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IDMT Neurological 4-3

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


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


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


oppisite side


loss of initiative

TX for CVA/stroke/ infarction

BLS, airway, BR, O2, foley, MONITOR LOC-GCS

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