Neurology for primary Care Flashcards
A CSF lab result of glucose of 35 is indicative of
CSF infection
Of the 4 types of stroke which one is the most common and has a gradual onset?
Thrombotic
Leading cause of bacterial meningitis ?
Streptococcus pneumonia
What is the first sign of Parkinson’s disease
Rest tremor
Which test is specific of Myasthenia Gravis
Serum acetic hotline receptor antibody
Types of stokes
Ischemic
Hemorrhagic
Cardiac sources for an emboli
A fib
Mitral valve disease
Post Mi thrombi
Atrial defects
Client has a trike what is done first when presenting to the ER.
No contrast CT ECG CBC Cardiac Enzymes and troponin PT and INR PTT O2 Lipid profile
What are stroke treatments to decrease the brain tissue infarction
IV thrombolitics
Neuroprotection: hypothermia
Antithrombic treatment
Medical support and rehab
Cerebral sculpt sources for Emboli
Ulcerated plaque from a cerebral artery Atherosclerosis near the carotid artery Hypotension Sickle cell Polycythemia
What Is contralateral homonymous hemianopsia:
Loss of half of the vision on the same side in both eyes.
Seen in a stroke and tram attic head injury.
Which drug used for Parkinsonism mimics dopamine?
Bromocriptine
Ways to prevent a stroke
Statin Therapy
Antiplatelet therapy
ASA 325
Warfarin in selected pts.
Define hemianopsia
Decrease vision in half the visual field.
What is the most sensitive indicator of Increased intracranial pressure and the first symptom to change as pressure rises.
Altered mental status
Which type of meningitis is a benign, self limited syndrome caused primary by viruses?
Aseptic
Which prognosis is better a cerebral infarct or subarachnoid hemorrhage.
Infarct
Define cry of which nutritional source leads to paresthesias of the hands and feet that are usually painful?
B12
Infarct stroke is
Thrombotic
Embolic
LOC with a cerebral infarct is predictive of what?
Poorer prognosis
What are the parts of the Stroke Scale
Facial droop
Arm drift
Speech
A client that is 52 and presents with rapidly progressive weakness of her legs that is moving up her trunk. Has absent reflexes and no sensory changes
What do you suspect?
Guillain- Barre syndrome
Two type of stroke
Thrombotic
Embolic
Risk Factors for Stroke
HTN, Hx of TIA, carotid stenosis, cardiac disease, DM, dyslipidemia, smoking,hypercoaguable states.
Main the treatment for a stroke is to do what?
Decrease or reverse the amount of brain tissue infarction.
What are some of the hypercoagulable disorders to test for when a person has a stroke.
Factor V Leiden
Protein C, S,
Antithrobim
Prothrombin gene mutations
Which following cardiac drugs is used to treat Migraine H/A
Beta Blockers
Hypercoagualble states that can lead to a emboli
Oral contraceptives
Protein C,S deficiency
Antithrombin III
TTP
Major signs and symptoms of a stroke?
Hemiparesis and sensory loss Hemineglect Expressive or receptive aphasia Dysarthria Contra lateral homonymous hemianopsia
Stroke is gradual or abrupt?
About
What are a differential diagnosis for a stroke
Hypoglycemia
TIA
Mass lesion
Intercept rail hemorrhage
What are some s/s that can lead to a stroke diagnosis
Sudden onset of a neurological onset
HX of high B/P, valvular heart disease, athrosclerosis
Dissenting neuro signs related to region of the brain involved.
You place a key in a persons hand and have them close their eyes and identify the object is called.
Stereo gnosis
Define agraphesthesia:
Inability to recognize writing on the skin.
Should you give a CT of the head in a suspected stroke before you give ASA
Yes
Goals of neuro imaging
Evidence of vascular origin
Alternative non ischemic sign
Underlying vascular mechanism hat allows for selection of best therapy.
Prognostic outcomes
Mess that lower seizure threshold
Quinolone so Cephalosporins Antipsychotics Wellbutrin TCAs Fentanyl/Demerol Cocaine Amphetamines Theophylline
