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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.
Conntinuous vomiting
Blurred vision
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
Staphlococcal meningitis
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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