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Neisseria Meningitidis
Characteristics
Gram-Negative
Diplococci
Chocolate Agar
Thayer-Martin Media
VPN
Oxidase-Positive
Maltose Fermentation
Glucose Fermentation
Endotoxin
Lipooligosaccharide (LOS) in Membrane
Polysaccharide Capsule
IgA Protease
Disease
Waterhouse Friderichsen Syndrome
Adrenal Insufficiency
Petechial Rash
Treatments
Ceftriaxone
Rifampin Prophylaxis
5 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
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
Common Causes of Meningitis: Elderly (60+ Years Old)
Streptococcus pneumoniae
Gram-Negative Rods
Listeria Monocytogenes
56 secs
Common Causes of Meningitis: Children (6 Months - 6 Years)
Enteroviruses
Neisseria meningitidis
Haemophilus influenzae Type B
Streptococcus pneumoniae
2 mins
Common Causes of Meningitis: Newborn (0-6 Months)
Group B Streptococci
E. coli
Listeria monocytogenes
1 min
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
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
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
2 mins
Myasthenia Gravis
Mechanism
Antibodies to Acetylcholine Receptor
Symptoms
Ptosis
Diplopia
Weakness with Muscle Use
Respiratory Death
Thymus Associated
Treatment
Acetylcholinesterase Inhibitors
Plasmapheresis
Thymectomy
1 min
Cryptococcus neoformans
Characteristics
Monomorphic
Encapsulated
Polysaccharide Capsule
Narrow-Based Buds
Latex Agglutination
Pigeons
India Ink
Mucicarmine stain
Signs and Symptoms
AIDS/Immunocompromised
Meningitis
Soap Bubble Lesions in Brain
Pneumonia
Treatment
Fluconazole
Flucytosine
Amphotericin
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
Left Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Side to Side Discrimination
Aphasia
Agraphia
Slow Performance
Aware of Deficits
Anxiety
Depression
2 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
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
Anterior Cerebral Artery
Contralateral paralysis of lower limb
Contralateral loss of sensation in lower limb
1 min
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
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
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
2 mins
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