29.5.2013(neurology) 21 Flashcards
(119 cards)
0
Q
Incubation period of tuberculoid leprosy
A
2-5 yrs
1
Q
Mode of transmission of leprosy
A
Respiratory
2
Q
Incubation period of lepromatous leprosy
A
8-12 yrs
3
Q
Organs not affected by leprosy
A
CNS
LUNG
4
Q
First sign of infection with leprosy
A
Indeterminate leprosy(solitary patch)
5
Q
Unusual feature of CMI in lepromatous leprosy
A
Specific anergy to Lepra bacilli alone
Unlike sarcoidosis or Hodgkin lymphoma(CMI to many antigens are impaired)
6
Q
Type of helper cell response in lepromatous leprosy
A
Th2
7
Q
Acid fast stain used in leprosy
A
Fite stain
8
Q
Fernandez reaction
A
Erythema 48hrs following lepromin skin test
9
Q
Mitsuda reaction
A
Nodules and papules 3-4wks following lepromin skin test
10
Q
Distribution of neuropathy in leprosy
A
Affects the cooler areas
Spotty
Dorsum of hand >palm
11
Q
Plantar ulcer surrounded by Hyperkeratosis in lepromatous leprosy
A
Mal perforans ulcer
Common over metatarsal heads
12
Q
Adverse effects of dapsone
A
Hemolysis in G6PD deficiency Methhemoglobinemia Peripheral neuropathy Psychosis Pancytopenia Sulfone syndrome Infectious mononucleosis like condition High fever Anemia Exfoliative dermatitis
13
Q
Side effect of clofazamine
A
Red to brown to purple discolouration of skin
14
Q
Rx of type 1 reaction
A
Prednisone
15
Q
Rx of type 2 reaction
A
Thalidomide
For mild cases aspirin
16
Q
Morphological index
A
a measure of the
number of acid-fast bacilli (AFB) in skin scrapings that stain uniformly
bright
17
Q
Morphological index is a measure of
A
viability
18
Q
Bacteriological index
A
logarithmic-scaled measure of the density of M. leprae in the
dermis
19
Q
Only bacterium to invade peripheral nerves
A
M.leprae
Trisacharide of leprae binds basal lamina of Schwann cells
20
Q
Nerve abscess in leprosy is common in which type of leprosy
A
BT
21
Q
Leprae PGL specific antibodies are high in
A
Lepromatous leprosy(95%)
Phenolic glycolipid
22
Q
Common site of leprosy in children
A
Buttocks and thighs
23
Q
Lesions of tuberculoid leprosy
A
Dry,
Scaly
Anhidrotic
Absence of hair follicle and sweat glands
24
Leprosy
| Skin lesions are symmetric in
Lepromatous leprosy
25
Diffuse lepromatosis
No visible skin lesions
Diffuse dermal infiltration
Thickened dermis
Western Mexico and carribean area
26
CD4:CD8 ratio in tuberculoid leprosy
2: 1
1: 2 in lepromatous leprosy
27
Nerve most commonly involved in reversal reaction
Ulnar nerve
28
Untreated reversal reaction
| Irreversible nerve damage can occur within
24hrs
29
Types of type 1 reaction
Reversal-become tuberculoid-occurs after Rx
Downgrading-becomes lepromatous-occurs before Rx
30
Characteristic microscopic feature of type 1 reaction
Edema
31
Unique feature of T cells in type 1 reaction
T cells with gamma/delta receptors
32
Fever is profound in which leprosy reaction
ENL
| it is mild in type 1reaction
33
Effect of leprosy on nose
Nasal stuffiness
Epistaxis
Anosmia
Saddle nose
34
Slit lamp finding in LL patients
Corneal beading
35
Leprosy type
| False positive serologic tests
LL
| hyperglobulinemia
36
Granuloma formation within dermal nerves
Pathognomonic of leprosy
37
Only bactericidal antileprotic agent
Rifampicin
38
Clinical trial
Most potent bactericidal
Antileprotic drug
Moxifloxacin
39
Multibacillary leprosy
6 or more skin lesions
40
Sub cortical dementia
```
Huntington
PSP
parkinson
MS
dementia in HIV
```
41
Mixed dementias
Vascular
Alzheimer's with lewy body
LBD
dementia due to fragile X associated tremor ataxia
42
Alzheimer's disease involves
Temporo parietal cortex
43
Central anticholinergics used in Parkinsonism
Trihexyphenidyl(most commonly used)
Procyclidine
Biperidin
Benzatropine
44
Anticipation in Huntington disease
More in spermatocytes
45
PSP
| Other name
Steel Richardson syndrome
46
Posture in steel richardson syndrome
Head extension
47
Causes of pseudotumor cerebri
```
HypervitaminosisA
Hypoparathyroidism
Outdated tetracyclines
Quinolones
Withdrawal of corticosteroid
Addison
SLE
```
48
Trinucleotide expansions affecting noncoding regions
Fragile X
Friederich ataxia
Myotonic dystrophy
49
Disease due to mutated androgen receptor
Spinobulbar muscular atrophy
Kennedy disease
CAG repeats
50
Haw river syndrome
Dentatorubropallidolusian atrophy
51
Demonstration of fragile X
Culture of cells in folate deficient medium
52
Anticipation in fragile X
In oocytes
53
Second most common genetic cause of mental retardation
Fragile X
First:down
54
Chronic infections causing dementia(reversible)
```
Neurosyphilis
Whipple
TB
Fungal
Protozoal
```
55
CSF glucose
| Relation to plasma glucose
2/3
| 40-70mg/dl
56
CSF pressure
| Normal
50-180mm of h20
57
CSF protein
| Normal
15-50mg/dl
58
CSF leukocytes
| Normal
<5/micro litre
No neutrophils
60% lymphocytes
59
CSF
| pH
7.10-7.34
60
CSF chloride
| Normal level
116-122ug/dL
61
Pleocytosis
Both neutrophils and lymphocytes
62
Meninges spared in TB
Dura
Basal exudate
63
Hydrocephalus
| TB
Communicating
| Doesn't resolve with ATT
64
CNS findings
| TB
Basal exudate
Meningeal calcification at base of brain
Hydrocephalus
Ventriculitis
65
Meningitis and cl-
Bacterial Low
TB VERY low
Viral Normal
66
Recurrent Meningitis In CSF leaks
| Organism
Pneumococci
67
Subdural empyema
| Organisms
Aerobic and anaerobic streptococci
68
Subdural empyema in children
| Organism
H.influenzae
69
Cerebritis
Non encapsulated brain abscess
70
Most common cause of meningoencephalitis in children
Enterovirus
71
Most common cause of sporadic encephalitis
HSV
72
Most common cause of epidemic viral encephalitis
Arbovirus
73
Most common cause of viral meningitis
Enterovirus
74
MRI findings in herpes encephalitis
Increased intensity in temporal lobe and inferior frontal lobe
Cingulate gyrus
75
Rx of herpes simplex keratitis
Trifluridine/vidarabine
76
Rx of Herpes simplex oro labialis
Penciclovir
77
Order of involvement of cysts in taenia solium
CNS
Subcutaneous tissue
Striated muscle
Eye
78
Second most common site of neurocysticercoisis
Ventricle
First: brain parenchyma
79
Drug preferred in neurocysticercosis and why?
```
Albendazole
Penetrates subarachnoid space better
Course of treatment shorter(1week)
Cheaper
Coadministration with steroid increases absorption
```
80
Most common primary intracranial neoplasm in adults
Glioblastoma multiforme
81
Most common tumors in children
Leukemia
82
Most common solid tumors in children
CNS tumors
83
Most common site of brain tumor in neonates
Supratentorial
84
Most common supratentorial tumors in children
Craniopharyngioma
85
Radiosensitive brain tumors in children
```
Medulloblastoma
Glioma,ependymoma
Pinealblastoma
Craniopharyngioma
Germ cell tumors
```
86
Brain tumors involving the CSF
```
Medulloblastoma
Anaplastic ependymoma
Choroid plexus carcinoma
Pineoblastomas
Germ cell tumors
Lymphomas
```
87
Most common extracranial solid tumor in childhood
Neuroblastoma
88
Most common intraabdominal solid tumor in childhood
Neuroblastoma
89
Sites of metastasis of neuroblastoma
Long bones
Liver
Lymph node
Skin
90
Local infiltration by neuroblastoma
It often encases aorta and IVC
91
Most common renal tumor in children
Wilms tumor
92
Commonest tumor in type1 neurofibromatosis
Optic nerve glioma
93
Most common orthopaedic manifestation of neurofibroma 1
Scoliosis
94
Tumors in VHL
RCC
Pheochromocytoma
Pancreatic endocrine tumors
Adrenal carcinomas
95
Cerebellar hemangioblastoma
Cerebellar dysfunction
Hydrocephalus
Polycythemia
96
Ash leaf macules
| Distribution
Dermatomal
97
Type of seizure in tuberous sclerosis in infancy
Infantile spasm
98
Systemic features of tuberous sclerosis
```
Renal angiomyolipoma
Heart-rhabdomyoma
Pulmonary lymphangiomyomatosis
Retinal hamartoma
Cystic rarefaction of finger bones and toes
```
99
Systemic conditions associated with neuropathy
Diabetes
Uremia
HIV
It is VERY RARE in hypothyroidism
100
Rx of vein of Galen malformation
Embolisation
101
Disorders associated with defect in neural migration
```
Lissencephaly
Pachygyria
Microgyria
Heterotopias
Schizencephaly
```
102
Stages of brain development
S1 :Dorsal induction- formation and closure of neural tube
S2:Ventral induction- formation of brain segments and face
S3:Migration
S4:Myelination
103
Investigations used to differentiate arachnoid cyst from epidermoid cyst
Diffusion weighted MRI
| FLAIR
104
Diffusion weighted MRI of epidermoid cyst
Bright
105
Most common location of CNS epidermoid cyst
Cerebellopontine angle cistern
106
Most common site of arachnoid cyst
Middle cranial fossa anterior to temporal lobe
107
Diff btw epidermoid and arachnoid cyst
Epidermoid cyst encases arteries and nerves
| Arachnoid cyst displaces them
108
Investigation of choice for Leptomeningeal carcinomatosis
Gadolinium enhanced MRI
109
Systemic conditions associated with neuropathy
Diabetes
Uremia
HIV
It is VERY RARE in hypothyroidism
110
Rx of vein of Galen malformation
Embolisation
111
Disorders associated with defect in neural migration
```
Lissencephaly
Pachygyria
Microgyria
Heterotopias
Schizencephaly
```
112
Stages of brain development
S1 :Dorsal induction- formation and closure of neural tube
S2:Ventral induction- formation of brain segments and face
S3:Migration
S4:Myelination
113
Investigations used to differentiate arachnoid cyst from epidermoid cyst
Diffusion weighted MRI
| FLAIR
114
Diffusion weighted MRI of epidermoid cyst
Bright
115
Most common location of CNS epidermoid cyst
Cerebellopontine angle cistern
116
Most common site of arachnoid cyst
Middle cranial fossa anterior to temporal lobe
117
Diff btw epidermoid and arachnoid cyst
Epidermoid cyst encases arteries and nerves
| Arachnoid cyst displaces them
118
Investigation of choice for Leptomeningeal carcinomatosis
Gadolinium enhanced MRI
