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Mosier Neuro > Neuro Final Questions > Flashcards

Neuro Final Questions Flashcards

1
Q 
Which region of the spinal cord is MOST commonly injured in a traumatic accident?
A. Cervical
B. Thoracic
C. Thoracolumbar
D. Lumbar
A

A. Cervical

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2
Q

Which of the following may present with cervical spine injury?

a. Pain
b. Numbness
c. Weakness
d. All of the above

A

D. All of the above

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3
Q

Potential damage to which of the following may occur in cervical spine surgery?

a. Phrenic nerve
b. Vertebral artery
c. Recurrent laryngeal nerve
d. Both b and c

A

D. Both B and C

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4
Q

When considering IVF therapy for a patient with a intracranial tumor you should be concerned with which of the following:

a. IVF that contain glucose can increase cerebral edema
b. Over-transfusion can increase CVP, predisposing the patient to increase in ICP
c. Limiting fluid intake during craniotomy
d. All of the above

A

D. All of the above

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5
Q

Which of the following anesthetic gases is most appropriate to use during removal of an intracranial tumor?

a. Desflurane
b. Isoflurane
c. Sevoflurane
d. Any of the above if you are experienced with its use

A

D. An of the above if you are experienced with its use

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6
Q

It is important in the preoperative setting to evaluate which of the following:

a. the patients baseline neuro status
b. Patients medical history including seizure activity
c. Medication history and last dose of anticonvulsant medications and antihypertensives
d. All of the above

A

D. All of the Above

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7
Q

Trigeminal Neuralgia is an irritation of the ____ cranial nerve causing severe pain that usually affects one side of the face.

a. 2.5
b. 3
c. 14
d. 5

A

D. 5

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8
Q

Some risk of MVD surgery for trigeminal neuralgia include:

a. Mild facial numbness (25% -usually temporary)
b. Hearing loss on the affected side (3%)
c. Double vision (usually temporary)
d. All of the above

A

D. All of the above

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9
Q

Microvascular decompression (MVD) is a surgery to relieve abnormal compression of a cranial nerve causing?

a. Trigeminal neuralgia
b. Glossopharyngeal neuralgia
c. Hemifacial spasm
d. All the above

A

D. All of the above

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10
Q

What is the common location for placement of valve device for drainage of elevated CSF while VP shunt placement

a. Forehead
b. Underneath the skin behind the ear
c. Peritoneal cavity
d. Eye ball

A

B. Underneath the skin behind the ear

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11
Q

VP shunting is a surgical procedure that primarily treats a condition called

a. Hydrocephalus
b. Pleural effusion
c. Herpes
d. Ascites

A

A. Hydrocephalus

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12
Q

While performing VP shunt procedure, which of the following activities is most stimulating and is better to keep patient deep?

a. Making the incision of the abdomen
b. Tunneling the catheter
c. Prepping the surgical area
d. None of the above

A

B. Tunneling the catheter

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13
Q

Choose the Correct answer to the following statements:

a. MS is almost four times more prevalent in women than men.
b. 99% of patients with MS, also have a family member with MS.
c. MS is a chronic, progressive disease of the PNS affecting myelination of nerves.
d. Early signs and symptoms of MS include bowel/bladder loss of function and vision loss.

A

A. MS is almost four times more prevalent in women than men

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14
Q

All of the medications listed below are treatments of MS EXCEPT:

a. Glucocorticoids
b. low-dose methotrexate
c. Imuran
d. All of the above are possible treatments for MS

A

D. All of the above are possible treatments for MS

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15
Q

Which answer is FALSE regarding anesthetic considerations of the MS patient?

a. They typically have an increased MAC
b. hyperkalemia risk with Succinylcholine is higher d/t demyelination of neurons
c. increases in temperature may precipitate neurologic decline postoperatively
d. the delay of emergence is proportionate to the severity of the disease

A

A. They typically have an increased MAC

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16
Q 
A patient is headed to CT with Stereotatic Frame in place, the most critical concern for the anesthesia provider is,
A.	Getting Lunch relief
B.	Airway management
C.Lack of resources for transport
D.	All the above
A

B. Airway management

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17
Q

During a stereotactic surgery the surgeon has encountered an issue with bleeding. The patient’s airway is secured and under GA but you begin to notice a widen pulse pressure. Which would be the next appropriate action?
A. Do nothing because this is a normal finding.
B. Increase the volatile agents.
C. Hyperventilate the patient to a PaCO2 of 25mmHG
D. Bolus with Propofol, and or give osmotic diuretics.
E. Both C and D

A

E. Both C and D

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18
Q

Which of the following statements displays proper knowledge in regards to characteristics of stereotactic surgery.
A. Can be done awake or under GA
B. Allows for localization of intracranial lesions without a craniotomy
C. Pediatric patients arent canidates for this procedure.
D. Both A and B
E. None of the above

A

D. Both A and B

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19
Q

Which of the following is a life-threatening condition for a patient with Myasthenia Gravis where the breathing muscles become too weak to adequately ventilate the patient?

a. Myasthenic storm
b. Myasthenic crisis
c. Myasthenic overdose
d. Myasthenic flare-up

A

B. Myasthenic crisis

20
Q

Why do patients with myasthenia gravis experience muscle weakness?

a. Acetylcholine is not produced in the body
b. Inability of the body to breakdown protein
c. Neuromuscular junction receptor sites are destroyed by antibodies
d. Poor nutritional intake

A

C. Neuromuscular junction receptor sites are destroyed by antibodies

21
Q

When considering the dose and duration of action of a non-depolarizing neuromuscular blocker for a patient with myasthenia gravis, it is important to choose one with….

a. A smaller dose with a longer duration of action
b. A smaller dose w/ shorter duration of action
c. A larger dose with a longer duration of action
d. A larger dose with a shorter duration of action

A

B. A smaller dose w/ shorter duration of action

22
Q

What is Chiari Malformation?

a. A neurological consequence of hypertension
b. Cerebellar tonsillar herniation
c. Cerebral sulcus compression
d. A malformation of the Arnold Chiari structure

A

B. Cerebellar tonsillar herniation

23
Q

Which of the following are anesthesia concerns when performing anesthesia for a craniocervical decompression for chiari malformation? Select all that apply.

a. Autonomic dysfunction
b. Increased intraocular pressure
c. Difficult airway
d. Increased intracranial pressure
e. Sensitivity to neuromuscular blockers

A

A, C, D, E

24
Q

Increased ICP in patient with chiari malformation can result in:

a. Neurological damage
b. Hemodynamic instability
c. Increased difficulty of procedure for surgeon
d. All of the above

A

D. All of the above

25
Q

Which of the following conditions associated with pituitary tumors can lead you to anticipate a difficult airway?

a. Hyperthyroidism
b. Acromegaly
c. Cushing’s disease
d. All of the above

A

D. All of the above

26
Q

Which type of pituitary tumor is more likely NOT to secrete hormones, and is therefore detected only after the patient begins to experience symptoms from the tumor putting pressure on surround brain structures?

a. Microadenomas
b. Macroadenomas
c. Lipoma
d. Leiomyoma

A

B. Macroadenomas

27
Q

With which condition is it imperative to perform a baseline neurological assessment prior to providing these patients with anesthesia, as myopathy associated with this condition can mimic ineffective recovery from muscle relaxant?

a. Cushing’s
b. Hyperthydroidism
c. Acromegaly
d. None of the above

A

A. Cushing’s

28
Q

Which of the following infections are the most frequently associated with GBS?

a. Respiratory infection
b. GI infection
c. Both are correct
d. None of the above

A

C. Both are correct

29
Q

Which of the following statement is TRUE regarding GBS?

a. Affects all people of ages and not hereditary
b. Follows a respiratory or GI infection
c. Characterized by ascending muscle paralysis
d. All of the above

A

D. All of the above

30
Q

Which of the following treatment has shown to be effective for patients with GBS?

a. IVIG
b. Plasmapheresis
c. Both are correct
d. None of the above

A

C. Both are correct

31
Q

In which of the following situations would an awake craniotomy be indicated?

a. Epidural hematoma evacuation
b. Deep brain stimulator placement for Parkinson’s disease
c. Aneurysm repair
d. Never would you ever perform an awake craniotomy

A

B. Deep brain stimulator placement for Parkinson’s disease

32
Q

What is the potential cause of seizures during an awake craniotomy?

a. Music
b. Desflurane
c. Direct cortical stimulation
d. None of the above

A

C. Direct cortical stimulation

33
Q

If during an awake craniotomy, the patient begins to experience positional discomfort, what is the best medication to give?

a. Low dose remifentanil infusion
b. Rocuronium
c. Increase the desflurane rate
d. High dose Dilaudid

A

A. Low dose remifentanil infusion

34
Q

What are some initial symptoms of ALS?

a. Muscle twitching/cramping
b. Tripping/falling
c. Dropping things
d. All of the above

A

D. All of the above

35
Q

ALS affects:

a. Upper motor neurons
b. Lower motor neurons
c. Both A and B
d. None of the above

A

C. Both A and B

36
Q

The main cause of death in patients with ALS is:

a. Heart attack
b. Stroke
c. Unknown
d. Respiratory failure

A

D. Respiratory failure

37
Q

Select all that apply: DMD is a genetic disorder characterized by:

a. Progressive painful muscle degeneration and weakness
b. Progressive painless muscle degeneration and weakness
c. Onset ages 3-5
d. Onset ages 5-7

A

B and C

38
Q

The pre-op assessment of a pt with DMD should focus on

a. Baseline respiratory and cardiovascular function
b. Airway assessment
c. A and B
d. None of the above

A

C. A and B

39
Q

Select all that apply: patients with DMD who receive volatile agents or succs are at increased risk of

a. Rhabdomylosis
b. MH
c. Hyperkalemia
d. Hypokalemia

A

A, B, C

40
Q

What has been associated with post-op hemorrhage?

a. Hypotension
b. Hypertension
c. Hypoxia
d. Hyperthermia

A

B. Hypertension

41
Q

The Glasgow Coma Scale (GCS):

a. Is an objective neurological scale
b. Has scores ranging from 3-15
c. Used for initial and subsequent assessments
d. All of the above

A

D. All of the above

42
Q

Post-Coiling for an Aneurysm, how many hours does the patient have to lay flat?

a. 2
b. 4
c. 6

A

C. 6

43
Q

The standard treatment for a patient with a subarachnoid hemorrhage experiencing vasospasm includes (select 3):

a. Hypervolemia
b. Hypertension
c. Hypotension
d. Hemodilution

A

A, B, D

44
Q

What is the preferred medication to treat hemodynamic changes that may occur from direct laryngoscopy in a patient with increased ICP?

a. Hydralazine
b. Esmolol
c. Metoprolol
d. Norepinephrine

A

B. Esmolol

45
Q

During a carotid stenting procedure, which drug may be required to treat bradycardia from baroreceptor manipulation?

a. Atropine
b. Precede
c. Vasopressin
d. Esmolol

A

A. Atropine

Mosier Neuro (6 decks)

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