Neurological assessment

Question 1

What can cause uneven pupils?

Answer 1

Sub-dural haematoma
Sub-arachnoid haemorrhage
Brain tumor
Cranial nerve lesion
Stroke

Question 2

What can cause pupil constriction?

Answer 2

Medications:
Codeine, methadone, morphine, fentanyl

Drugs:
Heroin, opiates

Other factors:
Bright lights

Question 3

What can cause pupil dilation?

Answer 3

Medications:
Tricyclic antidepressants, antihistamines, atropine

Drugs:
Cocaine, amphetamines, LSD, MDMA

Other factors:
Low light, fear, pain, brain injury, death

Question 4

What are the 3 parts of GCS?

Answer 4

Eye opening
Verbal response
Motor response

Question 5

What is the GCS for eye opening response?

Answer 5

4 - Eyes open spontaneously
3 - Eyes open to verbal command speech or shout
2 - Eyes open to pain (not applied to face)
1 - No eye opening

Question 6

What is the GCS for verbal response?

Answer 6

5 - Oriented to time and place
4 - Confused conversation but able to answer questions
3 - Words discernible but inappropriate response
2 - Incomprehensible sounds or speech
1 - No verbal response

Question 7

What is the GCS for motor response?

Answer 7

6 - Obeys commands
5 - Purposeful movement to painful stimulus
4 - Withdraws from pain
3 - Abnormal (spastic) flexion, decorticate posture
2 - Exterior (rigid) response, decerebrate posture
1 - No motor response

Question 8

What is autonomic dysreflexia and it’s symptoms?

Answer 8

An uninhibited sympathetic nervous system response

-Anxiety, bladder or bowel problems, blurry vision, high blood pressure, heavy sweating

Question 9

What are the most common causes of seizures?

Answer 9

Discontinuation of medications
Infection
Metabolic abnormalities (sodium, calcium, hepatic and renal dysfunction)
Drug toxicity
Ethanol withdrawal
CVA
Intracranial mass
Head injury

Question 10

What are the diagnostic features of seizures?

Answer 10

Convulsions
Postictal confusion (5-20mins)
Incontinence
Tongue biting
Auras (smell, taste, deja vu, visual disturbances)
Absence

Question 11

During what length of ongoing seizure should you consider diazepam?

Answer 11

5mim or 2-3min for eclamptic

Question 12

What is the most common type of headache?

Answer 12

Tension headaches

Question 13

What are cluster headaches?

Answer 13

Repeated clusters of headaches with sharp unilateral periorbital pressure and autonomic features

Question 14

Do cluster headaches affect men or women more?

Answer 14

Men

Question 15

What other symptoms may accompany migranes?

Answer 15

Aura changes
Nausea
Visual disturbances

Question 16

What is cerebellar ataxia?

Answer 16

Poor muscle control that causes clumsy voluntary movements

Question 17

What gait accompanies parkinsons disease?

Answer 17

Slow shuffles with a hunched back

Question 18

What is status epilepticus?

Answer 18

A seizure that lasts longer than 5 minutes or more than 1 seizure within a 5 minute period, without returning to a normal level of consciousness between episodes.

Question 19

What spinal injuries cause neurogenic shock?

Answer 19

Spinal injuries above T5