Neurology Rosh Review
What are subarachnoid hemorrhages usually caused by - ANS-ruptured saccular
aneurysms, specifically ruptured berry aneurysms
What are symptoms of berry aneurism rupture - ANS-sudden-onset, severe headache,
also known as the thunderclap headache ("worst headache of my life")
Others may include: brief loss of consciousness, vomiting, and neck pain or stiffness
How is diagnosis of subarachnoid hemorrhage made - ANS-Non-con head CT
What is the only effective treatment for subarachnoid hemorrhage TO PREVENT
RE-BLEEDING - ANS-aneurism repair with surgical clipping or end-vascular coiling
How soon should SAH repair be initiated - ANS-Within 24 hours of diagnosis, after the
patient is stabilized
What is more commonly due to traumatic head injury more so than AV malformations, or
family history - ANS-Subdural hematoma
Which funduscopic finding predicts a poorer prognosis with intracranial hemorrhage? -
ANS-Terson syndrome (preretinal hemorrhages).
Treatment of SAH, other than surgical repair - ANS-supportive
Nimodipine (CCB; decreases vasospasm)
Risk factors for SAH - ANS-Family history
HTN
Smoking
What is used for symptomatic relief in patients with Alzheimer Dz, but does not change
the course of the disease - ANS-cholinesterase inhibitors
N-methyl-D-aspartate (NMDA) receptor antagonist
Vit E supplementation
Selegiline
Examples of cholinesterase inhibitors - ANS-Donepezil
rivastigmine
, galantamine
What N-methyl-D-aspartate (NMDA) receptor antagonist is used in the symptomatic
treatment of Alzheimer Dz - ANS-Memantine
What is given to a patient with an animal bite with unknown rabies status -
ANS-Administer the human diploid cell rabies vaccine and immune globulin in the site of
the bite
When is the immune globulin and rabies vaccine given - ANS-Immune globulin is only
given once - at the time of presentation
The rabies vaccine should be given on days 0, 3, 7, and 14 for optimal prevention of
rabies
How should pregnant women be treated for exposure to a potentially rabid animal? -
ANS-Post-exposure prophylaxis should be administered. Neither the immune globulin
nor the human diploid cell rabies vaccine have been associated with fetal abnormalities.
What are symptoms of rabies - ANS-Hydrophobia, agitation, spasms
What condition can commonly be associated with elevated eosinophils in the
cerebrospinal fluid? - ANS-parasitic infection
Protein, glucose, and culture of CSF in Viral Meningitis - ANS-Protein: normal - slightly
elevated (<200mg/dL)
Glucose: low - normal
Cultures: negative
Protein, glucose, and culture of CSF in Bacterial Meningitis - ANS-Protein: High
Glucose: Low
Cultures: positive
Protein, glucose, and culture of CSF in fungal Meningitis - ANS-Protein: High
Glucose: Low
Cultures: Positive (fungal)
Protein, glucose, and culture of CSF in TB Meningitis - ANS-Protein: Very high
Glucose: Low
Cultures: Positive (AFB)
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