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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
total spinal cord transection
-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
-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
total spinal cord transection
27
partial spinal cord injury
mild limb weakness or distal sensory disturbance sphincter function impairment may lead to urinary urgency and incontinence
28
unilateral spinal cord lesion
ipsilateral motor disturbance and impairment of prioception; contralateral loss of pain and temperature sensation below the lesion
29
central spinal cord syndrome
may lead to a lower motor neuron deficit and loss of pain and temperature, with sparing of the posterior column functions
30
radicular deficit -what is cauda equina is involved
may occur at the level of the injury; dysfunction of several lumbosacral roots
31
brain abscess tx
Chemo, radiation, or both
32
spinal cord injury tx/cord compression -early tx
immobilization, decompression laminectomy and fusion if there is cord compression early tx with high dose corticosteroids within 8 hrs of injury
33
CN 1-6
1- olfactory 2- optic 3- oculomotor 4- trochlea 5-trigeminal 6-abducens
34
CN 7-12
7- facial 8-vestibulocochlear 9-glossopharyngeal 10-vagus 11-accessory/spinal nn 12-hypoglossal
35
CN 3
oculomotor: eyes up and medial eyes up and in constricts pupils open and close eye
36
CN 4
trochlear eyes down and in
37
CN 5
trigeminal touch forehead and cheek clench teeth
38
CN 6
abducens (lateral rectus muscle) look side to side
39
CN 7
facial taste for anterior tongue puff cheeks smile and frown
40
CN 8
vestibular-cochlear hearing, equilibrium, whisper
41
CN 9
glossalpharyngeal posterior 1/3 of tongue, speech, gag reflex, swallow
42
CN 11
accessory/spinal shoulder shrug
43
CN 12
hypoglossal tongue movement
44
CN 10
vagus slow HR, digestion, defecation, coughing, motor gag reflex
45
pneumonic for CN sensory/motor
some say marry money but my brother says big brains matter most
46
Glascow eye opening points 4-1
4 spontaneous opening 3 eyes open to verbal command 2 eyes open to pain 1 no eye opening
47
glascow verbal response points 5-1
5 alert and oriented 4 confused yet coherent speech 3 inappropriate words and jumbled phrases 2 incomprehensible sounds 1 no sounds
48
glascow motor response points 6-1
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
Headaches Dizziness Fatigue Irritability Anxiety Insomnia Loss of concentration and memory Noise and light sensitivity
post concussive syndrome
50
post concussive syndrome meds
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
eyes up and medial constricts pupils open and close eye
CN 3 oculomotor superior/middle/inferior rectus inferior oblique
52
eyes down and in
CN 4 trochlea
53
touch forehead and cheek clench teeth
CN 5 trigeminal
54
look side to side
CN 6 abducens
55
taste for anterior tongue puff cheeks smile and frown
CN 7 facial nerve
56
hearing, equilibrium, whisper
CN 8 vestibular cochlear
57
posterior 1/3 of tongue, speech, gag reflex, swallow
CN 9 glossopharyngeal
58
shoulder shrug
CN 11 spinal/accessory
59
tongue movement
CN 12 hypoglossal
60
slow HR, digestion, defecation, coughing, motor gag reflex
CN 10 vagus
61
wernickes aphasia
word salad speech fluent but makes no sense left post sup temporal inferior posterior MCA embolus
62
brocas aphasia
telegraphic impaired speech with frustration few words with frequent pauses post. infer. frontal cortex superior MCA stroke

neurology (10 decks)

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