Neurological Emergencies Flashcards
Your patient states that he often experiences a painful cramping and “freezing up” of his hands and feet while handwriting or walking, respectively. This best describes:
Question 1 options:
A)
torticollis.
B)
dystonia.
C)
myoclonus.
D)
palsy.
dystonia
Which of the following is a risk factor for stroke?
Question 2 options:
A)
Atrial fibrillation
B)
Premature atrial contractions
C)
First-degree heart block
D)
Sinus arrhythmia
atrial fibrillation
Which of the following is a risk factor for stroke?
Question 2 options:
A)
Atrial fibrillation
B)
Premature atrial contractions
C)
First-degree heart block
D)
Sinus arrhythmia
Bells palsy
Your patient is a 55-year-old male with a history of seizures who is on the floor and experiencing tonic-clonic motor activity. His jaw is clenched, he has peripheral cyanosis, and there are frothy secretions in his airway. HR = 130, RR = 4 and shallow, SaO2 = 88%. Which of the following is most appropriate?
Question 4 options:
A)
Suctioning the airway, inserting a nasopharyngeal airway, assisting respirations by bag-valve-mask device with 100 percent oxygen
B)
An IV of normal saline at a keep open rate, check blood glucose level, administer 3 mg of lorazepam, IV
C)
Immediate nasal intubation and hyperventilation with 100 percent oxygen
D)
An IV of normal saline at a keep open rate, check blood glucose level, administer 5 mg of diazepam, IV
suctioning the airway, inserting a nasopharyngeal airway, assisting respirations by bag-valve-mask device with 100 percent oxygen
Your patient is a 45-year-old female type I diabetic with a history of a nonhealing foot ulcer. On examination, you find that her pedal pulse is present, but she lacks sensation in her foot. This is most likely due to:
Question 5 options:
A)
Brown-Séquard syndrome.
B)
Raynaud’s disease.
C)
claudication.
D)
peripheral neuropathy.
peripheral neuropathy
Your patient is a 48-year-old female who is alert and oriented after a possible seizure. Her friends state they witnessed her slump to the floor and “shake” for about 15 seconds. She awoke in less than 1 minute and was “a bit groggy” for a few minutes. She does not believe she had a seizure but thinks she may have fainted. Which of the following questions is least important when differentiating seizure and syncope?
Question 6 options:
A)
“Are you allergic to any medications?”
B)
“Do you have a history of seizures?”
C)
“What happened just before the event?”
D)
“What kind of medications do you take?”
are you allergic to any medications
You have been called for a 46-year-old female complaining of a headache. Which of the following statements made by the patient should you find most concerning?
Question 7 options:
A)
“I took two Tylenol tablets 2 hours ago, and the pain is still there.”
B)
“I have never had a headache this bad.”
C)
“I have never been nauseated like this with a headache before.”
D)
“The pain gets worse when the lights are on.”
I have never had a headache this bad
Your patient is a 76-year-old female who was initially lethargic but responded to verbal stimuli. According to family members, the patient experienced a sudden decrease in responsiveness. She had a left-sided facial droop, aphasia, a dilated and nonreactive right pupil, and a flaccid left arm. Lung sounds are decreased bilaterally. HR = 58, BP = 172/102, RR = 6 and shallow, SaO2 = 88%. As you start to treat her, the patient has a generalized seizure lasting about 30 seconds. She is now unresponsive. Which of the following is most appropriate?
Question 8 options:
A)
Hyperventilate by bag-valve mask, IV of normal saline at a keep open rate, check blood glucose level, administer 25 gm of dextrose if needed, administer naloxone and thiamine, intubate if no improvement, transport without delay
B)
Hyperventilate by bag-valve mask, IV of normal saline at a keep open rate, diazepam 5 mg IV, intubate if no improvement, transport without delay
C)
Intubation, IV of normal saline at a keep open rate, cardiac monitor, blood glucose determination, sublingual nitroglycerin spray, transport without delay
D)
Intubation, IV of normal saline at a keep open rate, cardiac monitor, blood glucose determination, transport without delay
intubation, IV of normal saline at a keep open rate, cardiac monitor blood glucose determination, transport without delay
Your patient is a 32-year-old female who is alert but in significant distress, complaining of a migraine. She has a history of migraines, describes a gradual onset of headache this morning, and is now experiencing nausea and intense throbbing pain behind her temples. She is lying on a couch in a dim room and keeps her eyes closed while talking to you in a low voice. HR = 100, BP = 148/100, RR = 12, SaO2 = 99%. Which of the following is most appropriate in the prehospital management of this patient?
Question 9 options:
A)
Lorazepam, 2 mg
B)
Morphine sulfate, IV in 2 mg increments, up to 10 mg
C)
A calm, quiet environment and dim lights
D)
NTG SL, 0.4 mg, up to 3 tablets or a diastolic blood pressure of 80 mmHg
a calm quiet environment and dim lights
Your patient is a 62-year-old female who is alert and oriented and sitting at her kitchen table. Her husband describes an episode of slurred speech and facial drooping that lasted about 10 minutes and resolved just before your arrival. Physical examination is unremarkable. She has no significant medical history and takes no medications. HR = 78, BP = 134/78, RR = 12, SaO2 = 99%. Which of the following is most likely?
Question 10 options:
A)
Stroke
B)
Absence seizure
C)
Ménière’s disease
D)
Transient ischemic attack
transient ischemic attack
A series of two or more generalized motor seizures without an intervening period of consciousness is known as:
Question 11 options:
A)
a petit mal seizure.
B)
status epilepticus.
C)
a complex partial seizure.
D)
hypertonic seizures.
status epilepticus
Which of the following infectious childhood diseases would most likely result in paralysis?
Question 12 options:
A)
German measles
B)
Spina bifida
C)
Poliomyelitis
D)
Rubella
poliomyelitis
The most common cause of dementia is:
Question 13 options:
A)
stroke.
B)
Alzheimer’s disease.
C)
Bell’s palsy.
D)
Korsakoff’s psychosis.
Alzheimer’s disease
A seizure that begins as an electrical discharge in a small area of the brain but spreads to include the entire cerebral cortex is a ________ seizure.
Question 14 options:
A)
complex partial
B)
simple partial
C)
myoclonic
D)
generalized
generalized
You should most highly suspect that a patient with tremors, periodic muscular rigidity, slowed movement, and impaired balance and coordination suffers from:
Question 15 options:
A)
peripheral neuralgia.
B)
amyotrophic lateral sclerosis.
C)
Parkinson’s disease.
D)
autonomic dysreflexia.
Parkinson’s disease
Which of the following should be suspected as a potential cause of syncope?
Question 16 options:
A)
Hypovolemia
B)
All of these
C)
Unknown cause
D)
Cardiac arrhythmia
all of these
A patient tells you that she experienced an episode of involuntary “shaking” in her arm. She describes a 1- to 2-minute-long episode of muscular jerking and contracting of her entire left arm. She retained consciousness, lacked an aura, and had no pain associated with the episode. This most indicates a(n) ________ seizure.
Question 17 options:
A)
psychosomatic
B)
petit mal
C)
simple partial
D)
absence
simple partial
Your patient is a 24-year-old male who is alert and oriented, complaining of severe “dizziness” and an earache for two days. He states that any movement of his head causes him to become very dizzy and nauseated. The patient’s skin is warm and dry, his pupils are equal and reactive, and there is no gross neurological deficit. HR = 82, BP = 120/82, RR = 12, SaO2 = 99%. Which of the following is most likely?
Question 18 options:
A)
Transient cerebral attack
B)
Subdural hematoma
C)
Labyrinthitis
D)
Hypersensitivity of the carotid sinus
labyrinthitis
You suspect your patient is experiencing a hemorrhagic stroke. He is confused, has a respiratory rate of 20, and a blood pressure of 178/88. Which of the following additional findings would most increase your suspicion of increased intracranial pressure?
Question 19 options:
A)
Slurred speech
B)
Heart rate of 50
C)
Anterograde amnesia
D)
Hallucinations
heart rate of 50
Which three cranial nerves are involved in the cardinal positions of gaze?
Question 20 options:
A)
III, IV, and VI
B)
I, III, and IV
C)
VI, VII, and X
D)
I, III, and VI
III, IV and VI
You are transporting a male patient to the hospital for an evaluation after a possible seizure when you notice the patient’s loss of consciousness. His muscles start to contract so that he is arching his back. This best describes the ________ phase of a generalized seizure.
Question 21 options:
A)
postictal
B)
tonic
C)
hypertonic
D)
clonic
hypertonic
A patient with speech impairment following a stroke would have involvement in the ________ lobe of the brain.
Question 22 options:
A)
occipital
B)
parietal
C)
temporal
D)
frontal
temporal
Your patient has a history of epilepsy and is experiencing loss of consciousness, tonic-clonic muscle activity, and erratic ocular movement. Based on this, you might also expect to find all of the following EXCEPT:
Question 23 options:
A)
pinpoint pupils.
B)
increased oral secretions.
C)
urinary incontinence.
D)
impaired respiration.
pinpoint pupils
Your female patient is experiencing sharp, stabbing, right-sided face pain of her upper and lower lips, cheek, and around her orbit. This best describes:
Question 24 options:
A)
Bell’s palsy.
B)
trigeminal neuralgia.
C)
temporomandibular joint syndrome.
D)
a cluster headache.
trigeminal neuralgia
Which of the following is a collection of genetic diseases characterized by progressive muscle weakness and skeletal muscle degeneration?
Question 25 options:
A)
Myasthenia gravis
B)
Multiple sclerosis
C)
Amyotrophic lateral sclerosis
D)
Muscular dystrophy
muscular dystrophy
The dorsal roots of the spinal cord contain afferent fibers that transmit impulses from ________ to ________.
Question 26 options:
A)
sensory nerves, central nervous system
B)
the central nervous system, sensory nerves
C)
the central nervous system, motor nerves
D)
motor nerves, the central nervous system
sensory nerves, central nervous system
The most common cause of lower back pain is:
Question 27 options:
A)
idiopathic.
B)
sciatica.
C)
arthritis.
D)
osteomyelitis.
idiopathic
During a domestic disturbance your patient experienced a sudden onset of violent, bizarre movements of the extremities followed by unresponsiveness to verbal stimuli. On your arrival the bizarre movements begin again but stop suddenly when you firmly say, “Stop!” This most indicates ________ seizure.
Question 28 options:
A)
simple partial
B)
pseudo
C)
complex partial
D)
absence
pseudo
A 35-year-old male complains of a “pressure”-type headache to the back of his head and neck. He states that he woke up with the discomfort this morning, and the pain has steadily gotten worse through the day. He denies any radiation of the pain and denies photophobia but states that he is slightly nauseated. Based on this clinical presentation, the paramedic should be suspicious of what type of headache?
Question 29 options:
A)
Tension
B)
Cluster
C)
Vascular
D)
Migraine
tension
All of the following may cause a transient ischemic attack EXCEPT:
Question 30 options:
A)
a small embolus.
B)
hypotension.
C)
intracranial hemorrhage.
D)
cerebrovascular spasm.
intracranial hemorrhage
Which of the following complaints is most typical for a patient suffering an exacerbation of multiple sclerosis?
Question 31 options:
A)
“I cannot remember my address or phone number.”
B)
“Each night I seem to get a fever and break out in a sweat.”
C)
“My legs feel heavy, and I am having trouble walking.”
D)
“I have no feeling in either my arms or my legs.”
my legs feel heavy and I am having trouble walking
