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Clinical Medicine 4 > Neuro emergencies > Flashcards

Neuro emergencies Flashcards

1
Q

Anterior Cerebral Artery occlusion affects what and where?

A

Contralateral sensory and lower motor extemity

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2
Q

Lacunar Infarcts of which artery?

A

Penetrating arteries

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3
Q

Which infarction is typically silent?

A

Lacunar infarction

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4
Q

Which artery MC for occlusion?

A

MCA

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5
Q

MCA occlusion presents how?

A

Contralateral sensory and motor loss

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6
Q

MCA occlusion loss greater in which two places?

A

Face and arm&raquo_space; leg/foot

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7
Q

Occlusion of MCA on dominant side can cause hearing and speech issues called what?

A

Brocha (speech) and Wernicke (understanding)

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8
Q

Lower extremity, vertigo, ataxia from which artery?

A

PCA

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9
Q

Ataxia, nystagmus, vertigo, gait, and CN palsies from which artery?

A

Veterbo-basilar infarct

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10
Q

Time of onset of Intracerebral Hemorrhage?

A

Gradual. Minutes to hours.

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11
Q

Dx for Intracerebral Hemorrhage?

A

Non-con CT

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12
Q

MC cause of Intracerebral Hemorrhage?

A

HTN vasculopathy

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13
Q

BP and MAP goal in Intracerebral Hemorrhage?

A

160/90 or 110 MAP

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14
Q

PaCO2 for elevated ICP in Intracerebral Hemorrhage?

A

PaCO2 25-30mmHg

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15
Q

Tx for Warfarin induced Intracerebral Hemorrhage?

A

VitK

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16
Q

Tx for Rivaroxaban or Apixaban induced Intracerebral Hemorrhage?

A

Kcentra

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17
Q

Tx for Pradaxaban induced Intracerebral Hemorrhage?

A

Praxabind

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18
Q

SAH secondary to what?

A

Ruptured saccular “beri” anuerysm

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19
Q

Main risks for SAH?

A

Tobacco and HTN

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20
Q

Onset and description of HA in SAH?

A

Sudden onset, worst HA of life

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21
Q

Dx for SAH? What next if normal?

A

Non-con CT. If norml then LP for blood or Xanthrocomia

22
Q

What GCS to intubate SAH?

A

<8

23
Q

Tx for vasospam in SAH?

A

Nomodipine

24
Q

When to intervene in SAH?

A

24-72h post SAH

25
Q

Where are 85% of unruptured intracranial anuerysms located?

A

Anterior circulation, mostly circle of willis

26
Q

Sx of unruptured intracranial anuerysms?

A

ASx until ruptured

27
Q

What size can an MRA or CTA see an unruptured intracranial anuerysms?

A

5mm or larger

28
Q

Tx of unruptured intracranial anuerysms if <7mm and no risk factors?

A

Observation

29
Q

Where is Subdural Hematoma?

A

Btwen dura and arachnoid veins (outtermost membrane)

30
Q

Subdural Hematoma venous or arterial bleed?

A

VENOUS

31
Q

MC type of traumatic intracranial amss lesion?

A

Subdural Hematoma

32
Q

Subdural Hematoma d/t tearing of which vein?

A

Bridging vein

33
Q

When it acute Subdural Hematoma?

A

1-2d after trauma

34
Q

Main dx of aucute Subdural Hematoma?

A

LOC

35
Q

When it subacute Subdural Hematoma?

A

3-14d

36
Q

When is chronic Subdural Hematoma?

A

> 15d

37
Q

Onset of chronic Subdural Hematoma?

A

Insiduous onset. HA, dizzy, seizure, vomiting

38
Q

CT shows what shape in Subdural Hematoma?

A

Crescent shape

39
Q

Crescent Shape on CT from which bleed?

A

Subdural Hematoma

40
Q

Epidural Hematoma located where?

A

Btwn dura and skull

41
Q

Epidural Hematoma bleed from vein or artery?

A

Artery!

42
Q

Epidural Hematoma bleed from which artery?

A

Meningeal artery

43
Q

Epidural Hematoma due to?

A

Shearing force to side of head

44
Q

Epidural Hematoma lucid followed by what?

A

Ludic followed by rapid deterioration and sudden unconsciousness

45
Q

“Worst HA of life” which bleed?

A

Subarachnoid hemorrhage

46
Q

Dx for Epidural Hematoma?

A

Head CT

47
Q

What shape in Epidural Hematoma CT

A

Biconvex

48
Q

Biconvex shape which ic bleed?

A

Epidural Hematoma

49
Q

Which test CI’d in Epidural Hematoma?

A

LP

50
Q

What GCS requires surgery in Epidural Hematoma?

A

GCS <9

51
Q

How can small bleeds be treated in Epidural Hematoma?

A

Non-surgical

Clinical Medicine 4 (10 decks)

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