Lab Work and Physical Assessment

Question 1

mneumonic for cranail nerves

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Answer 1

olfactory
optic
oculomotor
trochlear
trigeminal
abducens
facial
acoustic
glossopharyngeal
vagus
spinal accessory
hypoglossal

Question 2

mneumonic for cranial nerves
S=sensory M=motor B=both
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Answer 2

Olfactory
optic
oculomotor
trochlear
trigeminal 
abducens
facial
acoustic
glossopharyngeal
vagus
spinal accessory
hypoglossal

Question 3

Assessing I olfactory

Answer 3

distinguishing smells

Question 4

assessing II optical

Answer 4

EOM’s, identify the number of fingers in central field

Question 5

assessing III oculomotor, IV trochlear, VI Abducens

Answer 5

EOM’s

Question 6

assessing V trigeminal

Answer 6

able to sense touch queally on checks and forehead and chew symmetrically,

Question 7

assessing VII facial

Answer 7

smiles symmetrically and frowns symmetrically

Question 8

assessing VIII auditory

Answer 8

hears equally

Question 9

assessing IX glossopharyngeal

Answer 9

gag reflex intact

Question 10

assessing X vagus

Answer 10

able to make guttural sound

Question 11

assessing XI accessory

Answer 11

shrugs shoulders symmetrically

Question 12

assessing XII hypoglossal

Answer 12

sticks out tongue in midline without tremors

Question 13

Normal level
Na

K

Protein total

HgbA1C

creatinine

Ca

Answer 13

136-146 mEq/L

3.5-5.1 mEq/L

6-8.5 g/dL

less than 6.5

M 0.7-1.3 mg/dL
F 0.6-1.1 mg/dL

8.4-10.2 mg/dL

Question 14

Normal level
TSH

free T3

free T4

Answer 14

2-10 mcU/ml

2. 3-4.2pg/ml
3. 7-2.0 pg/ml

Question 15

Normal Level
ALT/SGPT

Albumin

AST/SGOT

Bilirubin

CPK

Answer 15

0-55 units/L

3.5-5 g/dL

0-50 units/L

0.2-1.2 mg/dL

male: 55-170
female 30-135

Question 16

Normal Levels
RBC

HCT

HGB

WBC

Answer 16

m 4.3-7 million/mm3
f 3.8-5.1 million/mm3

m 39-49%
f 35-45%

m 13.5-17.5 g/dL
f12.0-16.0 g/dL

4.5-11 thousand/mm3

Question 17

symptoms of serotonin syndrome

Answer 17

diarrhea
diaphoresis
tremor
ataxia (in-coordination)
myoclonus (brief, involuntary twitching of muscle or group of muscles)
hyperactive reflexes 
disorientation
lability of mood
treatment: cyproheptadine Periactin (blocks 5HT production) and is used; hospitalization, fluids for dehydration, BZD for agitation or seizures

Question 18

neuroleptic malignant syndrome characteristics

Answer 18

life threatening complication that can occur anytime during a course of antipsychotic treatment;
-motor and behavior sx: muscular rigidity
dystonia
akinesia
mutism
obtundation
agitation
-autonomic sx: hyperthermia
diaphroesis
increased pulse and BP
-Lab findings: increased WBC, creatinine phsphokinase (CPK), liver enzymes, plasma myoglobin and myoglobinuria, and commonly associated w/ renal failure
-sx evolve over 24-72 hours; untreated lasts 10-14 days

Question 19

neuroleptic malignant syndrome treatment

Answer 19

often dantrolene (Dantrium) and bromocriptine (Parlodel)
sometimes amantadine (Symmetrel)
-Bromocritpine and amantadine pose direct DRA affects and my overcome the antipsychotic induced dopamine receptor blockade
-ECT has been used
-antipsychs with highest anticholinergic activity seem less likely to cause NMS

Question 20

agranulocytosis reflective on lab work

Answer 20

looking at WBC and ANC
normal WBC >or equal to 3500/mm3 and ANC >or equal to 2000/mm3

Mild leukopenia/granulocytopenia: WBC 3500-3000; ANC 2000-1500
Mod: WBC 3000-2000; ANC 1500-1000
Severe: WBC