Ace Your First Aid for the USMLE Step 2 CK (10th Ed.) Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Medicine (MD/DO) Students
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First Aid for the USMLE Step 2 CK (10th Ed.) | Medicine (MD/DO) School Study Aid
Left Hemisphere Stroke Assessment
- Opposite Side Weakness (Hemiplegia)
- Side to Side Discrimination
- Aphasia
- Agraphia
- Slow Performance
- Aware of Deficits
- Anxiety
- Depression
2 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
Right Hemisphere Stroke Assessment
- Opposite Side Weakness (Hemiplegia)
- Poor Proprioception
- Disoriented to Person, Place, Time
- Can't Recognize Faces (Prosopagnosia)
- Loss of Judgement and Awareness
- Impulsiveness
- Personality Changes
- Tonal Hearing Loss
2 mins
CHA2DS2-VASc for Stroke Risk in Atrial Fibrillation
- CHF (+1)
- Hypertension (+1)
- Age 75 + (+2)
- Diabetes (+1)
- Stroke or TIA or Thromboembolism History (+2)
- Vascular Disease (+1)
- Age 65-75 Years (+1)
- Sex Female (+1)
- Interpretation
- 0 = No Anticoagulation
- 1 = Consider Anticoagulation
- 2 = Anticoagulation
3 mins
Histologic Evolution of Ischemic Stroke
- > 5 Minutes
- Irreversible Neuronal Injury
- 12-24 hours
- Red Neurons
- 1-3 days
- Liquefactive Necrosis (Neutrophils)
- 3–5 Days
- Microglia
- 1-2 Weeks
- Reactive Gliosis (Astrocytes)
- Vascular Proliferation
- > 2 weeks
- Glial Scar
2 mins
Basilar Artery Stroke Assessment
- Characteristics
- Brainstem Structures
- Lateral Corticospinal and Corticobulbar Tracts
- Clinical Findings
- Locked-in Syndrome
- Motor Dysfunction
- Preserved Vertical Eye Movements
2 mins
Anterior Inferior Cerebellar Artery Stroke Assessment
- Characteristics
- Anterior Inferior Cerebellar Artery
- Lateral Pontine Syndrome
- Ipsilateral Clinical Findings
- Decreased Facial Pain and Temperature Sensation
- Facial Muscle Weakness
- Decreased Taste from Anterior 2/3 of Tongue
- Deceased Salivation and Lacrimation
- Nystagmus and Hearing Loss
- Horner Syndrome
- Ataxia
- Contralateral Clinical Findings
- Decreased Body Pain and Temperature Sensation
3 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
1 min
Visual Field Defects - Left Upper Quadrantic Anopia
- Visual Field Abnormality
- Left Upper Quadrantic Anopia
- Pie in the Sky
- Location of Lesion
- Meyer's Loop
- Right Temporal Lobe
- Cause
- Middle Cerebral Artery (MCA) Infarct
1 min
Visual Field Defects - Left Lower Quadrantic Anopia
- Visual Field Abnormality
- Left Lower Quadrantic Anopia
- Pie on the Floor
- Location of Lesion
- Dorsal Optic Radiation
- Parietal Lobe
- Causes
- Middle Cerebral Artery (MCA) Infarct
1 min
Circle of Willis
- Characteristics
- Anterior Cerebral Artery (ACA) Supplies Motor/Sensory Parts of the Cortex for Lower Extremities
- Anterior Communicating Artery (Acomm) Connects ACA to ACA
- Internal Carotid Arteries (ICA)
- Middle Cerebral Arteries (MCA) Supply Cortex for Upper Limbs and Face
- Posterior Communicating Artery (Pcomm) Connects ICA to PCA
- Posterior Cerebral Arteries (PCA) Supply Occipital Cortex
- Basilar Artery Supplies Medulla, Pons, and PCA
3 mins
Anterior Cerebral Artery
- Contralateral paralysis of lower limb
- Contralateral loss of sensation in lower limb
1 min
Visual Field Defects - Left Hemianopia with Macular Sparing
- Visual Field Abnormality
- Left Hemianopia with Macular Sparing
- Vision Loss - Same Side in Both Eyes
- Center Spared
- Location of Lesion
- Occipital Lobe
- Causes
- Posterior Cerebral Artery (PCA) Infarct
1 min
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
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
Neurovascular Assessment 6 P's
- Pain
- Paresthesia
- Pulse
- Pallor
- Pressure
- Paralysis
1 min
Wallenberg Syndrome (PICA Syndrome)
- PATHOPHYSIOLOGY
- Compromise of PICA
- Lateral Medullary Ischemia
- CLINICAL FEATURES
- Vertigo
- Nystagmus
- Nausea and Vomiting
- Loss of Pain and Temperature in the Ipsilateral Face
- Loss of Pain and Temperature Sensation in the Contralateral Limbs
- Dysphagia
- Dysarthria and Dysphonia
- Loss of Gag Reflex
- Ipsilateral Horner Syndrome
- Ipsilateral Ataxia and Dysmetria, as well as Dysdiadochokinesia
4 mins
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