Sensorium&Sleep

Question 1

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

Answer 1

Consciousness

Question 2

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.

Answer 2

Stupor

Question 3

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

Answer 3

True

Question 4

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

Answer 4

True

Question 5

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

Answer 5

Persistent vegetative state

Question 6

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

Answer 6

True

Question 7

Electrocerebral silence is considered to be present if?

Answer 7

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.

Question 8

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

Answer 8

25 ml/min/100g brain tissue

Question 9

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

Answer 9

above 41 degrees Celsius or below 30 degrees Celsius

Question 10

Most common underlying biochemical derangement in recurring episodes of stupor

Answer 10

hepatic failure

Question 11

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

Answer 11

True

Question 12

Conditions which could give rise to Cheyne-Stokes Respiration

Answer 12

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

Question 13

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

Answer 13

True

Question 14

The most common pathologic basis of vegetative state

Answer 14

Diffuse cerebral injury

Question 15

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

Answer 15

12-15 mL/min/100g

Question 16

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

Answer 16

Inferoposterior wall of the left ventricle

Question 17

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

Answer 17

Nerve of hering

Question 18

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

Answer 18

Orthostatic hypotension

Question 19

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

Answer 19

Postprandial hypotension

Question 20

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.

Answer 20

True

Question 21

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

Answer 21

True

Question 22

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

Answer 22

Left insula

Question 23

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

Answer 23

Right insula

Question 24

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

Answer 24

Domperidone

Question 25

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

Answer 25

True

Question 26

Neurologic signs of sleep deprivation?

Answer 26

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

Question 27

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

Answer 27

True

Question 28

Genetic finding in people with periodic leg movements of sleep

Answer 28

Nucleotide variant in short segment of chromosome 6p

Question 29

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

Answer 29

True

Question 30

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

Answer 30

Acroparesthesia

Question 31

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

Answer 31

True

Question 32

Where is the lesion of von economo encephalitis?

Answer 32

Anterior hypothalamus and basal frontal lobes

Question 33

Where is the lesion of hypersomnia?

Answer 33

Hypothalamus and subthalamus

Question 34

In what stage of sleep does night terrors occur?

Answer 34

Stage 3 or 4

Question 35

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

Answer 35

Confusion

Question 36

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

Answer 36

Abulia

Question 37

Refers to the constant restless movements and inability to sit still

Answer 37

Akathisia

Question 38

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

Answer 38

True

Question 39

Most prominent early symptom of dementia

Answer 39

Gradual development of forgetfulness

Question 40

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.

Answer 40

True

Question 41

Refers to the mechanical disruption of the deep white matter

Answer 41

Axonal shearing

Question 42

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

Answer 42

True

Question 43

Where does the neural control of the circadian rhythms reside?

Answer 43

Suprachiasmatic nuclei of the ventral-anterior region of the hypothalamus

Question 44

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

Answer 44

4th or 5th year

Question 45

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.

Answer 45

True

Question 46

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

Answer 46

N3

Question 47

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

Answer 47

20%

Question 48

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

Answer 48

Insomnia

Question 49

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

Answer 49

True

Question 50

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.

Answer 50

True

Question 51

Treatment for nocturnal frontal lobe epilepsy.

Answer 51

Carbamazepine

Question 52

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

Answer 52

True

Question 53

Somnambulism almost exclusively occur during this stage of sleep?

Answer 53

N3

Question 54

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

Answer 54

25th

Question 55

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

Answer 55

1-2%

Question 56

T/F: stress is often blamed in bruxism.

Answer 56

True

Question 57

EEG in delirium

Answer 57

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

Question 58

Circadian pacemaker that regulates the sleep-wake cycle

Answer 58

Suprachiasmatic nucleus in the anterior hypothalamus

Question 59

The most effective stimulus for the internal clock

Answer 59

Light

Question 60

Usually the first symptom of narcolepsy

Answer 60

Excessive daytime sleepiness

Question 61

Most specific symptom of narcolepsy

Answer 61

Cataplexy

Question 62

First approved drug for treatment of cataplexy

Answer 62

Sodium oxybate

Question 63

First line agents for restless leg syndrome

Answer 63

Dopaminergic agonists

Question 64

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

Answer 64

Periodic limb disorder

Question 65

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

Answer 65

True

Question 66

Most common disorder associated with insomnia

Answer 66

Depression

Question 67

Stage of sleep that does not change significantly as we age

Answer 67

REM stage

Question 68

Most common traumatic brain injury

Answer 68

Subarachnoid hemorrhage