neuro SM Flashcards
What headaches need an immediate referral?
SNOOP - bleed, stroke, brain tumor (dull/persistent)
Systemic - fever, chills, myalgias, weight loss, jaw pain
Neurologic - visual, pulsatile, tinnitus, weakness, ataxia
Onset - new/sudden, worst HA of their life
Onset age - elderly >65 or <5 years
Pattern/positional - aggravated by posture/valsalva, pregnancy, cough, sex, exercise
Atrial fibrillation increases risk of:
ischemic stroke
Hypertension increase risk of:
hemorrhagic stroke
constant increase pressure, possible burst of blood vessel
may see TIA first
How are TIAs differentiated from a stroke? What mnemonic is helpful for a stroke?
TIA - symptoms resolves
Stroke - symptoms longer than an hour
BE FAST balance eyes face arms speech time
Wernicke’s area affects?
Broca’s area?
WeRnicke’s - Receptive
Broca’s - Expressive (B & E are close in the alphabet)
What is aphasia?
ability to understand or express speech
What vitamin deficiency leads to Wernicke-Korsakoff Syndrome?
vitamin B1 - thiamine
alcoholics
Headache: one sided, tearing, runny nose, occurs at the same time every day
How is this treated?
Cluster
100% oxygen - unless COPD/interferes with disease process
Calcium channel blockers - Verapamil
Headache: one sided, possible visual impairment, temple pain/pulsing, increased ESR
How is this treated? What is a definitive diagnosis? What can this headache lead to?
temporal arteritis - giant cell arteritis
long term steroids
dx: temporal artery biopsy
blindess
Headache: Occipital and typical upon awakening
Hypertension headache
Headache: difficulty with lights/noise, throbbing/pulsating with possible nausea/vomiting
Migraine
Headache: what headache presents bilaterally?
tension
What type of headache is associated with polymyalgia rheumatica? Why?
PMR - inflammatory disorder with lots of muscle pain
elevated inflammatory markers
15% will develop temporal arteritis/giant cell
Triptans are what type of treatment? What are absolute contraindications?
Sumatriptan
NO uncontrolled hypertension, CV disease, NO serotonin/MAOi medications in past 14 days (SSRIs)
What drug is used to treat Parkinson’s disease?
levodopa-carbidopa
will stop working over time for symptoms
What are symptoms commonly seen with Parkinson’s disease? What symptom tends to be the most debilitating?
bradykinsia, tremor, rigidity
bradykinsia is the most debilitating
Brudzinski versus Kernig
What are we assessing for?
meningitis
Brudzinski - Back of head
Kernig - Knee
What are the 3 A’s of Alzheimer’s disease?
Apraxia, Agnosia, Aphasia
movement
no sense
speech
What assessment tool can be used to assess cognitive decline?
MMSE
What CN is associated with trigeminal neuralgia? What are expected symptoms? Treatment?
CN 5
s/s: severe, stabbing pain in their face
TX: Tegretol/Carbamazepine (both start with T)
What CN is associated with Bell’s palsy? What should be done for their eyes?
CN VII
corneal abrasions = eye lubricant
What two tests can asses CN VIII
Acoustic
Rinne and Weber
What is the Weber test? How is it performed? What are the test findings if sensorineural vs conductive?
weber - tuning fork on head
Sensorineural - will lateralize to this side UNAFFECTED
Conductive - will lateralize to AFFECTED side
Normal - NO lateralization, equal on both sides
What are symptoms of Meniere’s disease? Biggest concern?
s/s: vertigo, tinnitis, nystagmus, ear pressure
concern: potential permanent hearing loss
Sensorineural
