T2: Transport w/in the CNS Flashcards
Modified ependymal cells that are found within the ventricular system appear to have a loss of function mutation that is allowing non-lipid soluble molecules to pass through. Which of the following are essential to the function of the cell described above? (mm)
A) Macula Communicans
B) Zonula Adherens
C) Desmosome
D) Zona Occludens
Answer: D- The cell described is the secretory epithelium of the choroid plexus. The choroid plexus forms the CSF-BBB barrier through the use of Tight junctions. Zone Occludens = tight junction
A- Gap junction - in the ependymal cells lining the ventricles
You suspect your patient to have Viral Meningitis and perform CSF sampling to find the composition. What is mist likely the composition of your patients CSF if they have what you suspect? (mm)
A) + protein, norm glucose, RBC present
B) + protein, norm or dec glucose, INC lymphocytes tumor cells
C) + protein, dec glucose, INC WBC
D) + protein, norm glucose, Excessive WBC
E) + protein, dec glucose, INC WBC (pmnlc type)
Answer: D- + protein, norm glucose. and excessive WBC (lymphocytes). Viral meningitis
A- Subarachnoid Hemorrhage
B- Metastatic cancer in meninges
C- Tubercular Meningits
E- Bacterial Meningitis
You are a radiologist and are assigned to take a CT of a patient. Upon walking into your room you notice that the patient smells like piss and are very grossed out. After putting on your gloves to help him into the CT machine because he is extremely clumsy he doesn’t stop talking about weird things like small dongs and bringing water balloons into his class. Where is this patient likely to have a tumor? (mm)
A) Cerebellum B) Choroid Plexus C) Thalamus D) Pons E) Medulla
Answer: B- The patient is displaying classical symptoms of Wet, Wacky and Wobbly indication of communicating hydrocephalus. A choroid plexus tumor causes over production of CSF responsible for all of this.
After assisting in delivery of an infant, you observe that the child has an abnormally large cranial circumference and suspect the possibility of hydrocephalus. Which of the following causes could be possible for this child’s potential hydrocephalus?
A) Widening of the aqueduct of sylvius B) A Choroidal Tumor C) Cellular Debris D) Tissue Loss E) Malfunction of the arachnoid villi
FA
C) Cellular Debris
None of the other choices would result in obstructive hydrocephalus. A choroidal tumor would secrete more CSF and thus cause communicating hydrocephalus
A patient is rushed to the ER after suffering an MI. You notice that the patient exhibits shortness of breath, sweating, and Jugular Veinous Distention. Which of the following structures drain directly into the internal jugular vein?
A) Sigmoid Sinus B) Superior Sagittal Sinus C) Interior Sagittal Sinus D) Transverse Sinus E) Straight Sinus
FA
A) the sigmoid and cavernous sinuses drain into the internal jugular vein.
Circumventricular organs are organs that have breaks within the blood brain barrier for specific sensing or release of hormones. Which of the following circumventricular organs respond to inflammation and Angiotensin II
A) Subfornical Organ B) Area Postrema C) Median Eminence D) OVLT E) Subcommisural Organ
FA
D) OVLT responds to signals from Interleukin-1 and Angiotensin II
Subfornical Organ responds to Angiotensin II and is considered the thirst sensor of the brain
Area Postrema responds to aromatic substances to initiate vomiting
Median Eminence is the point at which the hypothalamus release hormones into the hypothalamic-pituitary portal system to act on the anterior pituitary
After assisting in delivery of an infant, you observe that the child has an abnormally large cranial circumference and suspect the possibility of hydrocephalus. Which of the following causes could be possible for this child’s potential hydrocephalus?
A) widening of the aqueduct of sylvius B) A Choroidal Tumor C) Cellular Debris D) Tissue Loss E) Malfunction of the arachnoid villi
C) Cellular Debris
None of the other choices would result in obstructive hydrocephalus. A choroidal tumor would secrete more CSF and thus cause communicating hydrocephalus
A patient is rushed to the ER after suffering an MI. You notice that the patient exhibits shortness of breath, sweating, and Jugular Veinous Distention. Which of the following structures drain directly into the internal jugular vein?
A) Sigmoid Sinus B) Superior Sagittal Sinus C) Interior Sagittal Sinus D) Transverse Sinus E) Straight Sinus
A) the sigmoid and cavernous sinuses drain into the internal jugular vein.
You given a patient’s labs values:
Protein: increased greatly
Glucose:normal
Cells of Note: Presence of a few WBC observed
What is the problem diagnosis for this patient?
A.Viral Meningitis
B.Tubercular Meningitis
C. Metastatic Cancer
D. Guiliann Bare
RFA
D. Guillain Bare
Viral Meningitis- Protein:Increased, Glucose: Normal, Cells -EXCESSIVE WBC
Tubercular Meningitis- Protein:Increased, Glucose:DECREASED, Cells-increased WBC
Metastatic Cancer-Protein:Increased, Glucose: normal or DECREASED, Cells-increased WBC anc Cancer cells
Which of the following is false able CSF.
A. Has a greater Cl concentration than plasma
B. CSF is produced exclusively in the lateral ventricle
C. Influences rate of Pulmonary ventilation
D. Has a lower K concentration than plasma
E. Papilledema would be expected with a CSF pressure of 17 mm H20
RFA
B. CSF is produced in all intracranial ventricles
A patient comes in with a suspected neural issue what a CSF sample is ordered. From which level is appropriate.
A.L2-L3 BL4-L5 C.L3-L4 D.L1-L2 E. S1-S2
RFA
B.L4-L5
Which of the following is not a function of CSF?
A) Regulates extracellular environment.
B) Removes metabolites from the central nervous system.
C) Circulates higher levels of proteins in comparison to plasma.
D) Influences rates of pulmonary ventilation and cerebral blood flow.
E) Cushions the central nervous system.
C) Circulates higher levels of proteins in comparison to plasma.
CSF has lower proteins, glucose, K+, Ca+, and pH in comparison to plasma.
