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Confusional States - Level 3
Terms in this set (30)
Water restriction, for severe symptoms infusion of hypertonic saline with or without intravenous furosemide.
What is the treatment for hyponatremia?
A disorder of white matter associated with excessively rapid correction of hyponatremia that can produce a confusional state, paraparesis or quadriparesis, dysarthria, dysphagia, hyper or hyporeflexia, and extensor plantar responses.
What is central pontine myelinolysis?
Overt or latent tetany.
What is the most characteristic physical sign seen in hypocalcemia?
Neuronal loss, demyelination, and gliosis in periventricular gray matter.
What pathologic features are seen in Wernicke's encephalopathy?
What CSF abnormality is seen in hepatic encephalopathy?
Acute confusional state, skin rash, fever, vomiting, headache, neck stiffness, skin abscess, otitis, coma, seizures, cranial nerve palsy.
What signs and symptoms may be seen in meningococcal meningitis?
Acute confusional state, headache, fever, meningismus, neck stiffness, jaundice, organomegaly, orchitis.
What signs and symptoms may be seen in viral meningitis?
Supportive management (exception: acyclovir for herpes simplex encephalitis). Acetaminophen for headache and fever, phenytoin for seizures, mechanical ventilation and IV or NG feeding in comatose patients.
What is the treatment for viral meningitis/encephalitis?
Children and young adults.
What age demographics are most frequently affected with viral meningitis?
CSF pressure is normal or increased, lymphocytic or monocytic pleocystosis is present, with cell counts usually less than 1000/mL, protein is normal or slightly increased, glucose is usually normal.
What CSF abnormality is seen in viral meningitis?
Mumps, herpes zoster, and herpes simplex encephalitis.
Which viruses may cause viral meningitis with decreased CSF glucose?
Headache, lethargy, acute confusional state, nausea, vomiting, visual loss, seizures, meningismus, papilledema, spinal tenderness. In diabetic patients infected with Mucor: facial pain, eye pain, nasal discharge, proptosis, visual loss.
What are some signs and symptoms of fungal meningitis?
Fever, chills, myalgia, nausea, vomiting, anemia, renal failure, hypoglycemia, acute confusional states, seizures, and pulmonary edema.
What are clinical features of malaria?
None, as toxoplasmosis is normally asymptomatic in healthy individuals. Symptomatic infection is associated with underlying malignancy (e.g. Hodgkin disease), immunosuppressive therapy, or HIV infection.
In healthy individuals, what is the most common presentation of toxoplasmosis?
Multiple calcifications and ring enhancing lesions.
What MRI findings are seen in cerebral toxoplasmosis?
It is caused by free-living ameba Naegleria fowleri when patients are exposed to polluted water. N. fowleri enters the CNS through the cribiform plate. Produces a diffuse meningoencephalitis that affects the base of frontal lobes and posterior fossa, typically fatal within 1 week.
What causes primary amebic meningoencephalitis?
Through the cribiform plate. Produces a diffuse meningoencephalitis that affects the base of frontal lobes and posterior fossa, typically fatal within 1 week.
How does Naegleria fowleri gain entry to CNS?
Lower motor neuron weakness (78%), absent tendon reflex (60%), cognitive disturbance (50%), extensor plantar response (50%), dermatomal sensory deficit (50%), gait disturbance (46%), headache (38%), ophthalmoplegia (30%), altered mentation (25%), facial weakness (25%).
What are the most common signs and symptoms of leptomeningeal metastases?
9x more common in women than in men and usually has its onset between the ages of 10 and 40 years.
Describe the profile of a patient with SLE?
Antinuclear antibodies, anemia, hypocomplementemia, antinative DNA antibodies, leukopenia, and autoantibodies against ribosomal P proteins.
What laboratory findings are seen in SLE?
Pathologic activation of the coagulation and fibrinolytic systems in the setting of an underlying disorder such as sepsis, malignancy or trauma.
What is disseminated intravascular coagulation (DIC)?
Confusional states, coma, focal signs, and seizures.
What neurologic clinical findings are associated with DIC?
Treatment is directed at the underlying disease. Transfusion of RBCs, platelets, and coagulation factors from fresh frozen plasma and administration of heparin may be indicated.
What is the treatment for DIC?
It is a rare multisystem disorder defined by the pentad of: thrombocytopenic purpura, microangiopathic hemolytic anemia, neurologic dysfunction, fever, and renal disease.
What is thrombotic thrombocytopenic purpura (TTP)?
Altered consciousness, headache, focal neurologic signs, seizures or cutaneous purpura, ecchymosis or petichiae. Other symptoms may include malaise, fatigue, generalized weakness, nausea, vomiting, diarrhea, fever, and/or abdominal pain.
How do patients with TTP most often present?
Plasma exchange is the primary treatment and is sometimes combined with prednisone and antiplatelet agents.
What is the treatment for TTP?
What is the most common cause of dementia?
Atrophy of this anatomical structure in the brain is consistent with a diagnosis of Wernicke's encephalopathy?
What is a pseudonym for psychosis due to B12 deficiency?
Lactulose and Rifaximin
What are two treatments recommended in hepatic encephalopathy?
THIS SET IS OFTEN IN FOLDERS WITH...
Confusional States - Level 1
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Seizures and Syncope - Level 2
Motor Disorders - Level 1
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