Exam 2 SNAPP and Practice Qs Review

Question 1

What is a subgaleal hematoma and in what disorders is it common?

Answer 1

It is a hematoma between the periosteum and the skin of the cranium. It often occurs with vacuum-assisted delivery or epidural hematomas.

Question 2

High-impact injuries to the head present with what type of skull fracture?

Answer 2

Linear… depressed presents from blunt-object impacts.

Question 3

Growing fractures are caused from _____________.

Answer 3

arachnoid herniations

Question 4

The best predictor of prognosis following an epidural (or subdural) hematoma is ___________.

Answer 4

time to surgery

Question 5

Overactivation of NMDA and AMPA receptors leads to _______-toxicity.

Answer 5

excito

Question 6

What is worse (in a GCS test), abnormal extension or flexion?

Answer 6

Extension

Question 7

What feature underlies the phenomenon of second-impact syndrome?

Answer 7

Vasogenic edema from the first impact occurs due to loss of autoregulation. The increases in ICP from the second impact add to this and make it that much worse.

Question 8

In children, ependymomas most often appear in the ___________, whereas in adults it is most often __________.

Answer 8

4th ventricle; in the spinal cord

Question 9

“Tightly packed cells that cause obstructive hydrocephalus” are most often ____________.

Answer 9

choroid plexus papilloma

Question 10

Having what genetic marker is predictive of worse prognosis in medulloblastoma?

Answer 10

Myc amplification

Question 11

In addition to promoting neovascularization, VEGF also stimulates ____________.

Answer 11

BBB leakiness

Question 12

True or false: individuals with delirium are usually unaware of the problem.

Answer 12

False. Because delirium symptoms tend to fluctuate, people will frequently be aware that something is wrong.

Question 13

What is the distinction between mutations in presenilin 1, presenilin 2, APP, and apoE in Alzheimer’s?

Answer 13

ApoE is a susceptibility gene (meaning you’re slightly more likely to get it but not absolute), while the others are considered causative mutations that greatly increase likelihood of developing AD.

Question 14

Stroke risk increases by ______ percent for every 20 years of life.

Answer 14

10

Question 15

_________ percent of those with MS present between ages 18 and 45.

Answer 15

75

Question 16

What is the relationship between types of immunopathologies and MS patients?

Answer 16

Four different types of immunopathologies can occur in MS, but most patients have only one or two subtypes –not all four in one patient.

Question 17

The defining cellular feature of MS is __________.

Answer 17

demyelination with a perivascular lymphocyte infiltration

Question 18

Glucose will always be normal in the CSF of patients with ___________.

Answer 18

MS

Question 19

___________ are only used in assessing the primary progression form of MS.

Answer 19

Evoked potentials

Question 20

Which tumor type commonly has p53 mutations?

Answer 20

Diffuse astrocytomas

Question 21

Describe the presentation of Wernicke’s encephalopathy.

Answer 21

WE (aka Wino’s encephalopathy) is due to thiamine deficiency (B1), often concurrent with alcoholism. It presents with ophthalmoplegia, ataxia, confabulation, and memory loss. It is a medical emergency –potentially lethal if IV thiamine is not administered.

Question 22

Rather surprisingly, metastatic lesions in the brain present as _____________ on pathologic examination.

Answer 22

well demarcated and non-infiltrative at their edges

Question 23

Brodmann’s areas 1 and 2 are involved in ________________.

Answer 23

detection of complex features of somatosensory stimulation such as orientation and direction of movement

Question 24

The only fibers that are non-myelinated are ________.

Answer 24

C fibers

Question 25

Go through the fibers again.

Answer 25

A alpha: muscle and tendon proprioception; myelinated largest; fastest

A beta: skin mechanoreceptors; myelinated; second largest; second fastest

A delta: hot pain; cold pain; cool temperature; sharp pain; myelinated second smallest; second slowest

C fibers: warm temperature; burning/aching pain; capsaicin sensing; unmyelinated; smallest; slowest

Question 26

Why can a small dose of local anesthetic selectively eliminate secondary pain but preserve primary (i.e., sharp) pain?

Answer 26

Because the C fibers that carry secondary pain are smaller and more easily blocked by local anesthetic!

Question 27

Lidocaine is __________ potent than bupivicaine.

Answer 27

less