Coma & Brain Death ; Lecture Flashcards
Define coma.
Coma is a state of unrousable unresponsiveness where a person cannot be awakened by any stimuli.
The difference between coma and sleep is that in coma, _________ and _________ are absent.
rousability; response to stimuli.
Match the term with its description:
Confused.
Delirium.
Stupor.
Obtunded.
Confused: Disoriented, impaired understanding.
Delirium: Acute, fluctuating confusion with inattention.
Stupor: Minimal response to vigorous stimulation.
Obtunded: Drowsy and slow to respond.
What is the primary purpose of the Glasgow Coma Scale (GCS)?
To assess severity and anatomical progression of brain injury.
The GCS is composed of three components: _________, _________, and _________.
eye response; verbal response; motor response.
True/False: GCS is a linear scale.
false
What are the GCS scores for:
Spontaneous eye opening?
Localizing pain?
Oriented verbal response?
Eye: 4.
Pain localization: 5.
Oriented: 5.
A student is hit on the head during an altercation and is unconscious. What should be your first steps?
Ensure safety.
Call emergency services.
Stabilize the airway, breathing, and circulation (ABCDE).
What does ipsilateral weakness with speech issues in a right-handed individual suggest?
A structural lesion affecting the left hemisphere.
List four non-structural causes of coma.
Diabetic emergencies (e.g., DKA, hypoglycemia).
Hypoxia or hypercapnia.
Drug overdose (e.g., opiates, benzodiazepines).
Meningitis or encephalitis.
Pinpoint pupils with low GCS and slow breathing suggest _________ overdose, while large pupils with arrhythmia suggest _________ overdose.
opiate; stimulant.
A diabetic patient is pale, clammy, and unresponsive with normal pupils. What is the likely diagnosis?
Hypoglycemia.
What are the key criteria for diagnosing brain death?
A known cause of irreversible brain damage.
Exclusion of all other causes of coma.
No brainstem reflexes.
Positive apnea test.
Brain death requires assessments by _________ senior doctors at _________ different times.
two; two.
True/False: Some spinal reflexes can still occur in brain-dead individuals.
true.
Which cranial nerve reflexes are assessed in brain death testing?
CN II/III: Pupillary response.
CN V/VII: Corneal reflex.
CN IX/X: Gag reflex and apnea test.
CN VIII: Vestibulo-ocular reflex (doll’s eyes test).
In brain death, there is no _________ response, no _________ reflex, and no _________ with breathing.
pupillary; corneal; heart rate change.
True/False: Nystagmus in response to caloric testing indicates intact brainstem function.
true.
What imaging modalities are used to investigate structural causes of coma?
CT and MRI.
A febrile patient with low GCS, stiff neck, and light sensitivity. What is the likely diagnosis?
Meningitis or encephalitis.
Encephalitis should be treated with _________, while meningitis requires immediate _________.
acyclovir; antibiotics.
True/False: GCS can be used to monitor deterioration in both structural and non-structural coma causes.
true.
