Neuro Flashcards

Question

Critères inclusion et exclusion pour thrombolyse 3-4.5hr

Answer 1

Cryoprécipités 6-8 unités Cryoprecipitate, 10 units immediately (infused over 10 to 30 minutes) and more as needed to achieve a serum fibrinogen level of ≥200 mg/dL ●Antifibrinolytic agents: aminocaproic acid 4 to 5 g intravenously (IV) during first hour, followed by 1 g IV until bleeding is controlled, or tranexamic acid 10 to 15 mg/kg IV over 20 minutes ●Prothrombin complex concentrate as adjunctive therapy to cryoprecipitate for patients on warfarin prior to alteplase treatment ●Fresh frozen plasma as adjunctive therapy to cryoprecipitate for patients on warfarin prior to alteplase treatment if prothrombin complex concentrate is not available ●Vitamin K as adjunctive therapy for patients on warfarin prior to alteplase treatment ●Six to eight units of platelets for patients with thrombocytopenia (platelet count \<100,000/microL) ●In patients receiving unfractionated heparin (UFH) for any reason, it is reasonable to treat with 1 mg of protamine for every 100 units of UFH given in the preceding 4 hours

Answer 2

glycémie, Na, et B HCG

Answer 3

Focal abnormality on neurological examination • Malignancy • Closed head injury • Neurocutaneous disorder • Focal onset of seizure • Absence of a history of alcohol abuse • History of cysticercosis • Altered mental status • Patient older than 65 years old • Seizure duration more than 15 minutes

Answer 4

Primary Headaches 1. Migraine 2. Tension-type headache 3. Cluster headache and trigeminal autonomic cephalalgias 4. Other primary headaches Secondary Headaches 5. Headache attributed to trauma or injury to the head or neck 6. Headache attributed to cranial or cervical vascular disorder 7. Headache attributed to nonvascular intracranial disorder 8. Headache attributed to a substance or its withdrawal 9. Headache attributed to infection 10. Headache attributed to disorder of homeostasis 11. Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cranial structures 12. Headache attributed to psychiatric disorder Painful Cranial Neuropathies, Other Facial Pains, and Other Headaches 13. Cranial neuralgias and other facial pain 14. Other headache disorders

Answer 5

At least five attacks fulfilling criteria in B, C, D, and E B. Attack lasts 4 to 72 hours (untreated or unsuccessfully treated) C. Headache has at least two of the following characteristics: 1. Unilateral location 2. Pulsating quality 3. Moderate to severe pain intensity 4. Aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs) D. During headache, at least one of the following: 1. Nausea or vomiting (or both) 2. Photophobia and phonophobia E. Not attributable to another disorder A. At least two attacks that fulfill criterion B B. Presence of at least three of the following four characteristics for a diagnosis of classic migraine: 1. One or more fully reversible aura symptoms indicating focal cerebral cortical or brainstem dysfunction (or both) 2. At least one aura symptom developing gradually over more than 4 minutes, or two or more symptoms occurring in succession 3. No single aura symptom lasting longer than 60 minutes 4. Headache beginning during aura or afterward, with a symptom-free interval of less than 60 minutes (also may begin before aura) C. Exclusion of related organic diseases by means of an appropriate history, physical examination, and neurologic examination with appropriate diagnostic tests

Answer 6

Other risk factors associated with SAH include hypertension, smoking, excessive alcohol consumption, and use of sympathomimetic drugs. A familial association of cerebral aneurysms with several diseases has been described, including autosomal dominant polycystic kidney disease, coarctation of the aorta, Marfan syndrome, and Ehlers-Danlos syndrome type IV

Answer 7

0Unruptured aneurysm 1Asymptomatic or minimal headache and slight nuchal rigidity 2Moderate or severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve palsy 3Drowsiness, confusion, or mild focal deficit 4Stupor, moderate to severe hemiparesis 5Deep coma, decerebrate posturing, moribund appearance

Answer 8

cervical artery dissection (CAD), cerebral venous thrombosis (CVT), reversible cerebral vasoconstriction syndrome, hemorrhagic or ischemic stroke, and primary headache disorders, including migraine and cluster headaches.

Answer 9

(1) unilateral headache or neck pain, sometimes radiating to the ipsilateral eye; (2) ipsilateral partial Horner’s syndrome; and (3) either blindness, due to retinal ischemia, or contralateral motor deficits, caused by cerebral ischemia.

Answer 10

Coagulopathie: Déficit protéine C/S, antithrombine, mutation V Leiden Prise contraceptifs oraux, suppléments hormonaux Néoplasie, maladie inflammatoire/auto-immune Trauma crânien Chirurgies, neurochirurgies Grossesse Infections para-méningées

Answer 11

1. Sx reliés à HTIC 2. Sx reliés à atteinte focale 2nd ischémie/hémorragie Céphalée, convulsions Dlr occulaire, proptose, chémosis, atteinte mvts extra-oculaires, papilloedème

Answer 12

Headache that remits with normalization of CSF pressure Papilledema Nonfocal neurologic examination May have CN VI palsy Increased CSF opening pressure \>250 mm in adults \>280 mm in children Normal CSF diagnostic studies Normal neuroimaging studies No other cause of increased ICP identified

Answer 13

Disturbance in attention and awareness. • The disturbance develops over a short time period, represents a change from baseline attention and awareness, and tends to fluctuate in severity during the day. • There are additional disturbances in cognition, such as memory, disorientation language, visual spatial ability, or perception. • The disturbances are not better explained by another preexisting, established, or evolving neurocognitive disorder and do not occur in context of a coma.

Answer 14

Primary Degenerative Dementias Alzheimer’s disease Lewy bodies disease Frontal lobe disease (Pick’s disease) Subcortical Dementias Parkinson’s disease Huntington’s disease Vascular Dementia Multi-infarct dementia Intracranial Processes Space occupying lesions (tumor, subdural hematoma) Hydrocephalus CNS infections (HIV-1, neurosyphilis, chronic meningitis) Repetitive head trauma Endocrinopathies Addinson’s and Cushing’s diseases Thyroid and parathyroid disease Nutritional Deficiencies Thiamine Niacin Folate Vitamin B12 Toxic Exposures Heavy metals Carbon monoxide Carbon disulfide Drugs Psychotropics Antihypertensives Anticonvulsants Anticholinergics Depression Pseudo-dementia

Answer 15

A. Cognitive decline from a previous level of performance in one or more cognitive domains: Complex attention, executive function, learning and memory, language, perceptual motor function, or social cognition. B. The disorder has an insidious onset and gradual progression. C. The deficits do not occur exclusively during the course of a delirium. D. The cognitive deficits are not better explained by another mental disorder, such as major depression or schizophrenia

Answer 16

Carbamazépine

Answer 17

- Innervation motrice du visage - goût + sensibilité 2/3 ant de la langue et palais mou - Sensibilité CAE - innervation parasympathique glandes sous-mandibulaire, sublinguales, lacrimales, nasale, palatines

Answer 18

PAralysie de Bell, maladie Lyme, Ramsey-Hunt, infections de l'oreille moyenne, mastoide et CAE. Trauma- fracture de l'os temporal, tumeur

Answer 19

PAralysie faciale aigue, s'installant sur 72 heures, devient complète en 1-7 jours Changements sensitifs a/n visage Dysgeusie Hyperacousie Otalgie Épiphora (augmentation des larmes coulant sur les joues)

Answer 20

Paralysie faciale Rash vésiculaire herpétiforme a/n oreille externe, CAE, tympan, palais, visage Dysfonction vestibulocochléaire (audition)

Answer 21

Maladie de Lyme Mononucléose infectieuse

Answer 22

Pred 50mg/jour x 10 jours Pour sx sévères, considérer ajout valacyclovir 1000mg PO TID x 7jours

Answer 23

Prednisone 50mg/jour + Valacyclovir 1000mg PO TID x 10jours

Answer 24

Tumeur située à l'angle pontocérébelleux, associé à perte d'audition unilatérale, progressive avec accouphène et déséquilibre, Ménière cause aussi perte d'audition unilatérale mais avec vertige franc. Méningiome est la 2e tumeur la + fréquente de l'angle ponto-cérébelleux

Answer 25

CN III, puis IV et VI

Answer 26

Céphalée, diplopie, atteinte nerfs 3,4,6. Sx d'HTIC

Answer 27

- Névrite optique - Névralgie du trijumeau - Diplopie et nystagmus avec oscillopsie - Sx sensitifs diverses: paresthésie, engourdissement, aiguilles, sensation d'oedème

Answer 28

Tumeurs SNC Encéphalomyélite post-infectieuse/vaccinale Maladie Lyme Déficit B12 Vasculites Behcet Encéphalopathie VIH Neuro sarcoidose Compression moelle épinière

Answer 29

Détérioration des sx neurologiques avec une hausse de la température corporelle

Answer 30

1. Ralentir la progression de la maladie: interferon ou glatiramer 2. Tx exacerbation: solumedrol (pas PO) 3. Tx complications: spasticité avec baclofen, tremblements/ataxie avec propranolol, diazepam, névralgie trijumeau avec carbamazépine

Answer 31

1. Artère spinale antérieure, qui provient des 2 artères vertébrales. Perfuse les 2/3 ant de la moelle 2. 2 artères spinales postérieures qui irriguent le 1/3 post. 3. Contribution des artères radiculaires 4. Artère d'Adamkiewicz, qui origine entre T8 et L4

Answer 32

Trauma, tumeur, malformation vasculaire, hématome épidural, manipulation spinale, myélite à herpes zoster, lésion radique, spondylolise cervicale, atteinte discale dégénérative

Answer 33

Arnold chiari type 1 Post-trauma Post- méningite Tumeur compressive

Answer 34

The most common features on physical examination are lower limb hyperreflexia, weakness and wasting in the hands and arms, dissociated sensory loss, and gait disorder. The classic pattern of sensory deficit involves a loss of pain and temperature sensation in the upper extremities with preservation of proprioception and light touch The sensory deficit often is described as being in a “capelike” distribution over the shoulders and arms. The anatomic basis for the neurologic features of a syrinx is the location near the central canal.

Answer 35

Atteinte symétrique 1. distale, mixte (sensitif + moteur): polyneuropathie sym distale 2. prox/distale, mixte: polyneuropathie aigue démyélinisante (guillain-barré) ou polyneuropathie démyélinisante inflammatoire chronique Atteinte asymétrique 1. prox/distale, mixte: plexopathie, radiculopathie 2. distale, mixte: mononeuropathie ou mononeuropathie multiplex 3. distale, pure, mononeuropathie motrice ou sensitive

Answer 36

Autoimmune Demyelinating Guillain-Barré syndrome (GBS) Chronic inflammatory demyelinating polyneuropathy Myasthenia gravis Toxic Botulism Buckthorn Seafood Paralytic shellfish toxin Tetrodotoxin (puffer fish, newts) Tick paralysis Metals Arsenic Thallium Metabolic Dyskalemic syndromes Acquired (especially with thyrotoxicosis) Familial Hypophosphatemia Hypermagnesemia Porphyria Infectious Poliomyelitis Diphtheria

Answer 37

Guillain-Barré syndrome (GBS) Acute inflammatory demyelinating polyradiculoneuropathy Acute motor axonal neuropathy Acute motor and sensory axonal neuropathy Miller Fisher syndrome Chronic inflammatory demyelinating polyradiculoplexoneuropathy Malignant disease Human immunodeficiency virus (HIV) infection Hepatitis B Buckthorn Diphtheria

Answer 38

1. Campylobacter jejuni et CMV, EBV, mycoplasme pneumoniae

Answer 39

MIP inférieur à -30 cmH2O CVF inférieur à 20 mL/kg

Answer 40

IVIg ou plasmaphérèse. IVIg = 400mg/kg / jour x 5 jours

Answer 41

Diabète Alcool VIH Néo et paranéo Héréditaires Toxines: agents industriels Métaux: mercure, or, arsenic, thallium Nutritionnel: beriberi (thiamine), anémie pernicieuse B12, pellagre niacine, déficit pyridoxine Paraprotéines: myélome multiple, waldenstrom, MGUS, amyloidose Dysfonction d'organes: urémie, maladie pulmonaire, hypoT4, acromégalie Rx : nitrofurantoine/metronidazole/antirétroviraux/dapsone/ INH, disulfiram, paclitaxel, vinblastine/vincristine, amiodarone, phenytoine, statines, thalidomide Porphyrie

Answer 42

Gabapentin, lyrica, amitriptyline, duloxetine, carbamazepine, tramadol,

Answer 43

Plexopathie brachiale / lombosacrée ## Footnote Brachial Plexopathy Open Direct plexus injury (knife or gunshot wound) Neurovascular (plexus ischemia) Iatrogenic (central line insertion) Closed Traction injuries “Stingers” Traction neurapraxia Partial or complete nerve root avulsion Radiation Neoplastic Idiopathic brachial plexitis Thoracic outlet Lumbosacral Plexopathies Open Closed Traction injuries Pelvic double vertical shearing fracture Posterior hip dislocation Retroperitoneal hemorrhage Vasospastic (deep buttock injection) Neoplastic Radiation Idiopathic lumbosacral plexitis Infectious Herpesvirus (sacrococcygeal) Herpes simplex 2 Herpes zoster Cytomegalovirus polyradiculopathy (HIV infection)

Answer 44

Upper Extremity Radial nerve 1. Axilla - rare, implique alors faiblesse triceps + poignet/main 2. Humerus - saturday night palsy 3. Elbow (posterior interosseous neuropathy) 4. Wrist (superficial cutaneous radial neuropathy) Ulnar nerve 1. Axilla 2. Humerus 3. Elbow 4. Condylar groove 5. Cubital tunnel: a/n coude, distal au condyoar groove 6. Wrist (Guyon’s canal): ne cause pas de sx sensitifs car les branches palmaires et dorsales sortent AVANT le canal de Guyon (sauf branche superficielle terminale) 7. Hand 1. Superficial terminal ulnar neuropathy: face palmaire 4e-5e doigts 2. Deep terminal ulnar neuropathy: innervation des interosseux ad côté radial Median nerve 1. Axilla 2. Humerus (musculocutaneous mononeuropathy) 3. Forearm 4. Anterior interosseus 5. Pronator syndrome 6. Wrist (carpal tunnel) 7. Hand (recurrent motor branch) Suprascapular mononeuropathy Axillary mononeuropathy Lower Extremity Sciatic nerve Femoral nerve 1. Iliacus compartment (proximal) 2. Saphenous mononeuropathy (distal) Lateral femoral cutaneous (meralgia paresthetica) Peroneal nerve: inversion possible (via nerf tibial) alors qu'impossible lors d'atteinte du nerf sciatique 1. Common peroneal mononeuropathy (fibular head, popliteal fossa) 2. Deep peroneal mononeuropathy (anterior compartment) Tibial nerve 1. Popliteal fossa (proximal) 2. Tarsal tunnel (distal) Sural nerve 1. Popliteal fossa, calf (proximal) 2. Fifth metatarsal base (distal) Plantar nerve 1. Distal to tarsal tunnel 2. Interdigital neuropathies (Morton’s neuroma) Obturator mononeuropathy

Answer 45

Acromegaly Amyloid Diabetes mellitus Hypothyroidism Obesity Pregnancy Renal failure Rheumatoid arthritis

Answer 46

Vasculitis Systemic vasculitis Polyarteritis nodosa Rheumatoid arthritis Systemic lupus erythematosus Sjögren’s syndrome (keratoconjunctivitis sicca) Nonsystemic vasculitis Diabetes mellitus Neoplastic Paraneoplastic Direct infiltration Infectious Lyme disease HIV infection Sarcoid Toxic (lead) Transient (polycythemia vera) Cryoglobulinemia (hepatitis C)

Answer 47

Herpes Herpes simplex 1 and 2 Varicella-zoster (shingles) Inflammatory sensory polyganglionopathy Paraneoplastic Primary biliary cirrhosis Sjögren’s syndrome (keratoconjunctivitis sicca) Toxin induced Pyridoxine (vitamin B6) overdose Metals Platinum (cisplatin) Methyl mercury Vitamin E deficiency

Answer 48

Botulisme: diminution de la libération d'acétylcholine Myasthénie grave: blocage des récepteurs nicotiniques Intoxication organophosphates:inactivation de l'acétylcholine par liaison irréversible Repeated stimulation leads to diminishing motor strength, which is caused by one of three mechanisms: blockage of the receptors, as in myasthenia gravis; decrease in the amount of ACh released, as in botulism; or inactivation of ACh by irreversible binding, as in organophosphate poisoning.

Answer 49

Environ 90% des patients possèdent des anticorps pathogéniques dirigés contre les canaux calciques voltage-dépendants (CCVD) de type P/Q. Le dysfonctionnement et la diminution du nombre de ces canaux inhibe la libération de l'acétylcholine des terminaisons présynaptiques, ce qui conduit à une altération de la transmission neuromusculaire et à une faiblesse musculaire. In the case of Lambert-Eaton myasthenic syndrome, weakness is more pronounced at the beginning of muscle use and improves with repeated use as more ACh builds up in the synaptic cleft with each stimulation.

Answer 50

1. Anticorps contre récepteurs Ach post-synaptique 2. BLocage transmission Ach 3. Internalisation et dégradation des récepteurs 4. Destruction de la membrane par activation du complément

Answer 51

Admission USI Surveillance respiratoire, MIP/MEP, CVF Éliminer tous les Rx qui peuvent exacerber sx Traitement précipitant ex infection IVIg ou échanges plasmatiques (certains préfèrent plasmaphérèse, mais si pas différence significative démontrée entre les deux Cortico hautes doses 60mg/jour - ou immunosuppresseurs si cortico CI \* attention cortico pour exacerber faiblesse initialement pyridostigmine (tx en externe, inhibiteurs de la cholinestérase): non recommandé en crise (éviter augmentation des sécrétions associées) Intubation: anectine ok mais dose augmentée nécessaire

Answer 52

The edrophonium test and ice bag test are performed at the bedside for patients with suspected myasthenia gravis and ptosis. The results based on the effect of the intervention on the ptosis. Edrophonium is a short-acting acetylcholinesterase-blocking agent that produces an increase of ACh in the synaptic cleft and a reduction in ptosis after intravenous (IV) administration. With the ice bag test, cooling decreases symptoms in myasthenia gravis, whereas heat exacerbates symptoms. In both tests, the amount of ptosis is measured before and after administration of edrophonium or application of an ice bag. The distance from the upper to the lower eyelid in the most severely affected eye is measured first. If edrophonium is given, an IV test dose of 1 to 2 mg is given first because some patients have a severe reaction. If no adverse reaction is found and the patient does not dramatically improve in 30 to 90 seconds, a second dose of 3 mg is given. If there is still no response, a final dose of 5 mg is given for a total maximum dose of 10 mg. Atropine should be available at the bedside during the test. Because of the potential for cholinergic-induced increased airway secretions, this test should be used with caution in asthmatics and patients with chronic obstructive pulmonary disease. If the ice bag test is used, an ice pack is applied to the affected eye for approximately 2 minutes. An improvement in the amount of ptosis of at least 2 mm is considered positive. The pooled sensitivity and specificity of the ice bag test for detecting ocular myasthenia The edrophonium test and ice bag test are performed at the bedside for patients with suspected myasthenia gravis and ptosis. The results based on the effect of the intervention on the ptosis. Edrophonium is a short-acting acetylcholinesterase-blocking agent that produces an increase of ACh in the synaptic cleft and a reduction in ptosis after intravenous (IV) administration. With the ice bag test, cooling decreases symptoms in myasthenia gravis, whereas heat exacerbates symptoms. In both tests, the amount of ptosis is measured before and after administration of edrophonium or application of an ice bag. The distance from the upper to the lower eyelid in the most severely affected eye is measured first. If edrophonium is given, an IV test dose of 1 to 2 mg is given first because some patients have a severe reaction. If no adverse reaction is found and the patient does not dramatically improve in 30 to 90 seconds, a second dose of 3 mg is given. If there is still no response, a final dose of 5 mg is given for a total maximum dose of 10 mg. Atropine should be available at the bedside during the test. Because of the potential for cholinergic-induced increased airway secretions, this test should be used with caution in asthmatics and patients with chronic obstructive pulmonary disease. If the ice bag test is used, an ice pack is applied to the affected eye for approximately 2 minutes. An improvement in the amount of ptosis of at least 2 mm is considered positive. The pooled sensitivity and specificity of the ice bag test for detecting ocular myasthenia

Answer 53

LA toxine se lit de facon irréversible à la membrane pré-synaptique et inhibe la libération d'acétylcholine The botulinum toxin blocks both voluntary motor and autonomic functions. There is no pain or sensory deficit. The onset of symptoms is 6 to 48 hours after the ingestion of tainted food. Symptoms of gastroenteritis may or may not be present. The classic feature of botulism is a descending, symmetrical, flaccid paralysis. Cranial nerves and bulbar muscles are affected first, causing diplopia, dysarthria, and dysphagia, followed later by generalized weakness. Because the toxin decreases cholinergic output, anticholinergic signs may be present: constipation, urinary retention, dry skin and eyes, and increased temperature and dilated, non-reactive pupils. This can help differentiate botulism toxicity from myasthenia gravis. Deep tendon reflexes are normal or diminished.

Answer 54

Infantile botulism results from the ingestion of C. botulinum spores that are able to germinate and produce toxin in the high pH of the gastrointestinal tract of infants. Botulism spores can survive in honey, so it is recommended that honey not be fed to infants.

Answer 55

Admission USI Suivi respiratoire Anti-toxine rapidement IVIg si disponible Pas antibio pour botulisme infantile Antibio si botulisme 2nd plaie: pen G ou flagyl si all. et débridement de la plaie +++

Answer 56

pathophysiologie identique au botulisme. Paralysie flasque ascendante (similaire à Guillain-Barré), mais parfois atteinte oculaire avec pupilles dilatées et fixes. Traitement de support et retirer la tique

Answer 57

Inflammatoires et toxico-métaboliques

Answer 58

Douleur et faiblesse. Diminution des réflexes proportionnelle à la faiblesse musculaire. Svt post-viral, peut être paranéoplasique. Dermatomyosite avec atteinte cutanée, rash photosensible/ érythème a/n dorsum des mains a/n extenseurs

Answer 59

Hypo/hyperkaliémie, hypo/hypercalcémie, hypophosphatémie, hypomagnésémie Associées aux dysthyroidies, dysparathyroidies, atteintes surrénales Paralysies périodiques

Answer 60

3 formes ## Footnote 1. Hypokaliémique 2. Hyperkaliémique Hypo/hyper: maladie héréditaire, forme hypo + fréquente 3. Thyrotoxique: associé à l'hyperthyroidie, forme acquise de paralysie périodique hypokaliémique. Augmentation de l'activité de la pompe NaKATP ase avec shift intracellulaire de K. Faiblesse MI \> MS, pas d'atteinte bulbaire/ oculaires ou du système respiratoire. Svt après un gros repas (shift de potassium 2nd insuline) Traitement: autorésolutif, remplacement IV de K prudent car pas de déplétion corporel, max 20 MeQ IV puis PO.

Answer 61

N. meningitidis S. pneumoniae L. monocytogenes H influenzae Après manipulation chirurgicale, pneumocoque, staph aureus, pseudo, entérobactéries

Answer 62

Age \< 5 ans et \> 60 ans Sexe masculin Africains/américains Faible statut socio-économique / promiscuité Alcool/cirrhose / UDIV Diabète Immunosuppression / splénectomie Anémie falciforme / thalassémie majeure Néoplasie Atteinte durale (trauma, chirurgie, congénital, shunt) Infection contigue (sinusite, otite, abcès dentaire) Endocardite bactérienne Contact étroit avec méningite Colonisation antérieure

Answer 63

Immédiates: coma, perte protection airway, arrêt respiratoire, mort, convulsions, ép. péricardique, oedème cérébral, choc/CIVD Retardées: déficit neurologique, surdité, empyème sous-dural, épilepsie, retard intellectuel, hydrocéphalie, thrombose veineuse cérébrale, hémorragie bilatérale surrénales (Waterhouse-Friderichsen associé à la méningococcémie), mort

Answer 64

Infectieux: virus / bactérie / fongique/ parasite / rickettsie Enteroviruses—polio, Coxsackie, echovirus Herpes group of viruses Herpes simplex virus (HSV) types 1 and 2 Varicella zoster virus Cytomegalovirus Epstein-Barr virus Human herpes virus 6 (HHV-6) Respiratory viruses Adenovirus Rhino virus Influenza virus types A and B Arboviruses Mumps virus Lymphocytic choriomeningitis Human immunodeficiency virus (HIV) Bacteria Partially treated meningitis Parameningeal infection Endocarditis Mycoplasma pneumonia Mycobacterium tuberculosis Ehrlichiosis Borrelia burgdorferi Treponema pallidum Brucella Leptospirosis Fungi Cryptococcus neoformans Histoplasma capsulatum Coccidioides immitis Blastomyces dermatitides Candida Parasites Toxoplasma gondii Neurocysticercosis Trichinosis Naegleria Hartmannella Bartonella henselae Rickettsiae Rocky Mountain spotted fever Typhus Post-infectieux/ vaccinal 1. Rubella Rubella Varicella Variola Rabies vaccine Pertussis vaccine Influenza vaccine Vaccinia Yellow fever vaccine Rx: 1. Nonsteroidal anti-inflammatory drugs (NSAIDs) Trimethoprim-sulfamethoxazole, amoxicillin Muromonab CD3 (OKT3) Azathioprine Intravenous (IV) immunoglobulin Isoniazid Intrathecal methotrexate Intrathecal cytosine arabinoside Allopurinol Carbamazepine Sulfasalazine Maladies systémiques 1. Collagen vascular disorders Systemic lupus erythematosus Wegener’s granulomatosis Central nervous system (CNS) vasculitis Rheumatoid arthritis Kawasaki’s disease Sarcoidosis Leptomeningeal cancer Post-transplantation lymphoproliferative disorder Behçet’s disease Vogt-Koyanagi syndrome Néoplasies 1. Leucémie 2. Méningite carcinomateuse Infection contigue 1. abcès cérébral 2. abcès épidural Divers 1. migraine 2. Infection urinaire 3. Arachnoidite

Answer 65

Seuil maximum normal \< 5 GB / mm3

Answer 66

Among household contacts, the incidence of transmission of meningococcus is approximately 5%; therefore, we recommend that household contacts of bacteriologically confirmed cases receive rifampin (adults, 600 mg; children older than 1 month, 10 mg/kg; children younger than 1 month, 5 mg/kg) orally every 12 hours for a total of four doses. Ciprofloxacin 500 mg by mouth (adults only) and ceftriaxone 250 mg intramuscularly (125 mg intramuscularly for children younger than 15 years old) provide single-dose alternatives. PAs de prophylaxie contre pneumocoque

Answer 67

Antibios: aminoglycosides, fluoroquinolones, macrolides, vanco Cardiaque: procainamide, betabloqueurs, quinine Magnésium NMB AC monoclonaux ex pembro Chloroquine, plaquenil

Answer 68

Antérieure: AEC, jugement altéré, réflexes primitifs, incontinence, apraxie, démarche ébrieuse, paralysie MI opposée à la lésion, dysesthésie MI opposée à la lésion Moyenne: Paralysie MS/visage opposée à la lésion, sensibilité MS/visage opposé, aphasie broca/wernicke, dysarthrie, négligence, hémianopsie, agnosie, déviation du regard VERS la lésion Postérieure: Paralysie 3e nerf crânien, hémianopsie, Alexie, syncope, agnosie visuelle, nystagmus, no/vo, vertige 6 signes précoces AVC: artère hyperdense, Diminution sustance grise: perte différenciation/ perte du ruban cortical/disparition des noyaux gris centraux, perte sulcus, effet de masse: effacement des sillons/oedème cérébral, hypodensité aigue

Answer 69

A x B x C / 2 ( nombre coupes x long x largeur / 2)

Answer 70

Inclusion: age adulte, AVC ischémique avec déficit clinique mesurable, durée des symptômes inférieure 3heures Exclusion: Guidelines 2018 - AHA

Answer 71

- hyperdensité sinus veineux - Hyperdensité veine profonde - oedème cérébral - hémorragie 2nd congestion veineuse

Answer 72

Horner incomplet (sudation préservée) Céphalée unilatérale Perte de vision unilatérale

Answer 73

lésion ATM zona ramsay-hunt masse abcès dentaire

Answer 74

Diplopie, névrite optique, nystagmus Dysarthrie, dysmétrie, dysdiadococinésie Ataxie Paralysie, parésie 4 membres Paresthésie Dysfonction sexuelle, urinaire, fécale

Answer 75

Paraplégie Clonus Hyperréflexie Babinski Déficit sensitif transverse

Answer 76

Sx GI Sx neuro Sx anticholinergiques

Answer 77

Campylobacter CMV EBV Mycoplasma

Answer 78

Botulisme Myasthénie grave Guillain-Barré Lambert eaton Tick paralysis Paralysis periodic Puffy fish - tetrodotoxine Shellfish toxine Diphtérie/poliomyélite Organophosphates HyperMg, hypophosphatémie Buckthorn

Answer 79

CVF infé 20 mL/kg MIP / MEP ( -30 / -40) PCO2 augmentée

Answer 80

Carcinomatose méningée Leucémie Abcès Arachnoidite), Post-vaccinal INfectieux (viral, bactérien traité, fungique, rickettsie) Médicament ( AINS, sulfa, carbamazépine, allopurinol)