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Adams Principles of Neurology > Sensorium&Sleep > Flashcards

Sensorium&Sleep Flashcards

1
Q

A state of continuous awareness of one’s self and environment.

A

Consciousness

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2
Q

A state in which the patient can be roused only by vigorous and repeated stimuli and in which arousal cannot be sustained without repeated stimulation.

A

Stupor

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3
Q

T/F: Upon being awakened from deep sleep, a normal person may be confused for a few moments.

A

True

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4
Q

T/F: Cerebral oxygen uptake does not decrease during sleep.

A

True

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5
Q

A syndrome of unconscious awakening lasting for 3 months after non traumatic and 12 months after traumatic injury

A

Persistent vegetative state

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6
Q

T/F: The occurrence of a well-developed Babinski sign is unusual although its presence does not exclude the diagnosis of brain death.

A

True

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7
Q

Electrocerebral silence is considered to be present if?

A

There is no electrical potential of more than 2mV during a 30-minute recording except for artefacts created by the ventilator, ECG and surrounding electrical device.

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8
Q

An acute drop in CBF to this level causes slowing of the EEG and syncope or impaired consciousness

A

25 ml/min/100g brain tissue

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9
Q

Body temperature which can induce coma through a nonspecific effect on the metabolic activity of neurons

A

above 41 degrees Celsius or below 30 degrees Celsius

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10
Q

Most common underlying biochemical derangement in recurring episodes of stupor

A

hepatic failure

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11
Q

T/F: During a focal seizure, the eyes turn or jerk toward the convulsing side.

A

True

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12
Q

Conditions which could give rise to Cheyne-Stokes Respiration

A

massive supratentorial lesions, bilateral deep-seated cerebral lesions and mild metabolic disturbances

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13
Q

T/F: In hypertensive encephalopathy, focal signs may be present.

A

True

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14
Q

The most common pathologic basis of vegetative state

A

Diffuse cerebral injury

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15
Q

Cerebral blood flow below the level causes electrocerebral silence, comma and cessation of most neuronal metabolic and synaptic functions

A

12-15 mL/min/100g

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16
Q

Site in the heart with most of the subendocardial mechanoreceptors that are responsible for the afferent impulses to the nucleus tractus solitarius

A

Inferoposterior wall of the left ventricle

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17
Q

tributary of the glossopharyngeal nerve which transmit sensory impulses from the carotid sinus

A

Nerve of hering

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18
Q

This type of syncope is the result of orthostatic loss of blood pressure

A

Orthostatic hypotension

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19
Q

Type of syncope which is the result of impaired baroreflex function which cannot compensate for pooling of blood in splanchnic vessels

A

Postprandial hypotension

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20
Q

T/F: Bedside testing of orthostatic blood pressure is best performed by having the patient stand quickly and taking readings immediately and again at 1 min and at 3 min.

A

True

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21
Q

T/F: Syncope does not occur as a manifestation of TIA

A

True

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22
Q

Seizures arising from this area prolong the QT interval and increase sympathetic tone thereby lowering the threshold for ventricular arrythmia

A

Left insula

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23
Q

Seizures arising from this area shorten the QT interval and increase parasympathetic tone thereby increasing the risk of vagally mediated syncope.

A

Right insula

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24
Q

This medication may be helpful in patients with parkinsonism and chronic orthostatic hypotension

A

Domperidone

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25
Q

T/F: Arousing a person during Stage N3 is more difficult than arousal from REM sleep.

A

True

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26
Q

Neurologic signs of sleep deprivation?

A

mild and inconstant nystagmus, impairment of saccadic eye movements, loss of accommodation, exophoric, slight tremor of hands, ptosis of the eyelids, expressionless face, thickness of speech and mispronunciation

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27
Q

T/F: Fatigue worsens restless leg syndrome and there is a tendency for it to be worse in warm weather.

A

True

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28
Q

Genetic finding in people with periodic leg movements of sleep

A

Nucleotide variant in short segment of chromosome 6p

29
Q

T/F: Depressive illness produces early morning waking and inability to return to sleep

A

True

30
Q

Nocturnal tingling and numbness of the fingers and palms caused by tight carpal ligament which may awaken patient at night

A

Acroparesthesia

31
Q

T/F: The chronic insomniac who has no other symptoms should be discouraged from using sedative drugs

A

True

32
Q

Where is the lesion of von economo encephalitis?

A

Anterior hypothalamus and basal frontal lobes

33
Q

Where is the lesion of hypersomnia?

A

Hypothalamus and subthalamus

34
Q

In what stage of sleep does night terrors occur?

A

Stage 3 or 4

35
Q

term denoting the patient’s incapacity to think with customary speed, clarity and coherence.

A

Confusion

36
Q

It is the concomitant reduction and prominent delay in producing movement, speech, ideation and emotional reaction.

A

Abulia

37
Q

Refers to the constant restless movements and inability to sit still

A

Akathisia

38
Q

T/F: The EEG in delirium may show symmetrical mild generalized slow activity in the range of 5-10 per second.

A

True

39
Q

Most prominent early symptom of dementia

A

Gradual development of forgetfulness

40
Q

T/F: Ribot’s law states that up to a certain point in the illness, memories of the distant past are relatively well retained at a time when more recently acquired information has been lost.

A

True

41
Q

Refers to the mechanical disruption of the deep white matter

A

Axonal shearing

42
Q

T/F: The association cortex that are not obviously committed to primary motor and sensory functions is generally a heterotypical cortex.

A

True

43
Q

Where does the neural control of the circadian rhythms reside?

A

Suprachiasmatic nuclei of the ventral-anterior region of the hypothalamus

44
Q

Sleep becomes consolidated into a single long nocturnal period by what age?

A

4th or 5th year

45
Q

T/F: approximately 20-25% of total sleep time in young adults is spent in REM sleep, 3-5% in stage N1, 50-60% in stage N2 and 10-20% in stage N3 combined.

A

True

46
Q

Most important stage in sleep in restoring the altered function that result from prolonged sleep deprivation.

A

N3

47
Q

Approximately how many percent of dreaming occurs outside of REM periods?

A

20%

48
Q

Signifies a chronic inability to sleep despite adequate opportunity to do so.

A

Insomnia

49
Q

T/F: The diagnosis of periodic leg movements depend on finding them during polysomnographic recordings whereas restless leg syndrome is identified on clinical grounds.

A

True

50
Q

T/F: Von Economo encephalitis was related to a predominance of lesions in the anterior hypothalamus and basal frontal lobes whereas hypersomnia was related to lesions in the dorsal hypothalamus and subthalamus.

A

True

51
Q

Treatment for nocturnal frontal lobe epilepsy.

A

Carbamazepine

52
Q

T/F: Frightening dreams or nightmares are far more frequent than night terrors and affect children and adults.

A

True

53
Q

Somnambulism almost exclusively occur during this stage of sleep?

A

N3

54
Q

In fully 90% of nsrcoleptics, the condition is established by what age?

A

25th

55
Q

Risk of narcolepsy in a first-degree relative of an affected individual

A

1-2%

56
Q

T/F: stress is often blamed in bruxism.

A

True

57
Q

EEG in delirium

A

Symmetrical mild generalized slow activity in the range of 5-10 per second

58
Q

Circadian pacemaker that regulates the sleep-wake cycle

A

Suprachiasmatic nucleus in the anterior hypothalamus

59
Q

The most effective stimulus for the internal clock

A

Light

60
Q

Usually the first symptom of narcolepsy

A

Excessive daytime sleepiness

61
Q

Most specific symptom of narcolepsy

A

Cataplexy

62
Q

First approved drug for treatment of cataplexy

A

Sodium oxybate

63
Q

First line agents for restless leg syndrome

A

Dopaminergic agonists

64
Q

Repetitive, stereotyped movement of extremities with extension of big toe, ankle dorsiflexion, flexion of knee and hip during sleep

A

Periodic limb disorder

65
Q

T/F: Restless leg syndrome is a clinical diagnosis and polysomnography is generally unnecessary

A

True

66
Q

Most common disorder associated with insomnia

A

Depression

67
Q

Stage of sleep that does not change significantly as we age

A

REM stage

68
Q

Most common traumatic brain injury

A

Subarachnoid hemorrhage

Adams Principles of Neurology (19 decks)

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