Neurology

Question 1

Explain what cushings triad represents and what is the triad?

Answer 1

it is the physiologic response to increased intracranial pressure and really soon brain herniation
HTN, bradycardia, and abnormal breathing patterns

Question 2

4 categories of intracranial hemorrhage?

Answer 2

epidural, subdural, subaracnoid, intracerebral

Question 3

what is the location of HA for subarachnoid and describe the HA?

Answer 3

occipital and thunderclap. worst HA of life

Question 4

What is the strongest risk factor for SAH?

Answer 4

family history

Question 5

Most SAH are due to the rupture of?

Answer 5

saccular aneurysms

Question 6

What is the most common etiology of spontaneous ICH.

Answer 6

Hypertensive vasculopathy

Question 7

two step diagnosis for SAH?

Answer 7

first CT. best in the first 6 hours. If there is a negative CT or after 6 hours, try LP. Looking for blood and xanthochromia. if either is positive, need some type of angiography

Question 8

What is the single most important part of the history when diagnosing stroke?

Answer 8

onset of symptoms. when were they last symptom free

Question 9

What is involved in a thorough neurological exam?

Answer 9

level of consciousness, cranial nerves, gait, cerebellar, and strength and sensation

Question 10

expected effect of ishemic stroke of ACA?
MCA?
PCA?

Answer 10

contralateral leg
contralateral face, arm and aphasia
visual

Question 11

What are the two time goals of diagnosis and treatment of stroke?

Answer 11

door to CT time less than 25 mninutes

door to medication less than 60 mins

Question 12

two options for treatment of ischemic strokes?

Answer 12

thrombolytic agents and mechanical thrombectomy

Question 13

What two vessels get thrombectomy?

Answer 13

internal carotid and middle cerebral

Question 14

triad of meningitis?

Answer 14

neck stiffness, fever and AMS

Question 15

What is the preferred diagnostic procedure in patients with suspected bacterial meningitis or encephalitis.

Answer 15

A prompt lumbar puncture (LP). need to get cultures. ct if you are thinking something increasing cranial pressure.

Question 16

Opening pressure, glucose, protein, and cell for bacterial meningitis?

Answer 16

up, down, up, WBCs and spoecifically neutrophils

Question 17

Opening pressure, glucose, protein, and cell for viral meningitis?

Answer 17

normal, normal, normal

Question 18

in neonates or immunocomproimised patients, what 3 meds to consider?

Answer 18

gentamicin, ampiccilin, cefotaxime

Question 19

What is the most common cause of primary seizure recurrence?

What is the most common cause of reactive seizure?

Answer 19

medical noncompliance

hypoglycemia

Question 20

All new onset seizure patients should get what imaging done?

Status epilepticus should also get what?

Answer 20

CT, MRI, and EEG\

LP

Question 21

first line for seizure now?
second line?
third line?

Answer 21

benzo, lorazepam, midazolam, and diazepam
phenytoin, fosphenytoin
pehnobarbital

Question 22

Some etiologies of seizure have specific treatments:
Eclampsia
Hyponatremia
Isoniazid
Hypoglycemia

Answer 22

Magnesium sulfate
Hypertonic saline
Pyridoxine
Dextrose