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110 Cards in this Set
- Front
- Back
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ENC=encephalitis
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ENC
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ENC - def
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infection of the brain parenchyma
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ENC - etiology
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typically viral
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ENC - peak
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late summer
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ENC - clin man stage 1
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fever
malaise GI respiratory sx rash |
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ENC - clin man stage 2
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HA
photophobia stiff neck |
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ENC - clin man stage 3
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seizures
LOC |
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ENC - dx tests
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CT
CSF |
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ENC - CSF finding
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WBC > 50, mostly mononuclear leukocytes
gram stain negative normal glucose protein > 100 CRP nml |
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ENC - tx
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sx control
recovery 1-2 weeks |
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ENC - prognosis
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varies with cause
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ENC - herpes tx
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acyclovir
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MEN=meningitis
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MEN
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MEN - def
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inflammation of the arachnoid, pia matter, and CSF
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MEN - meningococcal meningtitis
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noted in crowded conditions
only etiology subject to outbreak |
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MEN - pneumococcal meningitis
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patients with acute otitis media and pneumonia
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MEN - staph aureus
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complication of a neurosurgical procedure
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MEN - clin man
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acute onset fever
HA vomiting stiff neck |
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MEN - neuro finding
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cranial nerves 3,4,6,7
seizures brain swelling papilledema - rare |
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MEN - signs
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brudzinski
kernig petechial or purpuric rash |
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MEN - CSF findings
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gram stain
WBC > 100 glucose < 40 protein >100 lactic acid and CRP elevated |
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MEN - complications
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hydrocephalus
deafness seizures palsies |
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MEN - kernig
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inability to extend the knee when the thigh is flexed, d/t hamstring shortening
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MEN - brudzinski sign
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hips and knees flex when neck is flexed
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MEN - nuchal rigidity
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pain with flexion of neck
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ALZ=alzheimer's
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ALZ
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ALZ - def
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progressive dementia with insidious onset and characterized by atrophy of the cerebral cortex
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ALZ - inc
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female 2:1
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ALZ - progression
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10 years from onset to death
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ALZ - early stage
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memory loss
word finding problems visuospatial disturbances (loss in familiar place) |
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ALZ - intermediate stage
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aphasia, apraxia, and behavioral problems
sleep/wake disturbances wander get lost |
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ALZ - terminal stage
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further cognitive decline
recent and remote memory lost unable to swallow or eat |
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ALZ - dx
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autopsy only
neurofibrillary tangles senile plaques |
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ALZ - tx delusions
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risperidone
avoid haloperidol |
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ALZ - tx agitation
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trazodone
avoid anticholinergics |
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ALZ - other helpful meds
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actylcholinesterase inhibitors
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GBS - def
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immune mediated acute or sub acute radiculoneuropathy
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GBS - progression
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ground to brain
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GBS - clin man
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ataxia and tingling in feet
weakness in legs DTR loss early |
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GBS - dx
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history
incr total protein in spinal fluid EMG consistent with myelinization |
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GBS - hospitalization bc
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respiratory involvement
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GBS - tx
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plasapheresis and high dose human IG
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ALZ - elderly most common cause of
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dementia
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ALZ - elderly first sign
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short term memory loss
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ALZ - elderly MMSE
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decline of 3-4 points on MMSE common
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ALZ - elderly decline blamed on
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loss of cholinergic neurons
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ALZ - elderly comorbidiy
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depression
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ALZ - elderly sleep
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sleep disturbances, sundowning common
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ALZ - elderly onset < 65
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rare, but strongly genetic
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ALZ - elderly memory impairment 3 characteristics
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new information acquisition impaired
short term memory absent even with cues previously well learned material is eventually lost |
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ALZ - elderly other characteristics (3 A's)
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aphasia
apraxia agnosia executive function |
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DEM=dementia
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DEM
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DEM - def
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acquired decline win memory and cognate functions
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DEM - characteristics
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inability to retain new information
language problems visuospatial probs - lost in familiar places loss of executive fx gait disorders and falls mood changes drives changes (sleep/food) |
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DEM - reversible causes (6)
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B12
ETOH opiates thiamine brain tumor HTN |
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DEM - 3 forms of evaluation
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ADLs/IADLs
MMSE Geriatric Depression scale |
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DEM - v. depression
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depression related has
acute onset pt is distressed by memory lost lack of effot in cognitive performance memories accessible with hints |
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DEM - tx
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cholinesterase inhibitors
NMDAs preventative |
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DEM - cholinesterase inhibitors
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donepezil
rivastigmine galantamine |
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DEM - NMDAs
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memantine
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DEM - preventative measures
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vitamin e
vascular protection |
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MS - def
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immune initiate demyelinization and axonal injury
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MS - loc
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temperate zones
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MS - onset
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20-50 yo
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MS - clin man
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weakness, tinglin in a limb
diplopia, monocular vision loss, blurry vision spasticity in upper extremities |
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MS - visual disturbances due
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optic neuritis
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MS - lhermitte's sign
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electrical feeling with passive flexion of neck
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MS - 3 paths
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relapsing remitting
secondary and primary progressive progressive relapsing |
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MS - CSF
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discrete oligoclonal bands
normal or elevated protein |
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MS - MRI
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multifocal, hyperintense lesions in the brain
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MS - dx
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CSF
MRI clinical |
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MS - tx
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symptomatic only
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MS - tx spasticity
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diazepam
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MS - tx fatigue
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amantadine
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MS - tx depression
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SSRI
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MS - role of corticosteroids
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helpful in relapse
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MS - progression can be slowed with
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interferon therapy
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SD=seizure disorders
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SD
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SD - def
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sudden excessive disorderly discharge of cerebral neurons that result in abnormal movements or perceptions that are of short duration
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SD - partial loc
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one locus in brain
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SD - partial clin man
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no loc
abnormal activity of one limb |
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SD - partial may be followed by
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tod's paralysis (focal weakness of part of a body after a partial seizure)
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SD - partial onset
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any age
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SD - partial tx
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carbamazepine
phenytoin |
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SD - partial complex def
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start in one locus, but spread through entire brain
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SD - partial complex mental sx
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sensory hallucinations
mental distortion loc |
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SD - partial complex tx
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carbemazapine
phenytoin lamictal |
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SD - partial complex movement
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lip smacking
chewing movements |
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SD - generalized progression
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loc
tonic (stiffening) clonic (rhythmic jerking) post ictal |
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SD - generalized common finding
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urinary incontinence
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SD - generalized tx
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carbemazepine
lamictal phenytoin |
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SD - absence def
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brief, abrupy, self limiting loc with no post ictal state
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SD - absence movements
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stare
rapid eye blinking |
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SD - absence tx
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lamictal
ethosuximide |
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SD - myoclonic
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short periods of muscle contraction
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SD - myoclonic loc?
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none
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SD - myoclonic tx
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valproic acid
diazepam |
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SD - febrile def
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generalized tonic clonic accompanied by high fever
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SD - febrile onset
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6 months to 4 years
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SD - physical exam
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generally normal
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SD - dx imaging
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EEG
MRI to r/o other causes |
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SD - tx
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no cure, but control
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SD - 5 year remission rate
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70%
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SD - special considerations
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driving precautions
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SD - status epilepticus def
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seizure lasting more than 90 minutes or several seizures without return of consciousness
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SD - status epileptics most common cause
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subtherapeutic drugs
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SD - status epilepticus dx tests
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eeg
must r/o other causes |
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SD - status epilepticus tx
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thiamine and glucose
diazepam phenytoin REPEAT |
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SD - status epilepticus when to intubate
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after 30 minutes
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epilepsy - def
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neuro disorder diagnosed after 2 seizures of unknown origin
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