Neuro 2 Part 2

Front 1

Meningitis is an infection of what part of the brain

Back 1

subarachnoid space

Front 2

Encephalitis is an infection of the

Back 2

brain tissue

Front 3

what is Wernicke’s encephalopathy?
How do you Tx it?

Back 3

- Thiamine deficiency in the chronic alcoholic
- Presents also with ophthalmoplegia/ nystagmus, gait ataxia, & confusion

- Requires prompt thiamine replacement

Front 4

what is the Classic triad in Meningitis pts?

Back 4

Fever >104
Nuchal rigidity
Mental status change

Front 5

a Purpuric rash is most likely caused by what bacteria

Back 5

N. meningitidis

Front 6

Describe Kernig’s sign

Back 6

pt does not allow knee extension when hip is flexed

Front 7

Describe Brudzinski’s sign

Back 7

pt resists passive flexing of chin to chest, brings knees up in response

Front 8

how does the Lumbar puncture of a POS bacterial Meningites look

Back 8

Cloudy CSF, high protein, high lactate, low glucose, many WBCs

Front 9

what are the most prevelent types of bacterial meningitis

Back 9

S pneumoniae 47%
N meningitidis 25%
Strep agalactiae 12%

Front 10

What is the Tx for bacterial meningitis for Age 3 months to 50 years

Back 10

(Ceftriaxone or cefotaxime) plus vancomycin*

Front 11

What is the Tx for bacterial meningitis for

Back 11

Ampicillin plus ceftriaxone or ceftriaxone plus vancomycin*

Front 12

What is the Tx for bacterial meningitis for Impaired cellular immunity

Back 12

Ampicillin plus ceftazidime plus vancomycin*

Front 13

Bacterial meningitis is a medical emergency, the goal is to begin ABX therapy within _______of arrival to the ER!

Back 13

60 min

Front 14

what is the most common cause of fatal encephalitis in the US? How do you Tx?

Back 14

Herpes Viruses

Antiviral treatment must be started ASAP
acyclovir IV

Front 15

before LP -in a possible Encephalitis pt you should R/O

Back 15

- Elevated intracerebral pressure (ICP)
- Obstructive hydrocephalus
- Mass effect

Front 16

CSF analysis of an pt w/ Encephalitis should look like?

Back 16

Protein normal/↑ slightly, lymphocytes present, glucose usually normal

Front 17

The Three most common reversible causes of Dementia
are

Back 17

- Depression
- Hydrocephalus
- Alcohol dependence

Front 18

what is the biggest risk factor for Dementia

Back 18

- Increasing age
Prevalence increases over age of 50

Front 19

The 4 major subclasses of dementia are?

Back 19

-- Alzheimer’s: Aβ42
- Frontotemportal dementia: tau
- Lewy Body Dementia (DLB): Α-synuclein
- Prion disorders: PrP

Front 20

Most common cause of dementia in the US

Back 20

- Alzheimer’s Disease

Front 21

what is defined as Lack of awareness of cognitive deficits

Back 21

Anosognosia

Front 22

Changes in Alzheimer’s Disease begin _______ before diagnosis

Back 22

20 years

Front 23

What meds are used for the Tx of Alzheimer’s (catagories)

Back 23

Cholinesterase inhibitors
NMDA receptor antagonist

Front 24

Dementia arising from vascular insult is called

Back 24

Vascular Dementia
Aka Multi-infarct dementia

Front 25

An Abrupt onset with stepwise deterioration signifies what dz

Back 25

Vascular Dementia
Aka Multi-infarct dementia

Front 26

Class of dementia that comes on b/t 50-70 years and Characterized by early behavioral symptoms Associated with marked atrophy of temporal and frontal lobes

Back 26

Frontotemporal Dementia (FTD)

Front 27

Dementia syndrome characterized by Visual hallucinations,
Parkinsonian symptoms,
Fluctuating alertness & Falling

Back 27

Dementia with Lewy Bodies

Front 28

What is the Classic triad normal pressure hydrocephalus

Back 28

- Cognitive decline
- Urinary Incontinence
- Gait difficulty

Front 29

Sudden, recurrent, quick, coordinated movements.

Back 29

Tic
(Tourette’s syndrome)

Front 30

a Grade 1 Concussion intails

Back 30

- Transient confusion for less than 15 minutes
- No loss of consciousness
- May return to activities if cleared

Front 31

a Grade 2 Concussion intails

Back 31

- Transient confusion
- No loss of consciousness
- Symptoms last more than 15 minutes
- May return to activities in a week if no symptoms.
- Needs head CT or MRI and neuro exam if symptoms persist

Front 32

a Grade 3 Concussion intails

Back 32

- Any loss of consciousness
- Emergent CT/MRI and thorough neuro examination
- Must stay out of competition for one – two weeks

Front 33

MACE score <25, PCS symptoms present:

Back 33

re-evaluate in 24 hr or evac to higher echelon of care

Front 34

MACE = 26-27, PCS symptoms present:

Back 34

- manage locally but re-evaluate, including MACE
- If re-eval shows deterioration in sx/MACE score, evac to higher echelon of care

Front 35

MACE > 28, no PCS symptoms

Back 35

consider return to duty

Front 36

What are the S/S of Trigeminal Neuralgia and how is it Dx'd & Tx'd

Back 36

***Excruciating “lancinating” pain on ONE SIDE OF THE FACE*** Unilaterally over lower 2/3 of face
- Exam, CT, MRI, arteriography normal
- Spontaneous recovery; also carbemazepine, phenytoin, baclofen.

Front 37

What are the S/S of Glossopharyngeal Neuralgia and how is it Dx'd & Tx'd

Back 37

- Similar to trigeminal neuralgia
- Paroxysmal, burning/aching discomfort in the oropharynx/base of the tongue/tonsillar pillars, or auditory meatus.
- Diagnosis made by hx and reproduction of pain
- Tx with carbamazepine (Tegretol)

Front 38

Constant, dull ache, worse with head movement
May worsen over few weeks with gradual improvement Nausea, vomiting common
what is it and how is it Tx'd

Back 38

Post-traumatic Headache

- Simple analgesics.
mitriptyline, propanolol, or ergot derivatives for pain refractory to analgesics.
- Encouragement

Front 39

Sinusitis, Dental, Depression, Glaucoma are what type of H/A

Back 39

Non-neurological