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neurology > cancer/abscess/concussion/CN > Flashcards

cancer/abscess/concussion/CN Flashcards

1
Q

space occupying lesion symptoms

A

vomiting, fever, altered mental status, and focal neurologic signs

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2
Q

avoid LP in who

A

focal neurologic signs; brain stem herniation may be precipated by LP; rule out space occupying lesion

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3
Q

imaging dx for abscess

A

MRI or CT with contrast medium

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4
Q

bacterial catagory of brain abscess

A

polymicrobial; gm+ and gm-

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5
Q

brain abscess medication tx

A

IV pen G or ceftriaxone plus flagyl - add vanco if staph aureus is suspected

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6
Q

Half of brain cancers are what

A

gliomas

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7
Q

10% of spinal tumors are what the rest are what

A

10 % are intramedullary rest are ependymona

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8
Q

common sources of intracranial metastasis

A

carcinoma of lung, breast, kidney, GI tract

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9
Q

personality changes, intellectual decline, emotional lability, seizures, HA, N/V, malaise

A

increased intracranial pressure

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10
Q

main brain tumor in adults and kids

A

adults: gliobastoma kids: astrocytomas

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11
Q

% of brain tumors - primary - metastatic

A

primary is 30% mets is 70%

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12
Q

progressive intellectual decline

slowing of mental activity

personality changes contralateral grasp reflexes

poss expressive aphasia

A

frontal lobe

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13
Q

lead to seizures, depersonalization olfactory or gustatory(taste) hallucinations licking or smacking of lips emotional and behavioral changes visual field defects auditory illusions

A

temporal lobe

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14
Q

cause contralateral disturbances of sensation

may cause sensory seizures

a cortical sensory loss or inattention

A

parietal lobe

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15
Q

crossed homonymous hemianopia or partial field defect visual agnosia for objects and colors or unformed visual hallucinations

A

occipital lobe

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16
Q

CN palsies, ataxia, incoordination, nystagmus, pyramidal and sensory deficits in limbs on one or both sides

A

brain stem and cerebellar cancer

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17
Q

ataxia

A

the loss of full control of bodily movements

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18
Q

loss of consciousness for how long implies a worse prognosis

A

2 minutes

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19
Q

s/s of acute epidural hemorrhage

A

HA, confusion, somnolence, seizures, focal deficits occurring several hours after injury

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20
Q

signs that occur with a brief loss of consciousness

A

bradycardia, hypotension, respiratory arrest

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21
Q

study of choice for brain injury

A

head CT

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22
Q

crescent shaped hemorrhage biconcave shaped hemorrhage

A

crescent: subdural biconcave: epidural

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23
Q

tx of increased intracranial pressure

A

ventricular drainage elevation of head of bed induce hyperventilation IV mannitol infusion sedation

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24
Q

anticonvulsant therapy for brain injury?

A

1 week for severe brain injuries

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25
Q

total spinal cord transection

A

-immediate, flaccid paralysis, loss of sedation below the level of lesion -reflex activity is lost for a variable time, urinary and fecal retention -spastic paraplegia or quadriplegia, with hyperreflexia and extensor plantar responses

26
Q

-immediate, flaccid paralysis, loss of sedation below the level of lesion -reflex activity is lost for a variable time, urinary and fecal retention -spastic paraplegia or quadriplegia, with hyperreflexia and extensor plantar responses

A

total spinal cord transection

27
Q

partial spinal cord injury

A

mild limb weakness or distal sensory disturbance sphincter function impairment may lead to urinary urgency and incontinence

28
Q

unilateral spinal cord lesion

A

ipsilateral motor disturbance and impairment of prioception; contralateral loss of pain and temperature sensation below the lesion

29
Q

central spinal cord syndrome

A

may lead to a lower motor neuron deficit and loss of pain and temperature, with sparing of the posterior column functions

30
Q

radicular deficit -what is cauda equina is involved

A

may occur at the level of the injury; dysfunction of several lumbosacral roots

31
Q

brain abscess tx

A

Chemo, radiation, or both

32
Q

spinal cord injury tx/cord compression -early tx

A

immobilization, decompression laminectomy and fusion if there is cord compression

early tx with high dose corticosteroids within 8 hrs of injury

33
Q

CN 1-6

A

1- olfactory 2- optic 3- oculomotor 4- trochlea 5-trigeminal 6-abducens

34
Q

CN 7-12

A

7- facial 8-vestibulocochlear 9-glossopharyngeal 10-vagus 11-accessory/spinal nn 12-hypoglossal

35
Q

CN 3

A

oculomotor:

eyes up and medial

eyes up and in

constricts pupils

open and close eye

36
Q

CN 4

A

trochlear

eyes down and in

37
Q

CN 5

A

trigeminal

touch forehead and cheek

clench teeth

38
Q

CN 6

A

abducens (lateral rectus muscle)

look side to side

39
Q

CN 7

A

facial

taste for anterior tongue

puff cheeks

smile and frown

40
Q

CN 8

A

vestibular-cochlear

hearing, equilibrium, whisper

41
Q

CN 9

A

glossalpharyngeal

posterior 1/3 of tongue, speech, gag reflex, swallow

42
Q

CN 11

A

accessory/spinal

shoulder shrug

43
Q

CN 12

A

hypoglossal

tongue movement

44
Q

CN 10

A

vagus

slow HR, digestion, defecation, coughing, motor gag reflex

45
Q

pneumonic for CN sensory/motor

A

some say marry money but my brother says big brains matter most

46
Q

Glascow eye opening points 4-1

A

4 spontaneous opening

3 eyes open to verbal command

2 eyes open to pain

1 no eye opening

47
Q

glascow verbal response points 5-1

A

5 alert and oriented

4 confused yet coherent speech

3 inappropriate words and jumbled phrases

2 incomprehensible sounds

1 no sounds

48
Q

glascow motor response points 6-1

A

6 obeys commands

5 localizes to a noxious stimulus

4 withdraws from a noxious stimulus

3 abnormal flexion(decorticate posturing)

2 abnormal extension (decerebrate posturing)

1 no response

49
Q

Headaches Dizziness Fatigue Irritability Anxiety Insomnia Loss of concentration and memory Noise and light sensitivity

A

post concussive syndrome

50
Q

post concussive syndrome meds

A

Amitriptyline. This medication has been widely used for post-traumatic injuries, as well as for symptoms commonly associated with post-concussion syndrome, such as irritability, dizziness and depression.

Amitriptyline may be combined with propranolol (Inderal, Innopran XL) to treat migraine-type headaches.

Topiramate. Commonly used to treat migraines, topiramate (Qudexy XR, Topamax, Trokendi XR) may be effective in reducing headaches after head injury.

Common side effects of topiramate include weight loss and cognitive problems. Gabapentin.

Gabapentin (Gralise, Neurontin) is frequently used to treat a variety of types of pain and may be helpful in treating post-traumatic headaches.

A common side effect of gabapentin is drowsiness.

51
Q

eyes up and medial

constricts pupils

open and close eye

A

CN 3

oculomotor

superior/middle/inferior rectus

inferior oblique

52
Q

eyes down and in

A

CN 4

trochlea

53
Q

touch forehead and cheek

clench teeth

A

CN 5

trigeminal

54
Q

look side to side

A

CN 6

abducens

55
Q

taste for anterior tongue

puff cheeks

smile and frown

A

CN 7

facial nerve

56
Q

hearing, equilibrium, whisper

A

CN 8

vestibular cochlear

57
Q

posterior 1/3 of tongue, speech, gag reflex, swallow

A

CN 9

glossopharyngeal

58
Q

shoulder shrug

A

CN 11

spinal/accessory

59
Q

tongue movement

A

CN 12

hypoglossal

60
Q

slow HR, digestion, defecation, coughing, motor gag reflex

A

CN 10

vagus

61
Q

wernickes aphasia

A

word salad

speech fluent but makes no sense

left post sup temporal

inferior posterior MCA embolus

62
Q

brocas aphasia

A

telegraphic

impaired speech with frustration

few words with frequent pauses

post. infer. frontal cortex

superior MCA stroke

neurology (9 decks)

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