Under (Pulmonary) Pressure
Big Ventricles, Bigger Problems
Brain Bubbles
Coke Addict
100
PAH in the setting of cirrhosis and elevated portal pressures is given this name.
What is portopulmonary hypertension?
100
This narrow channel connecting the third and fourth ventricles is the most common single site of CSF obstruction in noncommunicating hydrocephalus.
What is the cerebral aqueduct (of Sylvius)?
100
In endemic regions, neurocysticercosis is the most common cause of this adult-onset neurologic condition.
What are seizures?
100
McDonald's
Coca Cola
200
This remains the definitive intervention for patients with PAH refractory to optimized medical therapy.
What is lung transplantation?
200
When the peritoneum is unusable from adhesions or peritonitis, a shunt catheter is rerouted to one of these alternative sites.
What are the pleural space or the right atrium?
200
Before starting antiparasitic therapy for neurocysticercosis, this examination is recommended because positive findings may require surgical intervention first.
What is a funduscopic examination?
Ocular cysticercosis occurs in approximately 1-3% of cases of neurocysticercosis
200
Chick-Fil-A
Coke
300
According to the most recent guidelines, pulmonary hypertension is diagnosed when the mPAP exceeds this value.
mPAP = mean pulmonary arterial pressure
What is 20 mm Hg?
300
Before performing a large-volume LP for suspected NPH, imaging must exclude an obstructing lesion to avoid precipitating this potentially fatal complication.
What is cerebral herniation?
300
Before starting prolonged corticosteroid therapy for neurocysticercosis, screening or empiric therapy for this helminth is advised, to avoid triggering a hyperinfection syndrome.
What is Strongyloides?
Reported after corticosteroid courses as short as 6 days and doses as low as 20 mg prednisone/day
Carries a mortality rate >60% (up to 85–100% if left untreated)
300
Taco Bell
Pepsi
400
DAILY DOUBLE
Pre-capillary pulmonary hypertension is defined by these PVR and PCWP parameters.
PCWP = pulmonary capillary wedge pressure
PVR = pulmonary vascular resistance
What are increased PVR and decreased PCWP?
400
DAILY DOUBLE
Often mistaken for NPH on imaging, this condition shows ventriculomegaly in proportion due to brain atrophy.
What is hydrocephalus ex vacuo?
400
Antiparasitic therapy is not required when imaging in neurocysticercosis only shows these lesions.
What are calcified parenchymal lesions?
Calcified lesions do not contain viable parasites so there is no role for antiparasitic or anti-inflammatory therapy
400
Subway
Pepsi
500
Positive vasoreactivity testing for PAH requires a minimum absolute drop in mPAP of >10 mm Hg to a value of <40 mm Hg without a change in this parameter.
What is cardiac output?
If vasoreactivity testing results in decreased cardiac output, treatment with CCBs can be life-threatening — reflecting negative inotropy on the pressure-overloaded RV
500
This cranial nerve palsy is a false-localizing sign of elevated ICP.
What is a sixth (abducens) nerve palsy?
500
In viable neurocysticercosis, this is the minimum number of cysts that warrants dual antiparasitic therapy with albendazole plus praziquantel?
What is at least 3 viable cysts?
500
Domino's
Coke