Neurological Disorders Flashcards
Which cranial nerve controls pupillary constriction?
CN III (oculomotor)
What is cranial nerve I?
Olfactory
What is cranial nerve II?
Optic
Which cranial nerve controls down and inward eye movement?
IV (trochlear)
Which cranial nerve controls tongue movement?
XII (hypoglossal)
Which cranial nerve controls shrugging the shoulders?
XI (spinal accessory)
Which cranial nerve controls hearing?
VIII (acoustic)
Which cranial nerve controls the gag reflex?
IX (glossopharyngeal)
Which cranial nerve controls eye movement to the side?
VI (abducens)
Which cranial nerve controls muscles of mastication?
V (trigeminal)
Which cranial nerve controls puffing out the cheeks?
VII (facial)
A score of what or higher on the mini mental status exam indicates no cognitive impairment?
24 or above
What % of strokes are ischemic?
80%
What two kinds of vision changes classically occur in TIA?
Ipsilateral monocular blindness; homonymous hemianopia
On what side will vision changes be during stroke?
Ipsilateral (same) side
On what side will motor changes be during stroke?
Contralateral side
What two drugs are most important in management of TIA?
Aspirin and clopidogrel
When is a carotid endarterectomy indicated?
For greater than 70-80% stenosis with symptoms
Speech is normally impaired with a stroke in which hemisphere?
Left
Spatial disorientation is seen with stroke in which hemisphere?
Right
What is the latest you can give thrombolytics in stoke?
4.5 hours from sx onset
What two categories of pts have an indication for ICP monitoring?
Severe head injury with GCS of 8 + abnormal CT; severe head injury with GCS of 8 + normal with CT scan with any 2 of the following: age >40, BP <90, abnormal motor posturing
MAP should be maintained at what in stroke?
110-130
Why is MAP maintained at 110-130 in stroke?
To prevent cerebral vasospasm
What is the formula for CPP?
MAP-ICP
What type of drug is nimodipine?
Calcium channel antagonist
What does nimodipine do in stroke?
Counters vasospasm
What type of seizure has no LOC?
Simple partial
What is the main difference between a simple partial seizure and a complex partial seizure?
A complex partial seizure has an impaired LOC
What is an absence seizure?
Sudden arrest of motor activity with a blank stare
Antispasmodics and interferon therapy are used to treat what neuro disorder?
Multiple sclerosis
What kind of paralysis does Guillan Barre cause?
Progressive symmetrical ascending paralysis
What two signs may be seen in meningitis?
Kernig’s sign and Brudzinski’s sign
What is Kernig’s sign?
Pain and spasm of the hamstring muscles
What is Brudzinski’s sign?
Legs flex at hips and knees in response to flexion of the head and the neck to the chest
What happens to protein and glucose in bacterial meningitis?
Protein will be elevated and glucose will be decreased
How to treat meningitis in a pt under 50 years old?
Vancomycin plus ceftriaxone
How to treat meningitis in a pt over 50 years old?
Vancomycin plus ceftriaxone plus ampicillin
What kind of bleed is characterized by a lucid interval?
Epidural hematoma
What are the three components of Cushing’s triad?
Widening pulse pressure, decreased respiratory rate, decreased HR
If a pt has a cervical spinal cord injury they will be what?
Tetraplegic/quadraplegic
If a pt has a thoracic spinal cord injury they will be what?
Paraplegic
A major complication of spinal cord injury at C4 or above may be what?
Respiratory compromise
Injury at T4-T6 may lead to what complication?
Autonomic dysreflexia
What is Brown Sequard Syndrome caused by?
Damage to one half of the spinal cord
Which spinal cord injury causes same-sided motor neuron paralysis and loss of proprioception and opposite sided loss of pain and temperature?
Brown Sequard Syndrome
How is Brown Sequard Syndrome managed?
Steroids
How is Cauda Equina managed?
MRI, surgery and steroids
Neurogenic shock may happen with an injury at what level or above?
T6
What is Parkinson’s caused by?
Dopamine deficiency
Pts with Parkinson’s will have what trio of symptoms?
Tremor, rigidity and bradykinesia
Pramipexole, ropinirole, and rotigotine are all what class of drug, used in the management of what?
Dopamine agonists, used in Parkinson’s
Selegiline, rasagiline, and safinamide are all what class of drug, used in the management of what?
MAO-B inhibitors, used in Parkinson’s
Alzheimer’s disease is characterized by memory impairment AND one of what 4 things?
Aphasia, apraxia (inability to perform previously learned task), agnosia (inability to recognize an object) or inability to plan
What is apraxia?
Inability to perform previously learned task
What is agnosia?
Inability to recognize an object
Cholinesterase inhibitors are used to treat what?
Alzheimer’s
Donepazil, galantamine, and rivastigmine are what class of med?
Cholinesterase inhibitors
Memantine is used to treat what?
Alzheimer’s
Which drug is used to treat all stages of Alzheimer’s?
Donepazil
What is the CAGE mnemonic for alcohol use disorder?
Have you ever felt the need to Cut down on drinking; have people Annoyed you by criticizing your drinking; have you ever felt Guilty about your drinking; have you ever had a drink first thing in the AM to steady your nerves (eye opener)
What happens to pain tolerance in older adults?
Increases
