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Emergency Med > Neuro > Flashcards

Neuro Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Identify the seizure described below:

Consciousness fully maintained
Focal
+/- transient neuro deficit

A

Simple partial

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2
Q

Identify the seizure described below:

Consciousness impaired
Aura: Sec-min
Automatisms: lip smacking, manual picking, patting, coordinated motor movements

A

Complex Partial Seizure

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3
Q

Identify the seizure described below:

Brief lapse of consciousness: brief staring, eyelid twitching
No post-ictal phase
EEG: B/L symmetric 3hz spike & wave

A

Absence (Petit mal)

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4
Q

Based on this EEG, identify the seizure

-Generalize high amplitude rapid spiking

A

Tonic-Clonic (Grand mal)

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5
Q

Identify the seizure described below:

Sudden, brief sporadic involuntary twitching. No LOC

A

Myoclonus

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6
Q

Identify the seizure described below:

Sudden loss of postural tone= “drop attacks”

A

Atonic

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7
Q

Absence (petit mal) treatment

A

Ethosuximide

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8
Q

Grand mal treatment

A
  1. Valproic acid: Depakote

2. Phenytoin: Dilantin

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9
Q

Myoclonus treatment

A

Valproic acid: Depakote

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10
Q

Define Status Epilepticus

A

Repeated, generalized sz’s w/o reovery= >30 min

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11
Q

Status Epileptiucs treatment

A
  1. Benzos: Lorazepam or Diazepam

2. Thiamine + Ampule of D50

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12
Q

What nerve does Bell’s Palsy effect?

A

CN VII (7)

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13
Q

What is Bells Palsy highly associated with?

A

Herpes Simplex reactivation

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14
Q

Bellsy Palsy Tx

A
  1. Prednisone

2. Artificial Tears

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15
Q

Identify the HA described below:

B/L: Tight, band/vise-like
Worse with stress, fatigue
NO N/V or focal neuro sx’s

A

Tension HA

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16
Q

Tension HA treatment

A

1st line= NSAIDs, ASA, Acetaminophen

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17
Q

1st line Tx in mild migraine HA

A

NSAIDs/Acetaminophen

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18
Q

Symptomatic/Abortive in migraine HA

A

Triptans or Ergotamines: Serotonin 5HT-1 Agonist

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19
Q

Triptans or Ergotamines (Serotonin 5HT-1 Agonist) MOA. CI?

A

Vasoconstriction

CI: CAD or PVD, uncontrolled HTN

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20
Q

Migraine prophylaxis

A
  1. Beta Blocker, CCB
  2. TCA’s
  3. Anticonvulsants: Topiramate, Valproate
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21
Q

Identify the HA described below:

Severe/sharp/lancinating, unilateral periorbital/temporal pain
Ptosis, Miosis, Anhydrosis
Nasal congestion/Rhinorrhea, conjunctivitis, lacrimation

A

Cluster HA

22
Q

Cluster HA 1st line treatment

A

100% O2

23
Q

Cluster HA prophylaxis tx

A

Verapamil

24
Q

MC pathogen in bacterial meningitis in <1 mo

A

Group B Strep (Strep agalactiae)

25
Q

Abx treatmen in bacterial meningitis <1 mo

A

Ampicillin + Cefotaxime

26
Q

MC pathogen in bacterial meningitis in 1 mos-18 yo

A

N. Meningitidis

27
Q

Abx treatmen in bacterial meningitis 1 mos-50 y.o.

A

Ceftriaxone + Vancomycin

28
Q

MC pathogen in bacterial meningitis in 18 y.o.->50

A

S. pneumo

29
Q

Define TIA

A

Transient episode of neuro deficits caused by focal brain, SC, or retinal ischemia WITHOUT infarction
Lasts <24 hrs (most 30-60 min)

30
Q

Correctly identify the TIA described below:

Temporary monocular vision loss= Amaurosis Fugax
Weakness in contralateral hand

A

Internal Carotid Artery

31
Q

Correctly identify the TIA described below:

Gait & proprioception disturbances
Dizziness, vertigo

A

Brainstem/Cerebellar sx’s

32
Q

TIA treatment

A

ASA +/- Clopidogrel

33
Q

What is the MC type of stroke?

A

Ischemic stroke

34
Q

List the causes of ischemic stroke

A
  1. Thrombosis
  2. Emboli
  3. Cerebrovascular occlusion
35
Q

What part of the brain is the MC site of an ischemic stroke? what artery is MCly involved?

A

Anterior circulation

Middle cerebral artery=MC

36
Q

Middle cerebral artery stroke sx’s

A

Face/Arm weakness>leg/foot

Gaze preference toward left side

37
Q

Correctly identify the type of ischemic stroke described:

Purely motor sx’s:
Hemiparesis, hemiplegia
Ataxia, legs>arms
Dysarthria

A

Lacunar infarct

38
Q

Correctly identify the type of ischemic stroke described:

Visual hallucinations
Vertigo
N/V
Nystagmus, Diplopia

A

Posterior infarct: Posterior cerebral artery, basilar artery, Vertebral artery

39
Q

initial diagnostic TOC in a stroke

A

Noncontrast CT to r/o hemorrhage

40
Q

CI to tPA therapy in ischemic strokes

A
  1. BP > 185/110
  2. Recent bleed/trauma
  3. Bleeding disorder
41
Q

When should anti platelet therapy be given in an ischemic stroke?

A

ASA (or clopidogrel) given after 3 hrs if no thrombolytic tx OR @ least 24 hrs after thrombolytic tx

42
Q

When is the only time you want to decrease the BP in an ischemic stroke?

A
  1. BP >185/110 for thrombolytic tx

2. >220/120

43
Q

What is the MCC of a Hemorrhagic stroke? 2nd?

A

HTN=MC

AVM=2nd

44
Q

Hemorrhagic stroke sx’s

A
  1. LOC
  2. N/V*
  3. HA
  4. Hemiplegia/hemiparalysis

*Gradually increases in intensity

45
Q

Hemorrhagic stroke treatment

A
  1. Supportive: Head elevation, +/- Mannitol, decrease BP

2. Hematoma evacuation if increased ICP

46
Q

Why is an LP CI in a hemorrhagic stroke?

A

Can cause brain herniation

47
Q

if the CT scan is negative in a suspected Subarachnoid hemorrhage, what would be the next step? Findings?

A

LP: Xanthochromia (RBCs)

48
Q

What is considered Gold Standard Diagnostic TOC in a subarachnoid hemorrhage?

A

Angiography

49
Q

Subarachnoid hemorrhage treatment

A
  1. Decrease BP gradually: Nicardipine, Nimodipine

2. Aneurysm clipping or coiling

50
Q

Hepatic Encephalopathy si/sx’s

A
  1. Vomiting
  2. AMS, Coma
  3. Seizure
  4. Asterixis: Flapping tremor of hand w/ wrist extension
  5. Cerebral edema
51
Q

Pathophysiologyof hepatic encephalopathy?

A

Increased ammonia levels d/t failure of liver to excrete ammonia and covert ammonia to urea

Ammonia=Neurotoxic

52
Q

Hepatic Encephalopathy treatment

A
  1. Lactulose: converted into lactic acid by bacteria=neutralizes ammonia
  2. Abx: Neomycin, Rifaminin=decrease bacteria producing ammonia in GI tract
  3. Protein restriction

Emergency Med (10 decks)

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