L7: Coma - Pt 4 Flashcards
1
Q
Compare Between Bilateral Hemispere Lesion Vs. Brainstem Lesion
A
2
Q
Compare Between Bilateral Hemispere Lesion Vs. Brainstem Lesion
- Posture
- Symmetry
- Fits
- Reflexes
- Pupil
- Respiration
A
3
Q
Compare Between
- Cortical lesions with herniation (Secondary brainstem compression)
- Metabolic
Coma
A
4
Q
Compare Between
1. Cortical lesions with herniation (Secondary brainstem compression)
- Metabolic Coma
- Posture
- Pupil
- Respiration
- Others
A
5
Q
Key Features in Coma & Cause
- Fever/irritability/rash
- Opiate/pinpoint pupils
- Rapid onset
- Hyperglycemia
- Inconsistent history/bruising
- Hypertension
A
6
Q
INVx in Coma
A
7
Q
INVx in Coma
- Lumbar Puncture
A
8
Q
INVx in Coma
- Fundus Ex
A
9
Q
INVx in Coma
- Imaging
A
10
Q
INVx in Coma
- ICP Monitoiring
A
11
Q
INVx in Coma
- Detect Cause
A
12
Q
Managemnt of Coma
A
13
Q
Management of Coma
- Priorities
A
14
Q
Management of Coma
- TTT of Cause
A
15
Q
Management of Coma
- Management of Increased ICP
A
16
Q
Management of Increased ICP in Coma
- BP
A
17
Q
Management of Increased ICP in Coma
- Head Positioning
A
- Elevation 15 – 30 degrees → ↓ ICP without adversely affecting MAP/CPP
- Midline to avoid obstruction of venous return from head → thorax
18
Q
Management of Increased ICP in Coma
- Temperature
A
- Antipyretics to avoid ↑↑ ICP associated with hyperthermia
19
Q
Management of Increased ICP in Coma
- Fluids
A
- Target euvolemia to avoid serum hypo-osmolarity
20
Q
Management of Increased ICP in Coma
- Cerebral Edema
A
21
Q
Management of Increased ICP in Coma
- Therpeutic Hyperventilation
A
22
Q
Managemnt of Coma
- Indications of Intubation
A
