a. stenosis, cervical, or thoracic

true

b. anemia, chronic

true

c. Cushing disease

true

d. Lyme disease

true

e. acquired immunodeficiency syndrome (AIDS)

true

2. How does anemia produce myelopathy?

G7 p.1186:15mm

a. chronic: e_____ h_____, b_____ m_____ h_____, and c_____ c_____

extramedullary hematopoiesis, bone marrow hypertrophy, and cord compression

b. pernicious: s_____ c_____ d_____

subacute combined degeneration

3. How does Cushing disease produce myelopathy?

G7 p.1186:55mm

a. e_____ l_____

epidural lipomatosis

4. True or False. The following are neoplastic masses causing myelopathy, in order of most common to least common:

G7 p.1186:95mm

a. extradural, intradural extramedullary, intramedullary

true (It follows anatomically outside to inside, most to least common.)

b. intradural extramedullary, extradural, intramedullary

false

c. intramedullary, extradural, intradural extramedullary

false

d. extradural, intramedullary, intradural extramedullary

false

5. What is the frequency of spinal cord tumors?

G7 p.1186:96mm and G7 p.728:60mm

a. Extradural: _____%

55%

b. Intradural extramedullary: _____%

40%

c. Intradural intramedullary: _____%

5%

6. Complete the following regarding spinal cord infarction:

G7 p.1186:166mm

a. The most common artery involved is _____ _____ _____.

anterior spinal artery

b. The most common level of involvement is _____.

T4

c. Why?

watershed area

d. It spares _____ _____

posterior columns

e. caused by _____ and

hypotension

f. due to

     i. ath_____

atherosclerosis

     ii. emb_____

embolization

     iii. cla_____ a_____

clamping aorta

     iv. aor_____ d_____

aortic dissection

     v. s_____ p_____ in the presence of s_____ s_____.

sitting position in the presence of spinal stenosis

G7 p.1186:166mm

7. Necrotizing myelopathy associated with spontaneous thrombosis of a spinal cord arteriovenous malformation (AVM) presenting as spastic → flaccid paraplegia with ascending sensory level is called _____.

Foix-Alajouanine

G7 p.1187:50mm

8. True or False. Regarding acute (idiopathic) transverse myelitis:

G7 p.1187:85mm

a. Clinical onset is indistinguishable from acute spinal cord compression.

true

b. Normal imaging is expected, including CT, myelogram and MRI.

true

c. Cerebrospinal fluid (CSF) analysis shows pleocytosis and hyperproteinemia.

true

d. The thoracic region is the most common level.

true

e. The most common onset is 20 to 40 years of age.

false (Most common onset is first 2 decades of life, other answers define the disease.)

f. Usually results in a diagnosis of multiple sclerosis

false (MS is diagnosed in only 7%.)

G7 p.1187:100mm

9. Abdominal cutaneous reflexes are almost always absent in _____ _____.

multiple sclerosis

G7 p.1187:110mm

10. True or False. Regarding Devic syndrome:

G7 p.1187:113mm and G7 p.728:60mm

a. It is characterized by acute bilateral retinitis and transverse myelitis.

false (acute bilateral optic neuritis, not retinitis, and myelopathy)

b. The transverse myelitis can be a cause of complete block on myelography.

true

c. It is more common in Asia than in the United States.

true

d. It is a variant of multiple sclerosis (MS).

true

11. What is another name for Devic syndrome?

neuromyelitis optica

G7 p.1187:114mm

12. True or False. The following are part of the correct mechanism responsible for pernicious anemia:

G7 p.1187:148mm

a. malabsorption of B₁₂ in the proximal ileum

false (malabsorption of B₁₂ in distal ileum)

b. lack of secretion of intrinsic factor by pancreas

false (lack of secretion by gastric parietal cells)

c. dysfunction of gastric parietal cells

true (malabsorption of B₁₂ in the distal ileum due to lack of secretion of intrinsic factor, a small polypeptide, by gastric parietal cells)

d. downregulation of cyclic adenosine monophosphate (cAMP)—mediated transport of B₁₂

false

13. Matching. Match the disease with the important feature.

G7 p.1187:162mm and G7 p.1188:120mm and G7 p.1188:150mm

Disease:

pernicious anemia; Guillain-Barré; ALS

G7 p.1187:162mm

Important feature:

a. Ascending weakness

b. Atrophic weakness of hands

c. Symmetrical paresthesias

d. Posterior column involvement

e. Normal sensation

f. Dementia

g. Areflexia

h. Serum B₁₂ levels

i. Fasciculations

j. Shilling test

k. Preserved sphincter control

l. Treat with B₁₂

m. Proprioception difficulty

14. How might AIDS produce myelopathy?

vacuolization of spinal cord

G7 p.1188:78mm

15. Complete the following about sciatica:

G7 p.1188:183mm

a. The sciatic nerve contains roots from_____ to_____.

L4 to S3

b.

    i. The nerve passes out of the_____

pelvis

    ii. through the g_____ s_____ f_____.

greater sciatic foramen

c.

    i. In the lower third of the thigh it divides into the t_____

tibial

    ii. and the c_____ _____ nerves.

common peroneal

16. Complete the following about herpes zoster:

G7 p.1189:87mm

a. Rarely it might mimic_____.

radiculopathy

b. Lumbosacral dermatomas are involved in_____ to_____%.

10 to 15%

c. Significantly, pain is independent of_____.

position

d. Typical herpetic skin lesions follow pain in_____ to0_____days.

3 to 8

e. True or False. Motor weakness can occur.

true

f. True or False. Urinary retention can occur.

true

g. If so, it is due to_____ paralysis.

detrusor

h.

    i. If motor symptoms occur_____% have good recovery

55%

    ii. and_____% have fair to good recovery.

30%

17. Complete the following regarding differential diagnosis by signs and symptoms:

G7 p.1189:170mm

a. Pain produced in the sciatic distribution with weakness of external rotation and abduction of the hip is called _____.

piriformis syndrome due to sciatic nerve entrapment by piriformis muscle. (Symptoms are exacerbated by Freiberg test [forced internal rotation of hip with thigh extension]).

b. The Friedberg test consists of forced_____ _____ of _____

internal rotation of hip

c. and thigh_____.

extension

d. Significance of the Frieberg test is that it_____ the symptoms of the

exacerbates

e. p_____ s_____.

piriformis syndrome

18. Complete the following about extraspinal tumors causing sciatica:

G7 p.1190:60mm

a. Pain is almost always

    i. i_____

insidious

    ii. p_____

progressive

    iii. c_____

constant

    iv. not affected by_____

position

    v. worse at_____ in 80% and

night

vi. not benefited by_____ therapy

conservative

b. Diagnosis is best made by

    i. h_____

history

    ii. r_____

radiographs

    iii. of the entire p_____

pelvis

    iv. and p_____ f_____

proximal femur

19. Femoral neuropathy is often mistakenly identified as a radiculopathy at what level?

L4

G7 p.1190:120mm

20. Answer the following about femoral neuropathy:

G7 p.1190:125mm

a. Femoral neuropathy may be mistaken for radiculopathy at what level?

L4

b. That mistake can occur because both share weakness of the _____ muscle.

quadriceps

c. That mistake should be avoided because sensory distribution is different.

    i. Femoral nerve serves the_____ _____.

anterior thigh

    ii. L4 serves the knee to the_____ _____ and

medial malleolus

    iii. spares the_____ _____ motor weakness is different.

anterior thigh

    iv. Femoral nerve has weak_____.

iliopsoas

    v. Femoral nerve has strong_____ _____.

thigh adductors

    vi. L4 has strong_____.

iliopsoas

    vii. L4 has weak_____ _____.

thigh adductors

21. Peroneal nerve palsy may be mistaken for radiculopathy at what level?

L5

G7 p.1190:133mm

22. Complete the following regarding differential diagnosis by signs and symptoms:

G7 p.1191:32mm

a. Congenital degeneration of anterior horn cells leading to weakness, areflexia, tongue fasciculations, with normal sensation is W_____-H_____ d_____

Werdnig-Hoffmann disease

b. also known as s_____ m_____a_____

spinal muscular atrophy

c. also known as f_____ i_____ s_____

floppy infant syndrome

23. The most common etiology for pure motor hemiplegia without sensory loss is

G7 p.1192:50mm

a. l_____ i_____ of the

lacunar infarct

b. c_____ i_____ c_____.

contralateral internal capsule

24. Can hypoglycemia be associated with hemiparesis?

yes, treat with glucose— hemiparesis may clear

G7 p.1192:68mm

25. Complete the following about back pain:

G7 p.1192:120mm

a. Will patients with abdominal or vascular etiology of back pain keep still, or writhe in pain?

writhe in pain

    i. example: a_____ a_____ a_____

abdominal aortic aneurysm

b. Pain at bed rest. Think:_____ _____

spine tumor

c. Relieved by aspirin. Think:_____ osteoid osteoma

d. Back pain on percussion. Think:_____

infection

26. Complete the following regarding differential diagnosis by signs and symptoms:

G7 p.1192:145mm

a. Nocturnal back pain relieved by aspirin is suggestive of _____ _____.

osteoid osteoma (or benign osteoblastoma)

b. Morning back stiffness, hip pain, hip swelling, failure to get relief at rest, and improvement with exercise is suggestive of_____ or_____ _____.

sacroiliitis or early ankylosing spondylitis

27. Complete the following regarding cauda equina. Cauda equina syndrome has the following criteria:

G7 p.1193:62mm

a. p_____ a_____

perineal anesthesia

b. u_____ i_____

urinary incontinence

c. p_____ w_____

progressive weakness

28. Complete the following regarding annular tears:

G7 p.1193:103mm

a. assymptomatic in 50- to 60-year-old patients in _____%

40%

b. assymptomatic in 60- to 70-year-old patients in _____%

75%

29. Complete the following regarding Schmorl nodes:

G7 p.1193:179mm

a. defined as d_____ h_____

disc herniation

b. through the c_____ e_____ p_____

cartilaginous end plate

c. into the v_____ b_____

vertebral body

d. seen in_____% of asymptomatic patients

19%

30. Complete the following about chronic low back pain:

G7 p. 1194:19mm

a. Symptoms persist after 3 months in_____%.

5%

b. Structural diagnosis is possible in only_____% of these.

50%

c. Erosive changes adjacent to sacroiliac (SI) joint and positive test for human leukocyte antigen-B27 (HLA-B27) suggest the diagnosis of a_____ s_____.

ankylosing spondylitis

G7 p. 1194:40mm

d. In foot drop of unknown etiology, which muscle strength tests help differentiate peroneal nerve palsy from L4/L5 radiculopathy?

G7 p. 1194:85mm

    i. p_____ t_____ (f_____ i_____)

posterior tibialis (foot inversion)

    ii. g_____ m_____ (i_____ r_____ f_____ h_____)

gluteus medius (internal rotation flexed hip)( Both are spared in a peroneal nerve palsy, and both are involved with radiculopathy.)

e. Which division of the sciatic nerve is more sensitive to injury, the peroneal or the tibial division?

peroneal division is more sensitive to injury

G7 p. 1195:16mm

31. For a patient with foot drop, lesion could be at

G7 p.1195:26mm

a. main trunk of_____ _____

sciatic nerve

b. p_____ d_____

peroneal division

c. L_____ or L_____ radiculopathy

L4 or L5

d. c_____ p_____ nerve

common peroneal

e. s_____ p_____ nerve

superficial peroneal

f. d_____ p_____ nerve

deep peroneal

32. Study Chart. Examine the following functions tests and the muscles for a patient with foot drop:

G7 p.1195:27mm

a. Adduct thigh

Adductors L2-3

b. Extend knee

Quadriceps L2-3-4

c. Internally rotate thigh

Gluteus medius L4-5 S1

d. Dig heel into bed

Gluteus maximus L5 S1-2

e. Flex knee with thigh flexed

Biceps femoris L5 S1-2

f. Foot planter flexion

Gastrocnemius

g. Invert plantar flexed foot

Tibialis posterior L4-5

h. Evert foot

Peroneus longus and brevis L5 S1

33. Adduct thigh.

G7 p.1195:35mm

a. Utilizes_____ muscles

adductor

b. Nerve:_____

obturator

c. Roots:_____

L2, 3

d. If weak means lesion includes more than the_____ _____

sciatic roots

34. Extend knee.

G7 p.1195:35mm

a. Utilizes_____ muscles

quadriceps

b. Nerve:_____

femoral

c. Root:_____

L2, 3, 4

d. If weak means lesion includes more than_____ _____

sciatic roots

35. Internally rotate thigh.

G7 p.1195:62mm

a. Utilizes_____ _____ muscles

gluteus maximus

b. Nerve:_____

superior gluteal

c. Root:_____

L4, 5, S1

d. If weak means lesion is very_____

proximal

36. Dig heel into bed.

G7 p.1195:62mm

a. Utilizes_____ _____ muscles

gluteus maximus

b. Nerve:_____

inferior gluteal

c. Roots:_____ _____ and_____

L5-S1, 2

d. If weak the injury is very_____

proximal

37. Flex knee with thigh flexed.

G7 p.1195:76mm

a. Utilizes_____ _____ muscles

lateral hamstrings

b. Nerve: _____

sciatic

c. Roots:_____ _____ and_____

L5, S1, 2

d. If weak there is injury to the_____ _____

sciatic nerve

38. Foot plantar flexion.

G7 p.1195:76mm

a. Utilizes_____ _____ muscles

gastrocnemius

b. Nerve:_____

sciatic

c. Roots:_____

L5

d. If weak there is injury to the_____ _____

sciatic nerve

39. Invert plantar flexed foot.

G7 p.1195:92mm

a. Utilizes_____ _____ muscles

posterior tibial

b. Nerve:_____

tibial

c. Roots:_____ and_____

L4, 5

d. If weak there is injury to the_____ _____

tibial nerve

e. If strong but there is foot drop, it means that there is injury distal to the take-off of the_____ _____

common peroneal

40. Evert the foot.

G7 p.1195:92mm

a. Utilizes_____ _____ muscles

peroneus longus and brevis

b. Nerve:_____

superficial peroneal

c. Roots:_____ and _____

L5, S1

d. Preservation of these with foot drop means lesion is in the _____ _____ nerve

deep peroneal

41. What are ways to differentiate foot drop from injury to the

G7 p.1195:162mm

a. deep peroneal nerve?

    i. motor weakness manifests by_____ _____

foot drop (weak foot extension)

    ii. muscle that is weak is the_____ _____

anterior tibial (dorsiflexion)

    iii. sensory loss_____ _____

web space

b. common peroneal nerve?

    i. deficit is a _____ _____

foot drop

    ii. muscles involved are a_____ t_____ and p_____ l_____ and b_____

anterior tibial and peroneus longus and brevis

    iii. weakness of_____ and_____ _____

eversion and foot drop

    iv. sensory loss of_____ _____ and _____

lateral leg and foot

42. List the ways to differentiate.

G7 p.1195:182mm

a. plexus lesions on electromyography (EMG) _____ _____

paraspinals normal

b. root lesion on EMG_____ _____

paraspinals abnormal

c. superficial peroneal nerve

    i. motor weakness of _____

eversion

    ii. muscles that are weak are the_____ _____ and_____

peroneus longus and brevis

    iii. Any foot drop?

no

    iv. sensory loss at the_____ _____ and_____

lateral leg and foot

43. Complete the following regarding differential diagnosis by signs and symptoms:

G7 p.1196:29mm

a. Painless foot drop is likely due to_____ _____.

peroneal palsy

b. Painful foot drop is likely due to_____.

radiculopathy

c. Painless foot drop with no sensory loss could be due to _____ _____.

parasagittal lesion

d. If so how might the reflexes be?

hyperactive

e. This is called the_____ _____ _____.

spastic foot drop

44. A central nervous system (CNS) cause of foot drop is

G7 p.1196:60mm

a. the result of a_____ lesion

parasagittal

b. and may produce a_____ reflex

Babinski

c. or a hyperactive_____ reflex.

Achilles (= spastic foot drop)

45. Complete the following regarding symptoms in the hands:

G7 p.1196:155mm

a. Central cord syndrome shows more involvement in_____ than_____.

UE; LE

b. Syringomyelia has b_____ d_____ in the hands.

burning dysesthesias

46. Complete the following regarding lesion location and findings in “cruciate paralysis”:

G7 p.1196:180mm

a. Physical exam shows_____

atrophy of hands

b. due to pressure on the_____

pyramidal decussations

c. at the level of the_____.

foramen magnum

47. Complete the following about radiculopathy, upper extremity:

G7 p.1197:120mm

a. The “empty can” test suggests s_____ p_____.

shoulder pathology

b. Interscapular pain suggests c_____ r_____.

cervical radiculopathy

G7 p.1197:135mm

48. Myocardial infarction (MI) may present with symptoms similar to a radiculopathy at what level?

left C6

G7 p.1197:142mm

49. Matching. Match the symptom with the position of the disc most likely to produce it. Disc: central cervical disc; lateral cervical disc Symptom:

G7 p.1198:23mm

a. pain

lateral

b. myelopathy

central

c. bilateral symptoms

central

d. upper extremity symptoms

lateral

e. lower extremity symptoms

central

f. numb clumsy hands

central

50. Electric shock-like sensation radiating up or down the spine, usually with flexion and attributed to dysfunction of posterior columns is called the_____.

Lhermitte sign

G7 p.1198:170mm

51. True or False. Lhermitte’s sign can be seen in Hint: mc⁵rs

G7 p.1198:180mm

a. multiple sclerosis

true

b. cervical spondylosis

true

c. cervical disc

true

d. cervical cord tumor

true

e. Chiari I

true

f. central cord syndrome

true

g. radiation myelopathy

true

h. subacute combined degeneration

true

52. Complete the following regarding one or more episodes of brief loss of consciousness (LOC):

G7 p.1199:70mm

a. referred to as s_____

syncope

b. prevalence is_____

≈ 50% (higher in elderly)

c. presumed etiology is_____

vasovagal

53. What are the causes of syncope?

G7 p.1199:112mm

a. Disorder of AV node conduction is called_____

Stokes-Adams

b. Tight short collar, shaving, passing out is called_____

carotid sinus syncope

c. Fainting aka_____ syncope

neurocardiogenic

d.

    i. Micturition, cough called_____

triggered syncope

    ii. Usually associated with elevation of_____-_____ pressure

intra-thoracic

e. Orthostatic hypotension defined as a drop in BP of_____mm Hg on standing

25

f. Unknown etiology occurs in_____%

40%

54. Complete the following about transient neurological deficit (TIA):

G7 p.1200:175mm

a. By definition it lasts less than_____ hours

24

b. but usually subsides within_____.

20 minutes

c. They are_____.

temporary

d. They are a result of_____.

ischemia

55. Complete the following regarding the etiology of diplopia secondary to VI nerve palsy:

G7 p.1201:85mm

a. i_____ _____ _____

↑ ICP (pseudotumor cerebri)

b. s_____ _____

sphenoid sinusitis

c. t_____

tumor/mass etc.

56. Complete the following regarding transient ischemic attacks (TIAs):

G7 p.1200:175mm

a. By definition TIAs last less than_____.

24 hours

b. Most resolve within_____.

20 minutes

c. Migraine paresis differs from TIA in that it_____ over several minutes.

progresses (marches)

d. TIA-like symptoms from cerebral amyloid angiopathy (CAA) require avoidance of_____ or_____ drugs

antiplatelet or anticoagulation

G7 p.1201:29mm

e. because the CAA patient is more prone to_____.

hemorrhage

57. Complete the following about anosmia:

G7 p.1202:80mm

a. Most common cause is s_____ r_____ infection.

severe respiratory

b.

    i. Second most common cause is_____ _____.

head injury

    ii. For severe such cases_____ to_____% occurence.

7 to 15%

58. Complete the following about cranial neuropathies:

G7 p.1202:52mm

a. Congenital facial diplegia is also known as_____.

Möbius syndrome

b. It affects which half of the face more?

Upper

c. True or False. It may also involve other cranial nerves. If so, which ones?

true CN VI, III, or XII

d. Lyme disease can cause_____.

unilateral or bilateral seventh nerve palsy

e. Affects which half of the face?

lower (as in Bell palsy)

f. True or False. It may also involve other cranial nerves.

false

59. Complete the following about cavernous sinus syndrome:

G7 p.1204:60mm

a. A cavernous sinus aneurysm can compress the third nerve and cause_____

diplopia

b. due to_____.

ophthalmoplegia

c. In this form of third nerve palsy the pupil will be_____

not dilated

d. because the_____ that dilate the pupil

sympathetics

e. are_____.

also paralyzed

60. Complete the following about osteopetrosis:

G7 p.1204:75mm

a. It is also known as_____

marble bone

b. a_____ disorder

genetic

c. of defective_____ resorption of bone

osteoclastic

d. resulting in increased_____ _____.

bone density

e. The most common neurologic manifestation is_____.

blindness

f. Treatment consists of bilateral_____ _____decompression.

optic nerve

61. Complete the following about monocular blindness:

G7 p1204:178mm

a. Giant cell arthritis aka t_____a_____

temporal arthritis

b. Usually due to ischemia of the

    i. o_____ n_____ or

optic nerve

    ii. o_____ t_____

optic tract

    iii. less likely the c_____ r_____artery

central retinal

62. Complete the following about exophthalmos:

G7 p. 1205:73mm

a. aka p_____

proptosis

b. Following trauma, think: c_____c_____ fistula

carotid cavernous

c. Following frontal-orbital surgery, think:_____ in_____ _____

defect in orbital roof

63. Complete the following about arachnoid cyst:

G7 p.1207:40mm Also see

a. aka_____ _____

leptomeningeal cyst

G7 p. 222

b. Due to a d_____ of the_____

duplication; arachnoid

c. Reach maximum size in_____ _____

1 month

d. Need surgery in about_____%

30%

64. Complete the following regarding differential diagnosis by signs and symptoms:

G7 p.1208:87mm

a. Hemifacial spasm may produce tinnitus because of s_____ m_____spasms.

stapedial muscle

b. High cervical lesion may cause facial sensory changes due to compression of the s_____ t_____ t_____

spinal trigeminal tract

G7 p.1208:40mm

c. at cervical levels down to_____.

C2-C4

d. Causes of mutism include injury to

    i. f_____l_____

frontal lobes

    ii. c_____g_____

cingulate gyrus

    iii. c_____c_____t_____

corpus callosum plus thalamus

    iv. c_____

cerebellum

e. Swallowing difficulties can be caused by ossification of the_____ _____ _____.

anterior longitudinal ligament

G7 p.1209:53mm

65. Complete the following about CPA lesions:

G7 p.1210:133mm

Hint: amem

a.

    i. Acoustic neuroma more accurately known as v_____s_____

vestibular schwannoma

    ii. Occurs in_____to_____%

80 to 90%

b. Meningioma occurs in_____to_____%.

5 to 10%

c. Epidermoid occurs in_____to_____%.

5 to 7%

d. Metastatic_____

rarely

66. Matching. Match the characteristic with the condition.

G7 p.1211:120mm

Condition:

vestibular schwannoma;

meningioma

Characteristic:

a. Hearing loss occurs early in_____.

b. Facial weakness occurs early in_____.

c. Internal auditory canal (IAC) is enlarged in_____.

d. Calcification is seen in_____.

e. It represents 90% of cerebellopontine angle (CPA) tumors.

f. It represents 5 to 10% of CPA tumors.

67. Complete the following about posterior fossa tumor:

G7 p.1209:134mm

a. Most likely a solitary lesion in an adult is a_____.

metastasis

b. Most likely primary tumor is the_____.

hemangioblastoma

c. Radiologic characteristics include

    i. v_____n_____

vascular nodule

    ii. c_____

cyst

    iii. s_____ _____on_____

serpentine vessels on surface

d. The tumor that is common in young adults is p_____a_____.

pilocytic astrocytoma

68. Complete the following regarding differential diagnosis by location:

G7 p.1210:60mm

a. The modern name for medulloblastoma is_____ _____ _____.

primitive neuroectodermal tumor (PNET)

b. It usually begins at the_____,

fastigium

c. which is located at the_____.

roof of the fourth ventricle

d. The consistency is_____.

solid

69. For posterior fossa tumors in children, give types and percentage.

G7 p.1210:87mm

a. a_____ (p_____),_____%

astrocytoma (pilocytic), 27%

b. b_____ _____ _____,_____%

brain stem glioma, 28%

c. P_____(i.e., m_____),_____%

PNET (i.e., medulloblastoma), 27%

70. Complete the following about atlantoaxial subluxation:

G7 p.1230:144mm

a. Incompetence of the_____ligament

transverse

b. Results in increased_____ _____interval

atlantodental

71. Complete the following regarding differential diagnosis by location:

G7 p.1231:23mm

a. Morquio syndrome is hypoplasia of the_____

dens

b. due to a m_____.

mucopolysaccharidosis

c. It may result in_____subluxation.

atlantoaxial

72. Complete the following about multiple intracranial lesions on CT or MRI:

G7 p.1212:103mm

a. Glioma—what % are multicentric?_____%

6%

b. Herpes simplex usually occurs in the_____lobe.

temporal

G7 p.1213:117mm

c. MS lesions are p_____.

periventricular

G7 p.1213:25mm

d. Dural sinus thrombosis cause multiple_____ _____.

venous infarcts

G7 p.1213:721mm

e. Multiple hypertensive hemorrhages is likely_____ _____.

amyloid angiopathy

G7 p.1213:110mm

73. Name the ring-enhancing lesions on computed tomography and magnetic resonance imaging (CT/MRI).

G7 p.1214:100mm

Hint: haam

a. h_____

hematoma

b. a_____

astrocytoma

c. a_____

abscess

d. m_____

metastases

74. Complete the following about ring-enhancing lesions on CT/MRI:

G7 p.1214:100mm

a. A continuous ring suggests r_____h_____.

resolving hematoma

b. An interrupted ring suggests m_____.

malignancy

75. List the conditions that cross the corpus callosum.

G7 p.1215:70mm

Hint: ms-glld

a. m_____ s_____

multiple sclerosis

b. g_____

glioblastoma

c. l_____

lymphoma (primary CNS)

d. l_____

lipoma

e. d_____

diffuse axonal injury

76. Complete the following regarding sellar and parasellar lesions:

G7 p.1215:95mm

a. Adults: most common is_____ _____

pituitary adenoma

b.

    i. Children: most common are c_____

craniopharyngioma

    ii. and g_____

germinoma

77. Complete the following regarding sellar lesions:

G7 p.1215:150mm

a. Pituitary pseudotumor is due to_____,

hypothyroidism

b. which causes chronic pituitary stimulation by_____-_____ _____.

thyrotropin-releasing hormone

78. Germ cell tumors in the suprasellar area are

G7 p.1215:150mm

a. more common in_____.

women

b. have a triad of

    i. d_____ _____

diabetes insipidus

    ii. v_____ _____ _____

visual field defects

    iii. p_____

panhypopituitarism

79. Complete the following about juxtasellar masses:

G7 p.1216:16mm

a. Craniopharyngioma

    i. In this region account for_____% of tumors in adults

20%

    ii. and_____% in children

54%

b. Meningioma. To differentiate from pituitary macroadenoma use gadolinium. Meningiomas have:

    i. b_____h_____ e_____

bright homogeneous enhancement

    ii. Epicenter is_____

suprasellar

    iii. Tapered extension aka_____ _____

dural tail

    iv. Sella is usually_____ _____

not enlarged

    v. Rarely produce_____disturbances

endocrine

    vi. Tend to_____carotid artery

encase

80. True or False. Regarding lymphocytic hypophysitis:

G7 p.1212:15mm

a. It is rare.

true

b. It may cause hypopituitarism.

true

c. Most cases occur in women.

true

d. It tends to selectively affect a single hormone.

true

e. It requires surgery.

false (self-limiting or Rx with steroids)

f. It may produce diabetes insipidus (DI).

true

81. Complete the following about cavum septum pellucidum (CSP):

G7 p.1218:45mm

a. It is present in all_____ _____.

premature babies

b. Adults have them in_____%.

10%

c. It is commonly seen in_____.

boxers

82. Complete the following about cavum vergae:

G7 p.1218:45mm

a. posterior to_____

CSP

b. often communicates with the_____

CSP

83. Complete the following about cavum velum interpositum:

G7 p.1218:45mm

a. due to separation of the_____

crura

b. of the_____

fornix

c. with the_____above and

thalami

d. the_____ _____ below

third ventricle

e. present under 1 year of age in_____%

60%

f. present between 1 and 10 years old in_____%

30%

84. True or False. The most common benign primary intraorbital neoplasm is

G7 p.1218:128mm

a. capillary hemangioma

false

b. lymphangioma

false

c. optic nerve sheath meningioma

false

d. cavernous hemangioma

true

e. optic glioma

false

85. Matching. Match characteristics of orbital lesions with pathology (may match with more than one).

G7 p.1218:145mm

Pathology:

capillary hemangioma; lymphangioma; lymphoma; thyroid ophthalmoplegia

Characteristic:

a. infantile proptosis

,

b. regresses spontaneously

c. does not regress

d. painless proptosis ,

e. bilateral (80% of the time)

86. The most common primary ocular malignancy of childhood is_____.

melanoma

G7 p.1218:152mm

87. Complete the following about skull lesions:

G7 p.1220:27mm

a. Multiplicity suggests_____.

malignancy, especially if six or more

b. Expansion of diploë suggests_____.

a benign lesion

c. Peripheral sclerosis suggests_____.

a benign lesion

d. Full-thickness lesions suggest_____.

malignancy

e. Sharply demarcated, punched-out defects suggest_____.

myeloma

88. Complete the following about skull lesions:

G7 p.1220:80mm

a. Name the skull lesion that shows a

    i. trabecular pattern

hemangioma

G6 p.930:120mm

    ii. sunburst pattern

hemangioma

    iii. islands of bone pattern

fibrous dysplasia

    iv. site of tenderness to palpation

eosinophilic granuloma

b. Another name for Paget disease that is only osteolytic is_____ _____.

osteoporosis circumscripta

G7 p.1221:87mm

c. Eosinophilic granuloma is the mildest form of_____ _____.

histiocytosis X

89. Complete the following about skull lesions:

G7 p.1223:35mm

a. There is no_____lesion

intra-axial

b. that grows out of the_____.

skull

90. Choroid plexus calcification has the following characteristics:

G7 p.1224:45mm

a. % calcified between age 40 and 50 is_____

75%

b. rare under age_____

3

c. Under age 10 consider choroid plexus_____.

papilloma

d. If you see calcified choroid plexus in the temporal horn consider_____.

neurofibromatosis

91. Complete the following about basal ganglia calcifications:

G7 p.1224:55mm

a. Are common in the_____

elderly

b. May be due to_____

hyperparathyroidism

c. Or long-term use of_____

anticonvulsants

d. Or_____disease

Fahr

e. Correlated with psychiatric diseases if >_____cm

0.5

92. Complete the following about Fahr disease:

G7 p.1224:75mm

a. Cause is_____

idiopathic

b. Course is_____

progressive

c. What do we see in x-rays?

intracranial calcifications

d. Where?

    i. b_____ g_____

basal ganglia

    ii. s_____

sulci

    iii. d_____n_____

dentate nuclei

93. What are the characteristics of intraventricular lesions? Which:

G7 p.1224:150mm

a. is most common?

astrocytoma

b. is at foramen of Monro?

colloid cyst

c. has punctate calcification?

craniopharyngioma

d. fills the fourth ventricle?

medulloblastoma

e. is the most common fourth ventricle low density lesion?

epidermoid

f. has free-floating fat in ventricles?

dermoid

g. has fat and calcification?

teratoma

h. is at the septum pellucidum?

central neurocytoma

94. Intraventricular meningiomas are fed by the

G7 p.1224:180mm

a. a_____ c_____ a_____

anterior choroidal artery

b. and less commonly by the

    i. m_____ p_____ c_____a_____ medial posterior choroidal artery

    ii. l_____ p_____ c_____a_____

lateral posterior choroidal artery

c. and are thought to arise from the _____ _____ _____.

arachnoidal cap cells

95. True or False. The following intraventricular lesion is least likely to be found in the frontal horn:

G7 p.1225:130mm

a. astrocytoma

false

b. meningioma

false

c. dermoid

false

d. choroid plexus papilloma

true

96. Matching. Match most common tumor type with location.

G7 p.1225:125mm

Location: frontal horn; body; atrium; third ventricle; fourth ventricle

Tumor type:

a. Colloid cyst

b. Medulloblastoma

c. Meningioma

d. Ependymoma

e. Astrocytoma

f. Choroid plexus papilloma

g. Choroid plexus carcinoma

h. Subependymoma_____ or_____

or

    i. teratoma

97. Complete the following about tumors within the lateral ventricles. In adults all enhance except

G7 p.1226:65mm

a. c_____ and the

cysts

b. s_____.

subependymoma

98. Periventricular enhancing mass lesions. First consideration should be _____.

lymphoma

G7 p.1227:138mm

99. With periventricular low density, consider:

G7 p.1227:138mm

a. t_____ edema

transependymal

b. m_____ s_____

multiple sclerosis

c. acute arteriosclerotic encephalopathy aka_____ _____

Binswanger disease

d. leukoaraiosis

    i. representing_____ _____

normal aging

    ii. or w_____ i_____

watershed infarction

100. Ependymal enhancement can be due to

G7 p.1227:142mm

a. v_____

ventriculitis (pyogenic or viral)

b. l_____

lymphoma

c. m_____

metastasis

d. g_____

granuloma (TB)

101. What does the pattern of enhancement suggest?

G7 p.1228:35mm

a. Thin linear suggests v_____.

virus (CMV)

b. Nodular suggests l_____.

lymphoma

102. Complete the following about intraventricular hemorrhage:

G7 p.1228:95mm

a. Extension from

    i. t_____ in hypertensive adult

thalamus

    ii. p_____ in hypertensive adult

putamen

    iii. s_____ in premature newborn

subependyma

b. True or False. Occurs commonly with aneurysm of the

    i. MCA

false

    ii. A-comm

true

    iii. P-comm

false

    iv. distal basilar

false

    v. vein of Galen

false

    vi. carotid bifurcation

true

    vii. pericallosal

false

     viii. vertebral

true

     ix. PICA

true

     x. dissecting vertebral type

true

103. The most common medial temporal lobe lesions are

G7 p.1128:145mm

a. h_____

hamartoma

b. m_____ t_____ s_____ mesial temporal sclerosis

c. g_____

glioma (low grade)

104. True or False. Esthesioneuroblastoma most commonly presents with

G7 p.1230:42mm

a. pain

false

b. nasal obstruction

false

c. epistaxis

true

d. tearing

false

e. proptosis

false

105. To differentiate:

G7 p.1230:80mm

nasal encephalocele

nasal glioma in the newborn

a. pulsatile

b. swells with Valsalva

c. hypertelorism

d. attachment to CNS

106. Destructive spondylo-arthropathy is

G7 p.1233:30mm

a. the name for bone changes seen in c_____ r_____ f_____.

chronic renal failure

b. It resembles i_____.

infection

107. True or False. Destruction of the disc space is highly suggestive of

G7 p.1233:70mm

a. tumor

false

b. infection

true

c. degenerative disease

false

d. metabolic disease

false

108. Matching. Match the destructive lesion of the spine with its cause.

G7 p.1233:71mm

Cause: infection; tumor; Paget disease Destructive lesion:

a. Destruction of disc space suggests_____.

b. Disc space not destroyed suggests _____.

c. Single-level involvement suggests _____.

d. Multiple-level involvement suggests _____.

e. Dense vertebra on x-ray suggests _____.

109. True or False. Pott disease is confined to the disc space.

false (The disc may be relatively resistant to tuberculous involvement.)

G7 p.1233:88mm