ANSWERS COMPLETE STUDY PACK
●● S/S of Bell's Palsy
Answer: Has forehead involvement (whereas a stroke does not affect
forehead movement), facial weakness, inability to keep one eye closed
●● Treatment for Bell's palsy
Answer: Prednisone 60mg x 5 days, Valcyclovir 1000mg TID x 7 days,
artificial tears, lacri lube at night
●● When can I use tPA?
Answer: ischemic stroke presenting within <3 hrs and CT head negative
●● How do you treat high BP with stroke?
Answer: Nitroprusside (short half life, easy to titrate) or IV labetalol
●● What do you use for anticoagulation/antiplatelet therapy in stroke?
Answer: ASA (not in hemorrhagic), heparin for thrombosis
●● What do you do differently to treat hemorrhagic stroke?
,Answer: Give prophylactic anticonvulsant like phenytoin because of
increased seizure risk, antiplatelet therapy contraindicated
●● Types of Hemorrhagic Stroke
Answer: 1. Intracerebral (10%): results from rupture of small arterioles
2. Subarachnoid (3%): rupture of arterial aneurysms (hemorrhage into
subarachnoid space)
●● Causes of Intracerebral hemorrhagic stroke are what?
Answer: HTN, amyloidosis, iatrogenic anticoagulation, vascular
malformations, cocaine use
●● Causes of Subarachnoid hemorrhagic stroke are what?
Answer: berry aneurysm rupture, vascular malformation rupture
●● Signs and symptoms of Intracerebral hemorrhagic stroke are what?
Answer: ICP rises, vasoconstriction-sweating
●● Signs and symptoms of Subarachnoid hemorrhagic stroke are what?
Answer: may be preceded by warning headache, neck/back pain, "worst
headache of my life," thunderclap, may have loss of consciousness
●● Treatment of Subarachnoid hemorrhage
,Answer: surgery, control hypertension, analgesics
●● What is Complex regional pain syndrome (CRPS)
Answer: Chronic arm or leg pain developing after injury, surgery, stroke,
or heart attack.
●● Signs and symptoms of complex regional pain syndrome are what?
Answer: Pain out of proportion to injury. ANS sx: swelling, extremity
color changes, increased nail and hair growth.
●● Treatment for complex regional pain syndrome
Answer: Amitriptyline, nortriptyline, gabapentin, pregabalin,
lamotrigine; NSAIDs; Calcitonin to reduce pain as adjunctive therapy;
Bisphosphonates, IVIG, regional nerve blocks, dorsal column
stimulation
Vit C prophylaxis after fx
●● Imaging modality used to diagnose Subarachnoid Hemorrhage?
Answer: CT without contrast. If CT negative but still suspect SAH, do
LP to look for RBC or xanthochromia (will not develop until 12hrs after
onset)
●● Delirium
, Answer: transient disorder characterized by impaired attention,
perception, memory and cognition. Sleep wake cycles interrupted
("sundowning"). Reduced alertness, activity levels change rapidly.
●● Treatment of Delirium
Answer: treat underlying cause, Haloperidol 5-10mg for agitation,
Lorazepam 0.5-2 mg
●● Dementia
Answer: Loss of mental capacity. Psychosocial level and cognitive
abilities deteriorate and behavioral problems develop. Largest categories
are Alzheimer dz and vascular dementia. Hallucinations, delusion,
depression, repetitive behavior are common.
●● Treatment of Dementia
Answer: Antipsychotics to manage psychosis
●● Essential tremor does not occur at rest, occurs bilaterally, and has no
indication of other neuro signs. How do you treat essential tremor?
Answer: Propranolol, Primidone (can combine these 2 if needed)
●● Guillian Barre Syndrome
Answer: Idiopathic polyneuropathy often following minor infections,
immunizations or surgical procedures. Most times no cause is identified.