Neuro/Sedation Flashcards
What is a sudden interruption of arterial or venous blood flow to a focal region of the brain?
Stroke
What is the third line therapy for seizure control?
If lasting 40 is 60 minutes repeat dosing of second line, then anesthetic dose of versed, propofol, or pentobarbital
What diagnostics tool shows abnormality in 90% of encephalitis cases?
EEG
What kind of seizure results in a sudden loss of tone?
A tonic
When can children return to activities after traumatic brain injury?
Went at pre-morbid state and symptom-free at rest
What neurologic problem is a progressive and symmetrical with ascending paralysis progressive neuromuscular weakness?
Guillain-Barre
What are three kinds of shunts used to help with hydrocephalus?
VP or ventricular pleural, VA or ventricular atrial, VG ventricular gall bladder
What is the best radiographic view for viewing C1?
Udontoid view
What are some post-operative complications of craniosynostosis surgery?
Pain, bleeding, s i a d h, bradycardia, facial edema
What are signs of botulism in infants?
Constipation, hypertonia, listlessness, dysphagia, weak cry
What is initial therapy for seizure control?
In the 5 to 20 minutes after the seizure starts give benzodiazepines
What is the Mallampati score?
Score that describes ability to visualize the pharynx one and two are safest
Bleeding inside or around the ventricles of the brain?
Introventricular hemorrhage
What is the opening pressure of an LP in pseudotumor cerebri?
Greater than 280
What is a common cause of encephalitis and neonates?
Herpes simplex virus
What can an MRI identify?
Ischemia or infarcts, degenerative diseases, congenital anomalies, AV malformations, posterior fossa or spinal cord lesions
Why are children more prone to s c i w o r a?
They have cartilaginous end plates with wax interspinous ligaments
What medications used to treat delirium?
Haldol
What is the second line therapy in status epilepticus?
If lasting 20 to 40 minutes give keppra fosfone, valpo weight or phenobarbital as a last choice
What will a CT scan of a hydrocephalus patient show?
Ventricular magnolia, macrocephaly
What is a brief but widespread inflammation of the brain and spinal cord that damages the myelin usually following a bacterial or viral illness?
Acute disseminated encephalomyelitis
What are the two most common presenting signs of neurofibromatosis?
Lisch nodules and cafe au lait spots
When is p r e s most often seen?
In oncologic, transplant, dialysis patients
Or the three types of delirium?
Hyperactive, hypoactive, mixed
What imaging should be used to diagnose hydrocephalus?
CT scan
Ischemia, cell death, cerebral edema, increased intracranial pressure is primary or secondary brain trauma?
Secondary
What is a typical sign of shunt complications?
Wi’ll go back to pre-shunt functioning
If concerned for high ICP what should be performed prior to a lumbar puncture?
CT scan
What are some other presenting factors of tuberous sclerosis?
Infants with seizures or cardiac rhabdomyomas and seizures
What is the most common sight of the lumbar puncture?
Between l4 and l5 or one space above or one space below
What are two sedation scores?
State behavioral score and Richmond agitation scoring system
Is an intracranial contusion, hemorrhage, or diffuse external injury the primary or secondary injury?
Primary
Is the most common presenting symptom in pediatrics of posterial reversible encephalopathy syndrome?
Seizures
What is the diagnostic and treatment for pseudotumor cerebri?
Lumber puncture
What is the scoring method used to screen for delirium?
Pediatric confusion assessment method or P-CAM
What kind of seizure originates in one hemisphere?
Focal
What is the mnemonic used to determine if safe to sedate?
AMPLE
Allergies
Medications
Past illnesses
Last oral intake
Events leading up to injury
On a spinal cord injury impairment scale what is the best and worst category?
Best is category E where sensory and motor function is preserved
Worst is category A where there is no sensory or motor function preserved before S4 or S5
What kind of seizure affects bilateral hemispheres of the brain?
Generalized
When using an MRI to evaluate seizures what are the advantages?
Eliminates radiation exposure, higher resolution and differentiation of gray and white matter, higher resolution of skull base and orbits
Bleeding within the brain tissue is what kind of hemorrhage?
Intraparenchymal
What defines status epilepticus?
Single seizure lasting longer than 30 minutes or two or more consecutive seizures without returning to baseline level of consciousness
What can a CT identify?
Bony abnormalities, intracranial hemorrhage, hydrocephalus, cerebral edema, space occupying lesions and calcifications
What screening tool is used to test for traumatic brain injury during sporting events?
Scat 5
What is a motor impairment resulting from neurological insult?
Cerebral palsy
What is the PACARN or CHALICE criteria used for?
To decide whether or not to do a CT scan
When does the child was seizures need to be seen in the ear?
Last greater than 5 minutes, head injury, high fever, compromised cardiac function
What kind of seizure causes rhythmic or repetitive movements?
Chronic
What is the gold standard study to diagnose an arteriovenous malformation?
Cerebral angiography
What is an autosomal dominant disorder that develops benign tumors in the brain skin and kidneys?
Tuberous sclerosis complex
What are some features of tuberous sclerosis complex?
Hypomelanotic fibromas, cortical tubers, facial angiofibromas, lymphangioleiomyomatosis
Where do the tumors in neurofibromatosis present?
Brain, spine, skin, eyes
What should we watch for after a lumbar puncture?
CSF leak, headache, lower extremity sensory changes, hematoma at the site
What neurological problem is progressive, symmetrical with proximal weakness and has a genetic link?
Muscular dystrophy
When using a CT scan to evaluate seizures what are the advantages?
Sensitive to presence of blood, bones, lesions
Can be done quickly
Fluid changes can be seen such as hydrocephalus or cerebral edema
What kind of seizure causes sustained extension reflection of head trunk or extremities?
Tonic
How does a shunt infection present?
Can be meningitis like
What are the essential findings of brain death?
Coma, apnea, absence of brain stem reflexes
What syndromes are associated with craniosynostosis?
Aperts, cruizzon, Pierre Robin, Turner, Vader, dandy Walker
Which is the most severe and early onset form of SMA?
Type 1
Tearing of small vessels in the pia matter is what kind of hemorrhage?
Subarachnoid
What is the most common age for a febrile seizure to occur?
Between 6.and 60 months
What brain abnormalities are associated with craniosynostosis?
Hide yourself list, chiari malformation, increased ICP, vision problems, hearing loss
What injury are children with down syndrome prone to and why?
They are prone to arlanto axial subluxation after acute flexion injury due to atlanto axial instability
Preaching vein rupture that may cross sutureline but not midline and is typically a counter coup injury is what kind of hemorrhage?
Subdural
Injury to the middle meningeal artery or vein is what kind of hemorrhage? That does not cross the suture line
Epidural
What sedative agents are related to delirium?
Benzos, propofol, can mean, opioids
What is a skin feature of tuberous sclerosis complex?
Ashley’s spots
What is a SCIWORA?
Spinal cord injury without radiological abnormality
What are some common causes of hypoxic ischemic encephalopathy?
Birth trauma, submergent injury, is fixation, accidents, prolonged resuscitation
What are symptoms of delirium?
Impaired consciousness, impaired awareness, unable to focus, sleepwalk cycle abnormalities, thought processes disturbances, behavioral issues
