Neurological Emergencies Flashcards
What are the 5H’s to avoid in stroke management?
Hypoxia Hypovolemia Hyper/hypotension Hyper/hypothermia Hyper/hyponatremia/glycemia
What is the target MAP for acute stroke?
110-130
At what level of SBP, DBP and MAP should one start antihypertensive agents?
SBP >220
DBP >120
MAP >130
What is the golden period for IV rt-PA?
Arterial rt-PA?
IV 3h but benefit until 4.5h
IA 6h
What calcium channel blocker is given in SAH?
Nimodipine 60mg every 4h for 21 days
What is the affected part of the brain with the following kinds of respiration? Cheynes stokes Central hyperventilation Apneustic Ataxic
Cheynes stokes Bilateral cortex
Central hyperventilation Midbrain and upper pons
Apneustic Lower pons
Ataxic Medulla
In patients with increased ICP what is the target pCO2 to activate vasoconstriction?
pCO2 of 25-30mmHg
What is the recommended dosing for the following status epilepticus drugs? Diazepam Phenytoin Phenobarbital Valproic acid
Diazepam 5mg IV q5min x 4 doses
Phenytoin 20mg/kg 50mg/min
Phenobarbital 20mg/kg 100mg/min
Valproic acid 20mg/kg
What is the NORMAL CSF Protein Glucose Opening pressure WBC's
Protein 15-45mg/dl
Glucose 45-80mg/dl
Opening pressure 8-18cm H2O
WBC’s Less than or equal to 5
What empiric antibiotic is given in neonates to cover for Listeria?
Ampicillin 50mg/kg IV q6-8
In acute demyelinating polyneuropathy, what would the following diagnostics reveal?
CSF
EMG
CSF: Elevated protein and LESS THAN 10 WBC– ALBUMINO CYTOLOGIC DISSOCIATION
EMG: PROLONGED F waves
What classification of myasthenia:
- has Acute severe with bulbar and respiratory complications
- Ocular myasthenia only
- Class 3
2. Class 1
What diagnostic method has 90% Sn and 100% SPECIFICITY?
AChR antibodies
What is the MOA of Mestinon in the treatment of MG?
It is pyridostigmine an acetylcholinesterase inhibitor
