Neurology

Question 1

Cerebral perfusion pressure

Answer 1

CPP = MAP(80-90) - ICP(1-10)
CPP = 70 to 80 mmHg

Question 2

3 substances inside the cranial vault (skull)

Answer 2

Blood
Brain
CSF

Question 3

Vital signs for increased ICP

Answer 3

Depressed HR, depressed / irreg RR, increased BP, with widened pulse pressure. Called Cushings triade

Question 4

Interpretation of GCS

Answer 4

13-15 = mild
9-12 = moderate (close airway assessment, monitor for DLOC)
8 or less = critical

Question 5

Agnosia

Answer 5

Inability to name common objects

Question 6

Apraxia

Answer 6

Inability to know how to use a common object or improper movements

Question 7

Receptive aphasia

Answer 7

Pt cannot understand speech but is able to speak clearly. Indicates damage to temporal lobe.
Pt will give incorrect answers.

Question 8

Expressive aphasia

Answer 8

Patient can’t speak clearly, but is able to understand speech.
Patient can follow commands, but slurs or is unable to respond. Indicates damage to frontal lobe.

Question 9

Global aphasia

Answer 9

Combination of expressive and receptive aphasia.

Pt cannot follow commands or answer questions.

Question 10

Aniscoria

Answer 10

Unequal pupils. Can be a sign of ICP. Anything greater than 1mm difference should be noted.

Question 11

Hemiparesis and hemiplegia

Answer 11

Weakness (hemiparesis)

Paralysis (hemiplegia)

Question 12

Paresthesia and anesthesia

Answer 12

Numbness or tingling (paresthesia)

Absence of feeling (anesthesia)

Question 13

Hallmarks of ICP

Answer 13

Cushing reflex (bradycardia, bradypnea, widened PP, systolic HTN)
Decorticate or decerebrate, aniscoria
Biots, apneuistic, or cheyne-stokes respirations

Question 14

2 basic forms of stroke

Answer 14

Ischemic (blockage of a blood vessel supplying the brain)

Hemorrhagic (bleeding into the brain. Tends to get worse with time)

Question 15

Causes of seizures

Answer 15

Abscess, AIDS, alcohol, birth defect, brain infection or trauma, diabetes, fever, idiopathic, inappropriate med dose, organic brain syndromes, recreational drugs, stroke or TIA, systemic infection, tumour, uremia

Question 16

Causes of syncope

Answer 16

Cardiac rhythm, MI, cardiomyopathy

Dehydration, hypoglycemia, vasovagal reaction, drugs and toxins.

Question 17

Types of seizures

Answer 17

Generalized
Partial
Status epillepticus
Febrile

Question 18

Phases of tonic-clonic seizures

Answer 18

Aura: change in senses
Tonic: stiffness
Clonic: shaking
Postictal: recovery

Question 19

Types of generalized seizures

Answer 19

Absence seizure: DLOC, gazing off, no convulsions
Tonic-clonic: tightness, shaking
Pseudoseizure: not a true seizure. Unintended psych response.

Question 20

Partial (focal) seizure types

Answer 20

Simple: retained awareness
Complex: does not retain awareness.

Question 21

FAST VAN assessment

Answer 21

F: facial asymmetry/droop
A: arm drift/grip strength 
S: speech change suddenly
T: 6 hr or less or woke up with symptom (hot stroke)
V: vision L/R gaze
A: aphasia (3 or more common objects)
N: neglect (sensation)

Question 22

Dystonia

Answer 22

Severe abnormal muscle spasms that cause bizarre contortions, repetitive motions, or posture.

Question 23

Amyotrophic lateral sclerosis

Answer 23

Death of voluntary motor neurons. Average life expectancy 3-5 years.

Question 24

Guillain-Barré syndrome

Answer 24

A rare autoimmune disease that begins as weakness or tingling in the legs, moves up the body quickly and can lead to paralysis (usually within 2 weeks).

Question 25

Poliomyelitis

Answer 25

Viral infection transmitted by fecal-oral route. S/S sore throat, NVD, stiff neck, weakness or paralysis. Virus can damage nervous system and may lead to postpolio syndrome years later.

Question 26

Cerebral palsy

Answer 26

Presentation begins in infancy, as a childhood motor disability. Spastic CP results in near constant contraction of muscles. Other forms can result in poor coordination, tremors, uncontrolled writhing movements.

Question 27

Spina bifida

Answer 27

Neural tube defect which causes the spinal cord to remain outside its normal location. Can result in minor to severe deficits including seizure, paralysis, and hydrocephalus.

Question 28

Myasthenia Gravis

Answer 28

Body creates antibodies against acetylcholine receptors in muscular junction. Results in muscle weakness, which can lead to respiratory failure.

Question 29

Peripheral neuropathy

Answer 29

Damage to nerves resulting in loss of sensation, burning, tingling, pain, paresthesia, and muscle weakness.
Commonly caused by diabetes, trauma, toxins, tumour, autoimmunity

Question 30

Muscular dystrophy

Answer 30

Degeneration of muscular tissue due to genetic factors. Most common type is duchenne, which Begins in childhood and can include damage to respiratory and cardiac muscles.

Question 31

Cerebral perfusion pressure calculation

Answer 31

CPP = MAP - ICP

Example: 90 (MAP) - 10 (ICP) = 80mmHg CPP

Question 32

COASTMAP mnemonic for mental status evaluation

Answer 32

Consciousness 
Orientation 
Activity
Speech
Thought
Memory 
Affect/mood
Perception