Neuro

Question 1

S/S of epidural hematoma? Venous or arterial?

Answer 1

Lucidity then sudden unconsciousness. Arterial.

Question 2

S/S of subdural hematoma? Arterial or venous?

Answer 2

Slow development of neuro changes. Venous.

Question 3

S/S of increased ICP

Answer 3

Unequal pupil sizes, decreased LOC that progresses with continued elevation of ICP, N/V, seizure, headache, Cheyne-stokes respirations, pupil nonreactivity, papilledema

Question 4

Treatments to decrease ICP?

Answer 4

Elevate HOB, IV mannitol, hypertonic saline, transient hyperventilation, barbiturates

Question 5

How to treat elevated ICP if it is refractory to non-invasive measures?

Answer 5

Sedation, intubation, mechanical ventilation, and neuromuscular paralysis

Question 6

What is glutamate?

Answer 6

An excitatory neurotransmitter needed for post synaptic excitation of neural cells. Plays a big role in neural communication, memory formation, and learning

Question 7

What is glutamate a precursor for?

Answer 7

GABA (an inhibitory neurotransmitter)

Question 8

_____ is a glutamate receptor. ______, ____, and ______ are _____ receptor antagonists

Answer 8

NMDA. Ketamine, nitrous oxide, and methadone are NMDA antagonists

Question 9

S/S of autonomic dysreflexia (or hyperreflexia)?

Answer 9

Marker hypertension and bradycardia. Headache, blurred vision, LV failure, pulmonary edema, dysrhythmias, strokes, and seizures

Question 10

What is the most common cause of CVA?

Answer 10

Poorly controlled or uncontrolled HTN

Question 11

What is the most common cerebral artery involved in CVA?

Answer 11

The middle cerebral artery (MCA) is most often occluded in a stroke

Question 12

What cerebral arteries supply the brainstem?

Answer 12

The vertebral and basilar arteries (and their branches) supply the brainstem and cerebellum

Question 13

Within how many hours since onset of symptoms of a stroke must TPA be administered?

Answer 13

Within 4.5 hours of onset of symptoms

Question 14

Which disorder is characterized by progressive demyelination of the CNS?

Answer 14

Multiple Sclerosis

Question 15

What medication is important to know about when giving anesthesia to a patient with multiple sclerosis?

Answer 15

Succinylcholine - you cannot give it to MS patients because it can cause life threatening hyperkalemia in this population

Question 16

Which disorder is characterized by a decreased number of acetylcholine receptors?

Answer 16

Myasthenia Gravis

Question 17

Which disorder is characterized by improved muscle strength with use?

Answer 17

Myasthenic Syndrome (aka LEMS)

Question 18

Deficiency of which substance during pregnancy accounts for up to 70% of neural tube defects?

Answer 18

Folate/folic acid

Question 19

Which neural tube disorder is characterized by a sac-like cyst of meninges, spinal cord and nerves present on an infant’s back?

Answer 19

Myelomeningocele

Question 20

Which neural tube closure defect seen in infants also has accompanying vertebral defects and usually result in paralysis?

Answer 20

Spina bifida

Question 21

What is hydrocephalus?

Answer 21

Excess CSF in cranial vault due to either 1) CSF drainage 2) CSF overproduction, or 3) decreased CSF reabsorption

Question 22

What is craniosynostosis?

Answer 22

Premature closure of 1 or more of the cranial sutures during 1st 18-20 mo of life, leading to limitation of skull expansion that normally occurs to accommodate rapidly growing brain

Question 23

What is cerebral palsy?

Answer 23

Neurologic disorder of movement, muscle tone, or posture that is caused by injury to or abnormal development of the child’s brain from before, during or after birth up to 1 year

Question 24

Risk factors for cerebral palsy?

Answer 24

LBW, prenatal cerebral hypoxia, hemorrhage, infection, and genetic abnormalities

Question 25

Definition of febrile seizures in a child

Answer 25

Seizures occurring with fevers in the absence of a central nervous system infection

Question 26

Which are longer in duration - simple or complex febrile seizures?

Answer 26

Complex febrile seizures

Question 27

Is the EEG abnormal or normal between seizure bursts in simple febrile seizures?

Answer 27

Normal between seizures

Question 28

Are meds often given in febrile seizures in children?

Answer 28

No. Risk outweighs benefit

Question 29

What is the most common cause of hemorrhagic cerebrovascular disease seen in children?

Answer 29

Congenital cerebral AV malformations

Question 30

What number in the Glasgow Coma Scale indicates Coma?

Answer 30

Score of 3-8

Question 31

Which disease involves a genetic error that renders the body unable to metabolize an essential amino acid?

Answer 31

Phenylketonuria (PKU)

Question 32

3 functions of cerebrum?

Answer 32

Receives/processes conscious sensation, generates thought, controls conscious activity

Question 33

What are the functions of the archicerebellum?

Answer 33

Maintain equilibrium

Question 34

What are the functions of the paleocerebellum?

Answer 34

Regulates muscle tone

Question 35

What are the functions of the neocerebellum?

Answer 35

Coordinates voluntary muscle movement

Question 36

What are the 3 meninges?

Answer 36

Dura mater – outer, lines skull
Arachnoid – middle, contains blood vessels
Pia mater – inner, covers brain

Question 37

5 conditions that can mimic a stroke?

Answer 37

Seizures, systemic infection, syncope, toxic metabolic disturbances, tumor

Question 38

What neurotransmitter the symptoms and pathophysiology of Parkinson’s disease?

Answer 38

Too little dopamine

Question 39

Normal ICP is _____ mmHg

Answer 39

5-15

Question 40

Normal CPP is ____ mmHg

Answer 40

60-100

Question 41

What is a dermatome?

Answer 41

Specific areas of skin innervated by spinal nerves at various spinal cord segments, where sensory signals arise