Sessions 5+ review

Question 1

What symptoms is a patient likely to have if they have a tumour in the genu

Answer 1

UMN for face- facial and upper limb weakness

Question 2

Complete spinal cord injury destroying C5-T1 signs

Answer 2

LMN signs in both upper limbs
UMN signs in trunk and lower limbs

Question 3

STN damage leads to

Answer 3

hemiballismus

Decreased GPi and SNr = less inhibition of thalamus

Question 4

Which fibres transmit nociceptive inputs

Answer 4

C fibres

Question 5

Alpha A B and y fibres do what

Answer 5

A and y do motor

B does sensory

Question 6

left sided constricted pupil lesion

Answer 6

Superior cervical ganglion

Question 7

3 features of accommodation reflex

Answer 7

Constriction, convergence, convexity

Question 8

Fibres from the visual cortex synapse at the

Answer 8

midbrain

Question 9

from which artery is the right middle cerebral artery a branch of

Answer 9

ICA

Question 10

What forms circle of willis from ICA

Answer 10

Right middle cerebral
Posterior communicating artery
Anterior cerebral

Question 11

medial aspect of left parietal lobe stroke effects

Answer 11

Sensory deficit in right lower limb

Question 12

Other word for absence seizures

Answer 12

petit mal

Question 13

Rapid onset of dementia in a young person is suggestive of

Answer 13

Prion disease

Question 14

Sensible early investigation in sudden onset elderly confusion

Answer 14

urine dipstick

Question 15

Cushing’s response is characterised by

Answer 15

Hypertension and bradycardia (increased ICP)

Question 16

Which lobe is damaged in someone who only eats right side of dinner

Answer 16

Right parietal lobe (awareness of external environment)

Question 17

Anterior communicating artery connects which 2 structures

Answer 17

Anterior cerebral arteries

Question 18

Name a factor which increases risk of chronic subdural haemorrhage

Answer 18

Dementia

Question 19

Occlusion of the proximal portion of the superior cerebellar artery may lead to damage to which other structure?

Answer 19

Midbrain

(Supplies midbrain on way to cerebellum)

Question 20

Which part of the cortex is particularly vulnerable in occlusion of the anterior cerebral artery if herniation occurs

Answer 20

Cingulate cortex (can herniate between falx)

Question 21

Progression of condition of patient with raised ICP due to tumour in left cerebellar hemisphere

Answer 21

Lesion expands, first CSF, then venous blood forced out of cranial cavity

ICP increases more = compression of arterial supply to brain cells and
hypoxia

Hypoxia = increased [Na+] in brain cells, further swelling (osmosis)

Exponential increase in intracranial pressure

Question 22

Features of left cerebellar hemisphere tumour

Answer 22

DANISH
Papiloedema
Cranial nerve palsies CNV caudally
LOC

Question 23

OCD statistics

Answer 23

more common in men
1-3% prevalence
75% of patients will start experiencing symptoms before age 30

Question 24

where would you not find D2 receptors

Answer 24

neocortex

Question 25

where at D2 receptors found at high density

Answer 25

striatum, nucleus accumbent, olfactory tubercle

Question 26

where are D2 receptors found at low density

Answer 26

hippocampus, amygdala, hypothalamus, and cortical regions (substantia nigra)

Question 27

2 structures implicated in depression

Answer 27

Question 28

what chemical property of propofol enables it to cross the BBB

Answer 28

lipophilllic

Question 29

how does propofol decrease consciousness in general anaesthesia

Answer 29

Reticular formation: can’t stimulate cortex

Cortex: cannot generate neural signals

Hippocampus: amnesia

Thalamus: cannot transmit sensory information

Question 30

which cranial nerve transmits pain from the throat

Answer 30

glossopharyngeal

Question 31

name a pain modulation structure

Answer 31

periaqueductal grey
substantia gelatinosa
raphie magnus
dorsal horn

Question 32

80y/o M, sudden loss of vision, generally unwell, rheumatoid arthritis

Answer 32

Giant cell arteritis- already has immune condition and has been systemically unwell

optic nerve affected

Question 33

Amurosis fugax feature

Answer 33

would be transient

Question 34

Why is giant cell arteritis damage irreversible

Answer 34

neuronal loss, necrosis, CNS neurones do not regenerate. hypoxic injury

Question 35

define a stroke

Answer 35

sudden neurological deficit due to vascular cause

Question 36

2 risk factors for stroke

Answer 36

smoking and diabetes