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CNS Flashcards

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1
Q

On a CT what color is CSF?

A

dark

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2
Q

Which has more bony detail- CT or MRI?

A

CT scan

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3
Q

Which is more expensive, CT or MRI?

A

MRI

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4
Q

Which takes longer, MRI of brain or CT of brain?

A

MRI

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5
Q

Which has better soft tissue detail- MRI or CT?

A

MRI

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6
Q

Which scan should you use to rule out a bleed- MRI/ CT?

A

CT

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7
Q

What does MRI use to create images?

A

Magnets and radio waves

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8
Q

What are some risks of iodine?

A

Allergic rx
serious rxn
renal failure
extravasation (iodine not in blood)

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9
Q

What does CT contrast in the brain allow you to see?

A

Evaluate blood vessels and integrity of the BBB

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10
Q

What are some known causes of contrast induced nephrotoxicity?

A 
Renal insufficiency (Cr >1.5) 
Diabetes
Dehydration
CV disease
>70 years old
Myeloma, hypertension, Hyperuricemia
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11
Q

If an individual is taking ______ you need to change their dosage for a CT with contrast.

A

Metformin

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12
Q

What does a history of “kidney disease” include?

A

Tumor, solitary kidney and transplant

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13
Q

________ in huge amounts can be nephrotoxic.

A

NSAID’s

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14
Q

If an individual has an allergy to iodinate contrast what can you give?

A

Prednisone 50 mg PO 13, 7, and 1 hour before IV contrast injection
Benadryl 50 mg 1 hour before injection

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15
Q

Gadolinium can cause what (rare disease)?

A

Nephrogenic systemic fibrosis

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16
Q

What are some absolute contraindications of an MRI?

A

cardiac pacemakers and implantable defibrillators
implantable drug pumps
vagal and boen growth stimulators
metal in eye

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17
Q

What is a fibrosing disease of the skin and SQ tissues that has an association between gadolinium and severe chronic renal disease?

A

Nephrogenic systemic fibrosis

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18
Q

It a patient has renal disease what should you get within 6 weeks of an anticipated contrast MRI?

A

Glomerular filtration rates

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19
Q

if someone had a stroke what should you order?

A

non-contrast CT or MRI

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20
Q

If someone has a “worst headache of their life”

A

non-contrast CT to rule out subarachnoid hemorrhage

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21
Q

For seizures what should you order?

A

CT w/ and w/o contrast. MRI for intractable seizures

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22
Q

for cranial nerve issues what should your order?

A

MRI with contrast

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23
Q

For dementia what should you order?

A

Non-contrasted MRI

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24
Q

For trauma what should you order?

A

Non contrasted CT then get MRI for patients who don’t improve as expected

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25
For a person with vertigo and dizziness what should you order?
MRI with contrast
26
For hemorrhage what should you order?
Non contrasted CT
27
For atypical hemorrhage what should you order?
MRI w/ and w/o contrast
28
Why white matter lighter than grey?
white matter has axons with a little more fluid
29
What is better, 1.5 or 3 Tesla?
3 Tesla- better detail
30
For head trauma, what test is best to order?
CT w/o contrast
31
Patients with what other symptoms should undergo CT?
``` Headache Vomiting >60 y/o Drug/alcohol intoxication Deficits in short term memory presence of trauma above clavicles ```
32
How do most epidural hematomas occur?
With a skull fracture
33
how does epidural hematoma occur on CT?
Biconvex hemorrhage
34
If you hear a classic history of "temporary loss of consciousness followed by a lucid period then rapid clinical deterioration" what should you think?
Epidural hematoma
35
What artery is usually lacerated w/ epidural hematoma?
Middle meningeal artery
36
What does an epidural hematoma look like?
A lens
37
What does an subdural hematoma look like?
A crescent, tracks along the inner wall of the skull
38
What causes a subdural hematoma?
Occurs secondary to torn bridging cortical veins
39
Is a skull fracture common with subdural hematoma?
No
40
Where does a subdural hematoma occur?
Between arachnoid and dura mater
41
What causes the white in acute hemorrhage?
Methemoglobin
42
Someone who is very anemic (not a lot of met hemoglobin) can have what type of hematoma?
Isodense sub dural hematoma
43
What is blood in the cortical sulci, fissures and basilar cisterns?
Subarachnoid hemorrhage
44
What is the biggest thing that causes subarachnoid hemorrhage?
Aneurysm has ruptured
45
What can a subarachnoid hemorrhage cause?
hydrocephalus
46
what type pattern does subarachnoid hemorrhage have?
Branching pattern
47
What is a catheter directed procedure that is invasive and runs into carotid vessels and x-ray dye is injected and you take a picture of the brain?
Cerebral angiography
48
What are some non-invasive ways to do cerebral angiography?
CTA | MRA
49
What is like an x-ray but you are seeing it live?
Fluoroscopy (continuous beam)
50
What are some common causes of non traumatic intra parenchymal hemorrhage?
``` Hypertension Ruptured aneurysm or vascular malformaton Venous thrombosis Amyloidosis (patients older than 60) Collagen vascular disorders Anticoagulation therapies Tumors Cocaine use ```
51
What dose a basilar skull fracture opacify?
Sinus and mastoid air cells with blood
52
How can basilar skull fracture present clinically?
Otorrhea or rhinorrhea
53
What type fractures can present with pneumocephalus (air within cranial wall)
Sinus fracture or penetrating skull trauma
54
What happens in subfalcine herniation?
One side of brain moves over to the other (past the falx)
55
What is uncular herniation?
the innermost part of the temporal lobe, the uncus, can be squeezed so much that it moves towards the tentorium and puts pressure on the brainstem, most notably the midbrain
56
What happens with tonsillar herniation?
cerebellar tonsils move downward through foramen magnum
57
When you hear "blown pupil" what should you think?
increased intracranial pressure
58
Where does the 3rd cranial nerve run?
b/w posterior cerebral artery and posterior communicating artery
59
What is a problem where there is too much CSF coming in and not enough coming out?
hydrocephalus
60
How should you evaluate hydrocephalus in babies?
US
61
how can you fix hydrocephalus?
With shunts
62
Most of the time strokes are what?
Embolic
63
how long will cell viability be maintained w/o the available energy source needed?
2-3 minutes
64
You can only give thrombolytic therapy within how many hours of stroke onset?
3 hours
65
What type CT should you order with a stroke?
Non-contrast
66
What is TPA?
Tissue plasminogen activator
67
What is more sensitive to signs of stroke- CT or MRI?
MRI (due to diffusion)
68
How long does it take to see changes of acute ischemia on MRI?
within minutes on onset
69
How long does it take to see loss of cortical ribbon on CT?
Can occur as early as 3 hours, takes 4-6 hours
70
When will there be a normal CT with a stroke?
In the acute phase, within 12 hours of the stroke
71
What are the most common emboli origins for infarcts in the middle cerebral artery?
common carotid artery, internal carotid artery
72
What does a CT look like in the subacute (2-21 days) after stroke?
wedge-shaped area, low density. Loss of cortical ribbon
73
________ increase in the first 3 days after a stroke?
Mass effect
74
What are symptoms of normal pressure hydrocephalus.
Ataxia dementia urinary incontinence
75
What is treatment for normal pressure hydrocephalus?
Shunting
76
What is a vascular malformation w/ a risk of hemorrhage?
Arteriovenous malformations
77
What are 2 vascular malformations that are almost always asymptomatic?
Capillary telangiectasias | Cavernous angiomas
78
What is an intra-axial tumor with edema
vasogenic edema
79
What is the primary demyelinating disease?
Multiple sclerosis
80
If you see a white area at the base of the temporal lobes what should you think?
Herpes encephalitis

Radiology (11 decks)

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