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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
What does a score of 17 on the mini mental status exam indicate?
severe impairment — 0-17
26
What is a normal ICP?

5-15
27
What is  normal CPP?

60-80
28
What is the ICP goal in patients with increased ICP?

<20
29
What MAP goal should be used to treat cerebral vasospasm in patients with severe traumatic head injury?
110-130
30
What are indications for ICP monitoring for a trauma patient?
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
What level of spinal cord injury is associated with respiratory compromise?
C3-5
32
What level of spinal cord injury is associated with autonomic dysreflexia?
T4-6
33
What is status epilepticus?

Seizure lasting longer than 5 minutes or more than one seizure occurs within 5 minutes without return to normal LOC
34
What drugs are used during the initial phase of treatment of a seizure?
midazolam, lorazepam, or diazepam (may be repeated once)
35
What is the next step of seizure management for a patient who is seizing after receiving 4mg of ativan?
Repeat 4mg IV ativan
36
What drugs are used the second therapy phase?
fosphenytoin, valproic acid, or levetiracetam 
37
What is the third step in management of status epilepticicus?
repeat second line therapy or anesthetic dose of thiopental, pentobarbital, midazolam, or propofol with continuous EEG monitoring 
38
A CSF fluid analysis shows high protein, neutrophilic predominance, and low glucose. Which type of meningitis does this suggest?
Bacterial 
39
A CSF fluid analysis shows high protein, lymphocytic predominance, and normal glucose. Which type of meningitis does this suggest?
Viral
40
A CSF fluid analysis shows high protein, lymphocytic predominance, and low glucose. Which type of meningitis does this suggest?
fungal or TB
41
What are the most common bacterial pathogens responsible for meningitis in those ≥ 50 years old?

N. Meningitidis or S. pneumoniae
42
What are the most common bacterial pathogens responsible for meningitis in those > 50 years old?
N. Meningitidis, S. pneumoniae, gram negative enterics ( E. coli, Klebsiella, Enterobacter), and L. monocytogenes
43
What is the empire treatment for bacterial meningitis in those ≥ 50 years old?

vanco plus ceftriaxone
44
What is the empire treatment for bacterial meningitis in those > 50 years old?

vanco plus ceftriaxone plus ampicillin 
45
How does anterior cord syndrome present?
loss of movement and sharp/dull and hot/cold sensation below the level of injury, but without loss of proprioception, vibration, and pressure 
46
How does a central cord syndrome present?
loss of movement and sensation in arms without any loss in lower extremities
47
How does Brown Sequard syndrome present
ipsilateral paralysis and loss of proprioception with contralateral loss of pain, sensation, and temperature 
48
How does Cauda Equina syndrome present?
saddle anesthesia and loss of bowel/bladder function (incontinence or retention)
49
A patient who does not recognize his disordered behavior is in which stage of the readiness for treatment model?
Pre-contemplation 
50
A patient who recognizes the need to change is in which stage of the readiness for treatment model?    
Contemplation
51
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?  
Preparation
52
A patient who is taking steps to correct behavior (entering a rehab center) is in which stage of the readiness for treatment?   
Action
53
A patient who exhibits continued abstinence from disordered behavior is in which stage of the readiness for treatment model?
Maintenance
54
A patient who returns to his disordered behavior is in which stage of the readiness for treatment  model?

Relapse
55
What is another name for vitamin B1?

Thiamine
56
What is another name for vitamin B9?

Folic acid
57
Myerson’s Sign (glabellar reflex) is associated with which condition?
Parkinson’s Disease
58
What three key features are present in Parkinson’s?

resting tremor, rigidity, bradykinesia
59
What is the most common cause of dementia?  
Alzheimers
60
Which type of dementia is associated with Parkinson’s Disease?
Lewy Body Dementia
61
What three key features are present in Alzheimer’s?
aphasia, apraxia (inability to perform a previously learned tast), and agnosia (inability to recognize objects)
62
Which cholinesterase inhibitor is indicated for all stages of Alzheimer’s disease?
Donepezil
63
Which NMDA antagonist is given in Alzheimers?
 
Memantine
64
What is the initial diagnostic test of choice for MS?
MRI
65
What is a key difference between myasthenia gravis and MS?
MG has normal sensory function and DTRs
66
A patient with a TBI and a GCS Score of 14 would be classified as what severity of TBI?
mild 13-15
67
A patient with a TBI and a GCS Score of 10 would be classified as what severity of TBI?
mod 9-12
68
A patient with a TBI and a GCS Score of 6 would be classified as what severity of TBI?
severe 3-8

AGACNP Cert (12 decks)

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