Peer 8 - nervous system disorders Flashcards
what age group is status epilepticus common in?
extremes of age
tx of status epilepticus
benzodiazepines and phenytoin
2nd line: phenobarb, valproic acid, infusions of benzos and pentobarb or propofol
3rd line aggressive cooling, protecting airway, paralyzing the patient
most common type of migraine?
migraine without aura
most common type of primary headache?
tension headache
tx of cluster headaches?
sumatriptan or high flow oxygen
tx of myasthenic crisis?
close airway monitoring
sx of myasthenic crisis?
respiratory failure requiring mechanical ventilation, can be triggered by infection, fever, or stress
tx of epidural cord compression?
steroids and consult with rad onc if caused by malignancy
age for simple febrile seizure?
6 mo to 5 years
type of seizure in simple febrile seizure?
duration less than 15 minutes, generalized non focal, single episode
best predictor of respiratory failure?
negative inspiratory force less than 30
second best predictor of respiratory failure?
forced vital capacity less than 20
SBP for ICH?
180
tx of HTN with ICH?
nitroprusside or labetalol or nicardipine (best)
tx of dystonic reactions or akathisia?
antimuscarinic agent: diphenhydramine or benztropine
score system for stroke prediction after TIA?
ABCD, 5-6 pts bad
A - age 60 or older 1 pt
B - SBP >140 or DBP > 90 1 pt
C - clinical features of unilateral weakness 2pt or speech disturbance without weakness 1pt
D - duration of sx 10-59 minutes 1pt > 60 min 2pt
most common cause of bilateral facial nerve palsy?
lyme disease from borrelia burgdorferi
what should be started in patient with SAH?
nimodipine 60 mg orally q6 hours to reduce incidence of vasospasm
cause of death in advanced parkinson disease?
respiratory failure
work up of possible shunt malfunction and infection?
ct head, shunt series, shunt tap
criteria for tPA administration?
inclusion: age >18 sx onset less than 180 minutes, BP less than 185/110, stroke scale lower than 20
exclusion: evidence of ICH on non con CT, minor or rapidly resolving stroke sx, high suspician of SAH, active internal bleeidng past 21 days, platelet less than 100000 or recent heparin in 48 hours or anticoag, head sx within 3 months, 14 days of major surgery, art puncture, LP within 7 days, seizure at stroke onset, AMI
abx choice for epidural abscess?
cefepime and vanc
brain abscess tx?
if herniated can use corticosteroids, hyperventilation, administration of mannitol