Neuro

Question 1

Bell’s Palsy symptoms can present as a result of …

Answer 1

pregnancy, herpes simplex virus, or diabetes mellitus. “

Question 2

Ginkgo biloba is an herbal supplement mainly used for memory and cognition. While a patient is on ginkgo, it is important to watch for …

Answer 2

bleeding and ensure the patient is not taking any blood thinners

Question 3

Atypical antipsychotics such as Haldol or Risperdal place the patient at increased risk for ….

Answer 3

elevated triglycerides and glucose, which can lead to metabolic syndrome. They also lower the seizure threshold, making seizures more likely to occur. In addition, when used long term, some patients experience QT interval prolongation. Atypical antipsychotics may cause galactorrhea.

Question 4

Wernicke-Korsakoff’s syndrome, also known as Wernicke’s encephalopathy, occurs due to a deficiency of …

Answer 4

vitamin B1 (thiamine). Thiamine is a nutrient in the body that is necessary for growth and development. It also helps convert carbohydrates into energy.

Question 5

CN III is responsible for

Answer 5

several motor functions of the eye as well as pupillary response. Ex) the nurse practitioner asks the patient to follow their pen with their eyes to evaluate the patient’s intraocular movements. In addition, this cranial nerve manipulates the size of the patient’s pupil.

Question 6

CN VI is responsible for

Answer 6

outward eye movement by the lateral rectus muscle.

Question 7

How would the nurse practitioner assess cranial nerve IX?

Answer 7

Say “ahhh”
The glossopharyngeal nerve (CN IX) has both sensory and motor effects and innervates the tongue and the throat. Cranial nerves IX and X are often tested together and can be observed by watching the uvula rise and fall with phonation.

Question 8

Asking a patient to raise their eyebrows or puff their cheek tests tests what CN?

Answer 8

Asking a patient to raise their eyebrows or puff their cheek tests the facial nerve (CN VII).

Question 9

A patient in the office today with complaints of a fever, severe headache, limited neck range of motion, and nausea. Based on her presentation, you are concerned about meningitis. You passively flex the patient’s neck and it causes her hips to involuntarily flex as well. What sign is this?

Answer 9

Brudzinski’s sign - flex the back of the head and hips and knees bend
(Brudzinski’s = back of head)

Question 10

Kernigs

Answer 10

cant extent the knee past 90 degrees w/o pain

think Kernigs = knee

Question 11

CN nerves

Answer 11

C1: on (olfactory) - 1 nose
C2 : old (optic) - 2 eyes -Snellen chart
C3: olympus (oculomotor)- “3,4, and 6 make your eyes do tricks” follow my finger
C4: Towering (trochlear)- vision
C5: tops (trigeminal) - lightly touch face - trigeminal neuralgia
C6: A (abducens)
C7 : Finn (facial) - bells palsy
C8 : And (acustic)
C9 : German (glossopharyngeal) - gag reflex
C10: Viewed (vagus)
C11: Some (spinal accessory) - shoulder shrug
C12: Hops (hypoglossal) - stick out tongue because you are done

Question 12

Trigenminal Neuralgia affects what CN?

Answer 12

CN 5

Question 13

CN for eyes

Answer 13

CN 2,3,4,6

3,4,and 6 make your eyes do tricks. 2 is snellen chart

Question 14

Swallowing CN

Answer 14

5,7,9,10, and 12 for swallowing

Question 15

Normal Rinne Test

Answer 15

AC >BC

Question 16

Weber Test
Conductive hearing loss lateralizes to __ ear
Sensorineural lateralizes to __ ear

Answer 16

Conductive hearing loss lateralizes to BAD ear

Sensorineural lateralizes to GOOD ear (“trust your good sense”)

Question 17

Which of the following cranial nerves, when infected with the herpes zoster (shingles) virus, may cause blindness?

Answer 17

Cranial nerve 5, the trigeminal nerve, has an ophthalmic branch that when damaged by the herpes zoster (shingles) virus

Question 18

SNRIs S/E

Answer 18

are known to potentially increase blood pressure and therefore should be avoided in those with uncontrolled hypertension already. Concurrent use of the triptan drug class and SNRIs may lead to the development of serotonin syndrome. SNRIs are also processed in the liver, and if a patient has a liver condition, it may cause the drug to clear slowly. There is no contraindication for using Gabapentin (Neurontin) with a SNRI. SNRIs can be used to also help treat the neuropathic pain associated with fibromyalgia.