Neurological

Question 1

Normal ICP

Answer 1

0-15 mmHg

Question 2

Cushing’s triad

Answer 2

Bradycardia, abnormal respirations, increased systolic pressure (widened pulse pressure)

Question 3

Oval shaped pupils indicate…

Answer 3

Dysfuction or pressure on occulomotor nerve III

Question 4

Doll’s test (oculocephalic reflex)

Answer 4

Move the patients head quickly to one side - eyes will deviate away from the direction that the head is rotated

Question 5

Water caloric test (oculovestibular reflex)

Answer 5

Ice water injected into ear - both eyes move in the direction of the side water is instilled

Question 6

Diffuse axonal injury manifestations

Answer 6

Posturing, HTN, hyperthermia, sweating, loss of brain stem reflexes

Question 7

Epidural bleed location

Answer 7

Between skull and dura mater from the middle meningeal artery

Question 8

Epidural bleed manifestations

Answer 8

Period of unconsciousness followed by lucid period then again unconscious, hemiparesis, dilated pupil on same side of injury

Question 9

Subdural bleed location

Answer 9

between dura mater and subarachnoid from the small bridging veins

Question 10

Subdural bleed manifestations

Answer 10

Slow onset, aloc, hemiparesis, fixed dilated pupilar, nausea

Question 11

Subarachnoid bleed manifestations

Answer 11

“Worst headache of my life” nausea, vomiting, photophobia, seizure

Question 12

Basilar skull fracture manifestations

Answer 12

Ecchymosis behind ear (battle sign), altered eye movement, facial palsy, hemorrhage in periorbital spaces (raccoon eyes)

Question 13

Anosmia

Answer 13

inability to perceive smells

Question 14

Posterior cord transmists…

Answer 14

Light touch, proprioception, vibration

Question 15

Anterior cord transmits…

Answer 15

Motor function

Question 16

Lateral cord transmits…

Answer 16

Pain, temperature

Question 17

Brown-Sequard syndrome

Answer 17

Loss of motor function, proprioception and vibration on side of injury AND loss of pain and temperature on opposite side of injury

Question 18

Cauda equina syndrome

Answer 18

Damage to lower spinal cord, may cause bowel and bladder problems

Question 19

Autonomic dysreflexia

Answer 19

Sympathetic reaction to noxious stimuli (full bladder, full recturm, kidney stone, etc) causing vasoconstriction in lower body and vasodilation in upper body (HA, sweating, flushing, anxiety)

Question 20

ALS/Lou Gerhig’s disease

Answer 20

Twitching, tingling, cramping starting in one limb, ultimately affecting all limbs, leading to problems with respiratory system

Question 21

Multiple sclerosis

Answer 21

Autoimmune disease causing double vision, weakness, pain, tremors. Treatment is steroids and supportive care

Question 22

Parkinson’s disease

Answer 22

Loss of dopamine producing cells in the brain

Question 23

Myasthenia Gravis manifestations

Answer 23

Weakness, drooping eyelids, speech alteration

Question 24

Guillain-Barre patho

Answer 24

Acute inflammatory polyneuropathy that affects motor components

Question 25

Guillain-barre manifestations

Answer 25

Ascending weakness and neuopathy, mild febrile illness prior to GB, eventually leads to respiratory insufficiency

Question 26

Guillain-Barre treatment

Answer 26

Plasmaphoresis and IV immunoglobulin

Question 27

ED door to needle for TPA

Answer 27

60 min

Question 28

TPA contraindications

Answer 28

Hx of brain bleed within last 3 months, SBP >185, INR>1.7, PT>15 seconds, platelets>100,000