IM Flashcards
window period for IV thrombolysis
3 ~ 4.5h
stroke + lost Consciousness + convulsions + vomiting
hemorrhagic stroke
M/C type of stroke
thrombotic
M/C type of ischemic stroke
capsular hemiplegia
Cranial nerves affection in stroke
- Facial → angle of mouth deviated towards the healthy side
- Hypoglossal → tongue deviated towards the affected side
Right hemisphere stroke → Left lower facial weakness → Mouth deviates to the right (normal side)
Right hemisphere stroke → Left hypoglossal nerve weakness → Tongue deviates to the left (diseased side)
significance of CT in stroke
- 1st line intervention
- **door-to-CT → < 10 min **
- to exclude hemorrhage / large stroke
ischemic changes in stroke appear on MRI after
20 mins
cardiac patient with stroke
INR < 1.7 → ischemic stroke
regarding MCA sign
appears before other signs of infarcts are present on CT
in stroke, manage BP only if
> 220 /120
when to give IV thrombolysis
rTPA (Actilyse)
**door-to-needle → < 1h **
- Dose → 0.9 mg/kg (max 90mg)
- 10 % Bolus over 1 min → 90 % over 1 hour
patient presents with global aphasia , eyes deviated towards the opposite side
Major vessel occlusion / huge stroke → perform CT angiogram
window period for mechanical thrombectomy
6 hours
EXCEPT ** Basilar artery** → 24 hours
if a patient was last seen fine earlier than the window period
perform MRI-diffusion-perfusion scan to detect of the damage is salvageable or not
M/C cause of status epilepticus
non-compliance to AED
diagnosis of non-convulsive SE
EEG only
if CNS infection is suspected in SE
Empirical Ab / Antivirals → Non contrast CT → Lumbar puncture
drug of choice for Status epilepticus
Benzodiazepine (Diazepam)
meningitis is inflammation of
Leptomeninges (Pia + Arachinoid)
M/C cause of viral meningitis
HSV-2
M/C cause of Viral encephalitis
HSV-1
Meningitis + Extra pyramidal C/P
Arbovirus (West-Nile)
to differentiate between Bacterial & TB meningitis
Lancet consensus
Thwaites scoring system
M/C cause of nuchal rigidity
Cervical spondylitis
