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joy's deck for FNP > nervous system > Flashcards

nervous system Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

dangerous headaches

A

thundercalp

sudden

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2
Q

bacterial meningitis

A

stiff neck, classic purple colored petechial rash. emergency

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3
Q

temporal arteritis (giant cell arteritis)

A

headache one side of temple
temple has indurated, red, cordlike artery, tender
jaw pain (artery obstruction)
at risk: poymyalgia rheumatica

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4
Q

narrow angle glaucoma

A

ED
headache/pain behind an eye, n/v
cornea an looks hazy, pupil is dilated midway

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5
Q

stoke

A

hemorrhagic- uncontrolled HTN, abrust heacha, nuchal rigidity

embolization (afib, immobilzation )

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6
Q

subarchnoid hemmorhage

A

“worse headache of my life”, stiff neck,

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7
Q

mini mental exam

A 
orientation 
reigstration (recite 3 unrelated words)
attention
calculation 
spell "world" backward or serial 7's
look for aphasia (difficulty speaking)
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8
Q

cerebellar system

romberg

A

romberg- arms/hands staring on each side, close eyes.

positive- swaying
next, tell pt to hold arms straight

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9
Q

tandem gait

A

walk straight

then walk, toe to toe

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10
Q

sensory tests

A

vibration - use 128 hz and place distal joint of each thumb
shar/dull
temperature

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11
Q

stereognosis

A

ability to recognize familiar object through touch

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12
Q

graphesthesia

A

ability to identify number or letter written on skin

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13
Q

motor exam

A

gait, pronator drift , pincer grasp, etc

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14
Q

reflexes grading

A 
0= no response
1= low response
2= NORMAL
3= brisk
4=clonus
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15
Q

quadricep reflex ( knee jerk)

A

tap patellar

reflex center at L2 to L4

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16
Q

achillis reflex

A

L5 to S2

17
Q

plantar reflex

A

L4-S2

18
Q

test for meningeal irritation

A

kerning’s sign: resistance to leg straight dt hamstring tightness ( or c/o back pain)

brudzinski’s flexes hips/knee when head is passively flexed

nuchal rigitiy: touch chest with the chin= pain
.

19
Q

Cranial nerve test for zoster

A

CN 5 (trigeminal) ophthalmic branch can lead to corneal blindess

20
Q

cranial nerves

A 
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducents
Facial
Acoustic
Glossopharyngeal
Vagus- damage causes increase heart rate, difficulty swallowing 
Spinal accessroy 
Hypoglossal
21
Q

bacterial meningitis

A

acute bacterial infection of the brain/spinal cord (S. pneumonia, N. meningitides, H. influenza

3 main s/s:
fever
nuchal regidity

22
Q

labs for meningitis and rx

A

lumbar puncture: CSF (cloudy csf), MRI

Rx: IV cephlasporins plus chloramphenicol
infants: ampicillin
>50: amoxcilllin plus 3rd genertion cephalosprin

Prophylaxis oaf close contact with rifampin or ceftriaxon. REPORTABLE

23
Q

3 most common bacteria strain for meningitis

A 
Neisseria meningitidis (meningococcus),
Streptococcus pneumoniae (pneumococcus), and
Haemophilus influenzae type b (Hib).
24
Q

migraine tx

A

5 HT 1 agonists: sumatriptain (imitrex)

first, r/o cardiovascular disease (MI, angina, CVA, TIA)

do not start within first 2 wks of maoi use

25
Q

propylactic migraine tx

A

propranolol (Inderol)
TCA: amitriptyline (elevil) at HS
neurontin

26
Q

tests and tx for temporal arteritis (giant cell arteritis)

A

tests: ESR and SED rte
normal rnge ESR 0-22 (men), 0-29 (women)

tx: high dose prednisone

high risk of blindness (refer to ophthalmologist asap for biopsy and tx)

27
Q

polmyalgia rheumatica

A

high risk for developing temporal arteritis!

s/s: morning stiffness and aching (shoulders, hips, torso (diffictuly putting on clothes/bra).

28
Q

trigeminal neuralgia (tic doulourux)

A

3 divisions; opthalmic, maxi ally, and mandibular

unilateral headache dt compression of nerve root, located near nasal and cheeks ( near nose/chewing area)

tx: high dose anticonvulsants (i.e. carbamezipin/tegretol or phenytoi/dilantin. MRI

29
Q

bells palsy

A

unilateral facial paralysis dt dysfunction of CN 7 (facial). tear production on affected side may stop.
viral, autoimmune, pressure from a tumor

rule out: stroke, TIA, mastoid infection, fracture, lyme disease, tumor
corticosteroids at high dose x 10 days
acyclovir if herpes suspected
copmlications- corneal ulceration

30
Q

cluster headache

A

SEVERE one sided headache
“ice pick” behind one eye, tearing
several times a day, resolves spontaneously

tx: high dose 02 ( don’t use if COPD)
Sumatriptan (imitrex)

31
Q

rebound headache

A

over use of nsaids, aspirin, narcotics. taper the dose

32
Q

TIA

A

resembles a stroke but resolves in 24 hours.

33
Q

test for carpal tunnel syndrome

A

tinel’s sign (pins and needles when tapping wrist)

phalen’s sign (full flexion of wrist for 1 min causes tingling sensation of media nerve.

34
Q

bilateral headache

A

muscle tension ( all others are unilateral )

35
Q

trigeminal neuralgia (tic douloureux)

A

pain on ONE side of the face/cheek precipitated by talking, chewing, cold food, cold air

36
Q

cluster headache

A

ONLY headache accompanied by TEARING and NASAL CONGESTION. sever pain ONE side of eye.

middle aged males
risk of suicide.

joy's deck for FNP (24 decks)

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