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CSI Exam 1 > Important Notes > Flashcards

Important Notes Flashcards

1
Q

Paralysis of Unilateral Upper Limb and Face….means

A

Stroke MCA of contralateral side - motor cortex

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2
Q

Loss of Sensation of Unilateral Upper and Lower Limb and Face…means

A

Stroke MCA of contralateral side - sensory cortex

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3
Q

Stroke MCA Temporal or Frontal lobe results in

A

aphasia if in dominant hemisphere (left)

hemineglect if in non-dominant hemisphere (right)

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4
Q

Temporal lobe MCA stroke in dominant sphere

A

wernicke’s aphasia

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5
Q

Frontal lobe MCA stroke in non-dominant sphere

A

broca’s aphasia

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6
Q

Stroke ACA Motor Cortex

A

Paralysis of Contralateral Lower Limb

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7
Q

Stroke ACA Sensory Cortex

A

Contralateral loss of lower limb sensation

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8
Q

Unilateral Hemiparesis/hemiplegia

A

lenticulo-striate artery stroke

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9
Q

Common location of lacunar infarcts, secondary to unmanaged hypertension

A

lenticulo-striate artery stroke

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10
Q

Medial Medullary Syndrome (stroke location)

A

stroke of paramedian branches of ASA and vertebral a, commonly bilateral

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11
Q

Lateral Medullary Syndrome (stroke location)

A

PICA

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12
Q

What is meant by the phrase “Don’t pick a horse that can’t eat”

A

Stroke in PICA results in hoarseness and dysphagia

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13
Q

PICA supplies

A

lateral medulla, vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, nucleus ambiguus, sympathetic fibers, inferior cerebellar peducle

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14
Q

PICA stroke symptoms

A

vomiting, vertigo, nystagmus; decreased pain and temp sensation form ipsilateral face and contralateral body, DYSPHAGIA, HOARSENESS, DECREASED gag reflex, ipsilateral horner’s syndrome, ataxia, dysmetria

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15
Q

AICA supplies

A

lateral pons - cranial nerve nuclei; vestibular nuclei, facial nucleus, spinal trigeminal nucleus, cochlear nuclei, sympathetic fibers
and middle and inferior cerebellar peduncles

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16
Q

AICA stroke symptoms

A

vomiting, vertigo, nystagmus; paralysis of face, decreased lacrimation, salivation, decreased fast from ant 2/3 of tongue, decreased corneal reflex, decreased pain and temp of face, ipsilateral hearing decrease, ipsilateral hornet’s syndrome

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17
Q

What is meant by “Facial droop means AICA’s pooped”

A

paralysis of face/drooping = AICA stroke

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18
Q

AICA stroke in middle cerebellar peduncles

A

ataxia, dysmetria

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19
Q

Hemianopia with macular sparing (stroke location)

A

Contralateral PCA - occipital cortex, visual cortex

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20
Q

Locked- in syndrome

A

Basilar a. stroke

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21
Q

ability to move eyes only and consciousness, quadriplegia, loss of voluntary facial, mouth, and tongue movements

A

stroke in basilar a.

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22
Q

Basilar a. supplies

A

pons, medulla, lower midbrain, corticospinal and corticobulbar tract, ocular cranial nerve nuclei, paramedian pontine reticular formation

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23
Q

Visual field defects only

A

Anterior communicating a. stroke/berry aneurysm

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24
Q

Saccular (berry) aneurysm most common location

A

circle of willis junction of Acom and anterior cerebral a

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25
Berry aneurysm leads to
SAH "worst headache of life" or hemorrhagic stroke
26
CNIII palsy "down and out" ptosis, mydriasis
PCom stroke/saccular aneurysm
27
Saccular aneurysm common site
Posterior Communicating A
28
bitemporal hemianopia
Anterior communicating a. stroke/berry aneurysm compression of optic chiasm
29
Berry aneurysm predisposing conditions
Ehlers-Danlos, Marfan's, ADPKD, elderly, high BP, smoking, black
30
Charcot-Bouchard Microaneurysm
associated with chronic hypertension, affects small vessels
31
Central Post-stroke pain syndrome
neuropathic pain due to thalamic lesions, initial sensation go numbness and tingling followed in weeks to months of allodynia (pain from ordinary stimuli)
32
Epidural hematoma
temporal bone fracture, rupture of middle meningeal a. biconvex on CT, does not cross suture lines, does cross tentorium, falx
33
Subdural hematoma
slow, venous bleed from ruptured bridging veins, crescent-shaped on CT, can cross sutures, but cannot cross falx and tentorium, may have mid-line shift
34
Subarachnoid hemoorhage
rupture of aneurysm (berry aneurysm) or AVM, Rapid bleeding, "worst headache of life", bloody or xanthrochromic spinal tap, blood in SULCI, worry about vasospasm
35
Treatment for SAH blood breakdown
Nimodipine
36
Intraparenchymal hemorrhage most common cause
hypertension
37
Intraparenchymal hemorrhage causes
hypertension, Charcot-Bouchard aneurysmamyloid angiopathy, vasculitis, and neoplasm
38
Intraparenchymal hemorrhage locations
basal ganglia and internal capsule, white splotch in middle of brain
39
Ischemic brain disease/stroke time course
irreversible damage after 5 min of hypoxia
40
Stroke Imaging
3-30m: bright on diffusion-weighted MRI, 12-24h: dark abnormality on non contrast CT
41
Hemorrhagic stroke causes
hypertension, anticoagulation, cancer, repercussion following ischemic stroke,
42
Most common site of hemorrhagic stroke
basal ganglia
43
Brown Sequard Syndrome
Hemisection of the spinal cord; ipsilateral UMN signs below level, ipsilateral loss of tactile, vibration, and proprioception 1-2 levels below, contralateral loss of pain and temp, ipsilateral loss of sensation
44
Horner's Syndrome
ptosis, anhidrosis, mitosis of ipsilateral side of face
45
Horner's Syndrome is associated with
lesion of spinal cord above T1
46
Dermatome - posterior half of skull cap
C2
47
Dermatome - upper neck
C3
48
Dermatome - lower neck and
C4
49
Dermatome - nipples
T4
50
Dermatome - xiphoid process
T7
51
Dermatome - umbilicus
T10
52
Dermatome - inguinal ligament
L1
53
Dermatome - kneecaps
L4
54
Dermatome - penile and anal zones
S2, S3, S4
55
Legionnaires' Disease
pneumonia, fever, GI and CNS
56
Legionella pneumophila
gram-neg rod, Silver stain, grows on charcoal yeast extract with iron and cysteine, cause of Legionnaires' Disease
57
Pseudomonas aeruginosa
wound and burn infection, Pneumonia, Sepsis, External otitis, UTI, Drug use and Diabetic osteomyelitis
58
AHA
autoantibodies against I or Rh factor causing hemolysis of RBCs
59
Signs of AHA
anemia, low haptoglobin, increased lactate dehydrogenase, elevated indirect bilirubin, positive direct Coombs test
60
Warm hemagluttinins
IgG for Rh active at 37C
61
Cold hemagluttinins
IgM for I antigen active below 37C
62
Future treatment of AHA
Rituximab, danazol, immunosuppressants
63
Rituximab
monoclonal antibody against the B cell antigen CD20, is effective in some cases.
64
Danazol
less often effective than in immune thrombocytopenia but is well suited for long-term use because of its low toxicity
65
Immunosuppressants
cyclophosphamide, azathioprine, mycophenolate mofetil, or cyclosporine,
66
First line treatments of AHA
prednisone, transfusions, plasmapheresis, splenectomy is needed
67
Cold Agglutinin Disease
C3b present on the red cells is recognized by Kupffer cells (which have receptors for C3b), and red blood cell sequestration ensues
68
Cold Agglutinin Disease may follow an infection with
mycoplasmal | pneumonia or infectious mononucleosis
69
CAD laboratory findings
Mild anemia is present with reticulocytosis and rarely spherocytes, positive direct Coombs
70
Treatment of choice for CAD
Rituximab, a monoclonal antibody directed against the CD20 antigen on B lymphocytes
71
Prednisone and splenectomy for CAD?
NO, ineffective due to hemolysis in liver, NOT spleen like AHA
72
Common risk factors for ARDS?
sepsis, aspirations of gastric contents, chock, infection, lung contusion, non thoracic trauma, toxic inhalation, near-drowning, multiple blood transfusions
73
Regardless of cause of ARDS, what always occurs in ARDS?
damage to capillary endothelial and alveolar epithelial cells
74
Damage to capillary endothelial and alveolar epithelial cells causes
decreased production and activity of surfactant and increased vascular permeability leading to interstitial edema, alveolar collapse, and hypoxemia
75
Clinical finding of ARDS patient
rapid onset of dyspnea, tachypnea, labored breathing, crackles, CT: patchy infiltrates, pleural effusions small
76
Associated disorders with ARDS
trauma, sepsis, shock, burns, drug/drug OD, opioids, upper airway obstruction, aspiration, embolus, thrombus, pneumonia, etc
77
Treatment for ARDS
treat primary cause, incubation and ventilation with low tidal volumes to treat hypoxemia, central venous catheter, lower pressures (4-8), hemoglobin
78
Use of corticosteroids for ARDS
No
79
Mortality from ARDS
primary illness, secondary complications (MOF or sepsis)
80
Lesion of optic n =
R/L anopia
81
Lesion of optic chasm =
Bitemporal hemianopia
82
Lesion of optic tract =
R/L homonymous hemianopia
83
MCA R temporal lesion =
Left upper quadratic anopia
84
MCA R parietal lesion =
Left lower quadratic anopia
85
PCA infarct =
left hemianopia with macular sparing

CSI Exam 1 (16 decks)

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