General Neurocritical Care Flashcards
Labetalol is α1 selective and β nonselective blocker. Its effects include ICP reduction or no change, pulse rate decrease or no change, and it does not change cardiac output. What is the dose adjustment for renal failure?
● A. Same dose
● B. < 15%
● C. < 25%
● D. < 50%
● E. Absolutely contraindicated
A. Same dose
Dopamine has α, β, and dopaminergic effects at what dose
(μg/kg/min)?
● A. 0.5
● B. 1
● C. 2
● D. > 5
● E. > 10
E. > 10
Which of the following is a pure alpha sympathomimetic and useful in hypotension associated with tachycardia?
● A. Dopamine
● B. Dobutamine
● C. Phenylephrine
● D. Norepinephrine
● E. Isoproterenol
C. Phenylephrine
What is the mainstay of treatment of rhabdomyolysis?
● A. Antiallergics
● B. Steroids
● C. Mannitol
● D. Sodium carbonate
● E. Expansion of extracellular volume
E. Expansion of extracellular volume
Dialysis may be required in patients with rhabdomyolysis in all of the following except?
● A. Oliguric renal failure
● B. Persistent hyperkalemia
● C. Pulmonary edema
● D. Congestive heart failure
● E. Persistent metabolic alkalosis
E. Persistent metabolic alkalosis
Labetalol (Normodyne or Trandate) is an alpha one selective and beta nonselective blocker drug. It is used intravenously as an antihypertensive drug in dosage sequence of 20, 40, 80, 80, and then 80 (total 300 mg) every 10 minutes until the desired blood pressure (BP) is achieved. It is widely used in neurosurgical patients because of which of the following characteristics?
● A. It has no effect on ICP or may reduce ICP
● B. It does not exacerbate coronary ischemia
● C. It does not change cardiac output
● D. It does not affect pulse rate much
● E. All of the above
E. All of the above
Neurogenic shock, which occurs because of paralysis due to spinal cord injury, is caused by which of the following mechanisms?
● A. Dysrhythmias and myocardial infarction
● B. Pooling of blood in the venous capacitance vessels
● C. Because of hemorrhage due to spinal cord injury
● D. Disruption of neuronal signals below the level of injury
● E. All of the above
B. Pooling of blood in the venous capacitance vessels
Positive inotropic (causing heart to contract with more force) effect of dopamine occurs at what dosage (μg/kg/min)?
● A. 0.5 to 2
● B. 2 to 10
● C. More than 10
● D. 10 to 20
● E. Less than 0.5
B. 2 to 10
Which of the following drugs is avoided in neurogenic shock due to spinal cord injury?
● A. Dopamine
● B. Dobutamine
● C. Phenylephrine
● D. Norepinephrine
● E. All of the above
C. Phenylephrine
Stress ulcers AKA Cushing’s ulcer can occur because of which of the following CNS pathologies?
● A. Brain injury (especially GCS less than 9)
● B. Brain tumor
● C. Intracerebral hemorrhage
● D. CNS infection
● E. All of the above
E. All of the above
Acute kidney injury in rhabdomyolysis patient (a syndrome caused by injury to skeletal muscles) is because of which of the following mechanisms?
● A. Excessive ferrihemate which is formed from myoglobin released due to muscle injury at pH < 5.6
● B. Allergic reaction caused due to release of excessive myoglobin at the time of injury
● C. Renal vasoconstriction
● D. Decreased extracellular volume
● E. A, C, and D
E. A, C, and D
Management of patient with rhabdomyolysis involves the following steps except?
● A. Admission in ICU, input–output monitoring, electrolytes correction
● B. Expansion of extracellular fluid volume by giving IV fluid
● C. Use of mannitol and sodium bicarbonate
● D. Minimizing other nephrotoxic agents like nephrotoxic antibiotic or iodinated IV contrast
● E. Surgical removal of the whole muscle causing rhabdomyolysis
E. Surgical removal of the whole muscle
causing rhabdomyolysis
Followings are the side effects of using omeprazole (Prilosec) for prolonged period of time except?
● A. Nausea, vomiting, and headache
● B. Vertigo
● C. Diarrhea
● D. Abdominal pain
● E. Rash
B. Vertigo
Which of the following crystalloids has less tendency to promote cerebral edema?
● A. Normal saline
● B. Ringer lactate
● C. 5% dextrose water
● D. 3% NaCl
● E. None of the above
A. Normal saline
Dobutamine acts as vasodilator by acting on beta one receptors and as positive inotrope by acting on beta 2 receptors. Use of dobutamine at doses greater than 20 μg/kg/min can exacerbate what?
● A. Hypertension
● B. Myocardial ischemia
● C. Renal damage
● D. Hyperglycemia
● E. Hepatic failure
B. Myocardial ischemia
