Glossary of MDT 15.10 Neurology Test 1
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- What term means a brain injury that does not result in neurological change?
- How long should a pt. be observed in a suspected concussion?
- Wake every 2 hours for 24 hours
- In the TX of a concussion, what should not be given or taken for the first 48 hours?
Pain relievers (other than tylenol)
- In a pt with a suspected concussion with the following sx what is the disposition?
Difficulty waking pt.
- What could be the result of a hematoma from a tear in veins from the cortex to the superior sagittal sinus or cerebral laceration?
- Subdural Hematoma
- Thrombotic or embolic occlusion of a major blood vessel leads to what?
- cerebral infarction
- What may be of value in limiting or arresting further deterioration in Cerebral thrombosis?
- In cerebral thrombosis what is always evaluated in a exam
- Heart and subclavian and carotid vessels for bruits
- What can be prescribed to reduce vasogenic cerebral edema?
- What are 2 physical findings of a skull fx?
- crepitation and battle signs
- All penetrating trauma of the skull must be classified as what type of skull fx?
- Open Skull Fx
- What is the TX for an open skull FX?
- Hospitalize the pt. for debridement and closure in an operating room.
- What can result from cervical hyperflexion injuries?
- Anterior Cervical cord syndrome
- A pt that has had cervical hyperflexion, and has now lost motor function, temperature and pain sensation could be DX with what?
- Anterior Cervical cord syndrome
- What is the only thing affected by concussion?
- Between 5-10% of strokes are due to what?
- Subarachnoid hemorrhage
- What hemmorrhage has a sudden H/A never before expiernced by a pt. with increasing severity?
- Subarachnoid Hemorrhage
- Which hemmorrhage has a sudden h/a with inreasing severity that may be followed by n/v and loss or impairment of consciousness?
- Subarachnoid hemmorrhage
- What is an increased collection of CSF in the subdural space?
- Subdural Hygroma
- What is the most common cause of Subdural hygroma?
- Cranial trauma with tearing of arachnoid space.
- What is a important caution of Dx traumatic intracerbral hemmorrhage?
- Do not misdiagnose with ETOH or drug cause
- What hemmorrhage includes small reactive pupils with conjugate gaze deviation away from lesion, perserved vertical eye movement, and an ipsilateral peripheral facial palsy in some cases?
- Traumatic intracerebral hemmorrhage
- What may result from whip lash, or Fx/ dislocation causing compression or angular deformity of the cord in the c-spine or lower t-spine or upper l-spine?
- Central cervical cord syndrome
- What has been shown to improve neurological recovery in central cervical cord syndrome?
- Early high doses of Corticosteroids
- What is the sig for Methylprednisolone in Central cervical cord syndrome?
- 30mg/kg by IV bolus followed by 5.4mg/kg/h for 23hrs
- Which meningitis has increased in recent years and is the most common cause in epidemic disease in the U.S.?
- Group C Meningcoccus
- What are the S/S of Meningitis?
- Increased fever
- What is the antibiotic of choice in the TX of meningitis?
- Aqueous Pen G 24mu/24hrs in devided doses q4h
- In Tx meningitis by IV how long should the pt. be TX.
- Till afebrile for 5 days
- What is the disposition of a pt with meningitis?
MEDEVAC for further eval.
Rifampin for crew
- Which meningitis lacks a rash but, focal neurological deficits, cranial nerve palsies, and obtundation are more prominent?
- Pneumococcal meningitis
- What is an important lab finding in pneumococcal meningitis?
- CSF has 1000 WBC per ML, over 60% are polymorphonuclear leukocytes
- What is the most common cause of Pneumococcal meningitis in adults, and the 2nd in children over the age of 6?
- Strep pneumoniae
- How is meningococcal meningitis trasnmitted?
- By respiratory droplets
- Which meningitis has charateristics of fever, vomiting, irritability, convulsions, a high pitched cry, and a bulging or tight fontanelle, stiff neck may be absent?
- Streptococcal meningitis
- What produces disturbances of the sensorium, seizures, CSF may show lymphocytes?
- What is the RX for enchepalitis?
- Acyclovir 10mg/kg IV q8h x 10 days
- Acyclovir can cause what abnormalities?
- Liver function
Bone marrow suppression
Transient renal faliure
- To avoid nephrotoxicty how should acyclovir be given?
- Slowly over 1 hour
- What meningitis may have seizures and cranial neuropathies presents, dehydration is common and may lead to Waterhouse- Friderichsen syndrome, especially in meningococcal septicemoia?
- Influenza menningitis
- What can appear after a penetrating head trauma as a part of a mixed infection?
- Staphylococcal meningitis
- What can follow a viral infection and starts with sudden local back pain then sensory symptoms and motor weakness ascending from the feet
- What is characterized by focal ischemic cerebral neurological deficits that last for less than 24 hours?
- Transient ischemic attack
usually last less than 1-2 hours
- What is an important cause of a transient ischemic attack?
- What would explain seperate attacks and affects of a transient ischemic attack on different parts of the body?
- Embolic phenomenon
- Describe the progression of an transient ischemic attack?
- Abrupt onset without warning recovery occurs rapidly, often within a few minutess
- Where are most cerebral aneurysm located?
- Anterior part of Circle of Willis
- What is the 3rd leading cause of death in the USA?
- What are the 2 subdivisions of stroke?
- Occlusion of the posterior cerebral artery may lead to what?
- Thalamic syndrome
- What is thalamic syndrome?
- A contralateral hemisensory disturbance, followed by the development of spontaneous pain and hyperpathia
- What has been perscribed to reduce vasogenic cerebral edema?
- Anticoagulants drugs have no role in a completed stroke unless what?
- There is a cardiac source of embolism
- In which H\A syndrome do pt.'s complain of poor concentration, and constant daily headaches that are vise like?
- Tension Headache
- What med is for aborting migraines and is given SQ?
- Sumatriptan (Imitrix)
- How long do cough headaches last?
- Few minutes or less
- Which H/A is worse on arising in the morning and may be the focus of a somatic delusional system.
- Deppression H/A
- Which H/A is associated with Horner's syndrome?
- Cluster H/A
- What is Butorphanol tartrate
- A synthetic opiod agonist-antagonist
- What may occur in post traumatic H/A and is often enhanced by postural changes or head movement?
- Disequilibrium sometimes with rotary component
- Waht is it called when a pt. has further convulsions without recovery of consciousness between seizures?
- Status epilepticus
- What is the sig for Ethosuximide in a Petit Mal seizure?
- Ethosuximide 100-1500mg po bid
- What is the sig for Clonazepam in myclonic seizures?
- Clonazepam .04-.2mg/kg po bid
- What would be the location of a tumor that leads to progressive intellectual decline, slowing of mental activity, personality changes, and contralateral grasp reflexes?
- Frontal lobe lesion
- Which lesion has sensory loss that involves postural sensibility and tactile discriminaton, and asterognosis?
- Pariatal lobe lesion
- What is Gerstmann's syndrome?
- A combination of alexia, agraphia, acalculia, right and left confusion and finger agnosia
- What lesion leads to depersonalization, emotional changes, behavior disturbances?
- Temporal lobe lesions
- What may lead to dysomnia and receptive aphasia?
- Left sided temporal lesions
- What lesion will cause loss of color perception, and prosopagnosia?
- Occipital lobe lesion
- What is the term for denial of blindness?
- Anton's syndrome
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