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Clin med neurology > Dementia and head trauma > Flashcards

Dementia and head trauma Flashcards

1
Q

What blood work should be done when working up a patient for dementia

A

CBC
CMO
TSH
Drug screen
Ammonia levels
Syphilis screen
Heavy metal screen

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2
Q

What is the most common type of dementia

A

alzheimers dementia

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3
Q

What is Alzheimers dementia

A

Progressive dementia cause by intracellular neurofibrillary tangles and extracellular plaques

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4
Q

What are some Alzheimers dementia treatments

A

AChE inhibitors
-Donepezil, Rivastigmine

NMDA agonists
-Memantine

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5
Q

What is the second most common type of dementia

A

Vascular dementia

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6
Q

Which gender is at higher risk for vascular dementia

A

Men

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7
Q

What is vascular dementia

A

Ischemia of the brain & lacunar infarcts

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8
Q

What are some associated causes of vascular dementia

A

Hypertension
High cholesterol

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9
Q

What are the 2 subtypes of vascular dementia

A

Cortical
Subcortical

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10
Q

What is cortical vascular dementia

A

Speech difficulty
Loss of ADL
Confusion
Amnesia

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11
Q

What is subcortical vascular dementia

A

Motor deficit
gait changes
urinary incontinence
personality changes

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12
Q

What may be seen in labs for vascular dementia

A

Hyperlipidemia

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13
Q

What may be given as treatment for vascular dementia to manage disease

A

States and anti platelets for treatment of hyperlipidemia and hypertension

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14
Q

What is Lewey body dementia caused by

A

Deposits in nerve cells known as Lewy bodies in the midbrain, brain stem, and olfactory bulbs

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15
Q

What are some side effects from Lewy body dementia

A

Delusions
visual hallucinations
anxiety

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16
Q

What is frontotemporal dementia

A

Dementia caused by the degeneration of the frontal / temporal lobes

*pick disease

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17
Q

What does frontotemporal dementia cause

A

Euphoria
apathy
disinhibition
compulsions

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18
Q

What is pseudo dementia

A

Perceived memory loss with normal MOCA MRI and labs

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19
Q

What generally causes pseudo dementia

A

Uncontrolled depression and anxiety

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20
Q

How will you treat pseudo dementia

A

SSRIs and counseling

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21
Q

What does GCS stand for

A

Glasgow coma scale

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22
Q

What do you measure on a GCS

A

Eye open response
best verbal response
Best motor response

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23
Q

How do you measure the eye opening response with GCS

A

4- Spontaneously
3- To speech
2-To pain
1-No response

24
Q

How do you measure best verbal response on a GCS

A

5-Oriented to time, place, person
4-Confused
3-Inappropriate words
2-Incomprehensible sounds
1-No response

25
Q

How do you measure best motor response on a GCS

A

6- Obeys command
5-Moves to localized pain
4-Flexion withdrawal to pain
3-Abnormal flexion (decorticate)
2-Abnormal extension (decerebrate)
1-No response

26
Q

If someone is dead, what is their GCS

A

3

27
Q

If a patient is comatose, what is their GCS

A

8 or less

28
Q

What is the highest score you can get on a GCS

A

15

29
Q

What accounts for 50% trauma deaths in children

A

Head trauma

30
Q

What are contra-coup injuries

A

Injuries that happen on the opposite side of impact

31
Q

Where do intracerebral hemorrhages occur

A

in the intraparenchymal space (will not touch the skull)

32
Q

What causes an intracerebral hemorrhage

A

Trauma
AVM
Hypertension

33
Q

What are the symptoms of an intracerebral hemorrhage

A

Headache
N/V
hemiplegia
hemiparesis

34
Q

How do you treat an intracerebral hemorrhage

A

steroids to decrease edema
antiepileptics
possible surgical intervention

35
Q

If you are concerned someone has an intracerebral hemorrhage, would you preform an LP

A

NO!
Can cause herniation

36
Q

what are some causes of a subarachnoid hemorrhage

A

Trauma
AVM
Cherry aneurysm

37
Q

What are some symptoms of a subarachnoid hemorrhage

A

Sudden “thunderclap” headache
(usually unilateral)
N/V

38
Q

What are meningeal signs of a subarachnoid hemorrhage

A

Photophobia
confusion
Neck stiffness

39
Q

What treatment can you use for a subarachnoid hemorrhages

A

Stool softeners
Phenytoin
Nimodipine (BP control)

40
Q

Where does an epidural hematoma occur

A

It is an arterial bleed between the skull and the dura

41
Q

What causes an epidural hematoma

A

Skull fracture damaging the middle meningeal artery

42
Q

What are the signs of an epidural hematoma

A

Headache
N/V
CSF fluid leak
Focal neuro changes
Coma
*will have LOC and then regain it before losing it again

43
Q

What will an epidural hematoma look like on imaging

A

Convex bleed that doesn’t cross the line in the temporal area

44
Q

What is a subdural hematoma

A

Venous bleed between the dura and the arachnoid from torn bridging veins

45
Q

What causes a subdural hematoma

A

Trauma

46
Q

What symptoms occur with subdural hematoma

A

Focal neuro symptoms
severity varies

47
Q

What will be seen on imaging with a subdural hematoma

A

Concave bleeding that crosses suture lines

48
Q

What is a concussion

A

Traumatic brain injury causing alterations in mental status or LOC
*neurons lose their neurotransmitters

49
Q

What are immediate symptoms of a concussion

A

amnesia
confusion
decreased coordination
emotional changes
disorientation

50
Q

What symptoms should never be included with a concussion

A

change in pupil size
hemiparesis
visual field deficit

51
Q

What CT findings should be seen with a concussion

A

none

52
Q

What do you give someone with mild headache symptoms

A

NSAID
Excedrin

53
Q

What do you give someone with moderate headache symptoms

A

Triptan medications
*target the blood vessels
*cannot use it more than 10 days a month b/c of rebound migraines

54
Q

What do you give someone who is having severe migraines

A

Sumatriptan
*can give a warming sensation of the throat

55
Q

What medication can be given to prevent migraine reoccurrance within three days of the initial migraine

A

IV Dexamethasone

56
Q

What is generally helpful in treating cluster headaches

A

oxygen
prednisone taper

Clin med neurology (12 decks)

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