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29 Cards in this Set
- Front
- Back
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How long does ICP need to be significantly elevated before papilledema develops?
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>3 days
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What does papilledema suggest?
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-Intracranial mass
-Pseudotumor cerebri |
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What does an acute headache with papilledema suggest?
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Superimposed event ie bleed
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What should you do for a patient with a subarachnoid hemorrhage?
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Transfer to ICU and keep the SBP <165
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What is comatose?
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A change in level of consciousness
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What is awake?
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Able to maintain wakefulness without any stimulation
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What is sleepy?
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arousable but tending to fall asleep after a short period w/o stimulation
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What is stupor?
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arousable but unable to maintain wakefulness w/o continuous stimulation
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What is coma?
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Unarousable with ANY stimulation
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What is indicated by diminished level of consciousness?
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A lesion in the Reticular Activating System
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What are 2 classes of coma?
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-Metabolic
-Structural |
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What type of lesion does it require to cause coma?
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Bilateral
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What are 5 causes of Metabolic coma?
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GOT ME
Glucose deficiency Oxygen deficiency Thiamine deficiency Med overdose Infection Low Blood pressure Calcium/Sodium imbalance Narcotics/anticholinergics Uremia Toxins |
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What should you order to investigate for structural coma?
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CT OF for hemorrhage
EEG for status epilepticus MRI for stroke |
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Where does word fluency take place?
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Broca's
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Where does language comprehension take place?
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Wernicke's area
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Where does repetition of auditory words and phrases occur?
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Arcuate fasciculus
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What do ACA strokes lead to?
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Leg weakness
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What do MCA strokes lead to?
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Face and Arm weakness
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What is the timeframe for using tPA post AIS?
-IV -Intra-arterial |
IV - within 3 hrs of onset, or 4.5 if in posterior circulation
IA - within 6 hrs of onset |
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What are 5 reasons a person with a significant PMH would not be eligible for IV tPA?
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-Arterial puncture in last 7d
-Major surgery in last 14d -GI/GU bleed in last 21d -Stroke/hemorrhage in last 3mo -ICH ever |
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What are 5 things at presentation that would disclude a pt from being eligible for pTA?
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-Abnormal CT of Head
-PT >15 or PTT that's abnl -Plt <100,000 BP >185/110 Gluc <50 or >400 |
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What do you do when you find a patient has an acute stroke?
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Transfer to ICU
Keep SBP <165 |
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Does a normal CTOF exclude acute stroke?
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NO
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When should you lower the BP after an acute stroke?
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Only if SBP is >220
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What should you use to lower bp after stroke?
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labetalol
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What meds should you give for status epilepticus?
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-Ativan 2-4mg IV
-Fosphenytoin 20mg/kg |
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What is status epilepticus defined as?
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1 seizure lasting >10m
OR Recurrent seizures w/o recovery of mental status btwn |
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What type of imaging should you order to look for spinal cord damage?
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MRI stat with contrast
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