Neurodiagnostics

Question 1

Normal CSF pressure

Answer 1

70-180 mm H20

Question 2

Normal CSF total protein

Answer 2

15-60 mg/100ml

Question 3

Normal CSF glucose

Answer 3

50-80 mg/100ml

Question 4

Normal CSF cell count

Answer 4

0-5 WBCs and no RBCs

Question 5

Site of lumbar puncture

Answer 5

L3-L4 or L4-L5

Question 6

CI to lumbar puncture

Answer 6

increased ICP, spinal cord mass, uncontrolled bleeding diathesis, spinal column deformities

Question 7

xanthochromia

Answer 7

yellow, orange or pink CSF from lysis of RBCs (occurs within 2 hours, lasts 2 weeks)

Question 8

How do you distinguish between viral and bacterial meningitis?

Answer 8

Meningitis WBC < 100 (predominance of lymphocytes) more likely viral, WBC > 100 more (predominance of PMNs) likely bacterial meningitis

Question 9

CSF has positive India ink stain

Answer 9

cryptococcus

Question 10

CSF has positive Wright or Geisma stain

Answer 10

toxoplasmosis

Question 11

One of the most sensitive indicators of CNS pathology

Answer 11

CSF protein

Question 12

When is the CSF glucose level low?

Answer 12

CNS bacterial infection

Question 13

Measures how well and how fast the peripheral nerves send the signals. Evalution of entrapment neuropathies (carpal tunnel) and Guillian-Barre’

Answer 13

Nerve conduction velocity

Question 14

Measures the electrical activity of muscles during rest and contraction. Evaluate herniated disc, amyotrophic lateral sclerosis (ALS) or myasthenia gravis

Answer 14

Electromyelography (EMG)

Question 15

Why does NCV not work for assessing diabetic neuropathy?

Answer 15

NCV only measures velocity of fastest conducting fibers and diabetic neuropathy affects small nerve fibers

Question 16

Used to differentiate organic causes of encephalopathy or delirium, to distinguish epileptic seizures from other causes, testing for brain death, and to determine if you should wean anti-epileptic meds

Answer 16

EEG

Question 17

wave forms labeled according to their amplitude

Answer 17

Delta 0-4 Hz, Theta 4-8 Hz, Alpha 8-12 Hz, Beta greater than 12 Hz

Question 18

What type of waves indicated increased slow activity in the brain due to focal brain lesion?

Answer 18

theta and delta waves

Question 19

Indicative of focal brain lesion

Answer 19

polymorphic delta activity (PDA)

Question 20

Indication of encephalopathy

Answer 20

Generalized theta and delta activity

Question 21

When looking for neoplasm, infection, vascular dz, inflammatory dz, should you use IV contrast?

Answer 21

yes

Question 22

What does a new hemorrhage look like on CT?

Answer 22

bright

Question 23

What does water/CSF look like on CT?

Answer 23

dark

Question 24

Difference between subdural and intracerebral hematoma

Answer 24

subdural is located between dura and arachnoid mater whereas intracerebral is localized within the brain substance

Question 25

water/CSF is dark, fat is bright, White matter is brighter than gray matter

Answer 25

T1 MRI

Question 26

water is bright, blood is bright, White matter is darker than gray matter

Answer 26

T2 MRI

Question 27

Gold standard for imaging the carotid arteries and evaluating cerebral aneurysms after subarachnoid hemorrhage

Answer 27

cerebral angiography

Question 28

Patient exhibits: + Babinsky. Right sided hemi-paresis/paralysis. Hypereflexia. Mental Confusion. Amnesia. Slurred Speech. MRI shows displaced left cerebrum. Dx?

Answer 28

left subdural hematoma