Neuro

Question 1

The best way to assess for malnutrition or undernutrition in neuro ICU pts

Answer 1

The Nutritional risk screening (NRS) 2002 (>5) or nutritional risk in the critically ill (NUTRIC) score of greater than or equal to 5 to determining the patient is high risk

Question 2

First line treatment for depression in older adults

Answer 2

PHQ-9 screening tool is the most common type to screen for depression

TX. SSRI or SNRI

Once depression has been identified the Columbia-Suicide severity rating (C-SSRI) is used to screen for suicide

Question 3

Neurocognitive Risk factors for Alzheimers disease

Answer 3

-Traumatic Brain Injury
- Individuals reaching midlife with Down syndrome (Trisomy 21)
-Genetic susceptibility polymorphism apolipoprotein E4

Question 4

Asymptomatic incidental finding of thyroid nodules rec follow-up screening ?

Answer 4

3-6 mos

Question 5

Major depressive disorder s/s and treatment

Answer 5

s/s
- Anhedonia
- increased sleeping
-loss of appetite

Treatment:
- Psychiatry consult
-First-line SSRI Fluoxetine
- cognitive behavioral therapy
-social support

Question 6

Tricyclic antidepressants (ex. nortriptyline (pamelor)) overdose reversal

Answer 6

Sodium Bicarbonate to reverse metabolic acidosis and cardiac complications

Question 7

Tricyclic antidepressants (ex. nortriptyline (pamelor)) overdose reversal

Answer 7

Sodium Bicarbonate to reverse metabolic acidosis and cardiac complications

Question 8

Confirmation test for Tuberculosis

Answer 8

Send three sputum specimens for AFB smear and culture. Tuberculosis confirmation is made with a positive AFB smear along with a positive nucleic amplification (NAA) test for mycobacterium complex which is confirmed on culture

Question 9

What medication will decrease inflammation and slow the progression of Rheumatoid arthritis

Answer 9

DMARDs
-Methotrexate (first line treatment)
-Hydroxychloroquine
-sulfasalazine
-oral and parenteral gold
-penicillamine

Question 10

Statin therapy in the setting of CAD/MI

Answer 10

High intensity statin:
- Atorvastatin 40-80mg nightly
-Rosuvastatin (Crestor) 20-40 mg nightly

Question 11

Initial intervention for Carpal Tunnel

Answer 11

s/s
+Tinel and Phalen’s sign

Initial treatment:
-splinting of the wrist in a neutral position

If pain is not relived:
- cortisone injection