20 cards Flashcards
In the setting of suspected stroke, what can a CT help with identifying
Hemorrhage
Early ischemia
In the setting of suspected stroke, what can an MRI help with identifying
Ischemia
Posterior circulation events
TIA
Initial clinical assessment of ?stroke
- Confirm stroke dx, r/o mimics, determine if hemorrhage/ infarct
- If ischemic, determine suitablilty for reperfusion - dependant on time of onset/ last seen well
- Determine stroke cause and area of brain affected
- most ischemic is due to atheroscleoris
- subcortical syndromes often due to small vessel disease
- cortical syndromes due to cardiogenic emboli or carotid stenosis
New TIA definition
Tissue based not time based
If symptoms resolve completely within 24 hours and there is no brain infarction
Facial weakness with parotid mass = ??
Malignant parotid tumor with facial nerve involvement
What would a LMN lesion of the face look like compared to an UMN lesion
LMN = entire face incl forehead
UMN = face but forehead sparing
Subdural hematoma is due to ?
Rupture of the bridgin veins- cna be due to minor head trauma
Cllin F of Wernicke’s encephalopathy
Confusion
Ocular motor dysfunction
Gait ataxia
CT findings of subdural hematoma
Biconvex, concave lesion that may cross cranial suture lines
Clin F of meningoencephalitis
Fever, HA, photophobia, neck stiffness, AMS
Typical CSF findings for viral meningoencephalitis
Lymphocytic pleocytosis with mildly elevated protein, normal glucose
MCC of sporadic viral encephalitis in immunocompetent adults
HSV
Which lobe does HSV typically affect
Temporal lobe –> results in confusion
CSF findings for neisseria meningitidis and streptococcus pneumoniae
Markedly elevated WCC with neutrophil predominance.
V high protein , low glucose
Gram stain = gram negative dipplococci if neisseria , gram positive if strep
What clinical feature suggests encephalitis over pure meningitis
Confusion and AMS
Lab findings in SIADH secondary to head injury
Euvolemic hypotonic hyponatremia (low serum sodium and osmolality)
High urine sodium
Normal renal function
First line treatment for SIADH in clinically stable patient
Fluid restriction over 24hours- gradually correct excess water retention which allows serum sodium to normalise
Treatment of severe hyponatremia or symptomatic, unstable patients
IV hypertonic saline
Treatment of hypervolemic hyponatremia
IV frusemide - typically seen in HF, cirrhosis, nephrotic syndrome
Management of chronic hyponatremia
PO sodium supplements
