Module 2

Question 1

This records spontaneous electrical activity generated in the cerebral cortex

Answer 1

EEG

Question 2

Alpha waves start to appear at what age

Answer 2

6 yrs old

Question 3

Age where normal adult frequency is achieved

Answer 3

10-12

Question 4

Generalized spike wave; Focal spike and sharp wave discharges

Answer 4

Epileptiform discharges

Question 5

Sudden disappearance of spike wave complexes in all leads

Answer 5

Absence seizure

Question 6

This modality explains the functionality of the visual pathway

Answer 6

Visual evoked response

Question 7

VEP generator site

Answer 7

Occipital cortex

Question 8

Useful non invasive means of assessing somatosensory functioning

Answer 8

Sensory evoked response

Question 9

This represents the activation of a motor nerve with subsequent conduction toward the spinal cord and return of conduction back down the nerve

Answer 9

F-wave

Question 10

Represents the avtivation of the sensory nerve with subsequent conduction toward the spinal nerve and returns the conduction down the motor nerve

Answer 10

H-reflex

Question 11

Activity of cortical neurons is influenced and synchronized by the following subcortical structures

Answer 11

Thalamus

High brainstem reticular formation

Question 12

Tenderness, swelling and bruising over the mastoid bone

Answer 12

Battle’s sign

Question 13

Collection of pus between the dura and arachnoid membranes

Answer 13

Subdural empyema

Question 14

Most common predisposing cause of Subdural empyema

Answer 14

Paranasal sinusitis

Question 15

Most common pathogen of subdural empyema

Answer 15

Anaerobic and microaerophilic streptococci

Question 16

Invasive infection of the external auditory canal with spread to soft tissues and even the intracranial vault to cause cellulitis and abscess

Answer 16

Malignant external otitis

Question 17

What CN is involved if there’s ptosis

Answer 17

III

Question 18

Patient came in with High fluctuating fever and Headache. Upon PE there’s chemosis (edema of conjunctiva) papilledema and retinal hemorrhages; eyeballs are abnormally protruded. What would be your diagnosis?

Answer 18

Septic Cavernous Thrombophlebitis

Question 19

Why is it that brain abscesses don’t usually manifest as fever

Answer 19

They are contained inside the capsule

Question 20

Frequency of dominant rhythms in infants

Answer 20

3 Hz

Question 21

Imaging of choice for early cerebritis

Answer 21

MRI with gadolinium

Question 22

Why LP is contraindicated on patients suspected to have brain abscess?

Answer 22

Risk of transtentorial herniation

Question 23

Most common etiologic pathogen in brain abscess

Answer 23

streptococcus

Question 24

Most frequent initial symptom of intracranial abscess?

Answer 24

Headache

Question 25

Inflammation of the membranes of the brain or spinal cord

Answer 25

Meningitis

Question 26

Collection of infective and purulent material or pus formation in the brain or meninges

Answer 26

Abscesses

Question 27

Inflammation of the meninges and brain parynchema

Answer 27

Meningoencephalitis

Question 28

Most disastrous complication of increased ICP

Answer 28

Cerebral herniation

Question 29

Triad of meningitis

Answer 29

Headache, fever, nuchal rigidity

Question 30

Most common form of suppurative CNS infection

Answer 30

bacterial meningitis

Question 31

Most common cause of meningitis in adults >20y/o

Answer 31

S. pneumoniae

Question 32

Contraindications prior to LP

Answer 32

``` History of CNS dses (mass leisons, CVD etc) New onset seizure Papilledema Altered consciousness Focal neurologic deficit ```

Question 33

This is used to suppress the sequelae of bacterial lysis

Answer 33

Anti-inflammatory agents (dexamethasone)

Question 34

Drug of choice for Listeria

Answer 34

Ampicillin

Question 35

Most common cause of viral meningitis

Answer 35

Enteroviruses

Question 36

Drug of choice for encephalitis

Answer 36

Acyclovir

Question 37

Empiric treatment because of intracellular action

Answer 37

Ceftriaxone, cefotaxime

Question 38

These infections are associated with immunocompromised hosts, prosthetic devices and foreign body

Answer 38

Fungal cns infections

Question 39

Broad spectrum anti-fungal

Answer 39

Amphotericin B

Question 40

Lab to confirm infection of Cryptococcus

Answer 40

India ink stain and CALAS (Cryptococcus Antigen Latex Agglutination System)

Question 41

Small flask shaped amoeba that causes infection to the brain whe it enters into the nasal passages as a result of aquatic activities

Answer 41

Naegleria fowleri

Question 42

Large amoeboid trophozite with spiny pseudopods and a double walled cysts

Answer 42

Acanthamoeba

Question 43

Function of CSF

Answer 43

Protection Chemical regulation Immunologic

Question 44

Weight of the brain

Answer 44

1.3-1.4 kg

Question 45

Normal ICP

Answer 45

5-15 mmHg (7-17cm H20)

Question 46

CSF is secreted by ______ which are found primarily in the____

Answer 46

Choroid plexus; ventricles

Question 47

CSF reabsorption occurs within

Answer 47

Superior sagittal and related venous sinuses

Question 48

Total CSF volume

Answer 48

150cc

Question 49

CSF pathway:

Answer 49

LV – Foramen of Monroe- 3rd V- Aqueduct of Syl – 4th V – For of L&M – SubA space - SSS

Question 50

Rate of production of CSF is pressure _______

Answer 50

Independent

Question 51

Abnormal accumulation of CSF within the ventricles

Answer 51

Hydrocephalus

Question 52

Type of hydrocephalus wherein the obstruction is in the arachnoid granulation

Answer 52

Communicating

Question 53

Type of hydrocephalus wherein the obstruction is in the foramen of Monroe, aqueduct of sylvius, foramen of Magendie

Answer 53

Noncommunicating

Question 54

Most common cause of obstructive hydrocephalus in children

Answer 54

Aqueductal stenosis

Question 55

Chiari malformation that is commonly associated with meningomyelocele

Answer 55

Type II

Question 56

Triad of dandy walker malformation

Answer 56

Hypoplasia of the vermis Cystic dilatation of the 4th ventricle Enlarged posterior fossa

Question 57

Most common cause of communicating HCP

Answer 57

Infection

Question 58

Triad of Parinaud’s syndrome

Answer 58

Upward gaze palsy Convergence nystagmus Light near dissociation

Question 59

Growth rate of head circumference

Answer 59

1st 3 mos: 2cm/mo Next 3 mos: 1cm/mo Next 6 mos: 0.5cm/mo

Question 60

Cushing’s triad

Answer 60

Hypertension Bradycardia Irregular respiration

Question 61

Earlier signs of increased ICP

Answer 61

HA Nausea and vomiting Papilledema

Question 62

Treatment of choice for HCP

Answer 62

VPS insertion

Question 63

Suppurative infection that forms in the subdural space

Answer 63

Subdural empyema

Question 64

Condition in which a person has recurrent seizures due | to a chronic underlying process

Answer 64

Epilepsy

Question 65

Paroxysmal event due to abnormal excessive or synchronous neuronal activity in the brain

Answer 65

Seizure

Question 66

Type of seizure where the patient is conscious with motor signs

Answer 66

Simple partial

Question 67

Type of seizure where the consciousness is impaired. The px is not unconscious but does not respond

Answer 67

complex

Question 68

Brief period of transient paralysis following a seizure

Answer 68

Todd’s paralysis

Question 69

Type of seizure that begins focally w/ or w/o focal neurological symptoms then becomes generalized

Answer 69

Secondary generalized

Question 70

Type of diet recommended for px with epilepsy/seizures

Answer 70

Ketogenic diet

Question 71

Criteria for status epilepticus

Answer 71

More than 30 miinutes of continuous seizure or | 2 or more sequential seizures spanning this period w/o recovery btn seizures

Question 72

Performed to detect treatable lesions before secondary neurologic damage occurs

Answer 72

CT scan

Question 73

Most common manifestation of scalp injury

Answer 73

Subgaleal hematoma

Question 74

Most common type of skull fracture

Answer 74

Skull fracture

Question 75

Artery that is most commonly disrupted in epidural hematoma

Answer 75

Middle meningeal artery

Question 76

Which one is venous in origin, epidural or subdural hematoma?

Answer 76

Subdural

Question 77

Which one is arterial in origin, epidural or subdural hematoma?

Answer 77

Epidural

Question 78

Crescent shaped extra-axial collections of high attenuation in CT scan is suggestive of

Answer 78

Subdural hematoma

Question 79

Disruption of small subarachnoid vessels or direct extension into the subarachnoid space by a contusion or hematoma

Answer 79

Subarachnoid hemorrhage

Question 80

Linear areas of high attenuation within cisterns and sulci in CT scan is suggestive of

Answer 80

Subarachnoid hemorrhage

Question 81

This results from retrograde flow of subarachnoid hemorrhage into the ventricular system through the fourth ventricular outflow foramina

Answer 81

Intraventricular hemorrhage

Question 82

This is characterized by widespread disruption of axons that occurs at the time of an acceleration or deceleration injury

Answer 82

Diffuse axonal injury

Question 83

Small petechial hemorrhages at the gray-white junction of the cerebral hemispheres or corpus callosum in CT scan is suggestive of

Answer 83

DAI (but sometimes normal findings on CT)

Question 84

Type of herniation where the cingulate gyrus is displaced across the midline under the falx cerebri

Answer 84

Subfalcine

Question 85

Type of herniation wherein the medial aspect of the temporal lobe is displaced medially over the free margin of the tentorium

Answer 85

Uncal

Question 86

Type of herniation where the brain herniates either downward or upward across the tentorium

Answer 86

Transtentorial

Question 87

How does CSF rhinorrhea occur

Answer 87

Fractures that lead to communication between subarachnoid space and paranasal sinuses or mid ear cavity

Question 88

How does CSF otorrhea occur

Answer 88

Occurs when there’s a communication between the subarachnoid space and mid ear in association with disruption of the tympanic membrane

Question 89

Most common form of primary brainstem injury

Answer 89

DAI

Question 90

Characteristic secondary brainstem lesion that results from stretching or tearing of penetrating arteries as the brain stem is caudally displaced

Answer 90

Duret hemorrhage