Neurology Flashcards
Explain what cushings triad represents and what is the triad?
it is the physiologic response to increased intracranial pressure and really soon brain herniation
HTN, bradycardia, and abnormal breathing patterns
4 categories of intracranial hemorrhage?
epidural, subdural, subaracnoid, intracerebral
what is the location of HA for subarachnoid and describe the HA?
occipital and thunderclap. worst HA of life
What is the strongest risk factor for SAH?
family history
Most SAH are due to the rupture of?
saccular aneurysms
What is the most common etiology of spontaneous ICH.
Hypertensive vasculopathy
two step diagnosis for SAH?
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
What is the single most important part of the history when diagnosing stroke?
onset of symptoms. when were they last symptom free
What is involved in a thorough neurological exam?
level of consciousness, cranial nerves, gait, cerebellar, and strength and sensation
expected effect of ishemic stroke of ACA?
MCA?
PCA?
contralateral leg
contralateral face, arm and aphasia
visual
What are the two time goals of diagnosis and treatment of stroke?
door to CT time less than 25 mninutes
door to medication less than 60 mins
two options for treatment of ischemic strokes?
thrombolytic agents and mechanical thrombectomy
What two vessels get thrombectomy?
internal carotid and middle cerebral
triad of meningitis?
neck stiffness, fever and AMS
What is the preferred diagnostic procedure in patients with suspected bacterial meningitis or encephalitis.
A prompt lumbar puncture (LP). need to get cultures. ct if you are thinking something increasing cranial pressure.
Opening pressure, glucose, protein, and cell for bacterial meningitis?
up, down, up, WBCs and spoecifically neutrophils
Opening pressure, glucose, protein, and cell for viral meningitis?
normal, normal, normal
in neonates or immunocomproimised patients, what 3 meds to consider?
gentamicin, ampiccilin, cefotaxime
What is the most common cause of primary seizure recurrence?
What is the most common cause of reactive seizure?
medical noncompliance
hypoglycemia
All new onset seizure patients should get what imaging done?
Status epilepticus should also get what?
CT, MRI, and EEG\
LP
first line for seizure now?
second line?
third line?
benzo, lorazepam, midazolam, and diazepam
phenytoin, fosphenytoin
pehnobarbital
Some etiologies of seizure have specific treatments: Eclampsia Hyponatremia Isoniazid Hypoglycemia
Magnesium sulfate
Hypertonic saline
Pyridoxine
Dextrose
