N3

Question 1

deep lacunar stroke risk factors

Answer 1

hypertension, hyperlipidemia, and smoking

Question 2

deep lacunar stroke occurs due to

Answer 2

occlusion of a single, deep penetrating artery in the brain

Question 3

underlying pathology for deep lacunar stroke

Answer 3

combination of microatheroma (fat or fibrous deposition) and lipohyalinosis (segmental arteriolar disorganisation - thickening)

Question 4

lacunar infarcts are usually of

Answer 4

thrombotic origin

Question 5

lacunar infarct on non-contrast CT

Answer 5

not seen due to their small size

Question 6

most common site for a lacunar infarct is

Answer 6

posterior limb of the internal capsule

Question 7

posterior limb of the internal capsule infarct results in

Answer 7

a pure motor stroke

Question 8

posterior limb of the internal capsule infarct results in a pure motor stroke by affecting

Answer 8

corticospinal and some corticobulbar motor fibers located in the genu

Question 9

posterior limb of the internal capsule symptoms

Answer 9

affects the contralateral face, arm and leg equally

Question 10

other common lacunar stroke infarcts

Answer 10

ataxic hemiparesis, clumsy hand dysarthria, pure sensory stroke and mixed sensory motor stroke

Question 11

progressive signs and symptoms of elevated ICP =

Answer 11

headache, vision changes, nausea, vomiting and papilledema - brain tumor

Question 12

progressive signs and symptoms of elevated ICP on CT

Answer 12

mass lesion, edema, or midline shift on non contrast CT

Question 13

causes of embolic stroke

Answer 13

carotid artery thrombsis

cardiac emboli

Question 14

what vessels do embolic strokes affect?

Answer 14

large vessels

Question 15

lacunar infarcts are usually of what etiology

Answer 15

rarely embolic

Question 16

cardiac emboli causing a stroke

Answer 16

mural thrombi in patients with chronic A Fib may send emboli to the CNS

Question 17

cocaine and methamphetamines causing a stroke

Answer 17

drug induced vascular spasm - younger patient

Question 18

unilateral throbbing pain, nausea, phonophobia, and photophobia

Answer 18

migraine headaches

Question 19

headaches, altered sensorium and seizures

Answer 19

subarachnoid hemorrhages and subdural hematomas

Question 20

NF1 diagnosis

Answer 20

von Recklinghausen disease

Question 21

NF2 diagnosis

Answer 21

central neurofibromatosis

Question 22

NF1 gene mutation

Answer 22

NF1 tumor suppressor gene: codes for the protein neurofibromin

Question 23

NF2 gene mutation

Answer 23

NF2 tumor suppressor gene: codes the protein merlin

Question 24

NF1 gene location

Answer 24

chromosome 17

Question 25

NF2 gene location

Answer 25

chromosome 22

Question 26

NF 1 main clinical features

Answer 26

café au lait spots multiple neurofibromas lisch nodules

Question 27

NF2 main clinical features

Answer 27

bilateral acoustic neuromas

Question 28

NF1 inheritance pattern

Answer 28

autosomal dominant neurocutaneous syndrome

Question 29

most common type of intracranial lesion for NF1

Answer 29

optic pathway glioma

Question 30

most common type of intracranial lesion for NF1 manifests when

Answer 30

during toddlerhood

Question 31

bilateral sensorineural hearing loss

Answer 31

bliateral acoustic neuromas = vestibular schwannomas

Question 32

bilateral acoustic neuromas are diagnostic of

Answer 32

NF2

Question 33

best initial screening test for the diagnosis of acoustic neuromas

Answer 33

audiometry

Question 34

NF1 patients are at inc risk for

Answer 34

epilepsy - EEG is not indicated without seizures

Question 35

lumbar punctures are performed in headaches to rule out

Answer 35

infections - meningitis, encephalitis

Question 36

absence of fever and chronic nature of a headache would suggest

Answer 36

non infectious, growing intracrainial neoplasm

Question 37

chronic headaches and blurry vision

Answer 37

adrenal adenoma can cause hyperaldosteronism and secondary hypertension

Question 38

suspicion of adrenal adenoma

Answer 38

renin-aldosterone ratio is measured

Question 39

neurocutaneous syndrome associated with intracrainial tumors

Answer 39

tuberous sclerosis

Question 40

tuberous scleosis genes

Answer 40

TSC1 and TSC2

Question 41

subependymal giant cell astrocytomas

Answer 41

tuberous sclerosis

Question 42

subependymal nodules

Answer 42

tuberous sclerosis

Question 43

cotical tubers

Answer 43

tuberous sclerosis

Question 44

additional characteristics of tuberous sclerosis

Answer 44

``` hypopigmented macules (ash leaf spots) facial angiofibromas cardiac rhabdomyomas renal angioleiomyomas mental retardation seizures ```

Question 45

a young boy with symptoms of inc intracranial pressure, bitemoral hemianopsia and a calcified lesion above the sella has

Answer 45

craniopharyngioma

Question 46

craniopharyngioma is characterized by

Answer 46

nests of squamous cells in a loose stroma, resembling the appearance of embryonic tooth bud enamel

Question 47

location of craniopharyngioma

Answer 47

suprasellar and inf to optic chiasm

Question 48

craniopharyngioma endocrine symptoms

Answer 48

diabetes insipidus | growth failure - hypothyroidism or GH def

Question 49

presence of a cystic calcified parasellar lesion on MRI

Answer 49

almost diagnostic of craniopharyngioma

Question 50

pituitary adenoma vs craniopharyngioma

Answer 50

pituitary adenoma is more common in women | prolactinoma is an important part of this syndrome

Question 51

non-invasive tumors derived from arachnoid cap cells

Answer 51

meningiomas

Question 52

meningiomas consist of

Answer 52

concentric whorls and calcified psammoma bodies

Question 53

meningiomas - location and consequence thereof

Answer 53

it may indent the brain and cause hyperostosis and usually occur on the convex surfaces of the brain

Question 54

enlarged sella turcica with no pituitary gland due to

Answer 54

empty sella syndrome due to an incompetent sellar diaphtragm with compression of the pit gland by the herniating arachnoid or secondary to surgery radiotherapy

Question 55

ependymoma

Answer 55

gliomas and are benign