Blueprints

Question 1

CSF produced by

Answer 1

choroid plexus

Question 2

CSF absorbed by

Answer 2

arachnoid granulations in dural venous sinuses

Question 3

LP contraindications

Answer 3

space occupying lesion causing mass effect with increased ICP
local infection/inflammation
coagulopathy

Question 4

ASIS is at the level of the

Answer 4

L3-4

Question 5

normal CSF glucose, protein, WBC, OP

Answer 5

2/3 blood glucose, 40-50 protein,

Question 6

CSF with oligoclonal banding

Answer 6

MS

Question 7

CSF with xanthochromia

Answer 7

SAH, hemorrhagic encephalitis

Question 8

CSF positive EBV PCR

Answer 8

CNS lymphoma in immunosuppressed

Question 9

CSF in 14-3-3 protein

Answer 9

CJD

Question 10

complication of LP

Answer 10

low pressure headache

Question 11

DWI useful for identifying

Answer 11

stroke

Question 12

visual evoked potentials (VEPs)

Answer 12

diagnose optic neuritis and MS

Question 13

SSEPs somatosensory evoked potentials

Answer 13

peripheral nerve and spinal cord problems, anoxic brain damage

Question 14

BAEPs brainstem auditory evoked potentials

Answer 14

brainstem dysfunction, esp vestibular schwannomas

Question 15

Rx for commonly reversible coma

Answer 15

naloxone, thiamine, dextrose (thiamine b/f dextrose to prevent wernicke’s encephalopathy)

Question 16

altered consciousness can be due to two general categories

Answer 16

brainstem dysfunction or both cerebral hemispheres dysfunction

Question 17

ways to decrease ICP

Answer 17

raise head of bed, hyperventilate, mannitol/other osmotic diuretic

Question 18

locked in syndrome

Answer 18

lesion at base of pons, awareness and cognition intact but nearly complete paralysis

Question 19

persistent vegetative state

Answer 19

preserved sleep wake and autonomic functions, no awareness or cognition

Question 20

brain death

Answer 20

no brain function, irreversible

Question 21

chronic alcoholic, acutely confused (encephalopathic), eye movement abnormalities, ataxia, autonomic signs

Answer 21

wernicke’s encephalopathy

Question 22

long term memory disorder w/ anterograde amnesia, confabulations, after wernicke’s encephalopathy resolved

Answer 22

korsakoff’s syndrome

Question 23

losing some color vision (esp red)

Answer 23

MS

Question 24

dilation lag in small pupil (mitosis) and anisocoria greater in darkness

Answer 24

sympathetic defect (e.g. Horner’s)

Question 25

ptosis, dilated pupil (mydriasis), opthalmoplegia

Answer 25

3rd nerve palsy

Question 26

bilateral small pupils, irregular, impaired light reaction and intact LND

Answer 26

Argyll robertson pupil, syphilis

Question 27

dilated pupil, segmental contraction, light-near dissociation

Answer 27

adie's pupil, PS fibers affected

Question 28

causes of increased ICP

Answer 28

space-occupying lesion (tumor, AVM, aneurysm, edema) or idiopathic intracranial hypertension

Question 29

symptoms of ICP

Answer 29

morning headache, ataxia, transient visual obscuration, enlarged blind spot, bilateral disc hyperemia

Question 30

rx idiopathic intracranial hypertension

Answer 30

acetazolamide, nerve decompression, shunt

Question 31

hyaline bodies on funds, enlarged blind spot

Answer 31

drusen (calcified hyaline bodies) or pseudopapilledema; familial

Question 32

painful visual loss, worse with exercise or heat (Uhthoff's), RAPD, retro-orbital pain, loss of color discrimination, central scotoma

Answer 32

optic neuritis, usually due to demyelination (MS, SLE, sarcoid, adrenoleukodystrophy, tumor), or viral/meningitis, behcet, whipple, crohn

Question 33

optic neuritis rx

Answer 33

IV methylprednisolone

Question 34

painless sudden visual loss, usually over 50, associated with HTN or hypotension, DM. often unilateral segmental disc edema

Answer 34

anterior ischemic optic neuropathy, vascular causes or inflammatory (temporal arteritis)

Question 35

ipsilateral optic atrophy and contralateral papilledema

Answer 35

frontal lobe tumor, Foster Kennedy Syndrome

Question 36

eye is down and out

Answer 36

3rd nerve

Question 37

proximal symmetric weakness, can affect neck muscles, elevated CK

Answer 37

primary muscle disorder

Question 38

fluctuation in degree of weakness, proximal muscles > distal, some extra ocular and bulbar muscles

Answer 38

NMJ disorders

Question 39

muscle nerve root? shoulder abduction

Answer 39

deltoid axillary C5

Question 40

muscle nerve root? elbow flexion

Answer 40

biceps musulocutaneous C5/6

Question 41

muscle nerve root? elbow extension

Answer 41

triceps radial C7

Question 42

muscle nerve root? wrist extension

Answer 42

wrist extensors radial C7

Question 43

muscle nerve root? finger flexion

Answer 43

finger flexors median and ulnar C8/T1

Question 44

muscle nerve root? finger extension

Answer 44

finger extensors radial C7

Question 45

muscle nerve root? finger abduction

Answer 45

interossei ulnar C8/T1

Question 46

muscle nerve root? hip flexion

Answer 46

iliopsoas nerve to iliopsoas L1/2/3

Question 47

muscle nerve root? hip abduction

Answer 47

gluteus medius and minimus superior gluteal L5

Question 48

muscle nerve root? hip adduction

Answer 48

hip adductors obturatory L3

Question 49

muscle nerve root? hip extension

Answer 49

gluteus maximus sciatic S1

Question 50

muscle nerve root? knee flexion

Answer 50

hamstrings, sciatic, L5/S1

Question 51

muscle nerve root? knee extension

Answer 51

quadriceps femoral L3/4

Question 52

muscle nerve root? plantar flexion

Answer 52

gastrocnemius, soleus bibial S1

Question 53

muscle nerve root? dorsiflexion

Answer 53

tibialis anterior peroneal L5

Question 54

muscle nerve root? foot eversion

Answer 54

peroneus muscles peroneal S1

Question 55

muscle nerve root? foot inversion

Answer 55

tibialis posterior tibial L5

Question 56

muscle nerve root? great toe extension

Answer 56

extensor hallucis longus peroneal L5

Question 57

biceps reflex

Answer 57

C5

Question 58

brachioradialis reflex

Answer 58

C6

Question 59

triceps reflex

Answer 59

C7

Question 60

finger flexor reflex

Answer 60

C8/T1

Question 61

patellar reflex

Answer 61

L4

Question 62

hip adductor reflex

Answer 62

L3

Question 63

ankle jerk reflex

Answer 63

S1