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Neurology > Neuro Trauma > Flashcards

Neuro Trauma Flashcards

1
Q

meningitis hallmark

A

HA
Fever
Stiff neck

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2
Q

real clue to pay attention to with a patient

A

mental status change!

esp. with space occupying lesions

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3
Q

inflammation of meninges that line the brain and spinal cord

A

meningitis definition

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4
Q

inflammation of brain

A

encephalitis

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5
Q

MCC of encephalitis

A

viral infections

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6
Q

umbrella term used to describe several different medical conditions that cause a malfunction or failure of the Autonomic Nervous System (ANS)

A

Dysautonomia

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7
Q

generic term for presence of a greater than normal number of cells in cerebrospinal fluid

A

Pleocytosis

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8
Q

Functional tissue of a specific organ

A

Parenchyma

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9
Q

Micro-hemorrhages with small vessel leakage into surrounding tissue

A

Parenchyma contusion

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10
Q

Complete separation of tissue (type of parenchymal)

A

laceration parenchymal

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11
Q

injury occurs under the site of impact with an object

A

coup

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12
Q

injury occurs on the side opposite the area that was initially impacted

A

contrecoup

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13
Q

Symptoms of coup/contrecoup are directly related to…

nausea, vomiting, atxia, etc.

A

new pressure within the cranial cavity that creates swelling of the brain and micro-hemorrhages of the vessels

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14
Q

Torque injuries of brain

A

when coup and contrecoup occur, the brain sloshes and rotates. This creates a torque pressure and alteration on the brain stem. This effects the lifelines of respiration rates and heart rates.

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15
Q

Coup and Contrecoup cervical injuries

A

results in flexion/extension (compression and extension) fractures and/or connective tissue damages. Often times, the connective tissues are stronger and cause avulsion fractures of the cervical vertebrae (bone fragments are torn away from the main bone segment).

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16
Q

Inflammation / infection of the meninges and brain

two different things with the same presentation

A

Meningitis+ Encephalitis: Meningoencephalitis

aka Encephalomeningitis

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17
Q

Aseptic meningitis/encephalitis

A

due to a virus - not as contagious or deadly

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18
Q

meninges of the brain (superficial to deep)

A

dura mater
arachnoid mater
pia mater

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19
Q

Triad of Cushing’s Syndrome

A

As you increase ICP, see:

  • elevated BP with widened pulse pressure
  • decreased pulse rate
  • irregular breathing patterns
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20
Q

epidural

A

above the dura mater

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21
Q

subdural

A

below the dura mater

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22
Q

subacrachnoid

A

below the arachnoid

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23
Q

bleeds below pia mater

A

usually venous bleeds

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24
Q

When the periosteum is torn…

A

check for depressed skull fracture

mental status changes –> more severe and should be admitted

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25
Q

a state of prolonged unconsciousness

A

coma

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26
Q

Exists when there is a brain tissue insult with transient alteration in mental status

A

concussion

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27
Q

Complex disorder in which various symptoms

Headaches, dizziness, concentration difficulties

Can last for weeks and sometimes months after the injury

A

Post-concussion syndrome

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28
Q

Lightheadedness, fatigue, nausea, numbness, ataxia, confusion, disorientation, hallucinations, HA’s

A

Generalized Hypoxia

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29
Q

cyanosis

A

local hypoxia

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30
Q

Neurological abnormality affecting muscle coordination and movements.

Non-specific manifestation of CNS dysfunction

Causes:
CVA, Tumors, MS, Hypothyroidism, Vitamin B-12 deficiency…

A

ataxia

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31
Q

Virus transmitted by arthropod vectors

Probably most common:
Ticks
Mosquitoes

A

Arbovirus

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32
Q

Named by their transmission-route through the intestine (enteric = intestinal)

Examples:
Polio, Hand-foot-mouth dz, Encephalitis, Pericarditis

A

Enterovirus

33
Q

Eyesmove in the direction opposite to that of the head movement.

A

Positive/ normaldoll’s eyereflex

34
Q

Eyesmove in the direction of the head movement

A

Negative doll’s eyereflex signifies severe brain damage or brain death

35
Q

Four bacteria most commonly responsible for meningitis/encephalitis/brain abscesses

A 
Strep pneumoniae (45-61%)
Neisseria meningitides (13-16%)
Haemophilus influenzae type B (5-7%)
Listeria monocytogenes (2-4%)
36
Q

Four bacteria most commonly responsible for meningitis/encephalitis/brain abscesses in infants <2months of age

A

Group B strep

37
Q

MC to remember for Dr. Hatch for all ages is….

A

Strep pneumoniae

38
Q

For Dr. Hatch, children less than three months with fever (101 rectal), no matter what…

A

they get a full work up and admission. Concerned for meningitis

ESP when no response to Tylenol and ibuprofen (10mg/kg)

39
Q

brain abscess vs. meningitis/encephalitis…

A

brain abscess often does not have a fever

40
Q

common causes of viral encephalitis and treatment

A

herpes simplex virus
arboviruses

treat with acyclovir

41
Q

Empiric treatment of meningitis/encephalitis

A

ceftriaxone (rocephin)

42
Q

risk factors of intracranial abscess includes…

A

endocarditis

congential heart disease

recent neurosurgery

inadequately treated subacute/chronic ear, nose, mastoid, dental infection

43
Q

Prions cause what three neurodegenerative brain diseases

A

Creutzfeldt-Jakob
Fatal Familial Insomnia
Kuru disease

44
Q

meningitis rash

A

purpuric rash that does not blanch

45
Q

Posturing of meningitis

A

decerebrate (more severe and deadly)

decorticate (turn inwards towards core)

46
Q

When you suspect ICP, perform ____ before an ___, due to prevention of ___.

A

When you suspect ICP, perform CT before an LP, due to prevention of brain herniation through relief of the ICP.

Check papilledema to see if there is swelling of optic disc - performed when you don’t have a CT. If present, NO LP!!

47
Q

Common risks of LP’s

A

Post procedure headache - prevented by hydration (2L of normal saline) & after the procedure, do not allow the patient to sit up - keep them flat for an hour. Then sit up at 30degrees for one more hour. Then sit upright for another hour.

48
Q

Acute inflammatory demyelinating polyradiculopathy

Considered an autoimmune disorder

A

Guillian-Barre Syndrome (GBS)

49
Q

Most cases of GBS are preceded by an infection following…

A

Viral or febrile illness
Campylobacter jejuni
Vaccinations
Surgery / Trauma

50
Q

Classic GBS generally preceded by viral prodromal sx’s, followed by acute / sub-acute ascending symmetric weakness or paralysis and loss of DTR’s

A

Guillian-Barre Syndrome (GBS)

51
Q

Does Guillian-Barre Syndrome (GBS) affect diaphragm?

A

Yes - requires intubation/mechanical ventilation

52
Q

When these conditions occur, consider GBS

A
  • HIV peripheral neuropathy
  • Neurotoxic fish/shellfish poisoning
  • Spinal cord compression/syndromes
  • Tick paralysis
  • Vitamin deficiencies
  • West Nile
53
Q

For GBS, the LP should show…

A

elevated protein and low cell counts

54
Q

Treatment for GBS

A

AIRWAY management

AVOID corticosteriods - may not be beneficial and can be harmful

55
Q

Acute peripheral facial (Facial, CN VII) nerve palsy

A

Bell’s palsy

56
Q

Bell’s palsy is difficult to dx due to resemblance of a…

A

stroke!

or Ramsay Hunt syndrome! (herpes zoster in the eye/CN 7 and 2)

57
Q

Bell’s palsy common risk factors include…

A

Recent fever, viral infection, tooth extraction, chilling episode from cold exposure

58
Q

Facial nerve paralysis associated with ipsilateral zoster
Vertigo and ipsilateral hearing loss (CN VII)
Tinnitus
Otalgia
Headaches
Fever
Cervical adenopathy

A

Ramsay Hunt Syndrome

Often times starts as blisters in the conchal bowl of the pinna

59
Q

Cardinal sign of bell’s palsy that helps to distinguish between stroke and Ramsay Hunt

A

unable to raise eyebrows and furrow the forehead

60
Q

If the patient can raise the eyebrow / wrinkle forehead

A

then it is NOT Bell’s Palsy!!

61
Q

If unable to close affected eye =

A

If unable to close affected eye = Bell’s palsy

62
Q

Difference b/w Bell’s Palsy and stroke…

A

Bell’s Palsy will not be able to wrinkle the forehead as all three divisions of the trigeminal nerve are affected.

63
Q

Coma state is a…

A

spectrum. Ranges from awake/confused to frank/dense state of unresponsiveness.

64
Q

Thiamine of coma cocktail

A

treats for alcohol intoxication

65
Q

Glucose of coma cocktail

A

treats for diabetics

66
Q

Narcan of coma cocktail

A

treats for opioid OD

67
Q

Oxygen of coma cocktail

A

treats for hypoxia

68
Q

Romazicon of coma cocktail

A

treats for benzos

69
Q

Common age-related causes of Altered Mental Status and Coma:

Infant

A

infection
trauma
abuse
metabolic

70
Q

Common age-related causes of Altered Mental Status and Coma:

Child

A

toxic ingestion

71
Q

Common age-related causes of Altered Mental Status and Coma:

Adolescent, young adult

A

toxic ingestion
recreational drug use
trauma

72
Q

Common age-related causes of Altered Mental Status and Coma:

elderly

A 
med changes
OTC meds
infection (check skin, lungs, urine)
alterations in living environment
stroke
trauma
73
Q

Post concussion syndrome treatment for headaches

A
  1. amitriptyline
  2. propranolol
  3. neurontin
74
Q

On CT, epidurals (arterial) are shaped like…

A

lemons

75
Q

On CT, subdurals (venous) are shaped like…

A

bananas

76
Q

Full comatose LOC followed by fully lucid interval with subsequent rapid neurological demise

A

epidural bleed

77
Q

Progressive drop in LOC is likely a ___ bleed

A

Subdural bleed

78
Q

Subdurals are common in…

A

elderly, alcoholics, children <2

Neurology (12 decks)

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