of a previous lumbar puncture.