Neuro/AMS/OD

Question 1

1st time sz (5)

Answer 1

CMP
Glucose
bHCG
CT (in ED)
Admit

Question 2

Ecclampsia Tx?

Answer 2

Mag

Question 3

Isoniazid Toxicity?

Answer 3

Pyridoxine

Question 4

Status Epilepticus meds?

Answer 4

Benzo Q 2-5min
Phenytoin
Phenobarbital
Valproic Acid

Question 5

Order of w/u for suspected meningitis?

Answer 5

1. b/c x 2
2. Empiric ABX (cef + vanc) + Dexamethasone
3. LP (CT if suspect herniation)

Question 6

CSF in encephalitis?

Answer 6

Bloody, lymphocyte predominance

Question 7

Door to tPA decision and administration times?

Answer 7

45 - decision

1 hr - administration (within 3 hrs of onset)

Question 8

tPA contraindications

• hx (4)
• vitals (2)
• imaging (1)
• drugs (2)
• labs (3)

Answer 8

SAH symptoms
Hx of ICB, AVM, mass, aneurysm
Trauma in last 3 mo
arterial draw in last week
CT - internal bleed anywhere
SBP >185
DBP > 110
Any anti-coagulation
Heparin in last 48hrs
INR >1.7
PT >15 sec
PLT

Question 9

Aspirin administration during stroke timeline?

Answer 9

24 hrs after tpa

48 hrs after admission

Question 10

AMS
A E3 I o2 U
T2 I P2 S4

Answer 10

Alcohol
Encephelopathy
Electrolytes
Epilepsy
INFX
Trauma
Temp
Insulin
Poison
Psychogenic
SAH
Shock
Space-occupying lesion
Stroke

Question 11

Tx for encephalopathy?

Answer 11

Lower P (prusside, labetalol, fenlodapam)

Question 12

3 exceptions to admission for AMS?

Answer 12

known seizure disorder with low drug level

Hypoglycemia without other cause

Opiate OD

Question 13

Tylenol OD dose?

Answer 13

150 mg/kg

Question 14

Tylenol OD tx?

Answer 14

Charcoal, NAC

Question 15

ASA OD tx?

Answer 15

Bicarb, supportive, dialysis

Question 16

Ethylene glycol and methanol OD tx?

Answer 16

Ethanol or Fomepizole

Question 17

Ethanol or isopropyl alcohol OD tx?

Answer 17

Supportive

Question 18

Contraindications to charcoal?

Answer 18

SOMNOLENCE

Doesnt work for metals, alcohol, or hydrocarbons

Question 19

Indications for PEG bowel irrigation?

Answer 19

Intoxication without response to charcoal or unresponsive to charcoal

Question 20

Gastric Lavage indications?

Answer 20

Really only good for removing chunks of undigested pills

Question 21

Anti-cholinergic symp?

Answer 21

Dry
Red
Mad
Hot
Blind

Question 22

Anti-cholinergic causes and tx?

Answer 22

TCAs, anti-histamines

TX: Wide QRS with HCO3-

Question 23

Cholinergic tx?

Answer 23

SLUDGE

Atropine + Pralidoxime (2PAM)

Question 24

Rhyme for sympathetic OD tx?

Answer 24

Sedate
Hydrate
Lactate