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ICM > Neuro > Flashcards

Neuro Flashcards

1
Q

Classic triad for bacterial meningitis

A

Fever
Headache – severe, generalized, constant
Nuchal rigidity

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2
Q

Classic Triad for viral meningitis

A

Headache - frontal or retro-orbital
Photophobia
Pain on moving the eyes

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3
Q

Meningitis investigation

A

Lumbar puncture - CSF analysis

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4
Q

CSF analysis of bacterial

A 
Turbid
Opening pressures: markedly elevated
Protein >1.5
Neutrophils
Glucose down
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5
Q

CSF analysis of viral

A

Clear
Opening pressures normal to slightly elevated
protein <1

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6
Q

Prevention of meningitis ?

A

*Immunization:
H. influenzae, S.pneumoniae, N. meningitidis

Prophylaxis:
N. meningitidis, H. influenzae

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7
Q

Complications of meningitis (4)

A

seizures, cerebral edema, SIADH, deafness

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8
Q

MCC of Encephalitis

A

Viral - Herpes* (EBV, Varicella)

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9
Q

Herpes encephalitis affects which lobes ?

A

Frontal (hemiparesis, aphasia) and temporal lobes (olfactory and gustatory hallucination)

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10
Q

Feats of parenchymal involvement in encephalitis?

A

Altered mental status: confusion, hallucination, agitation

Focal neurologic deficits: aphasia, ataxia

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11
Q

Rabies virus encephalitis

A

early brainstem involvement

Hypersalivation
Hydrophobia
Aerophobia

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12
Q

West Nile Virus/St. Louis encephalitis

A

Basal ganglia and thalamus affected

tremor, myoclonus, TRAP

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13
Q

Investigation preferred for encephalitis

A

MRI

HSV - limbic

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14
Q

Abscess clinical feat

A

intracranial mass +/- infection

Headache 75%
Focal neurologic deficit: aphasia, ataxia >60%
Fever 50%

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15
Q

MC cause of abscess formation

A

Hematogenous spread: Endocarditis & pyogenic lung

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16
Q

Direct spread of an abscess

A

Mastoiditis

Sinusitis

17
Q

Abscess investigation

A

MRI

18
Q

Which sources are the most frequent causes are blood-borne infections?

A

lungs, heart, sinuses, and ears (chronic otitis media)

19
Q

Tension HA clinical feat

A 
F>M*
Minutes - days
NO Fam Hx
Bilateral - frontal, Nuchal - occipital*
Band-like; constant*
Triggers: depression, anxiety, noise, hunger, sleep
20
Q

Migraine: Clinical Features

A

AGE: 10 - 30
Sex Bias: F > M 3:1
Family History +++**
Location: UniLateral > bilateral; Fronto-temporal region**
Duration: Hours – days (4-72 hours)**
Quality: Throbbing/Pulsatile**
Severity: Moderate - Severe
Triggers: Tyramines (i.e. red wine), nitrites (i.e. processed meats), drugs, caffeine, alcohol, chocolate
Palliating: Rest, sleep
Assoc. Sy: Aura, N/V, Sensitivity to sound light

21
Q

Cluster Headaches Feat

A 
20 – 40
M > F
Fam Hx +
Retro-orbital
10 min – 2 h
Rapid onset, daily attacks for weeks to months; more common early am or late pm
Constant, aching, stabbing
Severe (wakes from sleep)
Light, Alcohol

** rhinorrhea, unilateral Horner’s (meiosis, ptosis, decreased sweating), unlilateral lacrimation, eye pain

Tx: 100 O2 ***

22
Q

Idiopathic Intracranial Hypertension(Pseudotumor Cerebri) clinical feat:

A

Headache
• Pulsatile, diffuse, awakens the patient/worse in am, exacerbated by Valsalva
• Nausea/ vomiting
• Pulsatile tinnitus
• Visual disturbance
• Bilateral Papilledema** - increased ICP

23
Q

What will investigations show for a IIH ?

A

normal CT

high opening pressure on LP

24
Q

Ictal Hx for seizure

A

Tonic (stiffening) or clonic (jerking) limb and body movement

Automatisms
Head turning
Tongue biting

25
Q

Ictal Hx for syncope

A

Patient falls limp
Pallor
Sweating
low BP

26
Q

Post Ictal hx for seizure

A

Confusion, reduced consiousness

Focal or unilateral weakness or other deficits
Amnesia for the ictal and postictal periods

27
Q

Post Ictal hx for syncope

A

Rapid recovery

28
Q

• Brief pauses (e.g 10secs)
• Presents in childhood
+LOC
-LOT

A

Absence

29
Q
  • Tonic (stiffness) followed by clonic (jerking)

* Loss of consiousness, post ictal confusion and drowsiness

A

• Tonic-clonic

30
Q

• Sudden jerk of a limb/face/torso
-LOC
+TONE

A

• Myoclonic

31
Q

• Sudden loss of muscle tone – falls, lasts 1-2 secs ‘drop attack’
-LOC
+LOT

A

• Atonic

ICM (6 decks)

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