Neuro emergencies Flashcards

1
Q

Altered mental status- Sx

A
  • Change in arousal, consciousness

- Delirium, dementia and coma

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2
Q

Altered mental status- Tx

A
  • Determine underlying cause
  • Glucose
  • Stabilize vitals
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3
Q

Coma- Sx

A
  • Unarousable to stimuli, including pain

- Doll eyes

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4
Q

Coma- Tx

A
  • Tx underlying cause
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5
Q

Stroke/ TIA- Sx

A
  • Jumbled speech- aphasia and apraxia
  • Unilateral motor deficits
  • AMS
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6
Q

Stroke/ TIA- Tx

A
  • Airway
  • Asses for trauma
  • Tx cerebral edema
  • Thrombolysis if indicated
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7
Q

Status epilepticus- Sx

A
  • Seizure lasting 5-15 min with out intervening periods of consciousness
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8
Q

Status epilepticus-Tx

A
  • Protect airway

- Benzos then phenytoin

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9
Q

Spinal cord injury- Sx

A
  • Head injury or trauma as mech of action
  • Neuro deficits and complaints
  • AMS, seiure
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10
Q

Spinal cord injury- Tx

A
  • Immediate immobilization

- ABCs

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11
Q

Headache- Sx

A
  • Sudden severe onset most concerning
  • Focal neuro defecits
  • Hx or trauma or nuchal rigidity, photophobia
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12
Q

Headache- Tx

A
  • CT to determine if emergency

- Neuro consult

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13
Q

Syncope- Sx

A
  • Transient loc

- May be due to CV issues, seizure

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14
Q

Syncope- Tx

A
  • Determine and tx underlying cause

- ECG, vitals

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15
Q

Meningitis/ encephalitis- Sx

A
  • Nuchal rigidity, photophobia, CSF findings

- Seizures and CN deficits

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16
Q

Meningitis/ encephalitis- Tx

A
  • Abx and steroids
17
Q

Basilar skull fracture- Sx

A
  • Base of skull- temporal occipital sphenoid or ethmoid
  • Sig force fracture to base
  • Sig risk for inter-cranial fx
  • Otorrhea and rhinorrhea due to torn dura
  • Battle signs and raccoon eyes
18
Q

Basilarskull fracture- Tx

A
  • Caution for epidural hematoma
  • Order CT
  • Consult neuro
19
Q

Epidural hematoma- Sx

A
  • Head trauma and LOC
  • Lucid interval
  • Rapid neuro deterioration
  • Blood between skull and dura
  • Increased IC pressure
  • Lenticular shape
20
Q

Epidural hematoma- Tx

A
  • Evacuate fluid for recovery
21
Q

Subdural hematoma- Sx

A
  • Sudden acceleration
  • Hematoma between dura and arachnoid
  • Slower collection longer time course
  • Falling elders chronic x 2 weeks
  • Crescent shaped on CT
22
Q

Subdural hematoma- Tx

A
  • Reverse anticoagulation

- Surg to evacuate

23
Q

Subarachnoid hemorrhage- Sx

A
  • Sudden onset of HA worst of life
  • Thunder-clap
  • Meningeal signs photophobia
  • Blood in CSF
24
Q

Diffuse axonal injury- Sx

A
  • Disruption of axonal fibers
  • post-traumatic coma
  • GCS 3-8
  • Amnesia > 7 days
  • CT- poor grey-white matter discrimination
    punctuate hemorrhages cerebral edema
25
Q

Concussion- Sx

A

Grade 1: Transient confusion, no LOC. sx 15 min
- Grade 3: LOC
Other sx: amnesia, vomiting, confusion, behavior change
- GCS 13-15

26
Q

Concussion- Tx

A

Grade 1: Remove from contest

  • Grade 2: Remove, return after 1 wk asymptom
  • Grade 3: 1-2 asymp wks
27
Q

Moderate head trauma- Sx

A
  • Initial GCS 9-12

- Post traumatic amnesia 24 hrs - 7 days

28
Q

Mild to moderate head trauma- Tx

A
  • Close f/u with PCP
29
Q

Diffuse axonal injury- Tx

A
  • Reduce cerebral edema
  • Mannitol
  • Volume resuscitation
30
Q

Skull fracture- Sx

A
  • Open- underlying laceraciton
  • Closed- swelling and hematoma
  • Depressed- visible on CT, palpation
31
Q

Skull fx- Tx

A
  • Open- abx, consult neuro
  • Closed- Close observation
  • Depressed- hospitalize and consult
32
Q

Whiplash= Sx

A
  • Appear 12-24 hrs after injury
  • Tenderness, limited ROM
  • Hoarse, dysphagia
  • No neuro defecit
33
Q

Whiplash- Tx

A
  • Xray and MRI
  • Immobilization
  • Musc relaxants, heat, NSAIDs
34
Q

Encephalopathy- Sx

A
  • AMS
  • Ophthalmoplegia, ataxia and confusion
  • Tremors
  • wide, unsteady gait
  • Decerebrate posturing
35
Q

Encephalopathy- Tx

A
  • Thiamine for wernikes
  • Lactulose for hepatic
  • glucose fluids and benzos for metabolic