Neuro Flashcards
tx Bell’s palsy
prednisone
artificial tears
MCC encephalitis
HSV1
CMV if immunocompromised
dx encephalitis
MRI
LP
what will LP show for encephalitis
increased WBC (mostly lymphocytes)
normal glucose
normal or increased protein
tell me about epidural hematoma
convex
doesn’t cross suture line
tell me about subdural hematoma
concave/crescent
crosses suture lines
LP for Guillain-barre
increased protein
normal WBC
tx Guillain-barre
plasma exchange
IVIG
triad meningitis
fever
nuchal rigidity
HA
which bacteria will more likely cause a rash for meningitis
N meningitides
LP for meningitis
increased protein
decreased glucose
increased opening pressure
tx meningitis
dexamethasone + vanc + cef (IDK if dexa is actually needed – just know it)
> 50 = vancomycin + cef + ampicillin
meds for exposure to meningitis
rifampin or cipro
tx status epilepticus
lorazepam
within what time period should you administer a thrombolytic for a stroke if you can
4.5 hours
what meds should not be used if you use TPA for stroke
No NSAIDS or ASA for first 24H
LP for subarachnoid hemorrhage
xanthochromia
blood in CSF
increased protein
increased pressure
in the question – make sure you look at all the tubes for many many many RBC (in the thousands)
tx subarachnoid hemorrhage
nimodipine - reduces vasospasms
surgical clipping
what should you know about vasovagal vs cardiogenic syncope
vasovagal - warning sx before!!!
Stroke ACA
contralateral LE and face
stroke MCA
aphasia
contralateral hemiparesis
stroke PCA
homonymous hemianopsia
sx anterior cord syndrome
Complete loss of motor, pain, &
temperature below injury, but
retains proprioception and vibratory
sensation
sx Brown-Séquard
Ipsilateral loss of motor, vibratory
sensation, and proprioception
with contralateral loss of pain and
temperature sensation
sx central cord syndrome
Sensory and motor deficit
Upper > lower extremities
tx cluster HA
100% oxygen
sumatriptan can be used as an adjunct
sx cluster HA
unilateral
SHARP
sx migraine HA
unilateral
pulsating
N/V
photophobia
tx migraines
NSAIDs, excedrin
triptans or ergotamine
prophylaxis indications and meds for migraines
> /= 4 HA/month or HA > 12 hours
divalproex, topiramate, propranolol
sx tension HA
band-like
B/L
tx tension HA
NSAIDs, excedrin
prophylaxis tension HA
TCAs (amitriptyline)
mirtazepine
topiramate
gabapentin
MCC epidural hematoma
middle meningeal artery
temporal bone fx
sx epidural hematoma
LOC –> lucid interval –> deterioration
MCC subdural hematoma
bridging veins (elderly, alcoholics, anticoags, shaken baby)
sx subdural hematoma
gradual increase in neuro sx
MCC subarachnoid hematoma
ruptured saccular (berry) aneurysm)
sx subarachnoid hematoma
thunderclap HA
LOC
meningeal sx
terson syndrome - pre retinal hemorrhages
what is myasthenia gravis
autoimmune destruction of acetylcholine receptors on the postsynaptic membrane
sx myasthenia gravis
Fatigue and muscular weakness are the hallmarks
Ocular symptoms are often the first manifestation, with ptosis worsening by the end of the day
dx MG
Serologic testing for autoantibodies: anti-nAChR, anti-MuSK
Electrophysiologic studies: repetitive nerve stimulation, single-fiber electromyography
tx MG
acetylcholinesterase inhibitors (pyridostigmine)
Acute myasthenic crisis: plasmapheresis, IVIG
MC affected vessel in ischemic stroke
middle cerebral artery (MCA)
MCC meningitis
Streptococcus pneumoniae
