amboss 7/9 Flashcards
what are risk factors for simple febrile seizures
high fever, viral infection (especially HHV-6 and influenza), a family history of febrile seizure, and recent immunization (especially DTP and MMR) are all known risk factors.
what is an effective way to reduce fevers
acetaminophen
what is a neurological SE of gentamicin
ototoxicity and cochlear dysfunction. they damage hair cells in the inner ear
there is typically no vertigo; but patients will experience oscillopsia or an abnormal head thrust test in both directions
differences between BPPV, menières, suppurative labrythitis and vestibulobasilar insufficiency
BPPV –vertigo while changing head position that lasts 1 min.
menieres –tinnitus, vertigo, hearing loss
labyrinthitis –chronic otitis media tinnitus and oscillopsia.
vestiulobasilar insufficiency –episodic tinnitus, and unsteady gait usually with dysarthria, dysphagia, paresthesias.
what is the most common cause of bacterial keratitis in contact lens wearers
pseudomonas aeruginosa
what is the course of pseudomonas kerititis
rapidly progressive and can lead to corneal perforation within 2-5 days
what is the treatment of pseudomonas kerititis
Prompt treatment with topical broad-spectrum antibiotics (e.g., cefazolin with tobramycin/gentamicin) should be initiated.
what is the best way to identify corneal abrasion
slit lamp with fluorescein staining
what is a common cause of sudden painless vision loss for diabetics
vitreous hemorrhage from sites of bleeding neovascularization. will present with blurry vision, dark streaks in the field, fundoscopic exam will be occluded
is noise-induced hearing loss sensorineural or conductive
sensorineural due to hair cell destruction from loud noises
what is the most likely cause of bilateral conductive hearing loss in a 20-30 year old
otosclerosis
what is otosclerosis
overgrowth of the footplate of the stapes bone in the middle ear leading to progressive fixation of the bone and decreased sound conduction. Usually initially unilateral but becomes bilateral in most cases.
what is the presentation of otosclerosis
constellation of tinnitus and insidious bilateral conductive hearing loss. About 25% of patients with otosclerosis would also complain of mild vertigo (often described by patients as “dizziness”). Patients with otosclerosis often report being able to hear better in noisy rather than quiet surroundings (paracusis of Willis) and characteristically develop a soft, monotonous speech.
what is the treatment for myasthenia crisis
if respiratory depression is severe enough then intubate. but if they do not require intubation then proceed with IVIG
what is the treatment for Menieres
no direct treatment for menieres disease.
what are the dietary and lifestyle triggers for menieres
caffeine, alcohol, stress.
what medical therapies can help menieres
Acute: vestibular suppressants (e.g., dimenhydrinate, benzodiazepines, meclizine); antiemetics (e.g., promethazine, ondansetron)
Prophylaxis: histamine analog (betahistine); diuretics (hydrochlorothiazide or triamterene)
what does hypertension do to the small communicating arteries
causes lipohyalinosis and eventually aneurysmal formation and risk for rupture and hemorrhagic stroke
what is the diagnosis of unilateral facial pain, cyclical headache, pupillary constriction differences, lacrimation and rhinorrhea
cluster headache
what is the presentation of diabetic autonomic neuropathy
orthostatic hypotension, urinary retention, gastroparesis, erectile dysfunction
what is cerebral venous thrombosis
thrombotic obstruction of the cerebral veins and/or related anatomical structures (dural sinuses) which drain blood from the brain. Women are affected more often than men. Predisposing factors include prothrombotic conditions, pregnancy, oral contraceptive use, malignancy, and infection.
what is the presentation of cerebral venous thrombosis
progressive worsening headache, chemosis, cranial nerve VI palsy (impaired right-sided lateral gaze), increased intracranial pressure (evident by headache and bilateral papilledema), and the occlusive lesion in a cerebral sinus on imaging indicates cerebral venous thrombosis (CVT).
what is the treatment for cerebral venous thrombosis
Administration of a low molecular weight heparin (LMWH), such as dalteparin, is the most appropriate next step in the management of a patient with acute (aseptic) CVT, as the drug acts to both dissolve the clot and prevent formation of a new clot. The typical duration is two weeks, after which treatment is switched to an extended duration oral anticoagulant (e.g., warfarin).
