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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
Q

Berry aneurysm leads to

A

SAH “worst headache of life” or hemorrhagic stroke

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26
Q

CNIII palsy “down and out” ptosis, mydriasis

A

PCom stroke/saccular aneurysm

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27
Q

Saccular aneurysm common site

A

Posterior Communicating A

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28
Q

bitemporal hemianopia

A

Anterior communicating a. stroke/berry aneurysm compression of optic chiasm

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29
Q

Berry aneurysm predisposing conditions

A

Ehlers-Danlos, Marfan’s, ADPKD, elderly, high BP, smoking, black

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30
Q

Charcot-Bouchard Microaneurysm

A

associated with chronic hypertension, affects small vessels

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31
Q

Central Post-stroke pain syndrome

A

neuropathic pain due to thalamic lesions, initial sensation go numbness and tingling followed in weeks to months of allodynia (pain from ordinary stimuli)

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32
Q

Epidural hematoma

A

temporal bone fracture, rupture of middle meningeal a. biconvex on CT, does not cross suture lines, does cross tentorium, falx

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33
Q

Subdural hematoma

A

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

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34
Q

Subarachnoid hemoorhage

A

rupture of aneurysm (berry aneurysm) or AVM, Rapid bleeding, “worst headache of life”, bloody or xanthrochromic spinal tap, blood in SULCI, worry about vasospasm

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35
Q

Treatment for SAH blood breakdown

A

Nimodipine

36
Q

Intraparenchymal hemorrhage most common cause

A

hypertension

37
Q

Intraparenchymal hemorrhage causes

A

hypertension, Charcot-Bouchard aneurysmamyloid angiopathy, vasculitis, and neoplasm

38
Q

Intraparenchymal hemorrhage locations

A

basal ganglia and internal capsule, white splotch in middle of brain

39
Q

Ischemic brain disease/stroke time course

A

irreversible damage after 5 min of hypoxia

40
Q

Stroke Imaging

A

3-30m: bright on diffusion-weighted MRI, 12-24h: dark abnormality on non contrast CT

41
Q

Hemorrhagic stroke causes

A

hypertension, anticoagulation, cancer, repercussion following ischemic stroke,

42
Q

Most common site of hemorrhagic stroke

A

basal ganglia

43
Q

Brown Sequard Syndrome

A

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
Q

Horner’s Syndrome

A

ptosis, anhidrosis, mitosis of ipsilateral side of face

45
Q

Horner’s Syndrome is associated with

A

lesion of spinal cord above T1

46
Q

Dermatome - posterior half of skull cap

A

C2

47
Q

Dermatome - upper neck

A

C3

48
Q

Dermatome - lower neck and

A

C4

49
Q

Dermatome - nipples

A

T4

50
Q

Dermatome - xiphoid process

A

T7

51
Q

Dermatome - umbilicus

A

T10

52
Q

Dermatome - inguinal ligament

A

L1

53
Q

Dermatome - kneecaps

A

L4

54
Q

Dermatome - penile and anal zones

A

S2, S3, S4

55
Q

Legionnaires’ Disease

A

pneumonia, fever, GI and CNS

56
Q

Legionella pneumophila

A

gram-neg rod, Silver stain, grows on charcoal yeast extract with iron and cysteine, cause of Legionnaires’ Disease

57
Q

Pseudomonas aeruginosa

A

wound and burn infection, Pneumonia, Sepsis, External otitis, UTI, Drug use and Diabetic osteomyelitis

58
Q

AHA

A

autoantibodies against I or Rh factor causing hemolysis of RBCs

59
Q

Signs of AHA

A

anemia, low haptoglobin, increased lactate dehydrogenase, elevated indirect bilirubin, positive direct Coombs test

60
Q

Warm hemagluttinins

A

IgG for Rh active at 37C

61
Q

Cold hemagluttinins

A

IgM for I antigen active below 37C

62
Q

Future treatment of AHA

A

Rituximab, danazol, immunosuppressants

63
Q

Rituximab

A

monoclonal antibody against the B cell antigen CD20, is effective in some cases.

64
Q

Danazol

A

less often effective than in immune thrombocytopenia but is well suited for long-term use because of its low toxicity

65
Q

Immunosuppressants

A

cyclophosphamide, azathioprine, mycophenolate mofetil, or cyclosporine,

66
Q

First line treatments of AHA

A

prednisone, transfusions, plasmapheresis, splenectomy is needed

67
Q

Cold Agglutinin Disease

A

C3b present on the red cells is recognized by Kupffer cells (which have receptors for C3b), and red blood cell sequestration ensues

68
Q

Cold Agglutinin Disease may follow an infection with

A

mycoplasmal

pneumonia or infectious mononucleosis

69
Q

CAD laboratory findings

A

Mild anemia is present with reticulocytosis and rarely spherocytes, positive direct Coombs

70
Q

Treatment of choice for CAD

A

Rituximab, a
monoclonal antibody directed against the CD20 antigen on B
lymphocytes

71
Q

Prednisone and splenectomy for CAD?

A

NO, ineffective due to hemolysis in liver, NOT spleen like AHA

72
Q

Common risk factors for ARDS?

A

sepsis, aspirations of gastric contents, chock, infection, lung contusion, non thoracic trauma, toxic inhalation, near-drowning, multiple blood transfusions

73
Q

Regardless of cause of ARDS, what always occurs in ARDS?

A

damage to capillary endothelial and alveolar epithelial cells

74
Q

Damage to capillary endothelial and alveolar epithelial cells causes

A

decreased production and activity of surfactant and increased vascular permeability leading to interstitial edema, alveolar collapse, and hypoxemia

75
Q

Clinical finding of ARDS patient

A

rapid onset of dyspnea, tachypnea, labored breathing, crackles, CT: patchy infiltrates, pleural effusions small

76
Q

Associated disorders with ARDS

A

trauma, sepsis, shock, burns, drug/drug OD, opioids, upper airway obstruction, aspiration, embolus, thrombus, pneumonia, etc

77
Q

Treatment for ARDS

A

treat primary cause, incubation and ventilation with low tidal volumes to treat hypoxemia, central venous catheter, lower pressures (4-8), hemoglobin

78
Q

Use of corticosteroids for ARDS

A

No

79
Q

Mortality from ARDS

A

primary illness, secondary complications (MOF or sepsis)

80
Q

Lesion of optic n =

A

R/L anopia

81
Q

Lesion of optic chasm =

A

Bitemporal hemianopia

82
Q

Lesion of optic tract =

A

R/L homonymous hemianopia

83
Q

MCA R temporal lesion =

A

Left upper quadratic anopia

84
Q

MCA R parietal lesion =

A

Left lower quadratic anopia

85
Q

PCA infarct =

A

left hemianopia with macular sparing

CSI Exam 1 (16 decks)

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