Final Exam

• Transient Ischemic Attack
• a temporary localized reduction of blood flow in the brain. Recovery occurs within 24 hours, generally 1-2hours
• "Little Stroke"

No opening

Congenital birth Defect where baby is born without a brain

• S&S:
• numbness, paresthesias (burning, foot going to sleep) weakness, visual disturbance(tunnel vision)

šDx: CT scan, MRI/MRA(angiography injecting dye looking at blood vessels, neuro exam , ECG

• Cerebrovascular Accident 
• 1. Thrombosis (atherosclerosis, blood clot) arteries leading to the brain
• resulting in occlusion of the vessel.
• 2. Hemorrhage- blood vessel, such a cerebral artery breaks and bleeding occurs
• (aneurysm, A-V malformation)
• 3. Embolus- travels to cerebral arteries and occluded a small vessel (fat, blood clot)
• š4. Brain Abscess

• S&S: loss of consciousness, cognitive and motor deficiencies
• šDx: history of syncope, numbness, H&P, neuro exam, CT scan, MRI/MRA, cerebral angiography
• Trx: Tissue Plasminogen Activator, Carotid Endarterectomy

removal of the atherosclerotic plaque along with the inner lining of the affected carotid artery

Brief LOC, Severe could lead to coma

Brain Bruise

C'mon really?

• Arterial bleed caused by head injury.
• Between Skull and dura as result of ruptured meningeal artery

• šS&S: puplis dilated, unconsciousness, increased ICP- intracranial pressure
• Dx: neuro exam, CT exam, MRI/MRA
• Trx: Craniotomy or Burr Holes

• tearing of veins between the dura and arachnoid membranes
• Blunt Trauma

Meninginoma and Schwanoma

Gliobastoma, Astrocystoma, Medullablastoma, Oligodendroglimo

• SS: Insidious Onset, Increased Intracranial Pressure, visual disturbances, N&V, vertigo
• Dx: Neuro exam, CT exam, MRI/MRA
• Trx: Craniotomy and Biopsy of tumor, SHUNT!

• Causes: H&P, description of seizure, CT scan, MRI/MRA, EEG, r/o underlying  disease process and treat if found, neuro exam
• Trx: anticonvulsant drugs like topamax and dilantin

Clam before storm, Dizziness, numbness, and visual disturbances

• Sudden LOC
• Falling Down and convulsing

• šDegeneration of neurons in the basal ganglia occurring in later life and leading to tremors, weakness of muscles, and slowness of movement
• Loss of dopamine (neurotransmitter) made by cells in the basal ganglia
• šMotor disturbances include stooped posture, shuffling gait, muscle stiffness, and often a tremor of the hands

• šS&S: bradykinesia, tremor, rigidity (facial), shuffling gait, sweating, drooling, dementia in advanced  stages
• šTrx: medication- dopamine (levodopa, sinemet), cogentin, parlodel
• Surgery-deep brain stimulation, implant of fetal brain tissue

• Causes: Atrophy of the cortex and loss of neurons in the frontal and temporal lobes.
• Dx: a diagnosis of exclusion via testing-cognitive tests, CT scan, MRI, H&P, neuro exam, r/o metabolic disorders
• S&S: insidious onset of memory loss, distorentation, abstract thinking is impaired, all symptoms become progressively worse

patient and family education, support groups, medications- aricept, memantine

because metabolism is faster; the condition is marked by an increase in heart rate (with irregular beats), higher body temperature, hyperactivity, weight loss, and increased peristalsis (diarrhea occurs).

• SS: nervousness, heat intolerance, weight loss, tremor, tachycardia, thyromegaly (goiter), hair loss, exophthalmos protrusion of the eyeballs
• Dx: Serum TSH, T3, T4, Thyroid Scan, Ultrasound of thyroid, fine needle aspiration
• Trx: Radiation and Thyroidectomy

• S&S: cold intolerance, bradycardia, cardiomegaly, lethargic, weight gain, thyromegaly
• Dx: Serum TSH will be up, T3, T4
• šTrx: thyroid replacement

• S&S: acute and sudden onset of polyuria, polydipsia, polyphagia, weight loss, ketosis, coma
• šDx: FBG- Fasting Blood Glucose over 126 mg/dl on more than one test (normal is less than 100mg/dl), glucose tolerance test (2-3 GTT)
• šTrx: Insulin- types rapid acting ( 10 minutes onset), short acting (regular insulin- 30 minutes onset) Intermediate acting (1-4 hours onset) Long acting (1-5 hours 24 hours)
• Drugs-Humo, Nuvo

• šS&S: Insidious Onset-developing in a gradual manner, polyuria, polydipsia, blurred vision, fatigue, paresthesias
• šDx: same at Type 1
• šTrx: antidiabetic drugs: metformin (glucophage), diabinese, orinase, actose, avandia, prandin, byetta, januvia, insulin if necessary

• increase in ketones when insulin is decreased and fat is
• being burned
• šS&S: 1-2 days of polyuria, n&v, stupor, coma, hyperglycemia of 250-1000, serum pH, bicarb and K+ are all out of balance
• Trx: low dose insulin, replace electrolytes