Random Flashcards
(14 cards)
CSF finding of increased glutamine is specific for?
hepatic encephalopathy often preciptated by GI bleed, infection and diuretics characterized by somnolence, agitation, asterixis, nystagmus, seizures, disconjugate movements. Treat by correcting electrolyte imbalance and glucose. Correct coagulopathy
Which vit def can present similar to friedrich ataxia?
vitamin E deficiency
signs of basilar skull fracture
racoon eyes -periorbital ecchynoses
battle’s sign -postauricular ecchymoses
hemotypanum
CSF rhinorrhea/otorrhea
how does hyperventilation help treat increased intracranial pressure
hyperventilation will lead to decrease paCO2 –> prevents cerebral vasodilation –> no cerebral edema
Pseudobulbar palsy
the inability to control facial muscles, including the tongue. This may manifest as: dysarthria (slowed or slurred speech) dysphagia (difficulty swallowing) dysphonia (spasms of vocal cord muscles)
The condition is usually caused by the damage (bilateral degeneration) to the neurons of the brain stem, specifically to the corticobulbar tract (upper motor neuron tract to cranial nerve motor nuclei).
first order sympathetic pathway is from ipsilateral posterolateral hypo to
intermediolateral cell columns (c8-T1)
most common sites of intracerebral hemorrhage are: 1) Basal ganglia 2) Pons. ICH presents with focal neuro deficits that worsen steadily. What are the pupil findings in ICH of basal ganglia, pons and thalamus
1- basal ganglia/putamen -dilated pupils
2- pons -pinpoint pupils
3- thalamus -poorly reactive pupils
In someone with a hemorrhage stroke in the parenchyma, it is impt that BP isn’t too high, but to reduce BP has to be careful b/c inducing hypotension can decrease cerebral blood flow. What’s generally the BP med of choice
nitroprusside
IF you want to do a LP but papilledema is noted, should you continue
NO bc of fear of herniation
TO diagnose SAH, do CT w/o contrast. If neg, but strong suspicion, do LP (finding xanthrocrhomia -sign of RBC lysis is gold std). if confirmed, what to do next?
cerebral angiogram to determine site for surgical clipping or coiling
Ataxia Telangiectasia
An AR d.o with onset in childhood presenting with ataxia and telangiectasias with increased incidence of cancer
Binswanger disease
insidiuous onset
due to diffuse subcortical white matter degeneration in pt with long standing HTN causing vascular dementia
What meds in particular should be avoided in someone with lewy body dementia?
neuroleptics
do not give someone with GBS steroids because they are usu harmful -T/F
true
