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SAPE October 2015 > NEURO > Flashcards

NEURO Flashcards

1
Q

Signs & Sxs:

  • Unilateral throbbing pain
  • Pain worse with movement or physical activity
  • N/V
  • Phonophobia, photophobia
A

Common migraine (w/o aura)

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2
Q

Signs & Sxs:

  • Unilateral excruciating, penetrating pain 15 mins-3 hours
  • Maximal pain behind eye
  • Lacrimation, rhinorrhea, conjunctival injection, congestion
  • Pts may pace or exhibit manic behavior
A

Cluster headache

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3
Q

Signs & Sxs:

  • Focal neurological deficit
  • Change in speech, visual loss, diplopia
  • Numbness or tingling
  • Dizziness, HA, confusion, vertigo
  • Impaired consciousness
A

Stroke/CVA

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4
Q

Signs & Sxs:

  • Tonic clonic movement
  • Post-ictal phase
A

Grand mal seizure

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5
Q

Signs & Sxs:

  • Altered consciousness
  • Bizarre sxs
  • Nausea
  • Dream like states, hallucinations
  • Affective disorders
A

Complex partial seizure

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6
Q

Signs & Sxs:

  • Unilateral throbbing pain
  • Pain worse with movement or physical activity
  • N/V
  • Phonophobia, photophobia
  • Unilateral paresthesia, numbness, unilateral weakness
  • Flashing lights, odors
A

Classic migraine (with aura)

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7
Q

Signs & Sxs:

  • HA
  • Photophobia
  • Seizures
  • Confusion, irritability
  • N/V
  • Stiff neck
A

Bacterial meningitis

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8
Q

Signs & Sxs:

  • Spacing out
  • Myoclonic
  • Isolated extremity jerking
A

Petit mal (absence) seizure

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9
Q

Signs & Sxs:

  • Focal neurological deficit
  • Change in speech, visual loss, diplopia
  • Numbness or tingling
  • Dizziness, HA, confusion, vertigo
  • Impaired consciousness
  • Spontaneous symptom resolution w/in 24 hours
A

TIA

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10
Q

Signs & Sxs:

  • Tightening band-like pressure
  • Usually bilateral
  • Mild to moderate intensity
  • Does not worsen with physical activity
A

Tension HA

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11
Q

Signs & Sxs:

  • No LOC
  • Motor or sensory manifestations
  • Unilateral tonic clonic
  • Numbness, flashing lights, olfactory
A

Simple partial seizure

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12
Q

Strokes are most common in what group of people?

A

African American

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13
Q

What is the most common occluded vessel in stroke?

A

MCA (middle cerebral artery)

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14
Q

Non-modifiable Risk Factors for Stroke

A
  • age
  • sex
  • race
  • FHx
  • prior stroke or TIA
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15
Q

Modifiable Risk Factors for Stroke

A
  • smoking
  • HTN, DM, hypercholesterolemia
  • cardiac dz, a-fib, valvular heart dz, carotid stenosis
  • obesity
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16
Q

Tests for Stroke

A
  • glucose
  • CBC, INR, lytes
  • neuro exam
  • MRI
  • CT without contrast looks for bleed
17
Q

When should tPA be given to a stroke patient?

A

within 3 hours

18
Q

How does a TIA differ from a stroke?

A
  • similar sxs
  • sxs resolve spontaneously
  • less than 24 hours
19
Q

ABCD2 Scale

A
  • age 60+ is 1 point
  • BP > 140/90 is 1 point
  • Clinical signs: unilateral weakness = 2 pts, speech change w/o weakness = 1 pt
  • DM = 1 pt
  • Duration: > 60mins = 2 pts, 1-59 mins = 1 pt
  • less than 4 = go home
  • 4-5 is mod risk and should be admitted
  • 6-7 high risk and should be admitted
20
Q

Tx for TIA

A
  • ASA or clopidogrel

- follow up q3 months for a year then yearly

21
Q

Migraine Precipitants

A
  • menstruation
  • sleep pattern changes
  • caffeine withdrawal/excess
  • red wine, hard cheese, herring, chocolate
  • estrogen (OTC)
  • fasting
  • stress
  • physical activity
22
Q

Imaging for Migraines

A

-CT to rule out other causes or if sxs warrant

23
Q

What consists of a series of HAs lasting 2-3 months, occurring every 1-2 years?

A

cluster HA

24
Q

Labs and Imaging for Cluster HA

A
  • ESR

- CT to rule out SAH

25
Q

How is tension HA diagnosed?

A
  • HA lasting 30 mins to 7 days with at least 2 sxs (tightening band pressure, bilateral, mild to moderate intensity, doesn’t worsen with activity) AND:
  • not associated w/ N/V
  • may have photophobia or phonophobia (not both)
26
Q

Common Causes of Bacterial Meningitis in Neonates under 1 month

A
  • GBS
  • E coli
  • Listeria
  • Klebsiella
27
Q

Common Causes of Bacterial Meningitis in 2-50 Year Old

A
  • N. meningitides

- S pneumo

28
Q

Common Causes of Bacterial Meningitis in 1 month to 23 month

A
  • S pneumo
  • N meningitides
  • H flu
  • E coli
  • GBS
29
Q

Common Causes of Bacterial Meningitis in 50+ Years

A
  • S pneumo
  • Listeria
  • Gram negative bacilli
30
Q

What is the classic TRIAD of sxs for Bacterial Meningitis?

A
  • fever
  • altered mental status
  • stiff neck (nuchal rigidity)
31
Q

Brudzinski’s Sign

A

-flexion of the hips when neck is flexed (bacterial meningitis)

32
Q

Kernig’s Sign

A

-resistance, pain and flexing of neck when flexing knee (bacterial meningitis)

33
Q

What labs/imaging are done for bacterial meningitis?

A
  • CBC with diff
  • 2 sets of blood cultures
  • CT if focal neuro deficit
  • LP at L4/5
34
Q

What labs/imaging should be done for seizures?

A
  • always check glucose
  • CT/MRI
  • EEG
  • possibly lytes and toxicology

SAPE October 2015 (12 decks)

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