patho xam 5 - neuro

Question 1

Which bleed could result in hydrocephaly?

Answer 1

subarachnoid hemorrhagic stroke

Question 2

Which sided stroke would you see slowness in responding. issues talking, and with logical reasoning?

Answer 2

left-sided

Question 3

Which imaging technique can you see smaller infarcts?

Answer 3

MRI

Question 4

What factors does the GCS look at?

Answer 4

eye opening, verbal response, motor response

Question 5

What type of axonal injury if:
- coma >24 hrs, no brain stem involvement s/s

Answer 5

moderate DIA - a type of TBI

Question 6

A 65 year old pt has suffered a concussion, and they are having trouble with their short term memory. Would you recommend a CT?

Answer 6

yes - risk factors to elevate to CT:
- trauma above clavicles
- gcs <15 2 hrs post injury
- anticoagulants on board or coagulopathy
- alcohol/drug
- persistent vomiting
- neuro defecit
- seizure
- short term memory defecit

Question 7

a concussion results in prolonged loss of consciousness, prolonged impairment, and seizures. What kind of concussion is it?

Answer 7

complex
simple - resolves in hrs-10days

Question 8

coup contra coup results in what type of injury?

Answer 8

axonal injury (DIA)

Question 9

a TBI results in a midline shift, and an arterial bleed. What kind of injury is this?

Answer 9

epidural hematoma

also - lucid interval then rapid deterioration

Question 10

Which neurodegenerative disease would you suspect if the patient presents with peripheral neuropathy and a recent diagnosis of an upper resp. infection?

Answer 10

GB -
ascending
autoimmune
60% full recovery after 2 years

Question 11

Which tell-tale sign of Parkinsons is missing? resting tremor, postural changes, rigidity

Answer 11

Bradykinesia

Question 12

Which neurodegenerative disease affects more women than men?

Answer 12

MS
- visual disturbances
-relapse remitting
-autoimmune

Question 13

Why does a parasympathomimetic help with myesthenia gravis?

Answer 13

myesthenia gravis causes blockade of acetylcholine receptors, so bulking up ACH accumulation at the NMJ helps to subvert this blockade

muscle weakness - ptosois, diplopia
-esp repetitive motions
rest improves

Question 14

What are differences between delirium and dementia?

Answer 14

onset - rapid vs insidious
deficit: delirium - attention, dementia - short term memory
fluctuations - delirium fluctuates throughout day, dementia does not
hallucinations - dementia less common

Question 15

What neurodegenerative disorder can result in dysphagia at the late stages?

Answer 15

MS

GB - diaphragm dysfunction - ventilator

Question 16

What neurodegenerative disorder can result in dysphagia at the late stages?

Answer 16

MS

GB - diaphragm dysfunction - ventilator

Question 17

What is missing from Cushing’s triad?
HR down, widening pulse pressure

Answer 17

abnormal respirations

Question 18

What are the differences between SDH and subarachnoid hemorrhagic stroke?

Answer 18

SDH - venous, slow, above arachnoid membrane (below dura), trauma
SHS- arterial, below arachnoid layer, can be caused by HTN, can cause hydrocephalus because of interaction with CFS, worst HA of life

Question 19

Which type of stroke is an arteriovenous malformation (AVM) likely to cause?

Answer 19

Hemorrhagic - intercerebral