Neurologic Tests

Question 1

CSF fluid:

Answer 1

Color: clear, colorless.
Pressure: 3x a day.

Question 2

Urgent indications for LP:

Answer 2

1. Suspected CNS infection except abscess or parameningeal process.
2. Suspected SAH if CT negative.
3. Idiopathic intracranial hypertension = pseudotumor cerebri

Question 3

Non-urgent indications for LP

Answer 3

1. CNS malignancies or carcinomatous meningits
2. TB meningitis, CNS syphilis
3. CNS vasculitis or paraneoplastic syndromes
4. NPH
5. Demyelinating disease (MS)
6. GBS

Question 4

Contraindications for LP:

Answer 4

1. Possible raised ICP
2. Thrombocytopenia or other bleeding diseases.
3. Suspected spinal epidural abscess

Question 5

Potential LP complications

Answer 5

• back pain
• post-LP HA
• infection
• bleeding
• cerebral herniation
• minor neurologic symptoms: radicular pain, numbness
• late onset epidermoid tumors of the thecal sac

Question 6

LP need insertion site:

Answer 6

Once at L3/L4 or L4/L5 interspace

Question 7

LP findings in Bacterial Meningitis:

Answer 7

Color: turbid yellow
Pressure: elevated
WBC count: >1000
Diff count(predominance): PMNs
Protein: Mild/Marked elevation
Glucose: Mild/Marked Low
Gram Stain: Positive 60-90%

Question 8

LP findings in Viral Meningitis:

Answer 8

Color: clear
Pressure: normal
WBC count: 10-100
Diff count(predominance): Lymphocytes
Protein: Normal to Elevated
Glucose: Normal
Gram Stain: Negative

Question 9

LP findings in Tuberculous Meningitis:

Answer 9

Color: Fibrin Web Yellowish
Pressure: variable
WBC count: 10-100
Diff count(predominance): Lymphocytes
Protein: Markedly Elevated
Glucose: Low
Gram Stain: Negative

Question 10

LP findings in Fungal Meningitis:

Answer 10

Color: Fibrin Web Yellowish
Pressure: variable
WBC count: 10-100
Diff count(predominance): Lymphocytes
Protein: Elevated
Glucose: Low
Gram Stain: Negative

Question 11

Indications for EEG:

Answer 11

• Unexplained episodes of altered consciousness
• Unexplained state of altered of consciousness
• Observed seizure w/o regaining consciousness
• Monitoring of iatrogenic coma
• Confirmation of Brain Death

Question 12

EMG is:

Answer 12

A technique for characterizing the electrical activity produced by skeletal muscles

Question 13

NCS:

Answer 13

Evaluates the electrical characteristics of signals that propagate along cranial nerves, spinal nerves, and smaller peripheral nerves

Question 14

EMG is contraindicated in:

NCS is contraindicated in:

Answer 14

EMG contrainidicated if clotting abnormalities.

NCS contraindicated if implanted cardiac defibrillator.

Question 15

EMG characteristics in neuropathic disease:

Answer 15

1. Increased AP amplitude
2. Increased duration of individual APs
3. Increased number of muscle fiber per motor unit (reinnervation)

Question 16

EMG characteristics in Myopathic disease:

Answer 16

1. Decreased AP amplitude
2. Decreased duration of individual APs
3. Decreased number of muscle fiber per motor unit (muscle fiber loss)

Question 17

NCS parameters:

Answer 17

1. Amplitude
2. Morphology
3. Velocity

Question 18

NCS pattern in axonal loss:

Answer 18

Decreased amplitude

Question 19

NCS pattern in proximal stimulation of demylination:

Answer 19

Altered morphology