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Clinical: Emergency Medicine > Neurology > Flashcards

Neurology Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

what is thiamine used for

A

wernickes encephalopathy

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2
Q

What makes up the Glasgow Coma Scale?

A

Eye-opening
Verbal
Motor

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3
Q

a GCS of less than 9 is indivative of what?

A

coma

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4
Q

what is the presentation of Bells Palsy

A

sudden onset unilateral facial nerve paralysis with no other focal neurologic or systemic findings

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5
Q

what is the treatment of Bells palsy

A

prednisone
artificial tears
tape eyelid shut

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6
Q

how does encephalitis present

A

begins wtih flu-like symptoms
fever, HA, AMS, Seizure, personality changes and exanthema

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7
Q

how is encephalitis differentiated from meningitis

A

altered brain functioning

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8
Q

what is Reye’s syndrome

A

rapid progressive encephalopathy with hepatic dysfunction, usually post-flu/URI
babinski positive and hyperreflexia noted

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9
Q

what are diagnostic tests used for diagnosing reye’s syndrome

A

Liver enzymes (elevated)
PTT (elevated)
Hyperammonemia
hypoglycemia
metablic acidosis

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10
Q

how is encephalitis diagnosed

A

LP and MRI
PCR for virues
Kernig and Brudzinski is usually absent

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11
Q

what is the treatment of encephalitis

A

supportive care and acyclovir 10mg/kg IV Q8hrs

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12
Q

what is the treatment of status epilepticus

A

Benzo (lorazepam, diazepam, midazolam)
phenytoin/fosphenytoin
phenobarbital and lacosamide

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13
Q

what is the treatment of focal seizures

A

pheytoin and carbamazepine

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14
Q

what are diagnostic tests for seizure workup

A

check electrolytes
glucose
pregnancy test
ECG
EEG
neuroimaging for adults with first seizure (CT/MRI)

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15
Q

a 27yo mountain biker strikes a tree and was not wearing a helmet. he loses consciousness for several minutes but later regains consciousness and reports feeling fine. several hours later his neurological state decompensates acutely.
what is his most likely diagnosis

A

epidural hematoma

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16
Q

what is the treatment of epidural hematoma

A

surgical craniotomy / medical management of increased ICP (mannitol, hyperventilate, steroids/ventricular shunt)

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17
Q

what is the most common artery involved with epidural hematoma

A

middle meningeal artery - blood fills space between dura and skull

18
Q

what type of head injury occurs when there is injury to the bridging veins

A

subdural hematoma

19
Q

where does blood collect with subdural hematoma

A

between dura and arachnoid mater

20
Q

how is subdural hematoma diagnosed

A

non-con head CCT (crescent-shaped, concave hyperdesnisty)

21
Q

what is anterior cord syndrome

A

loss of pain/temperature below the level of the lesion preserved joint position/vibration

22
Q

what is central cord syndrome

A

loss of apin and temperature sensation at the level of the lesion, where spinothalamic fibers cross the cord with other modalities preserved (dissociated sensory loss)

23
Q

what is complete cord transection

A

rostral zone of spared sensory levels (reduced sensation cuadally, no sensation in levels below injury); urinary retention and bladder distention

24
Q

what is Brown-sequard syndrome

A

semisection of cord
loss of joint position and vibration sense on the same side as the lesion and pain/temp on opposite side as a few levels below the lesion

25
Q

what presents as ascending paralysis beginning in distal limbs

A

guillain-Barre syndrome

26
Q

how is guillain-barre syndrome diagnosed

A

lumbar puncture - elevated CSF protein with normal CSF WBC

27
Q

what is the treatment of GBS

A

plasma exchange (remove circulating antibodies) and IVIG

28
Q

what is the diagnostic test for stoke evaluation

A

emergent brain imaging essentail for ischemic stroke - non-contrast CT scanning
transcranial doppler US, echo for ischemic stroke

29
Q

what is the treatment of stroke

A

thromolysis, IV admin for rtPA for occlusive disease treat with IV tPA within 3-4.5 hours onset

30
Q

what is the diagnostic test for subaarachnoid hemorrhage

A

non-contrast head CT, LP (elevated opening pressure / grossly blod fluid in all 4 tubes)
Cerebral angiogrpahy may be done
EEG may show the site of hemorrhage/diffuse changes

31
Q

what is the treatment of subarachnoid hemorrhage

A

prevention of elevated arterial/intracranial pressure - manage HTN
surgial clipping/wrapping of aneurysm

32
Q

how are TIA diagnosed?

A

CT (without contrast)
MRI more sensitive
carotid doppler US
CT angiography
MR angiography

33
Q

what is the treament for TIA

A

aspirin + dipryidmole or clopidogreal monotherapy (antiplatelet therapy )

34
Q

how is alzheimers disease diagnosed

A

Folstein Mini-Mental state examination (NMSE) or memory impairment screen

35
Q

what are treatment options for alzheimers disease

A

cholinesterase inhibitors (donepazil)
NMDA antagonist (memantine)

36
Q

what is the classic triad of meningitis

A

fever > 38C, nucal rigidity (stiff neck) and headache
(no mental status change)

37
Q

what is Kernig sign

A

neck pain with knee extension

38
Q

what is brudzinski sign

A

leg raise with a bent neck

39
Q

how is meningitis diagnosed

A

lumbar puncture - first check for increased ICP (papiledema)
CT if unsure

40
Q

what is seen on LP with bacterial meningitis

A

increase protein
decreased glucose
marked increase in opening pressure

Clinical: Emergency Medicine (13 decks)

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