Neuro Flashcards
obese female w/HA and diplopia
Psuedotumor Cerebri
how to tx SAH
Decrease the incidence of rebleed keep MAP <130 (IV Labetalol, PO Nimodipine [decreases vasospasm])
HA in a pregnant pt you have to r/o this
venous thrombosis
how to tx a CSF leak
Lay flat, IV Caffeine, Blood Patch
abortive migraine tx
Triptans, IV Reglan, Chlorpromazine (Thoazine), Prochlorperazine (Compazine), DHE(DihydroErgotamine) IV Infusion, NSAIDS
how to tx eclampsia (Pregnancy, Headache, Proteinuria, Elevated BP, Seizure)
Mag Sulfate
Retro-orbital/Temporal, Suicidal Ideation, occurs daily for weeks then resolves, Lacrimation, Rhinorrhea, Conjunctival Injection
cluster HA
how long till you cant give TPA
3 hours
anterior cerebral artery stroke will affect the
legs
middle cerebral artery stroke will affect the
arm, face, speech
posterior circulation stroke will affect
visual, dizziness, diplopia, ataxia, CN deficits, vertigo, Cranial Nerve Deficits, B/L limb weakness, Locked in Syndrome (they are aware of what is going on they just have all these defcicits)
chiropractic manipulation, lifting weights, straining
can result in
cervical artery dissection,
Treated with Antiplatelets (Aspirin, Plavix) Anticoagulation
nervous system response to increased intracranial pressure (ICP) that results in
Cushing’s triad of increased blood pressure, irregular breathing, and bradycardia
Dysdiadochokinesia
-clumsy/rapidly alternating movements
-over/undershoot (heel to toe, can’t feel it)
dysmetria
can be impaired in syphilis and Vitamin B12 deficiency
Impaired vibratory/position sense-posterior column
how to dx and tx vertigo
*Dix Halpike for diagnosis
*Epley Maneuver is curative
Tx: Benadryl, Meclizine, Reglan, Scopolamine Patch, Benzos
Tonic (rigid) Clonic (rhythmic jerking movements
grand mal
LOC, without loss of postural tone, appear confused
petit mal
Hallucinations, Memory Complaints, Disoriented Perception
complex partial
> 5 minutes continuous or intermittent without recovery of consciousness
status epilepticus
HTN, Seizure, Headache, Proteinuria, >20 weeks gestation or 3 weeks postpartum
eclampsia
Symmetric Ascending Weakness, Decreased DTRs
CSF elevated Protein, Normal Cell Count
GBS
UMN LMN dysfunction
ALS
Proximal Muscle Weakness, Fatigue, Ptosis, Diplopia, progress to Respiratory Muscle Weakness (Dyspnea/Fatigue)
Symptoms get worse throughout the day
MG
how to dx and tx MG
Dx: Ach receptor Antibodies! EMG rep stim, Edrophonium (Tensilon Test)- administer Edrophonium, if symptoms get worse it indicates cholinergic crisis and you may have to intubate. What?! No change in symptoms, assume Myasthenia gravis
Treatment Neostigmine, Pyridostigmine (Mestinon, Timespan)
Motor, Sensory, Visual (Optic Neuritis)
Relapsing and remitting (90%)
MS
how to tx MS
Methylprednisolone (acute exacerbation), Interferon (chronic)
Resting Tremor, Cogwheel Rigidity, Bradykinesia, Pill Rolling, Orthostatic Hypotension, Masked Face, Shuffling Gait
PD
bacterial meningitis blood count
high protein, low glucose
viral meningitis blood count
Glucose elevated, Protein elevated
how to tx miningitis
cef/vanco
>50 add ampicillin
HSV-affects frontotemporal region bilaterally. Can be seen as enhancement on MRI and EEG reveals bitemporal epileptiform discharges
encephalitis
