Cerebrovascular Disease and Infections

Question 1

ACA lesion?

Answer 1

• upper motor neuron type weakness and cortical type sensory loss
• Initally contralateral hemiplegia
• contralateral leg more than arm or face
  
  • alien hand syndrome

Question 2

PCA lesion?

Answer 2

Contralateral homonymous hemianopia

Question 3

MCA lesion?

Answer 3

• aphasia
• hemineglect
• hemianopia
• face-arm sensoriomotor loss
• gaze preference to side of lesion

Question 4

ACA-MCA watershed area infarction?

Answer 4

• proximal arm and leg weakness
• transcortical aphasia

Question 5

MCA-PCA watershed infarction?

Answer 5

Higher order visual processing

Question 6

Carotid stenosis thrombi symptoms?

Answer 6

• contralateral face arm weakness
• contralateral visual field defeccts
• aphasia
• face arm leg weakness
• contralateral sensory changes

Question 7

What artery is most affected by embolic infarction?

Answer 7

MCA

Question 8

____ hemorrhages are characteristic of bone marrow embolization.

Answer 8

Widespread white matter

Question 9

Heritable coagulation factor disorders?

Answer 9

• protein S or C deficiencyh
• Antithormbin III deficiency

Question 10

What are the two types of strokes?

Answer 10

• Hemorrhagic
  
  • emboli associated
  • hemorrhage secondary to reperfusion of damaged vessels
• Ischemic
  
  • thrombus associated
  • hemorrhagic conversion: vessels ruptures leading to secondary hemorrhage

Question 11

Ischemic stroke mechanisms?

Answer 11

• embolic
• thrombolic
• large vessel such as MCA
• small vessel especially in basal ganglia
• Lacunar infarcts: small vessel infarcts resembling small lakes

Question 12

What is a lower motor neuron lesion of cranial nerves IX X and XII?

Answer 12

Bulbar palsy

Question 13

What is the name for a condition that affects your ability to control the miscles in your face, including your jaw?

Answer 13

Psuedobulbar palsy aka involuntary emotional expression disorder

Question 14

Where is pneumococcal meingitis densest?

Answer 14

over convexitites near sagittal sinus

Question 15

Where is H. influenzae located in the brain?

Answer 15

Basal location

Question 16

Focal cerebritis?

Answer 16

• inflammatory cells infiltrate walls of the veins and extend in brain substance

Question 17

What does leptomeningeal fibrosis lead to?

Answer 17

Hydrocephalous

Question 18

What is ventriculitis?

Answer 18

• fulminant infection with inflammation that extends to ventricles

Question 19

Gram stain for N. meningitidis, S. pneumonia, H. influenzae, S.aureus, S. streptococci, E.coli?

Answer 19

• N. meningitidis Gram negative diplococci
• S.pneumoniae gram positive diplococci
• H. influenzae gram negative pleomorphic
• S. aureus and S epi streptococci gram positive cocci
• E. coli gram negative bacilli

Question 20

Glucose level in CSF if bacteria are present?

Answer 20

Low because bacteria eat glucose

Question 21

Viral meningitis CSF findings?

Answer 21

• normal pressure
• clear
• early PMNs and Late lymphs
• normal glucose and protein or negative
• 0-500 cells

Question 22

Bacterial meningitis CSF results?

Answer 22

• increased pressure
• opaque
• 1-60,000 cells
• lots PMNs
• negative glucose
• high protein

Question 23

3m-2yo unvaccinated with acute meningitis, what is t he cause?

Answer 23

H. influenza type B

Question 24

Neonate acute meningitis cause?

Answer 24

• E.coli
• Grp B strep

Question 25

Adolescent and young adult meningitis cause?

Answer 25

* N. meningitidis

Question 26

Elderly meningitis causes?

Answer 26

* Strep pneumonia * Listeria

Question 27

Acute meningitis in an immunocompromised patient is likely caused by…?

Answer 27

* S. pneumonia * N. meningitidis * L. .monocytogenes * P. aeruginosa

Question 28

Basilar skull fracture meningitis cause?

Answer 28

* S. pneumonia * H. influenzae * Grp A beta hemolytic strep

Question 29

Head trauma post neurosurgery meningitis causes?

Answer 29

* S. aureus * S. epi * aerobic gram - bacilli

Question 30

CSF shunt meningitis causes?

Answer 30

* S. epi * S. aureus * P. aeruginosa * P. acnes

Question 31

Waterhouse-Friderichsen syndrome?

Answer 31

Hemorrhagic infarction of adrenal glands seen with N. meningitidis

Question 32

Chronic meningitis CSF results?

Answer 32

* Elecvated protein * Mostly lymphocytic * Sometimes low glucose level

Question 33

HIV is associated with increased incidence of \_\_\_?

Answer 33

primary CNS lymphoma

Question 34

Rash on palms and soles?

Answer 34

* Hand foot mouth * Kawasaki Dz * Rocky Mtn spotted fever * Secondary Syphilis

Question 35

CNS Rocky mountain spotted fever symptoms?

Answer 35

* diffuse cerebral edema * meningeal enhancement * arterial infarction * signal abnormality within distribution of perivvascular spaces