Day 2 Review - Neuro3, Neuro4, Psych2 Flashcards
Complication may arise from LP in pt w/ elevated ICP
Uncal herniation of brain stem
Child p/w AMS, hypoglycemia, & lesions suggestive of chickenpox - most likely dx?
Hepatoencephalopathy - Reye’s syndrome
Prevent bacterial meningitis in newborns
Most common cause is E. Coli & GBS - Penicillin or Ampicillin in GBS+ moms during labor
Sx Encephalitis vs. Meningitis
Both HA, N/V, neck pain, fever; Encephalitis also have AMS & focal neuro defects
Initial radiographic study in pt w/ TIA/Stroke sx; Later studiess
Non-contrast Head CT (r/o hemorrhagic stroke); Later - Carotid duplex (plaques or clots), Echocardiogram (mural thrombosis, PFO, vegetations), MRA/CTA (angiogram of brain vascular to ID actual artery causing stroke)
Sx basilar artery stroke
Pontine ischemia - CN defects, AMS or coma (RAS disruption), Contralateral full body weakness (LCST) & decreased sensation; Vertigo, loss of coordination & difficulty speaking, Visual changes
Bp goals & meds: (1) Ischemic stroke (2) ICH (3) SAH
(1) Not lower bp unless BP > 220/120 or giving thrombolytic (tPA, urokinase, streptokinase) BP - MISSING INFO???
S/Sx of TCA overdose & Mgt
Cardiotoxicity, Anticholinergic sx, CNS toxicity; Sodium bicarbonate, especially QRS > 100 ms; Benzos if seizures; Monitor for at least 6 hrs to ensure no cardiotoxicity
Tx nephrogenic DI 2/2 Lithium toxicity
HCTZ always; In case of Lithium, also add Amiloride (closes Na channel at renal tubule affected by Li)
Feat. of Acute dystonia vs. Tardive dyskinesia
(1) Neck spasm, torticollis vs. (2) Repetitive facial movements
Tx Acute dystonia vs. Tardive dyskinesia
(1) Anticholinergic (Diphenhydramine or Benztropine) (2) D/d or change neuroleptic to one w/o extrapyramidal side effects (e.g., low potency or atypical neuroleptics)
EEG for Absence seizures
Generalized 3 cycle/sec (Hz) spike and wave pattern
