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Final Exam Prep > Neuro > Flashcards

Neuro Flashcards

1
Q

list all 12 cranial nerves with function

A

Oh Oh Oh To Touch And Feel A Very Good Vagina Such Heaven
I. Olfactory: Smell
II. Optic: Vision/pupil response
III. Oculomotor: Eyeball/lid movement
IV: Trochlear: Eyeball/lid movement
V: Trigeminal: Facial sensation and movement
VI: Abducens: Extraoccular eye movements
VII: Facial: movement and taste
VIII: Auditory: hearing
IX: Glossopharyngeal: gag/swallow
X: Vagus: gag/swallow/ taste
XI: Spinal: Shrug shoulders
XII: Hypoglossal: stick out tongue

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2
Q

12 Sensory vs Motor vs Both of cranial nerves

A

Some Say Marry Money But My Brother Says Big Bras Matter Most

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3
Q

What is the MMSE and the score interpretation

A

Assess cognitive impairment
Oral, One, Two, RWD (Orientation, Recognition, List two objects, follow three commands, recognize objects, write a sentence, draw a design)
>24 no impairment
<23 cognitive impairment

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4
Q

TIA treatment

A

Aspirin and plavix for the first few days then switch to mono therapy

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5
Q

S/S of ischemic stroke

A

Subtle, progressive or sudden usually a rolling out process that progresses

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6
Q

S/S of SAH vs SDH

A

SAH: arterial bleed, thunder clap headache, nuchal rigidity, transient LOC
SDH: venous bleed, headache, gradual LOC, seizures

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7
Q

What is the sign of increased ICP

A

Cushing’s triad: bradycardia, widening pulse pressure, apnea

Vomiting, altered mentation, headache

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8
Q

What are the 3 Hs of herniation risk

A

Hypotension, hypoxemia, hypercapnia

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9
Q

What is the goal CO2 for bleed patients

A

CO2 35

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10
Q

What is the goal MAP to prevent vasospasm

A

110-130

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11
Q

CPP formula

A

MAP-ICP

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12
Q

How to treat/prevent vasospasm

A

Increase MAP, nimodipine, CCB

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13
Q

GCS

A

15 point max
Less than 8 intubate
Eyes: 4
Verbal: 5
Motor: 6

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14
Q

Difference between simple vs complex focal seizures

A

Simple: no loss of conciousness
Complex: impaired conciousness

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15
Q

Seizure treatment

A

Initial: IM midazolam, or lorazepam, or diazepam (may repeat x1)
Second: Phenobarbital, OR rectal diazepam OR intranasal midazolam
Third: Fosphyentoin, OR valproic acid OR keppra, OR Phenobarbital
Fourth: Repeat third line OR intubate and sedate

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16
Q

S/S, Labs, and Treatment for Myasthenia Gravis

A

Weakness worse after exercise, improves with rest
Droopy eyelid, extremity weakness, normal sensory
LAbs: ACTH antibodies positive, CT/MRI to rule out thymoma
Tx: pyridostigmine, immunosuppressants, thymenectomy, plasmaphoresis, IVIG

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17
Q

MS symptoms, tests, and treatment

A

i. Autoimmune attacks myelin sheath
ii. Numbness, weakness, vision, speech, bladder, unsteadiness, spastic
iii. Young adults most common, more common in people of Western European decent
iv. MRI***
v. Tx: no treatment for progression, neuro referral, steroids, antispasmodics, plasmapheresis, immunosuppressants, interferon

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18
Q

GB symptoms, labs, treatment

A

a. Polyneuropathy, demyelination of peripheral nerves, progressive symmetrical ascending paralysis
b. Preceded by viral infection with a fever
c. Flaccid paralysis can result in 24 hours
d. Labs: CSF protein elevated, elevated IgG, leukocytosis, LP, MRI, CT
e. Tx: supportive care

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19
Q

CSF comparison in viral vs bacterial meningitis

A

Bacterial: Cloudy, xanthochromatic, elevated opening pressure (>180), elevated protein, WBC (10-10000), decreased glucose (<40)
Viral: normal/elevated opening pressure, normal protein, normal glucose, positive immunoglobulins

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20
Q

S/s and treatment for bacterial and viral meningitis

A

S/S: Consider in any patient with fever and neuro symptoms , Typical Strep pneumoniae E , Fever, severe headache, n/v, nuchal rigiditiy, positive kernigs (pain and spasm of hamstring), positive brudinski (flex of head and neck cause leg flex), photophobia, seizures
Bacterial tx: <50 : vanco plus ceftriaxone, >50: Vanco plus amipicillin and ceftriaxone, Dexamethasone
Viral: Acyclovir, Valcyclovir, Vaccinate

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21
Q

Battle sign vs Raccoon eye

A

Battle sign: bruising behind the ear, increased ICP
Raccoon eye: basilar skull fx

22
Q

Parkinson’s s/s, labs, and tx

A

a. Dopamine deficiency
b. Idiopathic
c. Tremor, rigidity, and bradykinesia*
d. Wooden faces: smile looks like Mardi grads mask
e. Myerson sign: blink when you tap over the bridge of the nose
f. Labs: diagnosis of exclusion
g. Management: Carvidopa/levodopa, premipexole, selegiline, resagiline*

23
Q

S/S of dementia and treatment

A

a. Lewy Body dementia linked with Parkinson’s
b. Alzheimer’s dementia: most common
i. DEMENTIA (drug reactions, emotional disorders, metabolic, ENT, nutritional, tumors, infections, art.scler.)
ii. S/S: Aphasia, apraxia, agnosia in addition to memory defects
iii. Earliest complaints of family is a loss of short-term memory
iv. Unknown cause; women more than men
v. ACTH deficiency
vi. MEDS: Cholinesterase inhibitors (donepazile, ritastigmine), Namenda ***
c. Unexplained Dementia
d. Delirium is sudden and transient
e. Dementia: gradual irreversible memory loss
i. Viral, CAD

24
Q

Which CN controls extraoccular movements, opening eyelids, pupillary constriction

A

CN: III Occulomotor

25
Q

Which CN controls down and inward eye movement

A

CN IV Trochlear

26
Q

Which CN is responsible for chewing

A

CN V Trigeminal

27
Q

Which CN is responsible for lateral eye movement

A

CN VI Abducens

28
Q

Which CN is responsible for puffing cheeks

A

CN VII Facial

29
Q

Which CN is responsible for swallowing

A

CN IX Glossopharyngeal

30
Q

How long do symptoms last in a TIA

A

Typically <1 hr with no residual

31
Q

S/S of a TIA

A

Ipsilateral monocular blindness (amaurosis fugax)
Homonymous hemianopia (half vision)
Paresthias of contralateral side

32
Q

S/s of Vertebralbasilar TIA

A

Vertigo, ataxia, dizziness, visual cuts, weakness, confusion

33
Q

S/s of carotid TIA

A

Aphasia, dysarthria, altered LOC, weakness, numbness

34
Q

Who can get a carotid endarectomy

A

Symptomatic with 50-90% stenosis or asymptomatic patients with >70% stenosis

35
Q

Differentiate left and right sided CVA symptoms

A

Left: aphasia, dysarthria, and difficulty reading/writing
Right: right visual field changes

36
Q

When can TPA be abministered

A

Up to 4.5 bars after LKW

37
Q

Indication for ICP monitoring

A

Severe head injury
GCS <8 + abnormal scan

38
Q

What is the goal MAP to treat vasospasms

A

110-130

39
Q

What do you give in a seizure if the bg <60

A

100 thiamine and D50

40
Q

What is a positive Kernig sign

A

Pain and spasms of the hamstring muscle
Sign of meningitis

41
Q

What is a positive Brudzinski sign

A

Legs flex at both hips and knees in response to flexion of the head
Positive meningitis sign

42
Q

What s/s suggest an expanding hematoma

A

Occurrence of a lucid interval

43
Q

At what spinal injury can a patient still extend their elbow, feed, and dress themselves

A

C6-C7

44
Q

At what spinal level does a patient lose their lower leg, feet, and perineum abilities, including incotninence of bowel/bladder/ and sexual function

A

L1-L2

45
Q

Managment of Acute spinal cord injury

A

Methylprednisolone sometimes but referr to neuro

46
Q

Which spinal level does Autnomic dysreflexia become a concern

A

T4-T6
Exaggerated autonomic response to a stimulus

47
Q

What spinal level does respiratory compromise happen

A

C4 or above

48
Q

What is Brown Sequard syndrome

A

Caused by damage to one half of the spinal cord
Ipsilateral upper motor neuron paralysis and loss of proprioception
Contralateral loss of pain and temperature

49
Q

Cauda Equina syndrome

A

Compression of nerve roots at end of spinal chord
Saddle region numbness
Steroids and surgery

50
Q

MAOB inhibitor examples

A

Rasagilline

Final Exam Prep (19 decks)

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