Recall 2018 Flashcards
What are the expected CSF findings in cerebral malaria?
a. Parasitized RBCS
b. Increased pressure
c. Significant leukocytosis
d. Low sugar
b. Increased pressure
The CSF may be under increased pressure, and sometimes contains FEW WBC, with NORMAL GLUCOSE (p. 736 , Infections of the CNS and Sarcoidosis, Adams 10th ed).
Cowdry type A inclusion bodies
a. HSV
b. CMV
c. EBV
d. HIV
A. Cowdry Type A
Cowdry type A in Herpes simplex virus and Varicella zoster virus
Cowdry type B in Polio and adenovirus
Negri bodies in Rabies, Guarnieri bodies in vaccinia, variola (smallpox)
Paschen bodies in variola (smallpox), Bollinger bodies in fowlpox,
Torres bodies in Yellow fever
Henderson-Patterson bodies in Molluscum contagiosum
Which of the following is not transmitted via retroaxonal transport?
a. Rabies
b. Varicella
c. Polio
d. HSV
c. Polio
Another pathway of infection is along peripheral nerves; centripetal movement of virus is accomplished by the retrograde axoplasmic transport system. HSV, VZV, and rabies virus utilize this peripheral nerve pathway, which explains why the initial symptoms of rabies occur locally, at a segmental level corresponding to the animal bite
Isolated weakness of quadriceps muscles are likely due to:
a. Steroids
b. Diabetes
c. Thyroid
d. Chemotherapeutics
a. Steroids
In adults, the most common cause is inclusion body myositis (where it may be unilateral or asymmetrical) or, a restricted form of Becker muscular dystrophy. In thyrotoxic and steroid myopathies, the major effects are on the quadriceps muscles. If unilateral or bilateral with loss of patellar reflex and sensation over the inner leg, this condition is most often the result of a femoral neuropathy, as occurs from diabetes, or of an upper lumbosacral plexus lesion. Injuries to the hip and knee cause rapid disuse atrophy of the quadriceps muscles. A painful condition of infarction of the muscle on one side is seen in diabetic patients.
Which of the following angiography signs is seen in ICA dissection?
a. String sign
b. Pearl sign
c. Dot sign
a. String sign
A double lumen is often apparent within the vessel on axial MRI sections. Arteriography by any of these methods or by CT or conventional angiography reveals an elongated, irregular narrow column of dye, usually beginning 1.5 to 3 cm above the carotid bifurcation and extending to the base of the skull, a picture that Fisher has called the string sign. There may be a characteristic tapered occlusion or an outpouching at the upper end of the string. It is the site and the shape of the occlusion that are helpful in identifying dissection.
Middle cerebral artery (MCA) dot sign, also known as the Sylvian fissure sign, is seen on CT of the head and represents the cross-sectional M2 equivalent of the hyperdense MCA sign. The dot sign represents a thromboembolus within a segmental branch of the MCA located within the Sylvian fissure (M2 segment).
Chronic hypercapnia syndrome syndrome can be seen in
a. COPD
b. Emphysema
c. Asthma
d. Fibrosing lung disease
Chronic obstructive pulmonary disease such as emphysema, fibrosing lung disease, neuromuscular weakness, and, in some instances, inadequacy of the medullary respiratory centers each may lead to persistent respiratory acidosis, with elevated of PCO2 and reduced in arterial PO2. The complete clinical syndrome of chronic hypercapnia described by Austen, Carmichael, and Adams comprises headache, papilledema, mental dullness, drowsiness, confusion, stupor and coma, and asterixis.
Where does bleeding in cerebral amyloid angiopathy occurs?
a. Occipital
b. Frontal
c. Parietal
d. Temporal
b. Frontal
Frontal > Parietal > Temporal = Occipital
Most common cause of stroke in the young?
a. Moyamoya
b. Sickle cell disease
c. Hypertension
d. Protein c deficiency
e. Factor V Leiden
c. Hypertension
Similarly, stroke is not an uncommon event in young adults (ages 15 to 45 years), accounting for an estimated 3 percent of cerebral infarctions in many series. In terms of causation, this group is remarkably heterogeneous. Among 144 such patients, more than 40 possible etiologies were identified by H.P. Adams and colleagues. Nevertheless, most of the strokes could be accounted for by three categories, more or less equal in size: atherosclerotic thrombotic infarction (usually with a recognized risk factor); cardiogenic embolism (particularly in the past association with rheumatic heart disease, bacterial and verrucous endocarditis, paradoxic embolism through patent foramen ovale, and prosthetic heart valves); and one of several nonatherosclerotic vasculopathies (arterial trauma, dissection of the carotid artery, moyamoya, lupus erythematosus, drug-induced vasculitis).
which drug does not affect Dabigatran?
a. Atorvastatin
b. Febuxostat
c. Verapamil
d. Some antibiotic
e. Phenytoin
b. Febuxostat
Dabigatran interacts with:
1. P-gp inhibitors – atorvastatin, verapamil, erythromycin,
azithromycin, itraconazole, ketoconazole,
2. P-gp inducers – phenytoin
3. Antacids – H2 antagonists, PPIs
