Neurology II Highlights Flashcards
TBI typically refers to moderate to severe head trauma leading to what?
Functional and structural dysfunction
Functional disturbance with preserved structure characterizes what?
Concussion
1) What type of injury is concussion?
2) What is it?
1) Mild TBI
2) Functional disturbance with preserved structure
Concussion is a head injury resulting in altered consciousness < ___________ hrs
< 6 hrs
Repeat neuro checks and rest are mainstays of treating what?
Concussion
What meds do you need to avoid post-concussion?
Avoid NSAIDs for 2-3 days (can worsen symptoms)
Avoid sedatives
Most adults fully recover from concussion by ____ weeks and kids within ___ weeks
2; 4
40 % of patients with concussion (but not necessarily LOC) will have lingering symptoms for how long?
Few weeks to years
True or false: a head CT would probably be normal with post concussion syndrome
True
How do you stratify the risks of pts with TBIs?
1) Low/Moderate: GCS = >15 (alert, fully oriented and following commands) and CT neg; may d/c home with close observation
2) Mod: GCS 9-14, CT findings do not require surgery; admit to ICU for close observation/neuro checks and repeat CT in 24 hrs
3) High: GCS <=8 serious head injury admit to ICU for neurosurgical consultation; stabilize patient, intubate; do not delay surgery as time is brain cells
When should you admit a pt with a TBI?
Intracranial bleed or skull fracture on CT, or:
1) Confusion, AMS
2) GSC <= 14
3) Focal neurologic deficits
4) Post traumatic seizure
5) Alcohol or drug intoxication
6) Significant comorbidities
-AFIB, etc
7) Unreliable living environment
Define apraxia
Disordered speech/fine motor skills typically; can’t button shirt, pick up pencil
True or false: ataxia is a Sx, not a disease
True
What typically involves the bilat hands and is brought about by intentional movements?
Essential tremor
Alcohol may alleviate what?
Essential tremor
Dopamine depletion is the pathophys of what?
(very emphasized in class)
Parkinson’s disease
What are some hallmark features of Parkinson’s?
1) Pill rolling tremor at rest –often unilateral, resolves with intentional movement
2) Cogwheel rigidity
Dopaminergic agents is the Tx for what?
Parkinson’s
List 2 medications that can Tx Parkinson’s, and what group of meds each is in
1) Levodopa-Carbidopa (Sinemet; dopamine agonist)
2) Benztropine Mesylate (anticholinergic (indirectly increases dopamine))
Chorea + dementia are characteristic of what?
Huntington’s disease
What condition usually begins prior to age 21 (usually <11) is more common in men, and is often assoc with ADHD and OCD?
Tourette’s
Dopamine hypersensitivity is likely the pathophys of what?
Tourette’s
What group of meds is contraindicated in Tourette’s?
Stimulants
Is restless leg syndrome (RLS) usually unilateral or bilateral?
Bilateral
True or false: RLS may be related to circadian rhythm
True
The Tx for Tardive Dyskinesia is immediate _____________ removal of offensive agent
gradual
15-50% of patients on antipsychotics may develop what?
Tardive Dyskinesia
True or false: Tardive Dyskinesia often causes permanent disability
True
Most common type of dementia in the elderly is what?
Alzheimer’s disease
Describe the pathophys of Alzheimer’s disease
1) Amyloid plaques, tau protein deposits, neuron tangles
2) APOE E3 gene
+Kernig and Brudzinski signs and G– diplococci are characteristic of what?
Neisseria meningitidis (Meningitis- meningococcal)
Lung, melanoma, breast are typically examples of what kind of tumors?
Metastatic
What is the most common benign tumor?
Meningiomas
Name a common cancer of the cerebral hemispheres
Gliomas; particularlyglioblastoma
Most glial cell tumors aremalignant; list 3
1) Astrocytoma
2) Ependymoma
3) Oligodendroglioma
What is the most common primary malignant brain tumor? (hint: has poor prognosis)
Astrocytomagrade four: Glioblastoma
True or false: most neoplasms are sporadic
True
Headache,nausea and vomiting, and seizures are the most common signs of what?
Increased IOP (secondary to brain tumor)
New onset seizure is a major Sx of what?
Brain tumor
Most common primary malignant brain tumor is what?
Astrocytoma/ tumors coming out of the glial/supportive cell tissue
MRI with gadolinium is preferred for what?
Intracranial and spinal neoplasms; neuroimaging
Characteristic appearance of _____________ on MRI is virtually diagnostic (typical site = coming from meninges)
meningiomas
What tumor is usually benign, grows very slowly on CN8, and can be diagnosed with MRI?
Schwannoma
Metastatic intracranial tumors:
1) What is the most common source?
2) What are some other sources?
1) Lung
2) Melanoma, breast, etc
(LaMB)
The most common sources of_____________ metastasis in adults are carcinomas from LaMB (Lung, Melanoma, Breast)
intracranial
List 5 brain tumor treatments
1) Shunting (for hydrocephalus)
2) Radiation and/or chemotherapy
3) Corticosteroids (for cerebral edema)
4) Anticonvulsants
5) Intramedullary cord lesions
