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Brain Power: Adam and Victor's Neurology > Neurodiagnostics > Flashcards

Neurodiagnostics Flashcards

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1
Q

What is the only possible indication for a cisternal (foramen magnum) puncture?

A

Spinal block

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2
Q

What spinal level corresponds to the axial plane of the iliac crests?

A

L3-L4

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3
Q

What is the most common cause of dry tap?

A

Improperly placed needle; other causes

  1. compressive lesion of the cauda equina
  2. adhesive arachnoiditis
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4
Q

What is the proportion of patients undergoing LP that develop headache?

A

1/3

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5
Q

What parameters must be ensured prior to doing LP?

A

INR >1.4

PLT

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6
Q

What is the normal ICP?

A

10-18 cm H2O
8-14 mm Hg
Note 1mmgHg = 1.3cmH20

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7
Q

What ICP indicated intracranial hypotension?

A

50 mm H20 and below

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8
Q

What is the test for spinal subarachnoid block?

A

Queckenstedt test. Normally there should be a rapid rise in CSF pressure within a few seconds after application of the pressure on the vein

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9
Q

A hazy ground glass appearance of CSF indicates how much RBC currently present in the CSF?

A

At least 200 rbc per cubic mm

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10
Q

T or F. Fibrinous webs and blood clots form in traumatic taps but not in CSF which have instrinsic RBC

A

T. CSF that really has RBC will have already been much diluted and defibrinated by CSF enzymes

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11
Q

What are the pigments that color the CSF following SAH?

A

Oxyhemoglobin: red
Bilirubin: canary yellow
Methemoglobin: brown

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12
Q

What protein level imparts xanthochromia

A

150mg/100ml

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13
Q

What are ddx for eosinophils in the CSF?

A
  1. Hodgkin disease
  2. Parasitic infection
  3. Neurosyphilis
  4. Cholesterol emboli
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14
Q

What are the normal protein concentrations

  1. Cord
  2. Basal cisterns
  3. Ventricles
A
  1. 45-50
  2. 10-25
  3. 5-15
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15
Q

What are the CSF correction factors

A

1000 RBC = 1mg CHON = 1-2 WBC

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16
Q

What is Froin syndrome?

A

Block in CSF flow causing high CHON 1000mg/dl or more, deeply yellow CSF and clots

17
Q

T or F Beta 2 transferrin or tau is detected ONLY IN CSF AND NOT IN OTHER FLUIDS

A

T

18
Q

What is normal CHO in the CSF?

A

45-80mg dl (0.6-0.7)

19
Q

What value of CSF glucose in absolutely abnormal?

A

Below 35 mg/dL

20
Q

What is the pathophysiology of low glucose in the meningitis?

A

Inihibition of entry of glucose into CSF because of an impairment of the membrane transfer system

21
Q

What are more specific tests for neursyphyillis? Compared to VDRL and RPR?

A

Treponema pallidum immobilization test and the Fluorescent treponemal antibody test

22
Q

lactate dehydrogenase in CSF is elevated in which conditions?

A

Bacterial meningitis and meningeal tumor infiltration particularly lymphoma

23
Q

Indicate the level of these components in the CSF compared to the serum.

  1. pH
  2. PCO2
  3. HCO3
  4. Ammonia
  5. Uric acid
A
  2. =
    4.
24
Q

What 3 components of the brain are equally visualized by both the CT and MRI?

A
  1. Ca
  2. Fat
  3. Bone
  4. Blood
25
Q

What to do in cases of poor GFR prior to contrast enhanced imaging?

A

If GFR 30-60: hydrate and discontinue potentially nephrotoxic medications prior to contrast administration

26
Q

What is the PP of restricted diffusion in acute ischemic stroke?

A

Failure of the Na K ATPase pump leads to cellular swelling and reduced intercellular space thus limiting the movement of free water resulting in hyperintensity on DWI

27
Q

What is facilitated diffusion and where is it seen?

A

Seen in vasogenic edema. Hyperintense in BOTH ADC AND DWI

28
Q

What are the following markers for in spectroscopy?

  1. N acetyl aspartate
  2. Choline
A
  1. Neuronal integrity decreased in destructive lesions in those that decrease the density of neurons
  2. Membrane turnover increased in tumors
29
Q

T or F. Even when there are no residual signs of reduced VA, visual field abnormalities, alterations of the optic nerve head, or changes in the pupillary reflexes conduction delays in the visual pathways of patients who have optic nerve disease can be seen with VER.

A

T

30
Q

The first downward deflection in Pattern Shift Visual Evoked Response in normal people appear when?

A

in 100 ms (P100)
Mean 104 (upper limit mean +3SD) 118
Also significant if DIFFERENCE OF LONGER THAN 9 MS

31
Q

What proportion of MS patients will have prolongation of PSVER?

A

1/3

32
Q

What are the 7 BAER waves?

A 
1 auditory nerve
2 Cochlear nuclei in pons
3 Superior olivary
4 Lateral lemniscus
5 Inferior colliculus
6 Medial geniculate
7 Auditory radiations
33
Q

What proportion of MS patients will have abnormal BAEPs even in the absence of clinical ssx

A

1/2

Brain Power: Adam and Victor's Neurology (19 decks)

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