Neuro 1 Flashcards
community acquired bacterial meningitis is most commonly due to
2
s. pneumoniae
n. meningitidis
acute bacterial meningitis s/sx
7
acute onset of high fever
severe HA
stiff neck (nuchal rigidity)
AMS
classic purple petechial rashes
NV
photophobia
polymylagia rheumatic PMR is associated with ___
giant cell arteritis
MS - electric shock like sensation runs down the back
Lhermitte sign
visual loss, diplopia, numbness on one side of face, urinary incontinence
MS
stereogonosis
ability to recognize familiar object through sense of touch only
graphesthesia
ability to identify figures “written” on skin
Babinski’s sign is positive in adults if
toes spread like a fan
achilles reflex with peripheral neuropathy
weak to no response
CN - reminds you of shoulder shrugging together
CN XI
shingles of the CN V can result in
corneal blindness
rash at the tip of nose and the temple area
r/o shingles infection of the trigeminal nerve
testing for pronator drift
pt stands with eyes closed and arms straight forward with palms up; arms drifting sideward or upward after a brisk tap indicate a positive test
flex pt’s hip one at a time, then attempt to straighten the leg while keeping the hip flex at 90 degrees - positive if there is resistance bc of painful hamstrings
kernig’s sign
passively flex/bend the pt’s neck toward chest - positive if pt flex the hips and knee to relieve pressure and pain
brudzinski’s sign
three test to assess for meningeal irritation
kernig’s sign
brudzinski’s sign
nuchal rigidity
acute onset of fever, severe HA, stiff neck
acute bacterial meningitis
acute bacterial meningitis - perform what before LP
CT scan of the head
acute bacterial meningitis - positive LP would show
CSF with large amount of WBCs and is cloudy; definitive dx made from bacteria isolated from the CSF with the presence of elevated protein and low glucose levels in the CSF
acute bacterial meningitis - CSF from LP protein and glucose
elevated protein
low glucose
acute bacterial meningitis - medication tx
IV 3rd gen cephalosporins + vanco + ampicillin; dexamethasone is also recommended
acute bacterial meningitis - supportive care includes
3
fluid management
reduction of ICP
prevention of neuro complications
bell’s palsy is abrupt onset of
unilateral facial paralysis due to dysfunction of the motor branch of the facial nerve CN VII
bell’s palsy skin sensation
remains intact
bell’s palsy - what is suspected to be the most likely cause in many cases
herpes simplex virus activation
bell’s palsy early tx
high dose oral glucocorticoids e.g. prednisone 60-80 mg/day for 1 week
bell’s palsy tx for severe palsy
oral glucocorticoid and antiviral therapy e.g. valacyclovir or acyclovir x 7 days
