1. Pupillary signs. Pg.

81
a. comatose pts, equal, round, reactive pupils
b. unilateral, enlarged, often oval, poorly reactive pupil
c. Bilaterally dilated, unreactive pupils
2. Ocular Movements
a. Conjugate eye deviation to one side
b. adducted eye at rest with impaired ability to turn eye laterally
c. dilated, unreactive pupil is often abducted at rest and cannot adduct fully
d. Vertical separation of ocular axes (skew deviation)
e. Doll’s head maneuver
f. caloric–induced eye movements
3. Define brain death.
4. Stroke
a. TIA vs stroke
b. Ischemia vs. hemorrhage
c. Transient mononuclear blindness (Amarausis fugax)
d. MCA stroke
e. ACA stoke
f. PCA stroke
g. Basilar a stroke
h. Vertebral a. stroke
i. Lacunar stokes
j. Acute ischemic stroke medical management components
i. Medical support – optimize perfusion
ii. intravenous thrombolysis
1. rtPA – golden period
2. Indications
iii. endovascular revascularization
iv. antiplatelet agents
1. Recommended drug?
v. anticoagulation
vi. neuroprotection
1. Hypothermia
5. Subarachnoid hemorrhages
a. Most common cause?
b. initial study of choice?
c. Xanthochromia?
d. Frequent electrolyte disorder found in rupture of aneurysm?
e. leading cause of mortality and morbidity following initial rupture, which may appear 4–
14 days after the initial hemorrhage?
f. Cerebral perfusion – Triple-H therapy
6. Intracranial pressure and head trauma
a. Normal values of ICP and CPP
b. Cerebral artery affected in uncal herniation – PCA
 c. Brain area affected in transfacial herniation. – cingulate gyrus
d. Cerebral artery affected in transfacial herniation - ACA
e. Deadly complication of forminal herniation – respiratory arrest
7. Spinal cord compression
a. Initial diagnostic procedure done. - MRI with gadolinium
b. Most commonly involved in spinal metastasis – thoracic vertebrae
c. Preferred location of metastasis of prostate and ovarian tumors. – lumbosacral
vertebrae
d. Golden period for substantial prognosis of fixed motor deficits. – 72 hours
e. Spinal epidural abscess triad. – pain, fever, progressive weakness
i. Duration of antibiotics prior to surgery. – 6 months
8. Status epilepticus
a. Duration - >5 minutes
9. Diabetic ketoacidosis
a. DKA vs. HSS
b. Predominant ketone product in DKA - Beta-hydroxybutyrate
c. Clinical manifestation of a prototype patient with DKA – polyuria, weight loss, anorexia
10. Hypoglycemia
a. Hypoglycemic unawareness.
b. Lab finding. - <45-50 mg/dl
c. Whipple’s triad – symptoms of hypoglycemia, low glucose level, relief of symptoms
after plasma glucose level is raised
11. Oncologic emergencies
a. Most common cause of spinal cord compression. – epidural metastasis
b. Most common paraneoplastic syndrome. – Hypercalcemia
i. Most common mechanism. – Bone resorption secondary to Parathyroid
hormone abnormality
c. SIADH
i. Limit to correct hyponatremia. – should not exceed >0.5-1.0 meq/H
ii. Characteristics.
1. High urine sodium excretion in the absence of volume depletetion
2. Inappropriately concentrated urine
3. Hyponatremia
d. Febrile neutropenia. - >38 C, ANC <1000
e. Tumor lysis syndrome
i. Hyperuricemia  AKI
ii. Hyperkalemia
iii. Hypophosphatemia  hypercalcemia
iv. Lactic acidosis
f.