Neurologic Impairment

Front 1

What problems does ICP cause ?

Back 1

expansion places pressure on vital centers, which can cause permanent neuro deficits or brain death

Front 2

Differences with ICP for Pedi ?

Back 2

open fontanels and sutures can expand with ICP
Primitave reflexes may reappear with neuro disease, eg, gralp, rooting

Front 3

What is the most important indicator of patients condition ?

Back 3

level of responsiveness and consciousness

Front 4

Most important information with assessment ?

Back 4

History !!!

Front 5

How do CO2 levels affect pressure ?

Back 5

As CO2 rises, ICP rises

Front 6

ICP causes

Back 6

decreased cerebral perfusion, stimulates further swelling and may shift brain tissue thru openings in the rigid dura, resultin in HERNIATION

Front 7

Early Stages of ICP

Back 7

Changes in LOC, Bounding pulse and resp. irregularities

Front 8

What is Cushing's Triad

Back 8

bradycardia, hypertension, and bradypnea...A grave sign !!!

Front 9

What do we avoid in patient's with ICP

Back 9

Lumbar Puncture

Front 10

Used to decrease cerebral edema

Back 10

MANNITOL to dehydrate brain tissue and reduce edema...important to monitor U/O for diuresis

Front 11

What med is used if cerebral edema is caused by Brain Tumor?

Back 11

Corticosteroids...they help reduce edema around tumor

Front 12

Anti Seizure med to reduce risk of post of seizures

Back 12

Dilantin or Cerebyx

Front 13

Drug of choice with brain tumor

Back 13

Decadron...only with brain tumor...this is a corticosteroid to reduce edema

Front 14

What is status epilepticus

Back 14

state of continuous seizure...or rapid succession without return to consciousness between seizures...neuro emergency

Front 15

Most important info used to classify the type correctly

Back 15

History and Physical

Front 16

Epidural Hematoma

Back 16

neuro emergency...bleeding between dura and inner surface of skull...s/s...decrease LOC, headache, n/v, focal findings

Front 17

Diffuse axonal injury (DAI)

Back 17

widespread damage occuing after mild, moderate or severe TBI
s/s..dec. LOC, INC ICP, decortication, decerebration, global cerebral edema

Front 18

Best way to detect DAI

Back 18

MRI

Front 19

Management of DAI

Back 19

ABC's, airway, O2, IV fluids, stabilize c-spine, control bleeding, assess wounds, assess for ICP

Front 20

Most common places for brain tumors

Back 20

Frontal or temporal

Front 21

clinical manifestations of brain tumors

Back 21

headache, worse at night...awakens patient...dull and constant

Front 22

TEMODAR

Back 22

drug used in chemo for tumor when effectiveness is limited by blood brain barrier

Front 23

Guillain-Barre syndrome symptoms

Back 23

ascending symmetric weakness

Front 24

Parkinson's disease

Back 24

central and peripheral disorder d/t decreased livels of dopamine

Front 25

Major med for Parkinson's

Back 25

Levodopa - converted to dopamine in the basal ganglia
can be given with carbidopa(sinemet) to prevent breakdown and reduce adverse effects.

Front 26

What is Chorea ?

Back 26

abnormal involuntary movements

Front 27

problems assoc. with Chorea

Back 27

slurred speach, chewing and swallowing difficulty, choking/aspiration, gait problems, loss of bladder/bowel control

Front 28

diff between bacterial and viral meningitis

Back 28

viral - aseptic, caused by viral or secondary cause..managed symptomatically
bacterial - septic caused by bacteria
dx by lumbar puncture to analize csf...except with ICP

Front 29

Key clinical manifestations with meningitis

Back 29

fever, severe headache, n/v, nuchal rigitity

Front 30

Most common form of dementia...

Back 30

Alzheimer's disease -a syndrome characterized by loss of memory, orientation, attention, language, judgement and reasoning.

Front 31

When is Dementia diagnosed

Back 31

when 2 or more functions are impaired
eg - memory loss and language skills

Front 32

characteristic findings in AD

Back 32

amyloid plaques, neurofibrillary tangles

Front 33

2 common causes of dementia

Back 33

neurodegenerative conditions - gradual/progressive onset
vascular disorders - abrupt onset

Front 34

explain symptoms of mild, moderate, severe AD

Back 34

mild - forgetfulness beyond normal
Moderate - impaired ability to recognize family
Severe - little memory, u/a to process new info

Front 35

What is Myasthenia Gravis?

Back 35

an sutoimmune disorder affecting the myoneural junction...varying degrees of weakness of voluntary muscles (skeletal muscles)

Front 36

Major complications of MG

Back 36

aspiration, resp insufficiency and resp infection. results from muscle weakness affecting swallowing/breathing

Front 37

Pyridostigmine bromide (mestinon)

Back 37

management of MG...1st line...dose is gradually increased

Front 38

Parkinson's disease

Back 38

disorder of central/peripheral nervous system; degenerative
Assoc with decreased dopamine

Front 39

Parkinson's drugs
anticholinergic
antiviral

Back 39

anticholinergic - controls tremors and rigidity, may be used with levadopa
antiviral - reduce rigidity, tremor, bradykinesia..releases dopamine

Front 40

management of meningitis

Back 40

dexamethasone (steroid), phenytion (IV), mannitol, bed rest, abx, codeine for headaches

Front 41

Frontal lobe Abscess findings

Back 41

hemiparesis
aphasia (expressive)
seizures
frontal headache

Front 42

Temporal Lobe Abscess findings

Back 42

localized headache
changes in vision
facial weakness
ap[hasia

Front 43

Cerebellar Abscess

Back 43

occipital headache
ataxia (inability to coodinate movements)
nystagmus (rhythmic, involuntary movements of the eye)