neurology

Question 1

aseptic mening

Answer 1

CHRONIC INFECTIONS
drugs alc spirochetes etc

Question 2

spread of mening

Answer 2

hematogenous - crossesthe blood btrain barrier/ contiguous - from adjacent structures

Question 3

mening clinical rep

Answer 3

fever headache vomm seizure photophobia confusion altered mental state red loc

Question 4

acute mx of mening

Answer 4

treated symptomatically
ct, if no contra ind lp.
may recommend steroid except listeria

Question 5

contra ind for lp

Answer 5

unexp seizures, cranial nerve pulse, dep loc, shunt present, systemic contraindications from skills stuff

Question 6

monitor for complications

Answer 6

raised icp, cerebral infartion, brain abcess, hyponatremia, seizures, hydroceph, venous thromb

monitor for expected improvement

Question 7

csf analysis inc what cell

Answer 7

viral - lymph gluc n and prot nto high - imp because doesnt need treament
bact - nuetro
fungal - lympho
tb - lympho

Question 8

pathogen of pneuococ, manignococ, haemophilus

Question 9

b lactamase

Answer 9

counteracts penicillin

Question 10

hx >2wks of mening sym

Answer 10

usually tb or fungal

Question 11

ires

Answer 11

immunresponse exacerabtion syndrome
find out the cause

Question 12

how long does it take for organisms toreach the csf

Answer 12

2 weeks post exposure

Question 13

nociceptors

Answer 13

periph sensory neurons that alert indiciduals to pain

Question 14

mechanisms of pain

Answer 14

irritation/infkammation
traction
vascular pain

Question 15

classific of headachr

Answer 15

prim- no underlying path cause, benign but often disabling
sec- underlying path casue
cranial neuralgias- nerve involement face pains

Question 16

type sof prim headache

Answer 16

migraine
cluster
tension
trigenimal neuralgia

Question 17

sec headachr causes

Answer 17

infection
vascilar eg subarach haem
malig htn
metab d/o
nonvasc cranial d/os- low ccsf pressure

Question 18

trigenimal neuralgia

Answer 18

compression of cnv pain radiating along cuorse of trigem nerve

Question 19

xanthochromia on lp

Answer 19

suggestive of sah
different from vascular bleed or thromnbosis as those will show cclots on lp

Question 19

snoop redf flags of sec headaches

Answer 19

systemic symptoms
onset of pain (acute/sudden eg thunderclap)
older
postural changes
(if precip with valsava, position, exertion)

Question 20

migraine attack phases

Answer 20

prodromal phase- activation of intracran center
aura phase- cortical spreading depression
headache phase- photophobia
postdrome- migraine hangover. fatigue

Question 21

ergotamines

Answer 21

migraine treatment but avoided because many cvs aes

Question 21

preventative migraine tx

Answer 21

antidep
beta bloc
caclium antag

nb theres different drug sets for the different tyoes of migraines

Question 21

triptans

Answer 21

most common treatment for migraines

Question 22

headache worse with coughing/ straining/valsava

Answer 22

indicates inc icp which may be mass lessions

Question 23

pit apoplexy

Answer 23

thunderclap headache between the eyes assoc visual disturbances

Question 24

headache worse in morning in elderly

Answer 24

icp in spine and head equalises over night assoc swollen disc common

Question 25

idiopathic intracran hypertension

Answer 25

lp req presents with optic compression- red visual field

Question 26

low csf pressure headache

Answer 26

worse standing up better lying down (opp to high icp) lp req if csf opening pressure is low then it is diagnostic mri will find thickening of dural layers

Question 27

pathophys of seizures

Answer 27

imbalance of excitabilty and inhibitory receptors in at a focal point that propagates the excitation to surrounding neurons via cc to other hemisphere

Question 28

focal aware seizures

Answer 28

pt fully aware of events occuring during seizure

Question 29

focal impaired awareness seizures

Answer 29

pt loses awareness of some events may be assoc with speech abn and memory loss

Question 30

generalized seirzures

Answer 30

motor- tonic-clonic or other motor non motor- absence

Question 31

epileptic diagnosis

Answer 31

two or more unprovoked seizures less than 24 hours apart. no metaimbalance because eg alcohol binges predisposes to seizures

Question 32

myoclonic seizures

Answer 32

single jerk

Question 33

epileptic spasms

Answer 33

most common in infants assoc trunkal spasms

Question 34

absent seizures

Answer 34

no loss of tone, unaware, blank stare, may have multiple attacks presents in children previously petit mal

Question 35

myoclonia

Answer 35

unable to open eyes during seizure

Question 36

lennox gastaut synd

Answer 36

childhood phsychomotor retardation therapy difficult

Question 37

febrile seizures

Answer 37

due to underlyling infection self limited does not devel seizures later on but any metab abn does inc risk of recurrent seizures