Neuro/Derm Flashcards
transient loss of consciousness from an injury, then lucid period followed by increasing drowsiness, headache, and unilateral (contralateral) weakness
Epidural hematoma
elderly patient with a history of multiple falls who is now presenting with neurological symptoms
Subdural hematoma
explosive “thunderclap” headache described as “the worst headache ever”
Subarachnoid headache
an abrupt onset of a focal neurologic deficit that worsens steadily over 30 to 90 minutes, altered level of consciousness, stupor, or coma. Headache, vomiting, and signs of increased ICP
Intracerebral hemorrhage
- The Middle meningeal artery at the temple is most commonly involved in what type of brain hemorrhage
Epidural hematoma
- Transient loss of consciousness from injury, then lucid period followed by increasing drowsiness, headache, and unilateral (contralateral) weakness.
Epidural hematoma
Epidural hematoma, convex or concave
- Diagnosis: CT brain - classic CT finding is lenticular, unilateral convexity, usually in the temporal region. (lens-shaped, biconvex)
- Most common intracranial pathology due to head trauma (rupture of veins in the cerebral cortex)
Subdural hematoma
Crescent shape hematoma
Subdural
Ruptured saccular (berry) aneurysm accounts for approximately 75% of nontraumatic cases of
Subarachnoid hemorrhage
Subarachnoid hemorrhage
- Altered mental status – may have neck stiffness and nuchal rigidity
Aphasia causes
- Postoperative cerebral vascular accident (stroke)- trouble speaking, along with having a numb or drooping face and feeling weak in one arm, is one of the three major signs of stroke
- Multiple sclerosis - lesions in areas of the brain responsible for speech can have speech issues that range from mild to severe
- Intracerebral hemorrhage
- Migraine headache may cause transient aphasia
- Carotid disease - see general surgery vascular disorders
- Recurrent laryngeal nerve injury 0.77% of thyroidectomies resulting in hoarseness and aphonia
- The most common cause of postoperative ocular injury is , which may or may not be associated with visual loss
corneal abrasion
- Loss of pain and temperature below the level with preserved joint position/vibration sense
Anterior cord syndrome
- Loss of pain and temperature sensation at the level of the lesion, where the spinothalamic fibers cross the cord, with other modalities preserved (dissociated sensory loss)
Central cord syndrome
Brown Sequard syndrome is what?
- Loss of joint position sense and vibration sense on the same side as lesion and pain and temperature on the opposite side a few levels below the lesion
- Lesion of half-ipsilateral cervical cord lesion
- Contralateral sensory findings: pain and temperature loss
Distal sensory polyneuropathy
- Stocking-glove sensory loss is a term used to describe sensory loss affecting the distal lower and upper extremities that is most commonly seen in length-dependent axonal neuropathies
What are the 4 stages of ulcers
- Stage 1: erythema of localized area, usually non-blanching over the bony surface
- Stage 2: partial loss of dermal layer, resulting in pink ulceration
- Stage 3: full dermal loss often exposing subcutaneous tissue and fat
- Stage 4: full thickness ulceration exposing bone, tendon, or muscle. Osteomyelitis may be present
Which stage ulcer does this describe “full thickness ulceration exposing bone, tendon, or muscle. Osteomyelitis may be present”
Stage 4
What is the wound mangement for ulcers stage 1-4
- Stage I: aggressive preventive measures, thin film dressings for protection
- Stage II: occlusive dressing to maintain healing, transparent films, hydrocolloids
- Stages III-IV: Débridement of necrotic tissue. Exudative ulcers will benefit from absorptive dressings such as calcium alginates, foams, hydrofibers. Dry ulcers require occlusive dressing to maintain moisture, including hydrocolloids, and hydrogels.
What is pruritis ani
is a rare condition characterized by an intraepithelial adenocarcinoma of the perianal skin. The most common presenting complaint is intolerable pruritus and examination typically reveals a well-demarcated, erythematous, eczematous rash
Fat emoboli in long bones would present how?
cause a syndrome characterized by respiratory insufficiency, coagulopathy, encephalopathy, and an upper body petechial rash
What is Dariers sign
localized urticaria appearing where the skin is rubbed (histamine release)
What is Clarks classification for staging of melanoma
Clark Classification System of Microstaging
- Level I: Confined to the epidermis (in situ)
- Level II: Invasion into the papillary dermis
- Level III: Penetration to the papillary-reticular interface
- Level IV: Invasion into the reticular dermis
- Level V: Penetration into the subcutaneous fat
What is the tx for postop drug eruption?
- STOP DRUG then → Intravenous immunoglobulin (IVIG)
- Steroids used to be the treatment of choice are now thought to be an increased risk for sepsisIntravenous immunoglobulin (IVIG)
- Steroids used to be the treatment of choice are now thought to be an increased risk for sepsis
nipple discharge, sexual dysfunction, reduced sex drive should make you think of what?
Hypogonadism
How is cellulitis treated
Treat methicillin-resistant Staphylococcus aureus infection (MRSA) with
- Trimethoprim-sulfamethoxazole (TMP-SMZ) 1 DS tab PO BID
- Clindamycin 300–450 mg PO
- Doxycycline 100 mg PO BID
- Intravenous Vancomycin or Linezolid
