Neurological, Immune & Musculoskeletal Disorders

Vocabulary flashcards summarizing essential terms, diagnostics, treatments, and clinical features related to strokes, ICP, seizures, TBI, tumors, SCI, anaphylaxis, SLE, RA, OA, and gout.

Ischemic Stroke

Brain infarction caused by thrombus or embolus blocking cerebral blood flow.

Hemorrhagic Stroke

Bleeding into brain tissue from ruptured vessel, raising intracranial pressure.

FAST Acronym

Facial droop, Arm weakness, Speech changes, Time to call 911—rapid stroke recognition.

tPA (Alteplase)

IV thrombolytic for ischemic stroke given within 3–4.5 h of onset if no contraindications.

Thrombectomy

Endovascular removal of large-vessel clot within 6–24 h after stroke onset.

Modifiable Stroke Risk Factors

Hypertension, smoking, diabetes, atrial fibrillation, hyperlipidemia, obesity, inactivity, alcohol.

Non-modifiable Stroke Risk Factors

Age > 55, male sex, African American race, family history, prior TIA or stroke.

NIH Stroke Scale (NIHSS)

Standardized tool to quantify neurological deficit and track stroke evolution.

tPA Contraindications

Active bleed, recent surgery/trauma, INR > 1.7, BP > 185/110, low platelets, etc.

Increased Intracranial Pressure (ICP)

Rise in brain, blood or CSF volume within skull causing reduced cerebral perfusion.

Cushing’s Triad

Late ↑ICP sign: widened pulse pressure, bradycardia, irregular respirations.

Cerebral Perfusion Pressure (CPP)

MAP minus ICP; normal 60–70 mmHg; <60 → ischemia.

CPP Formula

CPP = MAP – ICP.

MAP Formula

MAP = (SBP + 2×DBP) / 3; normal 70–100 mmHg.

Osmotic Diuretic — Mannitol

Pulls fluid from brain to blood; monitor serum osmolality & renal function.

Hypertonic Saline (3%)

Concentrated saline to shrink cerebral cells and lower ICP.

Venticulostomy

Catheter in ventricle for ICP monitoring and CSF drainage.

Subarachnoid Hemorrhage (SAH)

Bleed into subarachnoid space, usually from ruptured aneurysm; sudden thunderclap headache.

Nimodipine

Calcium-channel blocker given after SAH to prevent cerebral vasospasm.

Aneurysm Clipping/Coiling

Surgical/endovascular repair to secure ruptured or unruptured cerebral aneurysm.

Status Epilepticus

Seizure >5 min or back-to-back seizures without recovery; medical emergency.

Tonic-Clonic Seizure

Loss of consciousness with stiffening then rhythmic jerking; postictal confusion.

Absence Seizure

Brief staring episodes with impaired awareness, common in children.

Focal (Partial) Seizure

Begins in one cerebral hemisphere; may retain or lose awareness.

Atonic Seizure

Sudden loss of muscle tone causing falls (“drop attack”).

Myoclonic Seizure

Brief shock-like jerks of a muscle or group of muscles.

Aura

Sensory warning (odor, visual flash) that can precede some seizures.

Lorazepam

First-line IV benzodiazepine for acute seizure or status epilepticus control.

Phenytoin

Long-acting anticonvulsant; narrow therapeutic range, causes gingival hyperplasia.

Levetiracetam (Keppra)

Broad-spectrum antiepileptic with few drug interactions; common maintenance drug.

Seizure Precautions

Pad rails, bed low, suction/O₂ ready; turn patient on side during seizure.

Concussion

Mild traumatic brain injury with transient neuro dysfunction, no visible lesions on imaging.

Diffuse Axonal Injury

Widespread shearing trauma causing coma; often seen on MRI, poor prognosis.

Glasgow Coma Scale (GCS)

Scores eye, verbal, motor response (3–15) to assess consciousness after TBI.

Halo Sign

Ring pattern of CSF mixed with blood on gauze, suggests basilar skull fracture.

Brain Tumor

Abnormal intracranial mass (primary or metastatic) that raises ICP and causes focal deficits.

Dexamethasone

High-dose steroid to reduce cerebral edema around brain tumors.

Craniotomy

Surgical opening of the skull to remove tumor, evacuate hematoma, or relieve pressure.

Glioblastoma

Aggressive primary malignant brain tumor with poor prognosis.

Spinal Cord Injury (SCI)

Damage to spinal cord causing motor, sensory, autonomic deficits below lesion.

Neurogenic Shock

Loss of sympathetic tone after high SCI: hypotension, bradycardia, warm skin.

Autonomic Dysreflexia

Life-threatening uncontrolled sympathetic discharge (T6 or above) causing severe HTN, headache, bradycardia.

ASIA Scale

Assessment tool grading motor/sensory function after spinal injury (A–E).

Baclofen

GABA-agonist muscle relaxant for spasticity in SCI or MS.

Tizanidine

Alpha-2 agonist used orally to reduce muscle spasticity.

Anaphylaxis

Severe IgE-mediated allergic reaction with airway, breathing and circulatory compromise.

Epinephrine (IM)

0.3–0.5 mg IM into thigh—first-line drug for anaphylaxis; causes vasoconstriction, bronchodilation.

Type I Hypersensitivity

Immediate IgE-mediated reaction (e.g., anaphylaxis, allergic asthma).

Biphasic Reaction

Recurrence of anaphylaxis symptoms hours after initial resolution.

Systemic Lupus Erythematosus (SLE)

Multisystem autoimmune disease with immune-complex deposition (Type III hypersensitivity).

Butterfly (Malar) Rash

Characteristic erythematous rash over cheeks and nose seen in SLE.

Anti-dsDNA Antibodies

Highly specific lab marker for SLE; levels correlate with disease activity.

Lupus Nephritis

Renal involvement of SLE presenting with proteinuria, hematuria, rising creatinine.

Hydroxychloroquine

Antimalarial drug that reduces SLE flares; requires regular eye exams.

Rheumatoid Arthritis (RA)

Chronic autoimmune synovitis leading to joint destruction and systemic features.

Pannus Formation

Inflamed granulation tissue that erodes cartilage and bone in RA joints.

Morning Stiffness >1 hour

Classic symptom distinguishing inflammatory arthritis (RA) from OA.

Anti-CCP Antibodies

Highly specific blood test for RA; often positive early in disease.

Methotrexate

First-line DMARD for RA; weekly dosing, monitor liver, CBC, use folic acid.

Osteoarthritis (OA)

Degenerative joint disease due to cartilage loss and osteophyte formation.

Heberden’s Nodes

Bony enlargements at distal interphalangeal (DIP) joints in OA.

Bouchard’s Nodes

Bony enlargements at proximal interphalangeal (PIP) joints in OA.

Chondrodegeneration

Progressive cartilage breakdown characteristic of osteoarthritis.

Total Joint Replacement

Surgical implantation of prosthetic joint for end-stage OA.

Gout

Crystal-induced arthritis from hyperuricemia leading to acute joint inflammation.

Hyperuricemia

Serum uric acid >6.8 mg/dL predisposing to gout flares and tophi.

Tophi

Deposits of monosodium urate crystals in soft tissues during chronic gout.

Colchicine

Antigout drug that inhibits neutrophil action, used for acute attacks and prophylaxis.

Allopurinol

Xanthine oxidase inhibitor that lowers serum uric acid for chronic gout management.

Needle-shaped Negatively Birefringent Crystals

Synovial fluid finding diagnostic of gout on polarizing microscopy.

Mono-sodium Urate Crystals

Uric acid salt that precipitates in joints, triggering gouty inflammation.

Indomethacin

NSAID often used as first-line treatment for acute gout flare.

CPP < 60 mmHg

Level at which cerebral ischemia begins due to inadequate perfusion.

Barbiturate Coma

High-dose barbiturates to lower cerebral metabolism and ICP in refractory cases.

Decorticate Posturing

Flexed arms, extended legs indicating damage above brainstem; late ↑ICP sign.

Decerebrate Posturing

Extended arms and legs indicating brainstem damage; worse prognosis.

Intracranial Pressure Monitoring

Invasive measurement via ventricular or parenchymal catheter to guide ICP therapy.

Decompressive Craniectomy

Removal of skull section to allow brain swelling and reduce ICP.

Osteophytes

Bone spurs forming at joint margins in osteoarthritis.

Synovial Fluid in OA

Non-inflammatory fluid with WBC <2000 cells/µL.

Capsaicin

Topical analgesic that depletes substance P, used for OA hand or knee pain.

NSAID GI Risk

NSAIDs may cause ulcers/bleeding; use lowest dose, add PPI if needed.

Stool Softeners in SAH

Prevent straining and spikes in ICP following a subarachnoid hemorrhage.

Hypertonic Saline Indications

Used for acute ↑ICP or cerebral edema when mannitol contraindicated.

Spasticity

Velocity-dependent increase in muscle tone occurring after SCI or brain lesion.

Basilar Skull Fracture

Fracture at skull base; signs include raccoon eyes, Battle’s sign, CSF leak.

CSF Leak

Clear drainage from nose/ears positive for glucose; risk for meningitis.

Thunderclap Headache

Sudden, severe headache reaching peak intensity within seconds—classic SAH symptom.

Kernig’s Sign

Leg raise causing hamstring pain; meningeal irritation indicator.

Brudzinski’s Sign

Neck flexion causes knee/hip flexion; suggests meningeal irritation.

Photophobia

Light sensitivity common with meningitis or SAH.

Mannitol Monitoring

Check serum osmolality (<320 mOsm/kg) and renal function to prevent AKI.