Shane Shared "NBB 1" - 87 Picmonics

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NBB 1

Multiple Sclerosis Features and Mechanisms
Features
Twice as often in Women
Presents in 20's and 30's
Northern Europeans
Mechanism
Unknown mechanism, genetic factor
HLA-DRB1
Autoimmune Demyelination of CNS
White Matter of Brain and Spinal Cord
T Cell Mediated Inflammation
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2 mins
Multiple Sclerosis Symptoms and Diagnosis
Symptoms
Optic Neuritis
Internuclear Ophthalmoplegia
Scanning Speech
Urinary and Fecal Incontinence
Motor Issues (Intention Tremor, Paresis)
Numbness and Pain
Depression
Relapsing Symptoms
Diagnosis
Gold Standard = Plaques on MRI
Increased CSF Immunoglobulins (IgG)
Oligoclonal Bands
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4 mins
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
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2 mins
Guillain-Barre Syndrome Assessment
Assessment
Ascending Paralysis
Muscle Weakness
Paresthesias (Pins and Needles)
Diplopia
Difficulty Speaking
Dysphagia
Labile Blood Pressure
Loss of Bowel and Bladder Control
Considerations
Aggressive Airway Management
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2 mins
Amyotrophic Lateral Sclerosis (ALS)
Assessment
Progressive Muscle Weakness
Systemic Muscle Wasting
Fasciculations
Spasticity
Fatigue
Considerations
Riluzole (Rilutek)
Moderate Exercise
No Cognitive Decline
Respiratory Support
Palliative Care
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2 mins
Normal Pressure Hydrocephalus
Mechanism
Elderly
Idiopathic
Decreased Absorption of CSF
Ventricular Enlargement
Symptom Triad
Urinary Incontinence
Ataxia (Gait)
Cognitive Dysfunction
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2 mins
Cauda Equina Syndrome
Acute Loss of Lumbar Plexus Function
Surgical Emergency
Saddle Anesthesia
Causes
Inflammatory Disorders
Spinal Stenosis
Trauma
Lesions
Symptoms
Urinary and Fecal Incontinence
Sciatica
Diagnosis
Magnetic Resonance Imaging (MRI)
Clinical
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1 min
Common Causes of Meningitis: Newborn (0-6 Months)
Group B Streptococci
E. coli
Listeria monocytogenes
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1 min
Common Causes of Meningitis: Children (6 Months - 6 Years)
Enteroviruses
Neisseria meningitidis
Haemophilus influenzae Type B
Streptococcus pneumoniae
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2 mins
Common Causes of Meningitis: Adolescent and Adult (6 - 60 Years Old)
Enteroviruses
Herpes Simplex Virus (HSV)
Neisseria meningitidis (#1 Cause in Teens)
Streptococcus pneumoniae
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1 min
Common Causes of Meningitis: Elderly (60+ Years Old)
Streptococcus pneumoniae
Gram-Negative Rods
Listeria Monocytogenes
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56 secs
Meningitis Assessment
Assessment
Nausea and Vomiting
Fever
Nuchal Rigidity
Severe Headache
Purpura
Seizures
Photophobia
Infants and Young Children
Opisthotonus Position
High Pitched Cry
Bulging Fontanel
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2 mins
Meningitis Interventions
Drug Therapy
IV Antibiotics
Dexamethasone
Analgesics
Antipyretics
Considerations
Closely Monitor for Increased ICP
Bed Rest
Preventative Vaccinations
Droplet-Airborne Precautions
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2 mins
Lumbar Puncture
Indications
CSF Sample
CSF Pressure
Considerations
Empty Bladder
Side-lying Position
Between 3rd and 4th Lumbar Vertebrae
Number Tubes
Supine Position After Procedure
Contraindications
Increased ICP (Intracranial Pressure)
Infection at Puncture Site
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2 mins
Middle Cerebral Artery
Contralateral paralysis upper limb and face
Contralateral loss of sensation of upper limb and face
Affects Wernicke's area and Broca's area
Aphasia if Lesion in Dominant (Left) Hemisphere
Hemineglect if lesion in nondominant (right) hemisphere
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1 min
Anterior Cerebral Artery
Contralateral paralysis of lower limb
Contralateral loss of sensation in lower limb
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1 min
Traumatic Brain Injury Assessment
Assessment
Change in LOC
Personality Changes
Amnesia
Increased Intracranial Pressure
Diplopia
Posturing
Location of Injury
Basilar Skull Fracture
Halo or Ring Sign
Considerations
Intracranial Bleeding
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2 mins
Increased Intracranial Pressure (ICP) Assessment
Change in LOC
Headache
Cushings Triad
Irregular Respirations
Widening Pulse Pressure
Bradycardia
Projectile Vomiting
Abnormal Pupils
Papilledema
Posturing
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2 mins
Increased Intracranial Pressure (ICP) Interventions
Interventions
Elevate Head Of Bed
Foley Catheter
Mannitol (Osmitrol)
High Dose Barbiturates
Passive Hyperventilation
Dexamethasone (Neoplasm or Infection)
Considerations
Neuro Assessment
Maintain Normal Temperature
Avoid Activities That Increase ICP
Intracranial Monitoring System
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2 mins
Epidural Hematoma
Mechanism
Middle Meningeal Artery Rupture
Temporal Bone Fracture
Hematoma Between Skull And Dura Mater
Transtentorial Herniation
Lucid Interval
Imaging
Lens-shaped on CT
Does Not Cross Suture Lines
Treatment
Craniotomy
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1 min

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