Qtr 3 Head and Neck Neurology (RAJA) Final

  1. What is the most common location of an Intraparenchymal hemorrhage?
    Basal ganglia and thalamus 65%
  2. What is the most common cause of cerebral hemorrhage?
  3. What might a patient be diagnosed with if they present with sudden loss of consciousness, hemiplegia, convulsions, coma?
    Parenchymal hemorrhage
  4. What type of hemorrhage occurs with a berry aneurysm?
    Subarachnoid hemorrhage
  5. What is the most common cause of a subarachnoid hemorrhage?
    Berry aneurysm
  6. What is the symptomology of a subarachnoid hemorrhage?
    • Headache 
    • Nuchal rigidity
    • Altered mental status
    • Hydorcephalus (if blockage occurs)
  7. What vein is most vulnerable to a subdural hemorrhage?
    Superior Cortical Veins
  8. What is the most common cause of a subdural hemorrhage?
  9. What artery is commonly injured by a skull fracture and what type of hemorrhage does it cause?
    • Middle meningeal artery
    • Epidural Hemorrhage
  10. What percent of Berry aneurysms occur within the carotid supply?
  11. What type of aneurysm is most common in subacute bacterial endocarditis. It can spread infection into the subarachnoid space and cause leptomeneningitis and brain abscess?
    Mycotic (Septic) Aneurysm
  12. Where do most thrombosis cause damage in the brain?
    Basal ganglia
  13. Where does atherosclerosis most commonly appear first in the brain?
    Carotid artery
  14. What percentage of adults have experienced a severe or disabling headache at least once?
  15. Where is headache pain referred from the brain parenchyma?
    None it does not produce pain
  16. What type of headache is caused by muscle spasm, irritation of nasal and accessory structures, and eye disorders?
  17. What type of headache causes extreme pain over the entire head?
    Headache of meningitis
  18. What type of headache is caused by a lumbar puncture?
    Intracranial (low CSF pressure)
  19. What is another name of a classical headache?
    Migraine with aura
  20. Are migraines unilateral or bilateral?
  21. What type of headache presents with pain around one eye, tearing of eye, ptosis, stuffy nose, temporal pain?
    Cluster headache
  22. What type of headache presents with an abrupt elevation in BP, Tachycardia, palpitations, sweating, tremor, sense of apprehension?
    Headache due to Pheochromocytoma
  23. where are neurofibrillary tangles found in alzheimer's disease?
    Intracellular fluid
  24. Where are neuritic plaques found in alzheimer's disease?
    Extracellular fluid
  25. What areas of the brain are atrophied in Pick's disease?
    frontal and temporal lobes
  26. In what disease would one see lewy bodies?
    parkinson's disease
  27. What are the parts of the corpus callosum?
    • Rostrum:ant tip of canoe
    • Genu:
    • Trunk:
    • Splenium:
  28. What type of fibers synapse with the anterior lobe of the cerebellum?
    • Spinocerebellar
    •  - Golgi tendon, muscle spindle
  29. What type fibers synapse with the posterior lobe of the cerebellum?
    • Cerebrocerebellar
    •  - Conscious movement
  30. What type of fibers synapse with the folliculonodular lobe of the cerebellum?
    • vestibulocerebellar
    •    - balance and eye movement
  31. What are the three layers of the cerebellum?
    • Molecular layer (outer)
    • Purkinge layer (primary ouput of cerebellum
    • Granular (deep)
  32. What are the fibers of the spinocerebellar and pontocerebellar tracts called?
    Mossy Fibers
  33. What is caused by denaturing of proteins of the lens of the eye? (inability to accommodate)
  34. What is hyperopia and what is the correction?
    • It is farsightedness caused by focal point being behind the retina
    • Convex lense
  35. What is Myopia and what is the correction?
    It is nearsightedness (focal point in front of retina)

    Concave lense
  36. What is the correction for astigmatism?
    Spherical lense
  37. A rare neurologic disorder that impairs autonomic function and has parkinsonian symptoms
    What is Multiple System Atrophy (shy-drager syndrome)
  38. Atrophy of Caudate nucleus, frontal and temporal gyri
    what is huntingtion's disease
  39. What chromosome is the mutant gene for Huntington's disease found on?
    chromosome 4
  40. Individuals having more than 40 repeating CAG sequences
    what is huntington's disease
  41. what is the probable mechanism of cell death in Huntington's disease?
    Glutamate excitotoxicity
  42. Beta-hemolytic strep infection (rheumatic fever) is precursor. Typical onset of 5-15 yrs of age. 3-6 month duration of chorea?
    Sydenham's Chorea (St. Vitus' Dance)
  43. Mutation of long arm of chromosome 13. Symptoms: Tremor, diminished dexterity, unsteady gate, rigidity, Kayser-Fleischer ring?
    • Wilsons Disease (hepatolenticular)
    • Improper copper metabolism
    • symptoms depend on deposit in lenticular nucleus
  44. What movement is seen in globus pallidus lesion?
    Athetosis (worm like hand eye neck)
  45. Where is the lesion most likely in hemiballismus?
    • Subthalamus 
    • Hemiballismus (violent movements)
  46. Where is the lesion most likely in Chorea (quick jerky movments face and limbs)
  47. How does dopamine affect the direct and indirect pathways respectively?
    • Direct = excitatory
    • Indirect = inhibitory
    • overall = excitatory
  48. CSF findings: Clouded, increased pressure, increase in neutrophils, increased protein, absence of sugar (eaten by bacteria), presence of organism
    Suppurative meningitis (leptomeningitis)
  49. What type of infection would you see CSF with: increase in lymphocytes and proteins, normal glucose?
    Viral meningitis
  50. Rapidly fatal dementia, pyramidal and extrapyramidal symptoms, severe atrophy of brain; intense astrocytosis in cerebral cortex, caudate, putamen.
    Creutxfeldt-Jakob Disease
  51. What is the anatomical presentation of prion diseases?
    spongiform encephalopathy
  52. Papovavirus that infects oligodendrocytes 
    Symptoms: hemiparesis, intellectual impairment, blindness, aphasia, death 3-6 months
    Progressive multifocal leukoencephalopathy
  53. Type of meningitis narrowing and obliteration of subarachnoid space due to trabeculae formation leading to hydrocephalus
    Acute suppurative meningitis
  54. Onset is insidious, anorexia and weightloss. 
    CSF contents: lymphocytes, increased protein, decreased glucose, tubercle bacilli
    Tubercculous menningitis
  55. Associated with prior measles infection
    multifocal areas of neuronal, destruction and gliosis fatal in 1-2 years.
    Subacute sclerosing panencephalitis
  56. What is the most common demylination disease?
    Multiple sclerosis
  57. What area if the spinal cord is most commonly affected by Multiple sclerosis?
  58. CSF FINDINGS: increased lymphocytes and Ig levels, normal glucose levels, oligoclonal immunoglobulin bands
    Multiple sclerosis
  59. A patient presents with scanning speech, intention tremor, nystagmas what is your initial diagnosis?
    Multiple Sclerosis (classic triad)
  60. What viral infections are associated with acute disseminating encephalomyelitis
    • measles  
    • mumps 
    • rubella 
    • chickenpox
  61. What disease involves demyelination of the peripheral nerves?
    • Guillian -Barre syndrome 
    • (demyelination occurs inferior to superior)
  62. CSF Findings: Albumino-cytoogic dissociation of CSF, greatly increased protein, slightly increased cell count
    Gullian-Berry syndrome
  63. CN VII Upper motor neuron (ipsilateral or contralateral)
  64. Where is the lesion: ipsilateral facial paralysis, loss of tast over anterior two thirds of tongue, hypercousis?
    Facial canal
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Qtr 3 Head and Neck Neurology (RAJA) Final