Term
| what type of aphasia is the inability to repeat what he hears? |
|
Definition
|
|
Term
| what tytype of aphasia is the inability to repeat what is said? |
|
Definition
|
|
Term
| what is life-threatening condition is global aphasia associated with? |
|
Definition
usually correlates with infarction of the middle cerebral artery
OR early manifestation of neoplastic, inflammatory, or degenerative disorder |
|
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Term
| what is a lesion to the frontal lobe result in? |
|
Definition
|
|
Term
| what does a lesion to the posterior temporal region result in? |
|
Definition
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|
Term
| what speech problem is caused by a stroke or CN involvement? |
|
Definition
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Term
| what is the treatment for Alcohol withdrawl? |
|
Definition
| Diazepam 5-20 mg po q4h prn |
|
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Term
| Pt. presents with Paresthesias, + trousseau's, + chvostek....what is this? How do you treat? |
|
Definition
Hypocalcemia
- tx: IV calcium gluconate and seizure precaution |
|
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Term
| what is the most common cause of Meningitis? MC pathogen? |
|
Definition
Viral Meningitis
MC pathogen: Enterovirus |
|
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Term
| What are the tests used to diagnose meningitis? |
|
Definition
1. Kernig's
2. Brudzinski
3. Lumbar puncture (cloudy CSF, high protein) |
|
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Term
| How do you treat viral meningitis? |
|
Definition
| Acyclovir 1.25 mg/kg/day IV divided TID x10days |
|
|
Term
| what is an infection of the brain parenchyma? |
|
Definition
|
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Term
| what is characterized by hemiparesis, personality changes, focal seizure, ataxia, dysphagia, and hemiparesis? |
|
Definition
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|
Term
| What is the most common cause of fatal encephalitis in the US? |
|
Definition
|
|
Term
| what is the second most common cause of dementia? |
|
Definition
| Dementia with Lewey Bodies |
|
|
Term
| what is the third most common cause of dementia? |
|
Definition
| Vascular (Multi-infart) dementia |
|
|
Term
| what should you screen for if you suspect dementia? |
|
Definition
|
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Term
| what is a sudden,rapid, twitch like muscle contraction? how do you treat? |
|
Definition
Myoclonus
- valproic acid (anticonvulsant)
-clonazepam (benzodiazepines_ |
|
|
Term
| What is a form of myoclonus associated with hepatic encephalopathy? |
|
Definition
|
|
Term
| what does a CT or MRI demonstrate in patients with Huntington's? |
|
Definition
| atrophy of cerebral cortex and caudate nucleus |
|
|
Term
| what is Gilles de la Tourrette's syndrome? |
|
Definition
| chronic motor and vocal tics |
|
|
Term
| what drugs cause "tardive dyskinesia" |
|
Definition
1. reglan
2. phenergan
3. haldol |
|
|
Term
| what are the "TRAP" presenting symptoms of parkinson's |
|
Definition
1. Tremor (resting)
2. Rigidity
3. Akinesia/bradykinesia
4. Postural instability |
|
|
Term
| how do you test bradykinesia? |
|
Definition
ask patient to "polish" the back of one hand with another, or tap the table with fingers of one hand then another
you will see "masked facies"
-characteristic of parkinson's |
|
|
Term
| what occurs when the function of both cerebral hemisphere or the brainstem RAS is compromised? |
|
Definition
|
|
Term
| what are two major causes of LOC? |
|
Definition
|
|
Term
| what is an episode of altered consciousness characterized by excessive or over-synchronized discharges of cerebral neurons? |
|
Definition
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|
Term
| what is characterized by brief symptoms that may precede the onset of some seizures? |
|
Definition
|
|
Term
| what is sx is suggestive of a seizure vs. syncope? |
|
Definition
syncope --> prodromal lightheadedness
seizure --> "aura" symptoms. postictal confusion state |
|
|
Term
| what labs do you order to confirm seizures? what may confirm seizures |
|
Definition
glucose, calcium, FTA-ABS, electrolytes, CBC,ESR,BUN, Cr, LFTs
-EEG may confirm seizures but does not rule out if negative |
|
|
Term
| what is necessary to order with a patient presenting with a first time seizure? |
|
Definition
|
|
Term
| when is an EEG indicated with seizures? |
|
Definition
| in a patient with new-onset generalized tonic-clonic seizures |
|
|
Term
| when is a lumbar puncture indicated with a seizing patient? when would you do a lumbar puncture? |
|
Definition
| Perform a lumbar puncture only after CT and MRI have demonstrated the ABSENCE of a intracranial lesion |
|
|
Term
|
Definition
| a condition when a patient has RECURRENT seizures and may be essential (idiopathic) or due to secondary cause |
|
|
Term
| what is a partial seizure VS. generalized seizure? |
|
Definition
Partial seizure - preservation of consciousness
Generalized - loss of consciousness |
|
|
Term
| Pt presents with abnormal unilateral movements, tachycardia, dysphagia, without LOC that last for less than 1 min...what type of seizure is this? |
|
Definition
| partial seizure (because no LOC) |
|
|
Term
| Pt has unilateral movements, involuntary movement (clapping hands, licking lips) and has altered consciousness. What type of seizure is this? |
|
Definition
| Complex partial seizure ( no LOC but amnesia for the event) |
|
|
Term
| what area of the brain is involved in complex partial seizures? |
|
Definition
| medial temporal or inferior frontal lobes |
|
|
Term
| what seizure is characterized by brief lapses of consciousness without a loss of postural control and a vacant stare? |
|
Definition
|
|
Term
| What is the gold standard for diagnosing seizure disorders? |
|
Definition
|
|
Term
| what is the physiologic effect of a seizure last less than 15 min? |
|
Definition
| tachycardia, elevated BP, hyperglycemia, elevated temp, leukocytosis |
|
|
Term
| what is the physiologic effect of a seizure lasting 15-30 min |
|
Definition
| hypotension, hypoglycemia, dysrhythmias, pulmonary edema |
|
|
Term
| What is the physiologic effect of a seizure lasting longer than 1 hour? |
|
Definition
| hypotension with decreased cerebral blood flow, disruption of BBB leading to cerebral edema |
|
|
Term
| what is the treatment of choice for generalized tonic clonic seizures? |
|
Definition
|
|
Term
| what type of seizure involve clonic movements of a single muscle group in face, limb or pharynx, often preceded by an aura? consciousness is preserved |
|
Definition
|
|
Term
| what type of seizure involves impaired consciousness, responsiveness, and memory with olfactory hallucinations? |
|
Definition
|
|
Term
| what is the most common type of seizure? |
|
Definition
| partial seizures (6/10 people with epilepsy) |
|
|
Term
| what is first line treatment for partial seizures? |
|
Definition
|
|
Term
| 7 y/o boy with hx of brief loss of consciousness for 5-10 seconds that accompanies blinking and head turnig...what are you thinking? |
|
Definition
|
|
Term
| what type of seizure is a medical emergency? what does indicate? |
|
Definition
Status epilepticus
- may indicate brain injury or death
(mortality rate is 20% for first episode) |
|
|
Term
| what Rx is consider for status epilepticus? |
|
Definition
Thiamine 100 mg (pt. with hx of alcohol)
Diazepam 0.1-0.2 mg/kg IV
Lorazepam 0.1
Phenytoin 20 mg/kg IV with ECG monitor |
|
|
Term
| what is the time period for which seizures should be controlled? |
|
Definition
|
|
Term
| what is the most common seizure trigger? |
|
Definition
| missing a dose of medication |
|
|
Term
| what is the temp of a febrile seizure? |
|
Definition
|
|
Term
| what are Cheynes-Strokes respirations? |
|
Definition
| waxing and waning hyperpnea with brief eisodes of apnea seen in coma or stupor patients |
|
|
Term
| what two responses should be tested in an unconscious patient? |
|
Definition
1. oculocephalic (doll's eyes) response
2. caloric response |
|
|
Term
| what is the management for a stupor or comatose patient? |
|
Definition
1. ABCs
2. Intubation if GGS<8
3. IV NS with 25g dextrose, 100 mg thiamine, 0.4-1.2mg naloxone |
|
|
Term
| what are the cardinal features of brain death? |
|
Definition
1. coma/unresponsiveness
2. absence of brainstem reflexes (fixed pupils, oculocephalic, gag, grimacing)
3. apnea ( no respiration even with PC02>60mmHg |
|
|
Term
| What are brain attack sx? |
|
Definition
-trouble walking
-weakness on one side
-trouble seeing
-trouble speaking |
|
|
Term
| what is the most common type of stroke? |
|
Definition
|
|
Term
| what is the main risk factor for stroke? |
|
Definition
|
|
Term
| abrupt onset of symptoms followed by gradual improvement is suggest of what? |
|
Definition
|
|
Term
| abrupt onset with progression to maximal deficit over minutes to hours is suggesting of what? |
|
Definition
|
|
Term
| onset during sleep or a stepwise progression is suggestive of what? |
|
Definition
|
|
Term
| onset associated with severe headache or alterations in consciousness suggests? |
|
Definition
|
|
Term
| what are the two classification of vascular supply to the brain? |
|
Definition
1. anterior circulation
2. posterior circulation |
|
|
Term
| Patient present with abrupt onset of monocular blindness, transient aphasia, horner's sign , and carotid bruits. Where is the location of the occluded artery? |
|
Definition
| Carotid Artery Occlusion (anterior circulation stroke) |
|
|
Term
| patient present with sudden onset of contralateral paralysis that is affecting his leg more than his arm. He is apraxic and has abulia. Where is the occulsion causing these symptoms? |
|
Definition
| Anterior cerebral artery occlusion (anterior circulation stroke) |
|
|
Term
| Patient presents with hemiparesis that is affected his arm more than his leg. He has symptoms of global aphasia and homonymous hemianopsia. Where is the occlusion causing these symptoms? |
|
Definition
| Middle Cerebral Artery territory (anterior circulation stroke) |
|
|
Term
| What two occlusions are involved in posterior cerebral artery circulation? |
|
Definition
1. posterior cerebral artery occlusion
2. vertebral basilar artery occlusion |
|
|
Term
| Pt presents with sudden hemianopsia, alexia without agraphy, sensory loss, athetosis (weird movement), Weber syndrome, and paralysis of the eye. What type of occlusion would cause this |
|
Definition
| Posterior Cerebral artery occlusion syndrome |
|
|
Term
| Patient presents with sudden onset of binocular visual disturbances, vertigo, drop attacks. What type of occlusion causes these symptoms? |
|
Definition
| Vertebral-Basilar Artery occlusion |
|
|
Term
| Patient present with presyncope, neuro deficits, and blood pressure differences between arms. What causes these symptoms? |
|
Definition
| Subclavian steal syndrome |
|
|
Term
| What disease causes slowly evolving symptoms of pure motor hemiplegia, dysarthria, ataxic hemiparesis, dementia? |
|
Definition
|
|
Term
| what type of imaging should you order for a suspected stroke? |
|
Definition
|
|
Term
| what are the 3 most prominent examination findings for acute stroke? |
|
Definition
1. asymmetrical facial weakness
2. arm drift/weakness
3. abnormal speech (dysarthria) |
|
|
Term
| what is the most important diagnostic test when assessing a stroke patient? |
|
Definition
|
|
Term
| What does an ischemic stroke look like on noncontrast CT? |
|
Definition
| looks DARK (may look normal the first 24 hours) |
|
|
Term
| what does an Hemorrhagic stroke look like on noncontrast CT? |
|
Definition
| appears WHITE (seen earlier than ischemic) |
|
|
Term
| when should TPA be administed? |
|
Definition
| within the first 3 hours of the event |
|
|
Term
| when should IV TPA be administered? |
|
Definition
| administer in less than 60 mins after evaluation by a physician, and CT scan |
|
|
Term
| Subarachnoid Hemorrhage is suspected after a Nonconstrast CT is negative, what should you do next? what will you see? |
|
Definition
Lumbar puncture
- Xanthochromia (yellow CSF) within 4 hours from time of hemorrhage |
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