CNS

Question 1

Consequence of cerebral autoregulation failure

Answer 1

failure at mean arterial pressure of around 180 mmHg -> cerebral edema and increased ICP

Question 2

Etiology of vasogenic edema

Answer 2

BBB breakdown

increased vascular permeability

Question 3

etiology of cytotoxic edema

Answer 3

increase in intracellular fluid because of neuronal, glial or endothelial cell membrane injury

Question 4

Global symptoms of elevated ICP

Answer 4

Headache
Decreased consciousness
Vomiting

Question 5

3 common clinical settings associated with

herniation (a focal symptoms of elevated ICP)

Answer 5

cerebral edema
increased CSF volume (hydrocephalus)
mass lesions

Question 6

pathophysiology of NPH

Answer 6

Cerebrovascular disease
Hypertension
Congenital
Decreased CSF absorption

Question 7

Clinical triad of NPH

Answer 7

Gait difficulty

Cognitive deficits

Psychomotor slowing

Decreased attention and concentration

Impaired executive function

Urinary incontinence

Question 8

Causes of hypoxic-ischemic brain injury

Answer 8

Causes of hypoxic-ischemic brain injury

Question 9

etiology of SDH

Answer 9

tearing of the

bridging veins

Question 10

TBI Glasgow Coma Scale (GCS) score

Answer 10

13 to 15  mild traumatic brain injury

9 to 12  moderate

8 or less  severe

Question 11

TBI Primary brain Injury

Answer 11

diffuse axonal injury
focal cerebral contusions
Hematomas

Question 12

TBI secondary brain Injury

Answer 12

inflammatory responses
apoptosis
ischemias

Question 13

CTE and its pathophys

Answer 13

develops after repeated concussion

tau-immuno-reactive degenerative

Question 14

pathophys of myelomeningocele

Answer 14

Chiari II malformation
Brain stem dysfunction
Hydrocephalus

Question 15

CP pathophys

Answer 15

Periventricular leukomalacia (PVL)

Question 16

pathophys of meningitis

Answer 16

Cytokines
increased BBB permeability
increased ROS
increased ICP

Question 17

etiology of fever in meningitis

Answer 17

reset the hypothalamic thermal set point by pyrogens

Question 18

etiology of headache in meningitis

Answer 18

↑ ICP stimulate nociceptors

Question 19

etiology of changed mental status in meningitis

Answer 19

↑ICP → brain herniation → damage to ARAS

Question 20

PD pathophys

Answer 20

Dopamine depletion in basal ganglia

Disruptions in the connections to the thalamus and motor cortex

Question 21

Compensatory mechanisms in PD

Answer 21

Increasing dopamine synthesis
Increasing dopaminergic neurons
Increasing the proliferation of dopamine receptors

Question 22

Clinical features of PD

Answer 22

Tremor
Bradykinesia
Rigidity
Postural instability

Question 23

pathophys of vascular dementia

Answer 23

brain ischemia or loss of vascular integrity with hemorrhage disrupts normal brain function and causes cognitive impairment

Question 24

mechanism for HAND

Answer 24

HIV-1, through infected monocytes, can cross the BBB -> neuroinflammation
-> cytokines release

HIV+patients have high cortisol levels indicative of HPA axis deregulation

etiology of Alzheimer’s Disease is linked to HAND

HIV-1 induces synaptic deficits and neurodegeneration

Question 25

MS pathophys

Answer 25

begins as an inflammatory immune-mediated disorder microglia form a complex with the activated T cells -> destruction of the myelin and oligodendrocytes

Question 26

Clinically isolated syndromes (CIS) pattern of MS

Answer 26

first attack of a disease with inflammatory demyelination but has yet to fulfill MS diagnostic criteria

Question 27

MS Relapsing-remitting (RR)

Answer 27

clearly defined relapses/exacerbation with partial or full recovery

Question 28

MS Secondary progressive (SP)

Answer 28

initial RR disease course followed by gradual worsening

Question 29

MS Primary progressive (PP)

Answer 29

steady progression from onset

Question 30

etiology and pathophys of ALS

Answer 30

Excessive glutamate resulting in death of motor neurons (excitotoxicity) Inflammatory responses motor neuron degeneration and death Spinal cord becomes atrophic

Question 31

Clinical features of ALS

Answer 31

upper: weakness with slowness, hyperreflexia and spasticity lower: weakness, atrophy and fasciculations

Question 32

pathophys of GBM

Answer 32

mutation in isocitrate dehydrogenase (IDH)  accumulation of the onco-metabolite 2-hydroxyglutarate (2-HG)

Question 33

clinical symptoms of GBM

Answer 33

``` headache increased ICP nausea and vomiting cognitive impairment Seizures ```

Question 34

etiology and clinical features of meningiomas

Answer 34

abnormal chromosome 22 headache and weakness in an arm or leg are the most common symptoms

Question 35

most common tumor that metastasizes to the brain

Answer 35

lung