NEURO COMMON CONDITIONS

Age greater than 60

What age threshold is a non modifiable risk factor for stroke

Males greater than Females

What is the gender risk profile for stroke as a non modifiable factor

African Americans

Which race has a higher non modifiable risk for stroke

Family history

What genetic factor is a non modifiable risk for stroke

Prior stroke TIA or MI

What previous medical history events are non modifiable stroke risk factors

Hypertension

What is the most important modifiable risk factor for stroke

Atrial fibrillation

Which heart rhythm is a modifiable risk factor for stroke

Diabetes mellitus

Which modifiable condition accelerates atherosclerosis

Cigarette smoking

Which modifiable habit increases carotid plaque risk

Hyperlipidemia Obesity OSA and Alcohol abuse

Name four modifiable risk factors for stroke beyond hypertension and smoking

ACA

Contralateral weakness with the leg affected more than the arm or face describes a stroke in which artery

Apathy abulia decreased spontaneity of speech and frontal release signs

What are the other signs and symptoms of an ACA territory stroke

MCA

Contralateral weakness with the face and arm affected more than the leg describes a stroke in which artery

Aphasia hemineglect and gaze looking away from weakness

What are the other signs and symptoms of an MCA territory stroke

Broca and Wernicke

What are the two types of aphasia mentioned for MCA strokes

PCA

Minimal motor deficits unless the midbrain is involved describes a stroke in which artery

Homonymous hemianopia with macular sparing achromatopsia and memory loss

What are the other signs and symptoms of a PCA territory stroke

PICA

Ipsilateral facial numbness and contralateral body numbness describe a stroke in which artery

Wallenberg Syndrome

What syndrome is associated with a PICA stroke

Severe vertigo nausea Horner syndrome and ataxia

What are the signs and symptoms of Wallenberg Syndrome

Basilar

Quadriplegia and bifacial paralysis describe a stroke in which artery

Locked in Syndrome

What syndrome involves awareness and vertical eye movement being spared despite paralysis

0 to 4

What is the NIHSS score range for a mild stroke

5 to 14

What is the NIHSS score range for a mild to moderate stroke

15 to 24

What is the NIHSS score range for a moderately severe stroke

25 to 42

What is the NIHSS score range for a severe stroke

Hemorrhage or extensive hypodensity

What must a CT show to be an absolute contraindication for rtPA

Within 14 days

What is the time limit for severe brain injury to be an absolute contraindication for thrombolysis

Less than 14 days

What is the time limit for recent neurosurgery to be an absolute contraindication for thrombolysis

Within 3 months

What is the time limit for acute spinal cord injury to be an absolute contraindication for rtPA

Severe coagulopathy or thrombocytopenia

What blood related conditions are absolute contraindications for rtPA

Pregnancy and post partum

What maternal states are relative contraindications for thrombolysis

Within 10 days

What is the time limit for recent major non CNS surgery to be a relative contraindication

Within 21 days

What is the time limit for recent GI or GU bleeding to be a relative contraindication

Within 3 months

What is the time limit for a recent STEMI to be a relative contraindication

Within 3 months

What is the time limit for a prior ischemic stroke to be a relative contraindication

High greater than 18

What is the opening pressure in acute bacterial meningitis

Neutrophils

What is the predominant cell type in acute bacterial meningitis

High

What is the protein level in acute bacterial meningitis

Low less than 40 percent

What is the glucose level in acute bacterial meningitis

Gram stain and Culture

What are the other tests for acute bacterial meningitis

High

What is the opening pressure in tuberculous meningitis

Lymphocytes

What is the predominant cell type in tuberculous meningitis

High

What is the protein level in tuberculous meningitis

Very Low

What is the glucose level in tuberculous meningitis

AFB and GeneXpert

What are the other tests for tuberculous meningitis

High

What is the opening pressure in cryptococcal meningitis

Lymphocytes

What is the predominant cell type in cryptococcal meningitis

Normal or High

What is the protein level in cryptococcal meningitis

Normal or Low

What is the glucose level in cryptococcal meningitis

India Ink

What is the other test for cryptococcal meningitis

Normal or High

What is the opening pressure for viral HSV meningitis

Lymphocytes

What is the predominant cell type in viral HSV meningitis

Increased

What is the protein level in viral HSV meningitis

Normal or Low

What is the glucose level in viral HSV meningitis

PCR and RBCs

What findings or tests are associated with viral HSV meningitis

Cefotaxime and Ampicillin

What is the empiric therapy for meningitis in patients 0 to 4 weeks old

3rd Gen Cephalosporin and Vancomycin

What is the empiric therapy for meningitis in patients 3 months to 50 years old

3rd Gen Cephalosporin Vancomycin and Ampicillin

What is the empiric therapy for meningitis in patients over 50 years old

Listeria

What pathogen does Ampicillin cover in patients over 50

Vancomycin Ampicillin and Ceftazidime

What is the empiric therapy for meningitis in immunocompromised patients

Pseudomonas

What pathogen does Ceftazidime cover

Vancomycin and Ceftazidime

What is the empiric therapy for meningitis following head trauma or surgery

5 minutes

What is the T1 start medication time for generalized GTC status epilepticus

30 minutes

What is the T2 significant damage time for generalized GTC status epilepticus

10 minutes

What is the T1 start medication time for focal status epilepticus

60 minutes

What is the T2 significant damage time for focal status epilepticus

10 to 15 minutes

What is the T1 start medication time for absence status epilepticus

Unknown

What is the T2 significant damage time for absence status epilepticus

Abrupt

What is the typical onset of a seizure

Gradual

What is the typical onset of syncope

Cyanosis later on

What color change is associated with a seizure

Pallor as early finding

What color change is associated with syncope

Slow mental fogginess

Describe the recovery from a seizure

Prompt clear sensorium

Describe the recovery from syncope

Common

How common is tongue biting in a seizure

Rare

How common is tongue biting in syncope

Present

Is CK elevation present or absent in a seizure

Contractions

Why is CK elevated in a seizure

Absent

Is CK elevation present or absent in syncope

Systemic symptoms like Fever

What does the letter S stand for in the SNNOOP10 red flags

Infection or Meningitis

What possible secondary causes are linked to systemic symptoms

Neoplasm history

What does the first N in SNNOOP10 stand for

Brain Metastasis

What possible secondary cause is linked to a neoplasm history

Neurologic deficit

What does the second N in SNNOOP10 stand for

Stroke Tumor or Abscess

What possible secondary causes are linked to a neurologic deficit

Onset sudden or abrupt

What does the letter O stand for in the SNNOOP10 red flags

Subarachnoid Hemorrhage

What is the possible secondary cause for a thunderclap headache

Older age greater than 50 years

What does the second O in SNNOOP10 stand for

Giant cell arteritis or Neoplasm

What possible secondary causes are linked to older age in headaches

Positional

What does the letter P stand for regarding CSF leaks in SNNOOP10

CSF leak

What possible secondary cause is linked to a positional headache

Precipitated by Valsalva

What red flag suggests Chiari malformation or a posterior fossa lesion

Papilledema

What red flag suggests increased intracranial pressure

Progressive or Atypical

What red flag suggests a neoplasm

Pregnancy or Puerperium

What red flag suggests pre eclampsia or sinus thrombosis

Asymmetric

Is Parkinson disease symmetric or asymmetric

Resting tremor

What is the key sign of Parkinson disease

Alpha synuclein

Which protein is associated with Parkinson disease

Remarkable

How is the L Dopa response in Parkinson disease