Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MRCS A > Neuro - Neurological emergencies > Flashcards

Neuro - Neurological emergencies Flashcards

1
Q

Def status epilepticus

A

Life-threatening neuro condition - 5 or more mins of either continuous seizure activity or seizure activity w/o gaining consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RF status epilepticus (4)

A

Non-adherence to anticonvulsant Dx
Chronic alcoholism
Refractory epilepsy
Toxic/metabolic causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

1st step Mx status epilepticus

A

A-E
High flow O2
BM
Temp
Establish Hx /collateral Hx
IV access

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

2nd step Mx status epilepticus

A

After 5 mins
Buccal midazolam or IV lorazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3rd step Mx status epilepticus

A

After another 10 mins - give 2nd dose of benzos
Make sure anaesthatist has been called

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

4th step Mx status epilepticus

A

IV phenytoin 18mg/kg
Max = 50mg /min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute causes of NM ventilatory compromise

A

GBS
Myasthenic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Chronic causes of NM ventilatory compromise

A

MND
Myotonic dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sx NM ventilatory compromise (7)

A

Resp failure
Weak cough
Paradoxical diaphragm movement
Breathless when flat
Use of accessory mm
Incr RR
Can’t clear secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bedside Ix NM ventilatory compromise (2)

A

VITAL CAPACITY!!!
ABG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ABG results acute NM ventilatory compromise

A

pH <7.35
PO2 <8
PCO2 >6
Bicarb = low/norm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ABG results chronic NM ventilatory compromise

A

pH norm
PCO2 >6
Bicarb >26mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a primary traumatic brain injury

A

Immediate result of trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a secondary traumatic brain injury

A

From complications of the trauma
I.e. hypoxia, ischaemia, haematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Def concussion

A

Transient LOC but no persistent neuro signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of concussion

A

Temporary confusion/amnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PS diffuse axonal injury

A

Decr [ ]/memory
Personality change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Mx diffuse axonal injury

A

Supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

2 types of damage in focal brain injury

A

Coup + counter-coup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is post-concussion syndrome

A

Dizziness
Headache
Decr [ ]/memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mx post-concussion syndrome

A

Physio + OT helps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Assessment of someone with suspected head injury

A

C-Spine
A-E
Record GCS
Hx if conscious
Check for signs incr ICP
Imaging - CT/C spineXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Signs of declining neurological status after head injury (5)

A

Decr in GCS
Pupil changes
Development of focal signs
Change in resp rate
Cushings sign - decr pulse but incr BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why does Cushings signs occur?

A

Pressure on medulla oblongata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Bilateral pupil changes after head injury signify
Pre-terminal
26
Who must have a CT head within an hour? (7)
If GCS <13 on admission or <15 at 2hrs Focal neuro deficit Incr ICP Suspected skull # Post-trauma seizure Vom >1
27
Who must have CT head within 8hrs (4)
Anti-coag'd LOC + : +65 y/o Dangerous mechanism Retrograde amnesia >30 mins before injury
28
Which bone is involved in a posterior fossa fracture?
Temporal bone
29
What is Battle's sign
Bruising over mastoid
30
PS posterior fossa fracture
Battles sign CSF otorrhoea Bleeding in ear Conductive deafness CN palsy 5-7
31
Mx posterior fossa fracture
Rx to neurosurgery
32
What bones are involved in an anterior fossa fracture
Occipital Sphenoid Ethmoid
33
PS anterior fossa fracture
Raccoon eyes CSF rhinorrhoea Bleeding from nose
34
Mx anterior fossa #
Rx to neurosurgery
35
Complications fossa # (3)
Intracranial infection Facial nn palsy Carotid injury
36
Mx depression skull #
Surgical exploration within 12hrs
37
GCS - E4
Open eyes spontaneously
38
GCS - E3
Open eyes to speech
39
GCS - E2
Open eyes to pain
40
GCS - E1
No response
41
GCS - V5
Oriented to time, person + place
42
GCS - V4
Confused
43
GCS - V3
Inapprop words
44
GCS V2
Incomprehensible sounds
45
GCS V1
No response
46
GCS M6
Obeys command
47
GCS M5
Moves to localised pain
48
GCS M4
Flex to withdraw from pain
49
GCS M3
Abnormal flexion
50
GCS M2
Abnormal extension
51
GCS M1
No response
52
DDx - unconscious pt
Vascular (stroke,shock,haematoma, SAH) Infective - sepsis, meningitis, encephalitis, abscess Trauma Autoimmune - BS demyelination Metabolic - gllucose, Ca, Na Neoplasm
53
What does Cheyne stokes breathing indicated
Coning
54
What does Kussmal resp indicate
Acidosis or Uraemia
55
Cause of extradural haemorrhage
Blow to side of head
56
Which artery is classically affected in extradural haemorrhage
MMA
57
PS extradural haemorrhage (4)
brief LOC Lucid phase Progressive hemiparesis + stupor Coning - dilated pupil
58
If unTx, how can extra-dural haemorrhage progress
To hemiplegia + resp arrest
59
Ix findings extradural haemorrhage
CT - lemon shape
60
Mx extradural haemorrhage
Urgent Rx neurosurgery Burr hole
61
What is hydrocephalus
Excessive CSF within cranium
62
What are the 2 types of hydrocephalus
Non-communicating Communicating
63
What is non-communicating hydrocephalus due to?
Blockage of CSF pathway from ventricles to SAS
64
What is communicating hydrocephalus due to?
impairment of CSF reabsorption in arachnoid villi Infection/SAH
65
Who are the 3 pt groups at risk of suffering from hydrocephalus?
Congen malformations - stensis aqueduct of sylvius tumour (post fossa/BS) Post brain assault (SAH/head injury/meningitis)
66
PS of acute hydrocephalus
Headache Vom Papilloedema Ataxia Bilatereal pyramidal signs
67
Ix acute hydrocephalus
CT MRI if suspect tumour
68
Mx acute hydrocephalus
Acetazolamide +/- furosemide Surgical shunt
69
What are the 2 types of shunts used in hydrocephalus Mx ?
Ventriculo-arterial Ventriculo-peritoneal
70
What is normal pressure hydrocephalus?
syndrome of enlarged lat ventricles which usually presents in elderly t
71
What is the clinical triad seen in normal pressure hydrocephalus
WACKY, WEEING, WOBBLY Dementia Urinary incontinence Apraxic gait
72
What is an apraxic gait
Slow Broad based Shuffling

MRCS A (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions