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27 terms

Neuro miscellaneous conditions

IDMT Neurological 4-3
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CNS infection
caused by bacteria, mycobacteria, spirochetes
complecations of cns infection
infection of middle ear, sinus, lungs, mastoiditis, skull fracture, uri, facial boils, furnuncle
S&S CNS infection
HA, fever, NECK/BACK STIFFNESS, N/V, CHANGE IN CONCIOUSNESS, +BRUDZINSKI/ KERNIG
3 types of CNS infection
meningitis, encephalitis, brain abcess
TX for CNS infection
IV, foley, supportive care, ceftriaxone and vancomycin (together), chloraphencial , close contact Rifampin
S&S of intracranial injuries
may or may not be due to head injury, HA, dizzy, MENTAL CONFUSION, LOSS of CONCIOUSNESS, N/V, unequal pupils, HEMIPELEGIA, visual disterbance, +kernigs/brudzinski/babinski, personality change
4 types of intracranial injuries
concussion, epidural hemorrhage, subdural hemorrhage, subarachnoid hemmorrhage
Diff DX intracranial injuries
diabetic emergancies, alcohol intoxication, CVA (cerebreal vascualr accident)
TX for intracranial pressure
supportive, if BP IS ELEVEATED DONOT RAPIDLY LOWER. KEEP DIASTOILC BP 100, restrict fluids to no more than 2L per day, IV limit 1200-1800cc/ day if uncioncious or cannot swollow.
Herniated Nucleus pulposus (HPN)
INVERTEBRAL DISK RUPTURE, and PART OF THE NUCLEUS PULPOSUS protrudes or ruptures into the foramen; most commonly occuring in LUMBOSACRAL or cervical area
S&S of HPN
pain C COUGH,SNEEZE, VALSALVA or BM, aggrevated when sitting or bending long periods, muscle weakness and atrophy, loss of bowel or bladder
TX for HPN
BR, analgesics, consult
cord and spinal column injuries
S&S hx of MVA, fall or flailed chest, pain, point tendernessm numbness, tingeling, weakness, paralysis, anesthesia or contusion
TX for cord and spinal column injuries
ABC's, immobilize, hard litter (min 3 people to move), supportive care, evac
botulism
FOOD POISENING casused by injestion of TOXINS of type A,B,E or F CLOSTRIDIUM BOTULINUM form HOME -CANNED FOODS, veggies, fish, fruit.
S&S of botulism
ABRUPT ONSET, within 18-36 hrs, incubation period 4 hrs to 8 days, N/V/D, ABD cramping precede neurological signs, usually bilat and symmetrical eith decending weakness
visual S&S of botulism
diplpia, loss of power pd accommodation, diminished acuity, blepharoptosis, diminished or total oss od pupillary light reflex
Diff DX for botulism
guillian barre syndrome, polio, stroke, tick infestation
TX for botulism
antitoxins, BR C lowered head, NG tube, supportive care
Stroke in evolution
an ENLARGED BRAIN infarction manifested by neurological deficit that WORSENS OVER 24-48 hrs
completed stroke
brain infarct manifested by neurological deficits that SIGNIFY STROKE injury
risk factors for stroke /infarction/ cerebral vascular accident
>60, fam HX, male, prior hx of transient ischemic stroke (TIA) or stroke
treat table risk factors for CVA/ stroke/infarction
arrthymais, cardiomyopathy, DM, excessive ETOH use, HX migraines, HTN, DRUGS, TOB, ELEVATED CHOLESTEROL
S&S of CVA/stroke/infarction
weakness/ sensory loss/ decreased grip strength on contralateral side,abulia, frank confusion
contralateral
oppisite side
abulia
loss of initiative
TX for CVA/stroke/ infarction
BLS, airway, BR, O2, foley, MONITOR LOC-GCS