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Emergency Med rotation > Neuro part 1 > Flashcards

Neuro part 1 Flashcards

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1
Q

Altered LOC/coma mnemonic for causes

A

Alcohol or AAA
Epilepsy, electrolytes, hepatic encephalopathy, endocrine problems
Insulin, intussusception, or inborn errors of metabolism
Opiates or overdose
Uremia
Trauma, temperature, toxemia, (brain) tumor
Infections
Psychogenic, pulmonary embolism, poisoning
Space-occupying lesions, stroke, shock, seizure, shunt

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2
Q

Pathophys of coma

A

Bilateral cortical disease
Suppression of reticular activating system via:
-Supratentorial pressure
-Infratentorial pressure
-Intrinsic brainstem lesion
-Torque on brainstem from sudden head blow

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3
Q

CNS causes of paresthesia

A 
CVA
TIA
Brain tumor
Head trauma
Brain abscess
Encephalitis
SLE
Vit B12 deficiency
MS
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4
Q

Metabolic causes of paresthesia

A 
DM
Hypothyroidism
EtOH abuse
Uremia
Amyloidosis
Porphyria
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5
Q

Entrapment neuropathy causes of paresthesia

A 
Carpal tunnel
Ulnar entrapment (cubital tunnel)
Thoracic outlet syndrome
Lateral femoral cutaneous syndrome
Peroneal palsy
Tarsal tunnel
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6
Q

Inflammatory causes of paresthesia

A

Local trauma
Acute idiopathic polyneuritis
Chronic relapsing polyneuropathy

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7
Q

Connective tissue causes of paresthesia

A 
Polyarteritis nodosa
Sjogrens syndrome
Systemic sclerosis
Autoimmune vasculitis
RA
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8
Q

Toxin causes of paresthesia

A 
Chemo
Heavy metal toxicity
Industrial toxin exposure
HIV meds
Chronic pyridoxine overdosage
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9
Q

Hereditary causes of paresthesia

A

Charcot-Marie-tooth
Denny-Brown’s syndrome
Familial amyloidotic poyneuropathy

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10
Q

Malignant causes of paresthesia

A 
Tumor compression
Paraneoplastic syndrome
Lymphoma
CA
Plasma cell dyscrasias
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11
Q

Infectious causes of paresthesia

A

HIV
Lyme disease
Leprosy

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12
Q

Miscellaneous causes of paresthesia

A

Sarcoidosis
Malnutrition
Panic attack

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13
Q

D/os that can cause seizures

A 
Genetic syndromes
Chromosomal deletion or duplication syndromes
Metabolic d/os
Mitochondrial diseases
Single-gene mutations
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14
Q

Workup for seizure sx/epilepsy

A

Prolactin
Serum anti-eleptic drug levels
MRI or CT
EEG

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15
Q

Workup for altered LOC: labs

A 
Immediate:
Bedside glucose
First-line:
CBC
CMP
Serum osmolality
Serum calcium
Serum magnesium
UA
Urine hCG when applicable
TSH
Tox screen
When infection suspected, or unknown cause:
BCx
Urine culture
LP
Serum lactic acid
Procalcitonin level
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16
Q

Workup for altered LOC: other labs to consider

A 
Ammonia
Carboxyhemoglobin level
HIV
RPR
Heavy metal screen
Vit B12
Serum cortisol
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17
Q

Workup for altered LOC: other

A

EKG and cardiac monitor

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18
Q

Workup for altered LOC: imaging

A

Head CT
C-spine CT if any risk of trauma
CXR

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19
Q

Tx of seizures

A

Absence, if only type present: ethosuximde
Absence with other seizure present, tonic or atonic, myoclonic, tonic-clonic: valproic acid, lamotrigine, or topiramate
Generalized and unclassified epilepsies: Valproate (pregnancy category X, find alternative)
Focal onset: carbamazepine
Medically refractory: immunotherapy

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20
Q

Which seizure meds decrease the efficacy of OCPs?

A 
Carbamazepine
Phenytoin
Phenobarbital
Primidone
Felbamate
Lamotrigine
Topiramate
Oxcarbazepine
21
Q

Causes of status epilepticus

A 
Poor medication compliance with low anticonvulsant drug levels
EtOH withdrawal
Drug overdose or toxin ingestion
Intracranial infection
Cerebral neoplasm
Metabolic d/o
22
Q

Causes of syncope: orthostatic

A 
Orthostatic hypotension
Hypovolemia
Medication-related syncope
Recreational drug use
Postural tachycardia syndrome
Autonomic failure
23
Q

Causes of syncope: cardiac

A 
Predisposing cardiac conditions
Arrhythmia
Valvular d/os
Myocardial d/os
Vascular d/os
24
Q

Causes of syncope: acute painful syncope

A 
SAH
AAA rupture
ACS
Aortic dissection
PE
Ectopic pregnancy
25
Q

Predisposing conditions for syncope

A 
FHx of sudden cardiac death
DM (hypoglycemia)
Parkinson's (orthostatic hypotension)
Seizure d/o
Dehydration or blood loss
Psychiatric illness
26
Q

What is the cause of the syncope likely to be if it occurs with prolonged standing?

A

Vasovagal syncope

Orthostatic syncope

27
Q

What is the cause of the syncope likely to be if it occurs immediately on standing?

A

Orthostatic hypotension

28
Q

What is the cause of the syncope likely to be if it occurs while lying supine?

A

Cardiovascular

29
Q

What is the cause of the syncope likely to be if it occurs with exertion

A 
Exertional syncope
Aortic stenosis
CAD or coronary artery abnormalities
Cardiomyopathy
Arrhythmia
30
Q

What is the cause of the syncope likely to be if it occurs after exertion in an athlete?

A

Vasovagal syncope

31
Q

What is the cause of the syncope likely to be if it occurs with Valsalva

A

Reflex-mediated syncope

32
Q

What is the cause of the syncope likely to be if it occurs with neck rotation or pressure?

A

Carotid sinus hypersensitivity

33
Q

What is the cause of the syncope likely to be if it occurs with use of arms?

A

Subclavian steal syndrome

34
Q

What is the cause of the syncope likely to be if it occurs with a stressful event?

A

Vasovagal syncope

35
Q

What is the cause of syncope likely to be if the pt has nausea, chills, and sweats?

A

Vasovagal syncope

36
Q

What is the cause of syncope likely to be if the pt has aura?

A

Migraine HA

Seizure d/o

37
Q

What is the cause of syncope likely to be if the pt has no prodromal sx?

A

Cardiovascular syncope

38
Q

What is the cause of syncope likely to be if the pt has slumping?

A

CAD

Arrhythmia

39
Q

What is the cause of syncope likely to be if the pt has kneeling?

A

Orthostatic hypotension

40
Q

What is the cause of syncope likely to be if the pt has brief loss of consciousness?

A

Arrhythmia

41
Q

What is the cause of syncope likely to be if the pt has loss of consciousness >5 mins?

A

Seizure d/o

Neurologic, metabolic,k or infectious cause

42
Q

What is the cause of syncope likely to be if the pt has focal neurologic deficits?

A

TIA or CVA

Todd’s paralysis

43
Q

What is the cause of syncope likely to be if the pt has severe thunderclap HA?

A

SAH

44
Q

What is the cause of syncope likely to be if the pt has CP?

A

CAD
PE
Aortic dissection

45
Q

What is the cause of syncope likely to be if the pt has palpitations?

A

Arrhythmia

46
Q

What is the cause of syncope likely to be if the pt has severe abdominal pain or back pain?

A

AAA

Aortic dissection

47
Q

What is the cause of syncope likely to be if the pt has pelvic pain or vaginal bleeding?

A

Ectopic pregnancy

48
Q

Workup of syncope

A

Target your workup based on hx and exam

Emergency Med rotation (12 decks)

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