Medical Management of TBI

Question 1

what class of medications can be used to induce coma and decrease metabolic requirements of brain

Answer 1

barbiturates or propofol

Question 2

when ICP reaches _______, there is neurogical dysfunction and brain impairment

Answer 2

> 40 mmHg

Question 3

what may anisocoria indicate?

Answer 3

transtentorial herniation to ipsilateral side

Question 4

MOA of Benzos

Answer 4

GABA

Question 5

Central perfusion pressure (CPP) should be kept at

Answer 5

> 60 mmHg

Question 6

what class of medications can be used to control anxiety and agitation

Answer 6

Benzos - cannot be used long term

Question 7

whats more important, controlling CPP or the ICP?

Answer 7

CPP

Question 8

what cranial nerve does uncal herniation affect

Answer 8

CN 3

Question 9

Anisocoria

Answer 9

inequality in pupil size

Question 10

elevated ICP is defined as

Answer 10

> 20 mmHg for more than 5 minutes

Question 11

CT findings that indicate increased ICP

Answer 11

absence of third ventricle and CSF cisterns

Question 12

How do you calculate CPP?

Answer 12

MAP - ICP

Question 13

in a normal adult, normal ICP is between

Answer 13

2 and 5 mmHg

Question 14

At what GCS is endotracheal intubation indicated

Answer 14

GCS less than or equal to 8

Question 15

uncal herniation can produce ipsilateral or contralateral hemiparesis if what or what is affected?

Answer 15

if corticospinal tract is affected, you get ipsilateral hemiparesis. if precentral motor cortex is affected, you get contralateral hemiparesis

Question 16

PO2 should be kept between

Answer 16

100 and 120 mmHg

Question 17

when ICP reaches ________, it’s usually fatal

Answer 17

> 60 mmHg

Question 18

why cant you give steroids for increased ICP management

Answer 18

increased in 2-week mortality in those given steroids in the acute phase

Question 19

PCO2 should be kept between

Answer 19

28 and 32 mmHg

Question 20

At what GCS is a CT head indicated

Answer 20

GCS <13

Question 21

most rapid means of lowering ICP

Answer 21

hyperventilation to reduce PaCO2

Question 22

what are some things you can do to decrease ICP?

Answer 22

raise head of bed, mannitol, hyperventilate

Question 23

Intracranial Pressure (ICP) should be kept at

Answer 23

<20 mmHg

Question 24

correlation between CPP and ICP

Answer 24

When ICP goes up, CPP goes down (MAP - ICP)

Question 25

what physical exam finding can be used to monitor ICP

Answer 25

papilledema