Chapter 17 Neurologic Emergencies Flashcards

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1
Q

The three major parts of the brain are the:

A

Cerebrum, cerebellum, and brainstem

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2
Q

What is a symptom that would lead the EMT to believe that a patients headache is caused by sinus congestion?

A

The pain is worse when bending over

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3
Q

The most significant risk factor for a hemorrhage stroke is:

A

Hypertension

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4
Q

The patient whose speech is slurred and difficult to understand is experiencing (the term):

A

Dysarthria

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5
Q

What is a condition that would likely mimic the signs and symptoms of a stroke?

A

Hypoglycemia

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6
Q

What can describe a simple partial seizure?

A

A seizure that begins in one extremity

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7
Q

What will the patient most likely experience during the postictal state that follows a seizure?

A

Confusion
Fatigue
Labored respirations
Altered mental status

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8
Q

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a two-year-old male. The child is conscious and crying. According to the mother, the child has been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:

A

Transport the child to the hospital and reassure the mother in route

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9
Q

A patient with an altered mental status is:

A

Not thinking clearly or is incapable of being aroused

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10
Q

When caring for a patient with documented hypoglycemia, you should most be alert for:

A

A seizure

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11
Q

During the primary assessment of a semi-conscious 70-year-old female: you should:

A

Ensure a patent airway and support ventilation as needed

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12
Q

You are caring for a 68-year-old man with sudden onset of left sided paralysis and slurred speech. Airway is patent, his respirations or 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include

A

Recovery position and transport

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13
Q

When you’re obtaining medical history from the family of a suspected stroke patient, it is most important to determine:

A

When patient last appeared normal

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14
Q

When assessing for arm drift of a patient with a suspected stroke, you should:

A

Ask the patient to close his or her eyes during the assessment

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15
Q

Your patient opens his eyes moans and pulls away from you when you pinch his check easiest muscle. You should assign a Glasgow Coma Scale (GCS) of

A

Eight

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16
Q

The patient who is possibly experiencing A stroke is not eligible for thrombolytic therapy if he or she

A

Has bleeding in the brain

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17
Q

A 30-year-old male experienced a generalized seizure, which stoped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. What would be the a compelling reason to disagree with his refusal of transport?

A

He is currently not prescribed any medications

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18
Q

The left cerebral hemisphere controls:

A

The right side of the body

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19
Q

What condition would most likely affect the entire brain?

A

Respiratory failure or cardiopulmonary arrest

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20
Q

When the blood flow to a particular part of the brain is cut off by a blockage inside a blood vessel, the result is:

A

An ischemic stroke

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21
Q

Patients with a subarachnoid hemorrhage typically complain of a sudden severe:

A

Headache

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22
Q

The principal difference between a patient who has had a stroke and the patient with hypoglycemia almost always has to do with the:

A

Mental status

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23
Q

Headaches, vomiting, altered mental status, and seizures are all considered early signs of:

A

Increased intracranial pressure

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24
Q

You are called to a home and find a 56 your old woman supine in her bed. She appears alert, but has slurred speech. Her family tells you she has a history of TIAs and hypertension. You asked the patient, “What day is today?” and her reply is, “Butterfly”. Which area of the brain is likely affected?

A

The left hemisphere

25
Q

The _____ controls the most basic functions of the body, such as breathing, blood pressure, swelling, and pupil constriction.

A

Brainstem

26
Q

At each vertebra in the neck and back, two nerves, called _____ nerves, branch out from the spinal cord and carry signals to and from the body.

A

Spinal

27
Q

_____ is the a loss of bowel and bladder control and can be due to a generalized seizure.

A

Incontinence

28
Q

_____ may reverse stroke symptoms and even stop the stroke if given within 3 to 6 hours of onset of symptoms.

A

Thrombolytics

29
Q

A swelling or enlargement of part of an artery resulting from weakness of the arterial wall is called:

A

An aneurysm

30
Q

An inability to produce or understand speech is called:

A

Aphasia

31
Q

A sense of warning experienced prior to a seizure is called:

A

An aura

32
Q

Weakness of one side of the body is called:

A

Hemiparesis

33
Q

What does TIA stand for?

A

Transient ischemic stroke

34
Q

Define a TIA

A

“Mini-stroke”
Brain cells stop functioning from lack of oxygen, causing stroke-like symptoms.
Completely resolves itself within 24 hours

35
Q

Define stroke

A

Interruption of blood flow to the brain, resulting in loss of function

36
Q

What are four causes of a stroke?

A

Thrombus
Embolism
Compression
Aneurism

37
Q

What is a CVA?

A

Cerebrovascular accident (stroke)

38
Q

What is the most common cause of a CVA?

A

A blood clot (thrombus)

39
Q

List the three stages of a seizure

A

Aura
Tonic-clonic
Postictal

40
Q

Define seizure

A

A surge of electrical activity in the brain

41
Q

What are three types of seizures?

A
Petite mal (absence)
Grand mal (tonic-clonic)
Febrile (high fever)
42
Q

What is status epilepticus?

A

A seizure that continues every few minutes without the person regaining consciousness or longer than 30 minutes

43
Q

What do you do for a patient who is having a grand mal seizure?

A

Protect the head and let it pass

44
Q

What is a tension headache caused by?

A

Muscle contractions in the head and neck attributed to stress

45
Q

What is a migraine headache?

A

Thought to be caused by changes in blood vessel size in the brain

46
Q

What symptoms might a patient with a migraine headache experience?

A

Nausea and vomiting

Light sensitivity

47
Q

What is a sinus headache caused by?

A

Pressure that is a result of fluid accumulation in the sinus cavities

48
Q

What is bacterial meningitis?

A

Inflammation of the meninges caused by a bacterial infection

49
Q

What signs/symptoms would a patient with bacterial meningitis experience?

A

Headache
Fever
Stiff neck
Sensitivity to light

50
Q

if a person is having a stroke on the left side of the brain what will they exhibit?

A

Aphasia (answers ‘butterfly’ when asked a question)

Right sided paralysis

51
Q

if a person is having a stroke on the right side of the brain what will they exhibit?

A

Dysarthia (slurred speech)
Trouble moving muscles on the left side
May be completely oblivious to it

52
Q

What is the GCS ratings for eye opening?

A

4 - Spontaneous
3 - Response to speech
2 - Response to pain
1 - None

53
Q

What is the GCS ratings for verbal response?

A
5 - Oriented conversation
4 - Confused conversation
3 - Inappropriate words
2 - Incomprehensible sounds
1 - None
54
Q

What is the GCS ratings for motor response?

A
6 - Obeys commands
5 - Localizes pain
4 - Withdraws from pain
3 - Abnormal flexion
2 - Abnormal extension
1 - None
55
Q

The brain is most sensitive to _____, _____, and _____ levels.

A

Oxygen
Glucose
Temperature

56
Q

A(n) _____ _____ seizure may cause twitching of the extremity muscles that may spread slowly to another body part.

A

Simple partial

57
Q

What is the difference between a simple partial and a complex partial seizure?

A

Simple partial - no change in mental status, may experience sensory changes or muscle twitching that slowly spreads to another area
Complex partial - altered mental status, isolated convulsions (lip smacking, eye blinking)

58
Q

What are three conditions that may simulate a stroke?

A

Hypoglycemia
Postictal state
Subdural/Epidural bleeding