- Pure motor (MC) - Ataxic hemiparesis (leg > arm) - Dysarthria (clumsy hand syndrome) - Pure sensory loss

thrombolytics within 3 horus of onset - Alteplase only tpa effective in ischemic stroke - antiplatelet therapy: ASA after 3 hours and TPA not give; or at least 24 hours after thrombolytics - only lower BP if >185/110 for thrombo or >220/120 with no thrombo

The End Flashcards by Jessica Singer

Stroke of small vessels (penetrating branches)

Lacunar

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CM lacunar stroke

Pure motor (MC)
Ataxic hemiparesis (leg > arm)
Dysarthria (clumsy hand syndrome)
Pure sensory loss

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Tx lacunar stroke

ASA

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Middle cerebral stroke CM

contralateral sensory/motor loss/hemiparesis greater in face, arm > leg/foot
Contralateral homonymous heminopsia, gaze preference toward lesion
D: broca (expressive), wernicke (sensory), math comprehension, agraphia
ND: spatial deficits, dysarrthria, left sided neglect, anosognois, aprexia

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Anterior cerebral artery storke CM

contralateral sensory/motor loss/hemiparesis greater in leg/foot
face spared, speech preservation
Personality changes, confusion
Urinary incontince
Gaze preference toward lesion

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Posterior cerebral stroke CM

Visual hallucinations
Contralateral homonymous hemianopsia
Ipsilateral CN deficts + contralatteral muscle weakness

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Basillar stroke CM

cerebellar dysfunction

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vertebral stroke CM

vertigo, nystagmus, N/V, diplopia

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Ischemic stroke dx

non-con CT to r/o hemorrhage

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Tx ischemic stroke

thrombolytics within 3 horus of onset

Alteplase only tpa effective in ischemic stroke
antiplatelet therapy: ASA after 3 hours and TPA not give; or at least 24 hours after thrombolytics
only lower BP if >185/110 for thrombo or >220/120 with no thrombo

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Berry aneurysm MC location

circle of willis

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Spinal injury MC after blowout vertebral body burst fracture

anterior cord

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Anterior cord mneumonic

ANT couldn’t walk to the bathroom in the TeePee so he peeds his pants when his bladder busted into flex

(LE >UE)

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Spinal injury MC after hyperextension injuries

central cord

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MC incomplete cord syndrome

central cord

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central cord mneumonic

because maleficicent developed frost bite when she extended her hand to touch the cold window pane, she couldn’t put her shawl on with her weak hands

-UE>LE
sensory “shaw distribution”

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Posterior cord

loss of proprioception and vibratiory sense only

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MC cord syndrome after penetrating trauma

Brown-Sequard

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Brown sequard mneumonic

the MVP (motor, vib, prop) on the winning side was oblivious 2 (levels) the stabbing heat of pain (temp and pain) of defeat from the losing side

Ipsilateral motor, vibration, proprioception
Contralateral: pain, temp

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optic neuritis tx

IV methylprednisolone followed by oral steroids

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Most important step in chemical eye burns

irrigation

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irrigate eye for how long?

30 minutes or >2 L until pH 7.0 - 7.3

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Orbital cellulitis is most commonly secondary to

sinus infection (ethmoid)

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Orbital cellulitis abx

vanco, clinda

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erysipelas tx

IV PCN, vanco

cellulitis tx

cephalexin, dicloxacillin | MRSA: Iv vanc or linezolid

folliculiits tx

topical mupirocin, clinda, eryth

6th disease =

roseola

Only childhood exanthem that starts on trunk and spreads to face

Roseola

MC viral cause of pericarditis/ myocarditis

coxsackie

MCC of pancreatitis in children

mumps

Measles =

rubeola

Koplik spots

Rubeola

Koplik spots def

buccal mucosa

Rubeola CM

URI prodrome (cough, coryza, conjunctiviits) --> koplik spots --> morbilliform rash (bright red) at hairline --> extremities

vitamin that reduces mortality in rubeola

Rubella AKA

3 day rash

Rubella CM

low grade fever/cough/anorexia/LN --> pink maculopapular rash on face --> extremities

Forcheimer spots def:

soft palate

Forcheimer spots

Rubella, Scarlet fever

Fifth dz

Erythema infectuosum

Slapped check rash

Erythema infectuosum

Can cause aplastic crises in those with SCD or G6PD

erythema infectiuosom

Childhood rash that spares palms/ soles

erythema infectuosom

Posterior pituitary releases?

oxytocin and ADH

SIADH is d/t

increased ADH (inappropriate)

MC of SIADH

stroke

Type of cancer that secrets ectopic ADH (resulting in SIADH)

SCLC

patient usually only becomes symptomatic with SIADH when

increase oral free water intake

Dx of SIADH

isovolemic hypotonic hyponatremia

Tx SIADH

water restriction; demeclocycline in severe cases | -severe hyponatremia or intracranial bleed --> IV hypertonic saline with furosemide

Diabetes insipidus d/t

1) ADH deficiency (central DI) | 2) Insensitivity to ADH (nephrogenic) --> large amounts of dilute urine

Nephrogenic DI often caused by what drug

lithium

dx DI:

- fluid deprivation test: continued production of dilute urine - desmopressin (ADH) stimulation test: differentiates nephrogenic from central - Central: reduction in urine output - nephrogenic: continued production of dilute urine

Tx: central DI

desmopressin; carbamazepine

Tx: nephrogenic DI

na/protein restriction --> HCTZ, indomethacin

autonomic symptoms of hypoglyemica:

sweating, tremors, palpitations, nervousness, tachy

CNS symptoms of hypoglycemia:

HA, lightheadedness, slurred pseech, confusion, dizziness

Symptomatic hypoglycemic?

<60

If <60 bs tx?

fast acting carb

If <40 bs or LOC tx?

IV bolus D50 or inject glucagon SQ

Gold standard for diagnosis DM

fasting >126 (at least 8 hours, two occasions)

2 hr GTT =

>200

Gold standard for gestational DM testing

2 hr GTT

HBA1c

6.5+

random glucose

200+

breathing associated with DKA?

kussmaul's

what type of acid/base is DKA?

high anion gap metabolic acidosis

MCC of DKA/HSS?

infection

Tx DKA/HSS?

IV fluids: isotonic 0.9% NS until hypotension resolves --> 0.45% NS - When glucose reaches 250, switch to DS 0.45 (1/2) NS to prevent hypoglycmia - Insulin - K+ correction --> 20-40 me1/L if <5.5

Anion gap calculation

Na - (Cl + HC03)

High anion gap if >

pH of HHS

>7.30

pH of DKA

<7.30

MC type of hyperparathyroidism?

primary

MCC of primary hyperparathyroidism?

parathyroid adenoma

Primary hyperparathryoidism is d/t

excess PTH production

Hyperparathyroidism is common in people taking?

lithium

MEN I:

HPT, pituitary tumors, pancreatic tumors

MEN 2A:

HPT, pheo, medullary thyroid cancer

Secondary hyperparathyroidism is d/t

increase PTH d/t hypocalcemia or vitamin D deficiency

MCC of secondary hyperparathyroidism?

Chronic kidney failure

Triad of hyperparathyroidism:

hypercalcemia, increased PTH, decrease phosphate

Tx: primary hyperparathyroidism

parahtyroidectomy

Tx: secondary hyperparathyroidism

vitamin D/calcium supplements

Trousseu's associte dwith

hypocalcemia

Chvostek's associated with

hypocalcemia

The End Flashcards

(87 cards)