NEURO Flashcards
What 2 HAs are unilateral? 1 HA that is bilateral?
Unilateral - cluster + migraine
Bilateral - tension
What can untreated temporal arteritis lead to? What lab test do we use to help diagnose?
Blindness
Sed rate
CSF findings in bacterial meningitis
Intracranial HTN
SAH
BM: elevated cell count, low glucose
IHTN: cell count and protein normal
SAH: +blood
How do we treat HAs
Treat cause
How do we treat bacterial meningitis?
Rocephin. When in doubt give med!
Times for CVA:
Non-con CT
CT read
TPA
CT: 20-25 min
Read: 40-45 min
TPA: 3 hours
HOB in stroke pt?
30-40 degrees if not contraindicated
CVA BP goals if giving TPA? Treatment?
Goal <185/<110
Treat with labetolol or nicardipine (CCB, drip)
This commonly affects memory but not level of consciousness. Dx of exclusion
Dementia
VP shunt problem that causes neuro problems is d/t what?
VP shunt problem that causes fever and abd distension is d/t what?
neuro = blockage
fever/abd distension = infection (infected fluid drains into abdomen)
What does an XR shunt series consist of?
-skull
-CXR
-KUB
This is an emergency bc you are unable to ventilate. Do not give paralytics initially b/c you want to see if patient stops seizing. Neuronal cellular changes/destruction will continue.
Status epilepticus
Characteristics of pseudoseizures
Sudden onset, abrupt return to normal
How do we calculate cerebral perfusion pressure? What is normal?
CPP = MAP - ICP
Normal = 70-100
How do we decrease CPP?
increase MAP, decrease intracranial volume (mannitol, elevate HOB), decrease vasodilation (CO2 causes vasodilation, so increase RR to decrease CO2 - this is only a temporary measure)
CUSHINGS TRIAD
(acute elevations in ICP)
1: irregular respirations
2: decreased HR
3: widened pulse pressure
This is d/t hemorrhage of meningeal artery r/t temporal skull fracture. Patients have LUCID INTERVAL.
Epidural hemorrhage
What do we do for CSF leaking from nose/ears in a skull fracture?
Cover loosely with dressing, DO NOT PACK
What is Brown-Sequard syndrome?
Complete damage to half of the spinal cord.
Symptoms of Brown-Sequard
Same side of SC damage: paralysis, paresis, loss of touch/pressure/vibration
Other side: loss of pain and temperature sensation
What SCI causes you to breathe no more?
C4
What is the difference between spinal shock and neurogenic shock?
Spinal shock: TEMPORARY loss of all neuro function
Neurogenic shock: causes decreased HR, vasodilation leading to low BP
What 3 things do you need to clear a c-spine?
-negative XR/CT
-NO motor sensory deficits
-no pain/tenderness on exam
Cognitive function generally spared, no consistent cause, autonomic control remains so no bowel/bladder involvement, usually have “limb onset” - usually legs so s&s are frequent tripping/stumbling/falls
Lou Gehrigs - amyotrophic lateral sclerosis
autoimmune, leads to physical and cognitive disability, normal life expectancy, most common initial symptom is change in sensation of arms, legs, face
MS
autoimmune, symptoms improve with rest, muscle weakness increases with activity, diagnosed with tensilion test, treated with cholinesterase inhibitors (neostigmine), immunosuppressants, steroids, thymectomy (increased r/f thymus cancer)
Myasthenia Gravis
d/t low dopamine, tremor at rest that improves with use
Parkinsons
GCS worse/best score
worse 3, best 15
Eyes 1-4
Verbal 1-5
Motor 1-6
