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emergency Medicine > neurosurgery > Flashcards

neurosurgery Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

What are the 3 main catagories involced with GSC

What does GCS stand for

What is the best GCS to have

A

Motor response
Verbal response
eye opening

Glascow Coma Scale

15

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2
Q

At what GCS do you intubate someone

A

less than 8

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3
Q

What is the initial intervention to those with a headache AFTER a bleed is ruled out

What if they are pregnant

A

Ketoralac

Tylenol & Reglan

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4
Q

What is the mortality associated with severe head trauma

A

40% in the first 48 hours

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5
Q

What is generally first line for seizure prophylaxis

A

Keppra
(Levetericitam)

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6
Q

What are the H bombs you want to avoid with head trauma

A

Hypotension
hypoxia
hypo/hypercarbia
hyper/hypoglycemia
hypo/hyperthermia

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7
Q

How is an epidural hemorrage described

A

Uncal herniation
-pt. had initial LOC followed by a lucid period and then rapid decline
-ipsilaterl CN3 palsey & contralateral hemiparesis

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8
Q

Who is most likely to get a subdural hematoma

A

Eldery

can cross suture lines

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9
Q

Where are aneurysms most likely located

A

Bifurcations (circle of willis)

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10
Q

What type of bleed indicates an LP

A

Subarachnoid

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11
Q

What bp needs to be maintained with a subarachnoid bleed

What is first line med to maintain BP

A

<140/80

Labetalol

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12
Q

When to image someone with a concussion (adults)

For kids?

A

those >65
>2 episodes of vomiting
Seizure
intoxication
Focal deficit
anticoagulated
basilar skull injury evidence
dangerous mechanism

PECARN

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13
Q

What defines increased ICP

A

> 22 for 5+ minutes

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14
Q

What is cushing triad

A

Irregular breathing
bradycardia
hypotension

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15
Q

What is the most common type of brain herniation

A

Uncal (transtentorial): temporal lobe compresses the upper brainstem

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16
Q

What is the first line treatment for those going through alcohol withdrawal and why

A

Phenobarbitol because they are at high risk for seizure

17
Q

What is FAST-ED and when is it used

A

Facial palsy
Arm weakness (look for arm drop)
speech changes
eye deviation
denial/neglect
*used for initial stroke eval before CT to get a baseline

18
Q

What cheif complaint gets a hints exam

What does it stand for

A

Dizziness

Head impulse, nystagmus, test of skew

19
Q

What does head impulse test check for

What if they have “dolls eye” result

A

Checks for central vs peripheral

Peripheral cause

20
Q

What does verticle nystagmus indicate

A

Wernickes encephalopathy

21
Q

Which type of vertigo will have a positive test of skew

A

Central vertigo

22
Q

What is status epilepticus

A

Siezure that lasts longer than 30 min (textbook answer)

Clinically if it lasts longer than 5 minutes or if the patient does not fully recover between seizures (real life)

23
Q

What is post ictal

A

A tired, fatigued, agitated, and Todd’s paralysis can be seen after a seizure

24
Q

What is the maximum number of times benzos can be given for a seizure

Which one?

How can it be delivered

A

benzodiazepines

Diazapine

IV, rectal, intranasal, IO

25
Q

At what BAC does alcohol withdrawal occur

A

IT DEPENDS

26
Q

What leads to hepatic encephalopathy

A

Ammonia buildup

27
Q

What is Asterixis

A

a clinical sign that describes the inability to maintain sustained posture with subsequent brief, shock-like, involuntary movements

28
Q

What causes SBP

What is SBP

A

when bacteria that normally live in the intestine enter the abdominal cavity and the ascites becomes infected.

Spontaneous bacterial peritonitis

29
Q

Why is lactulose helpful in those with alcohol withdrawal

A

Binds to ammonia

30
Q

What is the screening for alcohol withdrawal

A

CIWA

31
Q

What are the two main differences b/n MS and guillian-Barre

A

MS is central and effects oligodendrocytes

GB is a peripheral disease and effects the Schwann cells

32
Q
A

emergency Medicine (5 decks)

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