Inservice deck 8 - neuro and psych Flashcards
HTN patient awakens with arm paralysis. Two prior episodes that resolved. Consistent with what type of stroke?
thrombolic
tPA dose affected in 85 year old with stroke symptoms that has no contraindications?
no change in dose
name of med given for vaospasm in patient with headache, meningismus, and RBC’s in LP?
nimodipine
65 year old female with right eye vision loss and localized headache requires what treatment in the ED?
temporal arteritis
tx = prednisone 60 mg
BP tretament for ischemic stroke patient with pressure of 180/100?
None, tx if BP > 220/115
patient with vertebro-basilar artery stroke will present with what findings?
cerebellar findings: ipsilateral CN deficits, contralateral hemiplegia, contra sensory deficits
Most common cause of seizure in the elderly?:
CVA
most common complication of taenia soleum?
cysticercosis
patient with progress weakness, diplopia, and ptosis worsening throughout the day has what diagnosis?
myasthenia gravis
patient in his 60s presents with facial droop, decreased taste. what is the next phys exam test to differentiate serious from benign
forehead for sparing
60 year old with no trauma, unable to move anything but eyes?
locked in syndrome - basilar pontine hmorrhage
virus in patient who has unilateral facial droop that includes forehead?
herpes simplex in bell’s palsy
patient with torticollis, protruding tongue after receiving nause meds for gastritis has what complication of med?
dystonic reaction
next tx for patient on haldol who presents with dystonia, no help with benadryl?
benztropine
patient presents with headache aned meningisum, is febrile and nontoxic; normal neuro exam. Next step?
LP
CT in age > 55, HIV, immunocompromied, neuro findings
what adjustemtn at the time of LP has decreased incidence of post LP headache?
using a small gauge non-cutting needle
hematologic abnormality is associated with lead tox?
anemia
earliest sign in cavernous sinus thrombossi?
lateral gaze palsy, isolated CN VI palsy
patient presents 1 week s/p URI. Now with weakness and absent refloexes of lower extremities. Dx? what will CSF show?
GBS, CSF shows high protein
bacteria associated with development of GBS
campylobacter
25 y/o no trauma, develops bilateral leg sweakness, incontinence, increased DTRs with normal tone and upgoing plantar reflexes most likely has what diagnosis?
transverse myelitis
most common cause of delirium in elderly
meds
patient with SLE has mental status changes. most likely diagnosis? what radiology study?
cerebritis
CT brain with contrast
AMS, ataxia and incontinence?
NPH
60 y/o with hemorrhage CT brain loss of pupillary reflexes, loss of EOM and coma. Where is the lesion?
posterior fossa
HIV pt with focal seizure and ring lesions on noncontrast CT has what?
toxoplasmosis
patient with chronic alcohol intake presents with taxia, confusion, normal speech, inability to adduct eyes, nystagmus. dx and disposition? inability to adduct called? thiamine?
wernicke encephalopathy
admit to neuro
intranuclear ophthalmoplegia
give thiamine before glucose
elderly patient with head trauma less likely to have what?
epidural bleed
tx for 30 year old who presents febrile, altered with CT showing temporal lobe hemorrhage?
acyclovir
cefotaxime
tx for patient with shock like sensations on one side of hte face?
trigemincal neuralgia
carbamazepine
25 y/o with grandiose thinking, auditory hallucinations and unable to accomplish goal directed activity. Dx?
schizophrenia
