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70 Cards in this Set
- Front
- Back
What term means a brain injury that does not result in neurological change?
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Concussion
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How long should a pt. be observed in a suspected concussion?
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Wake every 2 hours for 24 hours
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In the TX of a concussion, what should not be given or taken for the first 48 hours?
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ETOH
Sedatives Pain relievers (other than tylenol) |
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In a pt with a suspected concussion with the following sx what is the disposition?
Difficulty waking pt. Conntinuous vomiting Blurred vision |
MEDEVAC
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What could be the result of a hematoma from a tear in veins from the cortex to the superior sagittal sinus or cerebral laceration?
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Subdural Hematoma
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Thrombotic or embolic occlusion of a major blood vessel leads to what?
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cerebral infarction
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What may be of value in limiting or arresting further deterioration in Cerebral thrombosis?
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Heparinization
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In cerebral thrombosis what is always evaluated in a exam
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Heart and subclavian and carotid vessels for bruits
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What can be prescribed to reduce vasogenic cerebral edema?
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Corticosteroids
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What are 2 physical findings of a skull fx?
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crepitation and battle signs
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All penetrating trauma of the skull must be classified as what type of skull fx?
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Open Skull Fx
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What is the TX for an open skull FX?
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Hospitalize the pt. for debridement and closure in an operating room.
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What can result from cervical hyperflexion injuries?
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Anterior Cervical cord syndrome
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A pt that has had cervical hyperflexion, and has now lost motor function, temperature and pain sensation could be DX with what?
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Anterior Cervical cord syndrome
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What is the only thing affected by concussion?
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Mentation
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Between 5-10% of strokes are due to what?
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Subarachnoid hemorrhage
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What hemmorrhage has a sudden H/A never before expiernced by a pt. with increasing severity?
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Subarachnoid Hemorrhage
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Which hemmorrhage has a sudden h/a with inreasing severity that may be followed by n/v and loss or impairment of consciousness?
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Subarachnoid hemmorrhage
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What is an increased collection of CSF in the subdural space?
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Subdural Hygroma
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What is the most common cause of Subdural hygroma?
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Cranial trauma with tearing of arachnoid space.
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What is a important caution of Dx traumatic intracerbral hemmorrhage?
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Do not misdiagnose with ETOH or drug cause
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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?
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Traumatic intracerebral hemmorrhage
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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?
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Central cervical cord syndrome
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What has been shown to improve neurological recovery in central cervical cord syndrome?
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Early high doses of Corticosteroids
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What is the sig for Methylprednisolone in Central cervical cord syndrome?
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30mg/kg by IV bolus followed by 5.4mg/kg/h for 23hrs
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Which meningitis has increased in recent years and is the most common cause in epidemic disease in the U.S.?
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Group C Meningcoccus
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What are the S/S of Meningitis?
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Increased fever
Chills H/A |
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What is the antibiotic of choice in the TX of meningitis?
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Aqueous Pen G 24mu/24hrs in devided doses q4h
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In Tx meningitis by IV how long should the pt. be TX.
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Till afebrile for 5 days
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What is the disposition of a pt with meningitis?
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Isolation
MEDEVAC for further eval. Rifampin for crew |
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Which meningitis lacks a rash but, focal neurological deficits, cranial nerve palsies, and obtundation are more prominent?
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Pneumococcal meningitis
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What is an important lab finding in pneumococcal meningitis?
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CSF has 1000 WBC per ML, over 60% are polymorphonuclear leukocytes
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What is the most common cause of Pneumococcal meningitis in adults, and the 2nd in children over the age of 6?
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Strep pneumoniae
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How is meningococcal meningitis trasnmitted?
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By respiratory droplets
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Which meningitis has charateristics of fever, vomiting, irritability, convulsions, a high pitched cry, and a bulging or tight fontanelle, stiff neck may be absent?
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Streptococcal meningitis
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What produces disturbances of the sensorium, seizures, CSF may show lymphocytes?
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Encephalitis
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What is the RX for enchepalitis?
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Acyclovir 10mg/kg IV q8h x 10 days
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Acyclovir can cause what abnormalities?
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Liver function
Bone marrow suppression Transient renal faliure |
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To avoid nephrotoxicty how should acyclovir be given?
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Slowly over 1 hour
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What meningitis may have seizures and cranial neuropathies presents, dehydration is common and may lead to Waterhouse- Friderichsen syndrome, especially in meningococcal septicemoia?
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Influenza menningitis
Staphlococcal meningitis |
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What can appear after a penetrating head trauma as a part of a mixed infection?
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Staphylococcal meningitis
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What can follow a viral infection and starts with sudden local back pain then sensory symptoms and motor weakness ascending from the feet
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Myelitis
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What is characterized by focal ischemic cerebral neurological deficits that last for less than 24 hours?
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Transient ischemic attack
usually last less than 1-2 hours |
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What is an important cause of a transient ischemic attack?
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embolizations
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What would explain seperate attacks and affects of a transient ischemic attack on different parts of the body?
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Embolic phenomenon
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Describe the progression of an transient ischemic attack?
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Abrupt onset without warning recovery occurs rapidly, often within a few minutess
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Where are most cerebral aneurysm located?
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Anterior part of Circle of Willis
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What is the 3rd leading cause of death in the USA?
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Stroke
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What are the 2 subdivisions of stroke?
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Infarctions
Hemmorrhages |
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Occlusion of the posterior cerebral artery may lead to what?
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Thalamic syndrome
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What is thalamic syndrome?
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A contralateral hemisensory disturbance, followed by the development of spontaneous pain and hyperpathia
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What has been perscribed to reduce vasogenic cerebral edema?
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corticosteroids
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Anticoagulants drugs have no role in a completed stroke unless what?
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There is a cardiac source of embolism
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In which H\A syndrome do pt.'s complain of poor concentration, and constant daily headaches that are vise like?
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Tension Headache
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What med is for aborting migraines and is given SQ?
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Sumatriptan (Imitrix)
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How long do cough headaches last?
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Few minutes or less
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Which H/A is worse on arising in the morning and may be the focus of a somatic delusional system.
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Deppression H/A
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Which H/A is associated with Horner's syndrome?
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Cluster H/A
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What is Butorphanol tartrate
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A synthetic opiod agonist-antagonist
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What may occur in post traumatic H/A and is often enhanced by postural changes or head movement?
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Disequilibrium sometimes with rotary component
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Waht is it called when a pt. has further convulsions without recovery of consciousness between seizures?
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Status epilepticus
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What is the sig for Ethosuximide in a Petit Mal seizure?
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Ethosuximide 100-1500mg po bid
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What is the sig for Clonazepam in myclonic seizures?
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Clonazepam .04-.2mg/kg po bid
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What would be the location of a tumor that leads to progressive intellectual decline, slowing of mental activity, personality changes, and contralateral grasp reflexes?
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Frontal lobe lesion
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Which lesion has sensory loss that involves postural sensibility and tactile discriminaton, and asterognosis?
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Pariatal lobe lesion
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What is Gerstmann's syndrome?
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A combination of alexia, agraphia, acalculia, right and left confusion and finger agnosia
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What lesion leads to depersonalization, emotional changes, behavior disturbances?
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Temporal lobe lesions
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What may lead to dysomnia and receptive aphasia?
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Left sided temporal lesions
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What lesion will cause loss of color perception, and prosopagnosia?
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Occipital lobe lesion
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What is the term for denial of blindness?
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Anton's syndrome
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