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Difference between an NSTEMI and STEMI on an EKG
NSTEMI = ST depression
STEMI = ST elevation
tunnel vision is a sign of ____
open-angle glaucoma
what is an arteriovenous malformation?
tangle of blood vessels connecting arteries and veins (typically present at birth) -- because veins are not equipped to withstand arterial pressure, they are prone to rupture overtime (increased risk of hemorrhagic stroke)
name some things we might do in the nursing care of head injuries
C-spine immobilization, report presence of CFS from nose and ear, prevent complications of immobility (e.g., turn q2h), neuro exam, avoid hypoglycemia, monitor for seizure
S/S: RLQ pain that comes on suddenly and intensifies over 24 hours (worse w movement, coughing). Loss of appetite, N/V, abd distension, low-grade fever, difficulty passing gas or BMs
Appendicitis
Key sign of a valve issue
Murmur
what are the 3 microlytic and 2 macrolytic anemias?
micro: iron deficiency, thalassemia, anemia of inflammation
macro: B12, folate
Most common stroke location
middle cerebral artery
Hallmark signs of increased ICP (BTdubs this is a MEDICAL EMERGENCY!!!)
Cushing's triad: widening pulse pressure, bradycardia, irregular/decreased respirations
S/S: weakness or paralysis of LEs, numbness in perianal, medial aspects of legs and thighs, urinary retention, urinary or fecal incontinence, sexual dysfunction
Cauda Equina Syndrome -- MEDICAL EMERGENCY!!!
requires immediate relief of pressure via surgical decompression
GDMT
bonus points if you can say what each one is for!
Diuretics: decrease blood volume (decrease preload)
ACEi/ARBs/ARNi: decrease resistance (decrease afterload)
Digoxin: increase contractility
Beta blockers: increase filling
In what condition might you see Cullen's sign or Grey Turner's sign?
acute pancreatitis
Stroke Signs
Weakness (esp. one side), Ataxia, Numbness (esp. one side), Thunderclap headache (SAH), Facial droop, Homonymous Hemianopia, Slurred Speech (aphasia)
formula for cerebral perfusion pressure, normal ICP, normal CPP
CPP = MAP - ICP
Normal ICP = <15 mmHg
Normal CPP = 60-80 mmHg
S/S: jaundice, ascites, coagulation, hepatic encephalopathy
Cirrhosis
BTdubs cate is sooo funny she said "Icterus is jaundice of the sclera [because] Icarus flew too close to the sun, causing his wings to melt and his liver to develop jaundice, and he plunged into the sea where he ultimately died of refractory ascites" HAHAHAHA too funny
MEDICAL EMERGENCY -- Cardiac tamponade!!! what would you expect to see
Beck's triad:
JVD, muffled heart sounds, hypotension
Meniere's triad
tinnitus, vertigo, unilateral sensorineural hearing loss
Left vs Right hemisphere stroke
Left: right-sided weakness, sensory changes, and homonymous hemianopia. Wernicke's and Broca's aphasia. Difficulty with math, reasoning, analysis, reading, writing, and learning new concepts. Depression, hesitancy, cautiousness
Right: left-sided weakness, sensory changes, neglect, homonymous hemianopia. Issues with spatial awareness, depth perception, proprioception, and object/location recognition. Behavioral changes, memory problems.
What are myelopathy and radiculopathy and how do we tell them apart?
Myelopathy: damage to spinal cord itself (weakness, incoordination, some pain potench or changes in sensation)
Radiculopathy: damage to spinal nerves, but not spinal cord (pain to the affected areas of skin--dermatome, potench some wekaness)
How to tell which is which? MRI and neuromotor exam w and w/o resistance
S/S: dysphagia, orthostatic HOTN, bladder difficulties, masked facies, pill-rolling tremor, shuffling gait
The following are signs of what condition?
petechiae, splinter hemorrhages, osler nodes, janeway lesions
Endocarditis -- a bacterial infection of the heart valves
Ulcerative Colitis vs. Crohn's Disease
UC is specific to colon/CD can be anywhere on GI tract
UC has continuously inflamed regions/CD has scattered, cobblestone appearance
UC S/S: diarrhea w mucus, blood, or pus/CD: steatorrhea (bulky, frothy, pale)
UC complications: toxic megacolon, bowel rupture, dehydration/ CD: abscesses, fistulas
Time window for highest risk of cerebral vasospasm
bonus points for S/S
highest risk 3-7 days post bleed, but can be up to 21 days post bleed
more info: cerebral vasospasm results in a secondary stroke. S/S = reduced consciousness, speech difficulty, motor deficits on contralateral side
Med: nimidopine (CCB)
Tell me a bit about GCS like high and low and stuff
S/S: dropping things, fasciculations, dyphagia, weakness/stiffness of a limb or more limbs, tripping
(Early) ALS