Term
| Central vs Peripheral vertigo |
|
Definition
Peripheral:
-85-90%
-self-limiting
-less serious
-abrupt onset, severe intensity
-↑ w/change in position
-N/V, tinnitus
-Nystagmus fatigable
Central:
-10-15%
-not self-limited
-insidious onset
-not assoc. w/postural changes
-HA, Diplopia, dyarthria
-Nystagmus non-fatigable |
|
|
Term
|
Definition
| Coarctation, polycystic kidneys, Marfan's, Ehlers-Danlos, fibromuscular hyperplasia |
|
|
Term
| Reitr's syndrome classic triad |
|
Definition
Urethritis, arthritis, conjunctivitis
"Can't see, can't pee, can't climb a tree" |
|
|
Term
|
Definition
| A reactive arthritis immuno triggered by infectious urethritis, cervicitis, dysentery |
|
|
Term
| DDX of polyarticular arthritis |
|
Definition
| RA, SLE, Viral (Rubella or hepatitis), Rheumatic fvr, Reiter's Syndrome, Lyme' dz, serum sickness |
|
|
Term
| DDx of monoarticular arthritis |
|
Definition
| G-Spot: Gout, Gonorrhea, sepsis, pseudogout, osteoarthritis, trauma/injury |
|
|
Term
| Cold Caloric test (oculovestibular test) |
|
Definition
Ice cold saline or H2O to the ear, pt at 30 degree inclination
COWS:
-Nystagmus both eyes fast opposite side, slow return toward cold side:Not comatose, intact midbrain
-Both eyes tonically deviate toward cold water: Coma with intact brainstem
-No eye movement: Brainstem injury
-Movement only of eye on side of stimulus: Internuclear ophthalmoplegia, suggests brainstem structural lesion |
|
|
Term
|
Definition
| Peripheral dz (unilateral vestibular pathology) |
|
|
Term
|
Definition
| Central dz (brain stem lesion) |
|
|
Term
|
Definition
| Irregular pattern, precedes death, assoc. w. medulla lesion |
|
|
Term
|
Definition
Plaques from large neck vessels
Mural thrombi from heart (A-Fib, ANI)
Endocarditis
FAt emboli - long bone f
Air emboli - thoracic or dysbaric injury |
|
|
Term
|
Definition
|
|
Term
|
Definition
Awoke from sleep w/HA,
Burning, unilateral w/ flushing, lacrimation, rhinorrhea, nasal stuffiness, horners (ptosis, miosis, anhydrosis) |
|
|
Term
| Who usually gets cluster HA |
|
Definition
| Male, >25 y/o, tob/EtOH use |
|
|
Term
| Mortality of diffuse axonal injury |
|
Definition
|
|
Term
|
Definition
| Tremor, torticllis, trismus, rigidity, opisthotonus,oculogyric crisis, dysphonia, dysphagia |
|
|
Term
| Drugs that causes extrapyramidal symptoms |
|
Definition
Thorazine
Promazine
Haloperidol
Metoclopramide |
|
|
Term
| What is apneustic breathing |
|
Definition
| End expiratory pause assoc. w/ lesions of the pons/CN 5 |
|
|
Term
| Definition: cluster breathing |
|
Definition
| Short bursts of breath assoc. w/ lower pontine lesions |
|
|
Term
|
Definition
| •MC: Incompletete cord Sy • Elederly pts w/DJD •EtOH •Hyperextension •Cord contussion/centrally •Weakness arms >> legs •Variable bladder •Non-surgical •Tx: Steroids? |
|
|
Term
| MCC sudden conduct hearing loss |
|
Definition
| Conduct - cerumen impactation |
|
|
Term
| MCC sudden hearing loss sensorineural-unilateral |
|
Definition
|
|
Term
| MCC sudden hearing loss sensorineural-bilateral |
|
Definition
|
|
Term
|
Definition
| Penetrating cord injury-cord hemisection: ipsilateral motor (paralysis), propioception & touch/vibratoty loss + contralateral pain/temp loss •hemitransection •Crossed findings below level of injury |
|
|
Term
| DDx of sensorineural hearing loss |
|
Definition
| •Unilateral- viral neuritis, acustic neuroma, Menieres Dz, loud noise •Bilateral-ototoxic drugs (aminoglyc, e-mycin, vanco, antimalarials, NSAIDS, loop diuretics, antineoplastics), loud noise |
|
|
Term
| Brain hemorrhage w/pin-poin pupils |
|
Definition
| Pontine hemorrhage: severe occipital HA ->rapid coma ->decerebrate posturing |
|
|
Term
|
Definition
| •Loss of central vision, loss of vision or blurred, periorbital pain (↑ w/EOM), Marcus-Gunn pupil, red vision changes, 25% MS changes •Consult ophthalmology |
|
|
Term
|
Definition
| •Vascuitis - Possibly autoimmune •Triad: chronic oral ulcers, relapsing iridocyclitis, genital ulcers. Also, polyarthritis, erythema nodosum ❑ Tx: Steroids suppress |
|
|
Term
|
Definition
| Transient focal paralysis. Indicates that a seizure has occurred. |
|
|
Term
| Painful unilateral vision loss |
|
Definition
| •Temporal arteritis (↑ESR, HA, temporal tenderness) ❑ Dx: need a Bx for Dx) ❑ Tx: steroid 60 mg/d |
|
|
Term
|
Definition
| •MC: visual-scintillating scotoma or visual field defects. •Motor-hemiparesis, ophthalmoplegia, aphasia •Sensory-dysesthesia •Brainstem-vertigo, ataxia |
|
|
Term
|
Definition
| CN-V: Sensory / CN-VII:motor |
|
|
Term
| What is the difference b/w neuropathy & myopathy |
|
Definition
| •Neuropathy: distal weakness w/prox progression, paresthesias, ↓sensation, ↓DTR's, normal abs •Myopathy: diffuse or proximal weakness, sensory usually intact, DTR's intact, abnormal labs: ↑ESR, WBC, mm enxymes |
|
|
Term
| Posterior cerebral circulation supplies what structures? |
|
Definition
| 20% of cerebral blood-medial aspect of temporal lobes, visual occipital cortex, thalamus, brainstem, upper spinal cord, cerebellum, auditory & vestibular fxns of the ear. |
|
|
Term
|
Definition
|
|
Term
| MC bacteria in meningitis 18-50 y/o? Tx? |
|
Definition
| Strep, neisseira. Tx: ceftriaxone |
|
|
Term
|
Definition
| •↑Seum osmol >290 + serum Na •↓urine osmol <150 |
|
|
Term
|
Definition
| DDAVP 0.4 mg/kg intranasal. If urine output do not slow down: nephro DI or improper administration of DDAVP |
|
|
Term
| MC sequela of temporal arteritis |
|
Definition
| Blindness. if one loses vision, the other eye has 75% chance of vision loss in 1-20 days |
|
|
Term
|
Definition
| •Fixed dilated ipsilateral pupul (CN3) •Contralateral hemiparesis •Posturing •Apnea, coma, death |
|
|
Term
|
Definition
| •Flexion injury •Younger pts •Complete motor paralysis •Preserved vibration, propioception •Loss sensation & temp distal to lesion •Needs surgery |
|
|
