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AGACNP Cert > Neuro > Flashcards

Neuro Flashcards

1
Q

What percent of CVAs are ischemic?

A

85%

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2
Q

With what deficits would a patient with an MCA stroke present with?

A

Middle cerebral artery CVA causes contralateral hemiparesis and sensory deficits

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3
Q

With what deficits would a patient with a left frontal stroke present with?

A

Brocas Area (left frontal lobe) causes dysarthria and expressive aphasia

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4
Q

With what deficits would a patient with a left temporal stroke present with?

A

Wernicke’s Area (left temporal lobe) causes receptive aphasia

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5
Q

With what deficits would a patient with PCA stroke present with?

A

Posterior Cerebral Artery CVA causes visual deficits, contralateral homonymous hemianopsia

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6
Q

With what deficits would a patient with a cerebellar stroke present with?

A

ataxia

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7
Q

At which point is CEA indicated for a patient with asymptomatic carotid stenosis?

A

CEA is indicated for asymptomatic patients with 70-99% stenosis

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8
Q

At which point is CEA indicated for a patient with symptomatic carotid stenosis?

A

CEA is indicated for symptomatic low-risk surgical candidates with 50-90% stenosis

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9
Q

What is cranial nerve I and what does it do?

A

I Olfactory — sense of smell

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10
Q

What is cranial nerve II and what does it do?

A

II Optic — vision

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11
Q

What is cranial nerve III and what does it do?

A

III Oculomotor — EOM, pupillary constriction response to light

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12
Q

What is cranial nerve IV and what does it do?

A

IV Trochlear — down and inward eye movement

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13
Q

What is cranial nerve V and what does it do?

A

V trigeminal — sensation of the face, scalp, cornea, mucous membranes & nose, movement of masseter muscle (mastication)

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14
Q

What is cranial nerve VI and what does it do?

A

VI Abducens — lateral eye movement

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15
Q

What is cranial nerve VII and what does it do?

A

VII Facial — facial movement, saliva and tear secretion, taste (anterior 2/3)

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16
Q

What is cranial nerve VIII and what does it do?

A

VIII Acoustic (Vestibulocochlear) — hearing and equilibrium

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17
Q

What is cranial nerve IX and what does it do?

A

IX Glosopharengeal — phonation, gag reflex, swalowing, taste (posterior 1/3), carotid reflex

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18
Q

What is cranial nerve X and what does it do?

A

X Vagus — talking, swallowing, cough reflex, general sensation of the carotid body, carotid reflex

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19
Q

What is cranial nerve XI and what does it do?

A

XI Spinal Accessory — movement of the trapezius and sternomastoid muscles (shoulder shrug)

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20
Q

What is cranial nerve XII and what does it do?

A

XII — Hypoglossal — movement of the tongue

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21
Q

What are the components of the Mini Mental Status Exam?

A

O — orientation to place and time
R — recognition (repeat three objects)
A — attention (serial 7s counting backwards from 100)
R — recall (ask to recall three objects five minutes later)
L — language
2 — identify names of two objects
3 — follow a three step command
R — reading
W — writing
D — drawing

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22
Q

What is the maximum score for the mini mental status exam?

A

30

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23
Q

What does a score of 24 on the mini mental status exam indicate?

A

average score (no cognitive impairment) — 24-30

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24
Q

What does a score of 23 on the mini mental status exam indicate?

A

mild impairment (delerium/dementia) — 18-23

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25
Q

What does a score of 17 on the mini mental status exam indicate?

A

severe impairment — 0-17

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26
Q

What is a normal ICP?


A

5-15

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27
Q

What is normal CPP?


A

60-80

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28
Q

What is the ICP goal in patients with increased ICP?


A

<20

29
Q

What MAP goal should be used to treat cerebral vasospasm in patients with severe traumatic head injury?

A

110-130

30
Q

What are indications for ICP monitoring for a trauma patient?

A

Severe head injury in patients who cant be serially neurologically assessed OR
Severe head injury (GCS <8) and abnormal head CT OR
Severe head injury (GCS <8) and normal head CT with two of the following — age>40, BP <90, or abnormal posturing

31
Q

What level of spinal cord injury is associated with respiratory compromise?

A

C3-5

32
Q

What level of spinal cord injury is associated with autonomic dysreflexia?

A

T4-6

33
Q

What is status epilepticus?


A

Seizure lasting longer than 5 minutes or more than one seizure occurs within 5 minutes without return to normal LOC

34
Q

What drugs are used during the initial phase of treatment of a seizure?

A

midazolam, lorazepam, or diazepam (may be repeated once)

35
Q

What is the next step of seizure management for a patient who is seizing after receiving 4mg of ativan?

A

Repeat 4mg IV ativan

36
Q

What drugs are used the second therapy phase?

A

fosphenytoin, valproic acid, or levetiracetam

37
Q

What is the third step in management of status epilepticicus?

A

repeat second line therapy or anesthetic dose of thiopental, pentobarbital, midazolam, or propofol with continuous EEG monitoring

38
Q

A CSF fluid analysis shows high protein, neutrophilic predominance, and low glucose. Which type of meningitis does this suggest?

A

Bacterial

39
Q

A CSF fluid analysis shows high protein, lymphocytic predominance, and normal glucose. Which type of meningitis does this suggest?

A

Viral

40
Q

A CSF fluid analysis shows high protein, lymphocytic predominance, and low glucose. Which type of meningitis does this suggest?

A

fungal or TB

41
Q

What are the most common bacterial pathogens responsible for meningitis in those ≥ 50 years old?


A

N. Meningitidis or S. pneumoniae

42
Q

What are the most common bacterial pathogens responsible for meningitis in those > 50 years old?

A

N. Meningitidis, S. pneumoniae, gram negative enterics ( E. coli, Klebsiella, Enterobacter), and L. monocytogenes

43
Q

What is the empire treatment for bacterial meningitis in those ≥ 50 years old?


A

vanco plus ceftriaxone

44
Q

What is the empire treatment for bacterial meningitis in those > 50 years old?


A

vanco plus ceftriaxone plus ampicillin

45
Q

How does anterior cord syndrome present?

A

loss of movement and sharp/dull and hot/cold sensation below the level of injury, but without loss of proprioception, vibration, and pressure

46
Q

How does a central cord syndrome present?

A

loss of movement and sensation in arms without any loss in lower extremities

47
Q

How does Brown Sequard syndrome present

A

ipsilateral paralysis and loss of proprioception with contralateral loss of pain, sensation, and temperature

48
Q

How does Cauda Equina syndrome present?

A

saddle anesthesia and loss of bowel/bladder function (incontinence or retention)

49
Q

A patient who does not recognize his disordered behavior is in which stage of the readiness for treatment model?

A

Pre-contemplation

50
Q

A patient who recognizes the need to change is in which stage of the readiness for treatment model?

A

Contemplation

51
Q

A patient who is making plans to correct behavior, establishing support networks, mediating triggers, and obtaining necessary resources is in which stage of the readiness for treatment model?

A

Preparation

52
Q

A patient who is taking steps to correct behavior (entering a rehab center) is in which stage of the readiness for treatment?

A

Action

53
Q

A patient who exhibits continued abstinence from disordered behavior is in which stage of the readiness for treatment model?

A

Maintenance

54
Q

A patient who returns to his disordered behavior is in which stage of the readiness for treatment
model?


A

Relapse

55
Q

What is another name for vitamin B1?


A

Thiamine

56
Q

What is another name for vitamin B9?


A

Folic acid

57
Q

Myerson’s Sign (glabellar reflex) is associated with which condition?

A

Parkinson’s Disease

58
Q

What three key features are present in Parkinson’s?


A

resting tremor, rigidity, bradykinesia

59
Q

What is the most common cause of dementia?

A

Alzheimers

60
Q

Which type of dementia is associated with Parkinson’s Disease?

A

Lewy Body Dementia

61
Q

What three key features are present in Alzheimer’s?

A

aphasia, apraxia (inability to perform a previously learned tast), and agnosia (inability to recognize objects)

62
Q

Which cholinesterase inhibitor is indicated for all stages of Alzheimer’s disease?

A

Donepezil

63
Q

Which NMDA antagonist is given in Alzheimers?


A

Memantine

64
Q

What is the initial diagnostic test of choice for MS?

A

MRI

65
Q

What is a key difference between myasthenia gravis and MS?

A

MG has normal sensory function and
DTRs

66
Q

A patient with a TBI and a GCS Score of 14 would be classified as what severity of TBI?

A

mild 13-15

67
Q

A patient with a TBI and a GCS Score of 10 would be classified as what severity of TBI?

A

mod 9-12

68
Q

A patient with a TBI and a GCS Score of 6 would be classified as what severity of TBI?

A

severe 3-8

AGACNP Cert (12 decks)

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