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Emergency Med > Neuro > Flashcards

Neuro Flashcards

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1
Q

What type of seizures arise from a localized region of the brain and have clinical manifestations that reflect that area of brain?

A

Focal or partial seizure

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2
Q

What type of seizure beings with abnormal electrical discharges in both hemispheres simultaneously?

A

Primary generalized seizures

Includes grand mal and petit mal

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3
Q

What type of seizure is characterized by a temporary loss of consciousness or motor activity, amnesia of the event, are generally brief, has no aura, and ends abruptly?

A

Absence seizure

A generalized seizure

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4
Q

What type of seizure may have aura with abnormal smell, taste, sound or visual changes, loss of consciousness, and tonic, hypertonic, clonic, and post-seizure phases?

A

Grand mal

A generalized seizure

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5
Q

What are the do’s and don’ts of helping someone having a seizure?

A 
Cushion head
Remove glasses
Loosen tight clothing
Turn on side
Time the seizure
Nothing in the mouth
Look for ID
Don't hold down
Offer help as it ends
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6
Q

What is status epilepticus?

A

A continuous, unremitting seizure lasting longer than 5 minutes

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7
Q

What is the cause of syncope?

A

Global cerebral hypoperfusion to the brain that most often results from hypotension

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8
Q

What is the most prevalent neurological disorder in terms of morbidity and mortality?

A

Cerebrovascular disease

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9
Q

What amount of time rules out transient ischemic attack (TIA)?

A

TIAs will resolve within 24 hours

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10
Q

What SSX are more common in hemorrhagic strokes than ischemic (but are not definitive)?

A

N/V
H/A
change in level of consciousness

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11
Q

What is the most common cause of thrombotic occlusion and where does it most commonly occur?

A

Atherosclerosis;

Carotid bifurcation or in the vertebrobasilar system

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12
Q

What vessel is found to have the greatest degree of compromise in a cerebral infarction?

A

Middle cerebral artery

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13
Q

What type of stroke is most common?

A

Ischemic (80%)

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14
Q

What type of stroke has the highest mortality rate?

A

Hemorrhagic (30 days - 40-80%)

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15
Q

What are the common SSX of stroke?

A 
Abrupt onset of mono-, hemi- or quadriparesis
Mono- or binocular visual loss
Visual field deficits
Diplopia
Dysarthria
Ataxia
Vertigo
Aphasia
Sudden change in consciousness
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16
Q

What do you call a stroke that only appears to affect one side of the brain?

A

Dominant (or non-dominant) hemisphere stroke

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17
Q

What is of paramount importance when considering possible thrombolytic therapy?

A

Establishing the time on onset of symptoms

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18
Q

What is a mini-stroke that sometimes precedes complete occlusion of a cerebral vessel?

A

TIA - transient ischemic attack

19
Q

What is the primary etiology of middle cerebral artery strokes and causes 15-30% of all strokes?

A

Embolism

20
Q

What is the primary underlying cause of most cases of intracerebral hemorrhage?

A

Hypertension

21
Q

Why are CT scans done immediately in stroke patients?

A

Do determine if it is hemorrhagic in which case anticoagulants would worsen the damage.

22
Q

Cerebellar and brainstem strokes generally occur as a result of pathology in what blood vessels?

A

Vertebral or basilar arteries

23
Q

What is the most frequent cause of clinically significant subarachnoid hemorrhage?

A

Rupture of a berry (saccular) aneurysm

24
Q

What are the four types of vascular malformations of the brain?

A

Arteriovenous malformations
Cavernous hemangiomas
Venous hemangiomas
Capillary telangiectasias

25
Q

What is a syndrome characterized by diffuse cerebral dysfunction, H/A, confusion, vomiting, convulsions, and possible coma?

A

Acute hypertensive enceohalopathy

26
Q

What is a sign of brain injury more serious than concussion?

A

Anisocoria

27
Q

What do you call a fracture in which bone is displaced into the cranial cavity by a distance greater than the thickness of the bone?

A

Displaced skull fracture

28
Q

What is a basal skull fracture?

A

A linear fracture extending through the petrus portion of the temporal bone that leaks spinal fluid from an ear. There may be hearing loss, instability of gait, and vertigo.

29
Q

What is Battle’s sign?

A

Mastoid ecchymosis that raises suspicion of basilar skull fracture

30
Q

What other sign associated with basilar skull fracture involved bilateral periorbital ecchymosis?

A

Raccoon’s eyes

31
Q

What may occur as a result of the rupture of a meningeal artery?

A

Epidural hematoma

32
Q

In 85-96% of epidural hematomas, a fracture lacerates either of what two vessels?

A

Middle meningeal artery

Dural venous sinus

33
Q

What usually occurs due to torn bridging veins and are characteristically found over the fronto-parietal regions of the cerebral hemispheres?

A

Subdural hematomas

34
Q

What are the most common symptoms of meningitis?

A

Fever
H/A
Neck stiffness

35
Q

How do you perform Kernig’s sign and what does it mean?

A

Lying supine, the hip and knee are flexed to 90 degrees. Then extend the knee. A positive is inability to extend due to pain, which may indicate meningitis.

36
Q

How do you perform and interpret Brudzinski’s sign?

A

Laying supine try to bring the pt’s head into flexion. If the knees and hips flex involuntarily, it is positive and may indicate meningitis.

37
Q

What is different about meningitis in children caused by Neisseria meningitidis?

A

A petechial rash

38
Q

Petechiae in children can occur with simple viral infections. They may be found in several potentially serious and even lethal conditions such as what three?

A

Meningococcemia
Leukemia
Thrombocytopenia

39
Q

What are the most common bacterial causes of meningitis in newborns? (3)

A

B. streptococci (vagina)
E. coli (GI)
Listeria monocytogenes (from mother before birth)

40
Q

What are the most common bacterial causes of meningitis in older children?

A

Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae B (unvaccinated)

41
Q

What are the most common bacterial causes of meningitis in adults?

A

Neisseria meningitidis
Strep. pneumoniae
Listeria monocytogenes in adults >50

42
Q

What is the most common type of viral meningitis?

A

Enteroviruses

43
Q

What are causes of non-infectious meningitis?

A 
Spread of cancer
Drugs (NSAIDs, abx, IV immunoglobulins)
Sarcoidosis
CT disorders
Vasculitis

Emergency Med (8 decks)

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