coma

Question 1

definition of coma?

Answer 1

coma is a state of unarousable unresponsiveness

Question 2

grading of coma?

Answer 2

1 patient respond to vocal command
2 maximum response to minimum stimuli
3 minimum response to maximum stimuli
4 no respond at all

Question 3

gcs?

Answer 3

eye 1-4 ( 1 no open, 2 open in respons to pain, 3 open in voice command, 4 open spontaneously
verbal 1-5 ( 1 no sound, 2 mumble sound, 3 inappropiate words, 4 speak but confused, 5 normal
motor 1-6 ( 1 no movement, 2 extend limbs in respond to pain, 3 react unusal to pain, 4 move away from pain, 5 pinpoint pain location, 6 obey command

Question 4

severity according to gcs?

Answer 4

less than 8 severe
09-12 moderate
13 or more minimum

Question 5

etiology?

Answer 5

metabolic: hyper/hypoglycemia, renal failure, uremia, liver failure, hypo/hyperkalemia, metabolic acidosis
endocrine: DKA, myxedema, addison’s disease, hypopituitarism
drugs: tricyclics, barbiturateds, alcohols, organophosphate, antidepressant, co, anticonvulsants
trauma: head injury
infections: meningitis, encephalitis, brain abscess, cerebral malaria, typhoid, rabies
vascular heamorhaagic
epilepsy, tumors, hypoxia, co2 narcosis

Question 6

care?

Answer 6

neurology abc
neck manipulation
airway
breathing
circulation 
iv dextrose
naloxone
aspiration
tracheostomy
suctioning
maintain fluids

Question 7

what is decorticate and decerebrate?

Answer 7

decorticate: above red nucleus of midbrain, arms bent on chest(flexion) legs extended
decerebrate: below red nucleus: bad prognosis
both upper lower limbs extended

Question 8

eyes in metabolic encephalopathies?

Answer 8

small pupil with preserved light reflex