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LAST PHARM/ICM TEST
Amyotrophic Lateral Sclerosis (ALS)
Assessment
Progressive Muscle Weakness
Systemic Muscle Wasting
Fasciculations
Spasticity
Fatigue
Considerations
Riluzole (Rilutek)
Stretching
Little to No Cognitive Decline
Respiratory Support
Palliative Care
2 mins
Friedreich's Ataxia
Trinucleotide Repeat
GAA Repeat
Frataxin
Mitochondrial Dysfunction
Autosomal Recessive
Hammertoes
High Arches
Kyphoscoliosis
Lateral Corticospinal Tract
Posterior Column
Spinocerebellar Tract
Type I Diabetes Mellitus
Hypertrophic Cardiomyopathy
1 min
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
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
1 min
Subdural Hematoma
Mechanism
Tear of Bridging Veins
Slow Bleeding, Over Time
Imaging
Subdural Space
Crescent-shaped on CT
Crosses Suture Lines
Midline Shift
Causes
Elderly
Whiplash
Abusive Head Trauma (Shaken Baby Syndrome)
2 mins
Subarachnoid Hemorrhage
Bleeding into Subarachnoid Space
Mechanisms
Trauma
Aneurysm Rupture
AVM Rupture
Vasospasm causes Ischemia
Signs & Symptoms
"Worst Headache Of My Life"
Diagnosis
Noncontrast Head CT
Lumbar Puncture
Angiography
Considerations
Surgery
Blood Pressure Control
Intracranial Pressure Control
Nimodipine for Vasospasm Prophylaxis
3 mins
Types of Strokes
Warning Signs
Transient Ischemic Attack (TIA)
Reversible Ischemic Neurologic Deficit (RIND)
Types
Ischemic
Thrombotic
Atherosclerosis
Embolic
Atrial Fibrillation
Hemorrhagic
Severe Hypertension
3 mins
Placental Implantation Abnormalities
Mechanism
Placenta Adheres Directly to Myometrium
Placenta Accreta
Placenta Increta
Placenta Percreta
Caused by Scar Tissue
Hemorrhage
Diagnosis
Ultrasound is First-line, then MRI
Treatment
C-section Delivery
Artery Ligation or Embolization
2 mins
Multiple Sclerosis Features and Mechanisms
Features
More Common 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
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
4 mins
5 A's of Alzheimer's Disease
Agnosia
Anomia
Aphasia
Apraxia
Amnesia
1 min
Glioblastoma Multiforme
Most Common Malignant Primary Brain Tumor
Grade 4 Astrocytoma
Can Cross Corpus Callosum
Butterfly Glioma
Pseudo-palisading Tumor Cells
Areas of Necrosis and Hemorrhage
Stain Astrocytes for Glial Fibrillary Acidic Protein (GFAP)
Grave Prognosis
2 mins
Meningioma
Epidemiology
Most Common Adult Primary Brain Tumor
pathology
Benign
Originate from Arachnoid Villi
Dural Attachment
Parasagittal
Clinical Manifestations
Contralateral Leg Weakness
Seizures
Diagnosis
Psammoma Bodies
Calcifications
Increased Bone Density
3 mins
Schwannoma
Characteristics
Acoustic Schwannoma
Cranial Nerve VIII
Cerebellopontine Angle
S100 Positive
Bilateral Schwannoma in Neurofibromatosis Type 2
Tinnitus
Cranial Nerve V
Affects Corneal Reflex
2 mins
Neurofibromatosis Type 1
Pathophysiology
Autosomal Dominant
Chromosome 17
Signs and Symptoms
Neurofibromas
Optic Glioma
Lisch Nodules
Hamartomas
Cafe Au Lait Spots
Scoliosis
Pheochromocytoma
4 mins
Neurofibromatosis Type 2
Pathophysiology
Autosomal-Dominant
Chromosome 22
Signs and Symptoms
Vestibular Schwannoma
Meningioma
Ependymoma
Cafe Au Lait Spots
Cataracts
2 mins
Ependymoma
Occur in Children
Fourth Ventricle
Hydrocephalus
Perivascular Pseudorosettes
Rod Shaped Blepharoplasts
Cauda Equina in Adults
Poor Prognosis
Neurofibromatosis Type II
2 mins
Oligodendroglioma
Slow growing tumor
Frontal lobe
Chicken Wire Pattern
Fried egg appearance
Calcifications
32 secs
Pilocytic Astrocytoma
Occurs Most Commonly in Kids
Posterior Fossa
Cerebellum
Well Circumscribed
GFAP
Rosenthal Fibers
Eosinophilic Corkscrew Fibers
1 min
Medulloblastoma
Pathophysiology
Occurs in Children
Cerebellum
Fourth Ventricle
Diagnosis
Small Blue Cells
Lots of Mitotic Figures
Homer Wright Rosettes
Signs and Symptoms
Hydrocephalus
Ataxia
Wide-based Gait
Treatment
Radiosensitive
2 mins
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