PRELIMS: Diagnostic Test Flashcards
Skull X-Ray Uses?
Detect fractures, dislocations, lytic lesions, blastic lesions, and foreign bodies.
Spine X-Ray: Cervical?
: Assess curve, alignment, vertebra, IV discs, foramina, fractures, dislocations, osteophytes, spondylosis, spondylolisthesis, DDD, foreign bodies, fusion, scoliosis.
Spine X-Ray: Thoracic & Lumbar?
Assess similar features as cervical; focus on fractures, alignment, and degenerative changes.
CT Scan Use?
Identify acute hemorrhage, bones of skull/spine; limitations in posterior fossa.
MRI: Lumbar?
Focuses on lumbar vertebrae, disc herniations, and spinal canal.
CT Scan Advantages?
: Cost-effective, fast, widely available; useful for acute stroke, head injury, infections, calcifications.
Contrast-Enhanced CT Uses?
: Breakdown of BBB, detect tumors, infections, inflammatory conditions, rule out cerebral metastasis.
CT Scan Limitations?
Limited in posterior fossa; not ideal for some detailed soft tissue evaluations.
CT Angiography (CTA) Advantages?
Identifies vascular abnormalities, available technology, requires less specialized skill.
CT Scan Uses?
Cost-effective, fast, widely available. Good for acute stroke, head injury, infections, calcifications. Useful for neurologically unstable patients, mechanical ventilator use, metallic implants, pacemakers.
Contrast-Enhanced CT Uses?
Detects breakdown of BBB, brain/spinal tumors, infections, inflammatory conditions, rules out cerebral metastasis.
MRI: Gold Standard for?
Intracranial, spinal, multiple sclerosis (MS).
MRI: Cervical/Thoracic Spine?
Evaluates spinal cord, vertebrae, and surrounding structures for lesions and alignment.
MRI-DWI Use?
Acute stroke imaging; detects cerebral ischemia.
MRI Disadvantages?
Requires patient cooperation, metal implants, pregnancy concerns, claustrophobia.
Magnetic Resonance Spectroscopy (MRS) Uses?
Assesses metabolic disorders, MELAS, MS plaques, hippocampal seizure foci, degenerative diseases, neoplasms. Measures choline, NAA, lactate levels.
Single Photon Emission Computed Tomography (SPECT) Use?
: Tomographic imaging of injected radioisotopes for cerebral perfusion. Widely available, cost-effective, useful post-tracer injection.
Functional MRI (fMRI) Use?
Maps cerebral activation; assesses motor, sensory, language functions. Guides surgery, embolization, radiation therapy, stroke recovery, cognitive changes.
Magnetic Resonance Angiography (MRA) Use?
Evaluates intracranial circulation patency, stroke/TIA, venous sinus thrombosis, AVM, vascular tumors, altered hemodynamics.
MRA vs. Other Techniques?
CTA: Non-invasive, no specialized catheter skills, avoids neuro complications. MRI: Better soft tissue contrast, multiplanar imaging, demonstrates physiological processes, visualizes posterior fossa/intra-spinal lesions.
Lumbar Tap/Puncture Use?
Analyzes cerebrospinal fluid (CSF), drains CSF, and reduces CSF pressure. Normal pressure: 100-150 mm CSF.
MRI Advantages?
Greater soft tissue contrast, multiplanar, demonstrates physiological processes, lacks ionizing radiation.
Myelogram Use?
Screens spinal canal and cord. Detects root compression. Complications: arachnoiditis, subdural injection, hematoma, spinal tumor impaction.
: Positron Emission Tomography (PET) Use?
Tomographic imaging of injected radioisotopes. Measures cerebral blood flow (CBF), oxygen utilization, protein synthesis, and turnover.
Transcranial Ultrasonography Use?
Evaluates hemodynamics, vasospasm, and stenosis.
Catheter Angiography Use?
Detailed evaluation of intracranial vascular disease. Preoperative assessment of intracranial vessels. Diagnosis of ischemic stroke in hyperacute phase.
Evoked Potentials (EP) Use?
Assesses CNS activity in response to specific stimuli. Extends neurologic examination.
Intracranial Pressure Monitoring Use?
Monitors and treats increased intracranial pressure (ICP). Useful in conditions like normal pressure hydrocephalus (NPH), post-op edema, traumatic hematoma.
CT Myelogram Use?
Identifies compressive and expanding lesions in the spine.
Needle Biopsy: Muscle Indications?
Limb weakness, infantile hypotonia, exercise intolerance, myoglobinuria, cramps.
Nerve Biopsy Use?
Diagnoses peripheral neuropathy. Sural nerve is most commonly studied.
Electroencephalogram (EEG) Use?
Measures brain electrical activity. Useful for diagnosing epilepsy and in obtunded patients.
Spinal Fluid Analysis Components?
Bacteriological, biochemical protein (0.15-0.45 g/l), biochemical glucose (0.45-0.79 g/l).
Electromyography-Nerve Conduction Velocity Studies (EMG-NCV) Use?
Assesses nerve and muscle activity, NMJ function. NCV measures conduction in nerves; EMG measures electrical activity in muscles.
Skin Punch Biopsy Use?
Assesses extensive cutaneous sensory and autonomic nerves. Detects painful or small-fiber neuropathy. Minimally invasive, can be taken from multiple sites.
Excision Biopsy: Muscle Locations?
Proximal: vastus lateralis, biceps. Distal: gastrocnemius, tibialis anterior, peroneus brevis.
