Term
| Management of ischemic stroke |
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Definition
restoration of blood flow
- risk of hemorrhage (increase BP, thrombolytics)
- TPA
limitation of deficit
primary prevention
secondary prevention
- cardioembolic: warfarin (A-fib)
- aspirin (everyone)
- statin (LDL> 100) |
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Term
| management of berry aneuryms |
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Definition
oxygenation, BP
calcium channel blocker (nimodipine)
management of vasospams
clip/coil (<3 days, >14days) |
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Term
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Definition
| closely packed, distended blood vessels of varying wall thickness |
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Term
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Definition
| small caliber, multiple within the normal brain |
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Term
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Definition
one or more dilated veins in normal brain
no arterial compartment |
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Term
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Definition
brain focal contusion
brusing area not the same as impact area |
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Term
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Definition
uncus of temporal lobe shift medially
comprssion on CN III - lose parasympathetic, extraocular muscle
compression on PCA
compression on cerebral peduncle - contralateral hemiparesis |
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Term
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Definition
compression of medullar oblongata
- respiration depression and death |
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Term
| frontal mass lesion symptoms |
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Definition
behavioral changes
poor decision making
decreased work performance
motor weakness (if posterior) |
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Term
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Definition
contralateral motor weakness (if anterior)
contralateral sensory change
dominant parietal lobe syndrome
- gerstmann's (agrahia without alexia, right/left disorientation, acalculia finer agnosia
receptive language error |
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Term
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Definition
language disturbance
memory, visual impairment
seizure common |
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Term
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Definition
hydrocephalus
ataxia of gait
dysmetria of arms
speech changes |
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Term
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Definition
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Term
| descending pain modulation pathways |
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Definition
serotonin: periaquaductal gray -> rostral ventromedial medulla -> dorsal horn
NE: cingulate gyurs -> dorsolateral pontine tegmentum -> dorsal horn
DA: hypothalamus -> dorsal horn |
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Term
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Definition
| innocuous pain -> suddenly painful |
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Term
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Definition
| mildly painful -> intensely painful |
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Term
| complex regional pain syndrome |
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Definition
antecedent injury -> severe pain
regional autonomic abnormality - high temperature, skin discoloration, edema |
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Term
| uses of strong opioid (morphine) |
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Definition
severe pain
allays anxiety and sedates
Acute MI - with vasodilators
acute pulmonary edema
general anesthesia
closed head injury - caution |
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Term
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Definition
euphoria
ventilation depression - increase ICP
nausea vomiting (emesia)
COPD, sleep apnea, other ventilation/respiratory problem -> safe dose can be fatal
constipation
gall bladder pain/spasm
hypotension |
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Term
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Definition
parental - general anesthesia, + midazolam -> conscious sedation
transdermal - hospice, not for fast management
transmucosal - preanesthetic medication (lollipop) |
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Term
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Definition
good oral bioavailability
long half life -> accumulation
detoxification for morphine addiction |
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Term
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Definition
use for less than 48 hrs, low dose
advantages: little bile duct spasms
disadvantages: frequent dosing, toxic metabolite -> tremor, seizure
DDI: MAOI and drugs that increase serotonin |
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Term
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Definition
lipophilic
active metabolite in CNS |
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Term
| uses of hydrocodone, oxycodone, codeine |
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Definition
moderate pain
antitussive
potentiated by aspirin,acetaminophen |
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Term
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Definition
oxycodone controlled release tablet
if not swallowed whole, rapid absorption and intense opioid-like euphoria |
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Term
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Definition
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Term
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Definition
opioid antagonist
tx opioid OD
no intrinsic toxicity
need frequent dosing
induce withdrawal syndrome if opioid dependent |
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Term
| Toxicity of local anesthesia |
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Definition
CV depression (Na channel blockade)
repiratory depression
generalized convulsive seizures (progressive CNS stimulation) |
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Term
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Definition
don't ionize well at physiological pH
topical use only
hydrolyzed to PABA |
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Term
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Definition
mucosal surface usage
cortical stimulant
block reuptake of NE -> sympathomimetic -> vasoconstriction |
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