Neurology and Endocrinology Flashcards
What are the three layers of the meninge in order from inside to outside?
-Pia mater
-Arachnoid mater
-Dura mater
Which portion of the brain is primarily responsible for temperature control?
Hypothalamus
What is the formula for determining cerebral perfusion pressure?
CPP = MAP - ICP
Your patient has a core body temperature of 39°C. You would expect this patient to have a _________ cerebral blood flow (CBF).
increased
What is the hallmark symptom associated with a vertebra-basilar artery occlusion/rupture?
Vertigo
You are treating a 14-year-old female with a head injury. Your patient’s ICP is 12mmHg. Her ICP is ________.
within normal range
Your patient has a serious injury and is being transported by ground to a trauma center one hour away. During the transport, how often should you reassess the patient’s GCS?
Every 5 minutes
There are three main contents within the cranium. What are they and in what percentages?
80% brain, 10% blood, 10% cerebral spinal fluid (CSF)
You are providing bag mask ventilations for a 7-year-old with a severe head injury. What is the appropriate ventilation rate for this patient?
20
What is the only clinical indication in ICP management for hyperventilating a head-injured patient?
You suspect brainstem herniation
T/F: A subdural hematoma typically results from venous bleeding, while an epidural hematoma typically results from arterial bleeding.
True
To meet the definition of a transient ischemic attack, the symptoms must resolve within ____ hours.
24
For a patient to be eligible for thrombolytics with an ischemic stroke, most protocols TYPICALLY require that the drug be given within ____ hour(s) of symptom onset.
3
You patient suffered a spinal cord injury at C5. What would you suspect about the patient’s breathing?
This patient may have diaphragmatic breathing, but will not have use of intercostal muscles.
You are treating a gunshot wound patient with a suspected spinal cord injury. The patient has ipsilateral motor loss and contralateral loss of pain and temperature. What type of spinal cord injury has this patient most likely experienced?
Brown-Sequard
What signs and symptoms should raise your suspicion of the potential for neurogenic shock?
Bradycardia with hypotension
What intracranial pressure monitor is most frequently used?
Intraventricular catheter
T/F: Intraventricular catheters allow CSF to be drained from the catheter, reducing ICP.
True
T/F: Intraparenchymal monitoring devices allow CSF to be drained from the catheter, reducing ICP.
False
Which is easier to place, the subarachnoid screw/bolt or an intraventricular catheter (IVC)?
the subarachnoid screw/bolt
What device would be used for monitoring ICP when the ventricles are very small, collapsed, or shifted?
the subarachnoid screw/bolt
What is referred to as the “master” gland of the endocrine system because it controls the function of all other endocrine glands?
Pituitary gland
What disease is caused when the pituitary gland makes too much ACTH, which in turn stimulates the adrenal glands to produce cortisol?
Cushing’s disease
You are transporting a patient with pheochromocytoma. What two things are most often secreted from the tumorous gland?
Epinephrine and Noepinephrine
What are the two most dangerous untoward effects of pheochromocytoma?
Severe hypertension and life-threatening cardiac arrythmias
You are transporting a patient three hours by fixed wing for treatment of pheochromocytoma. During the flight, you suspect that your patient is having a pheochromocytoma spell. What should you do?
Collect urine for analysis and keep specimen cold and in the dark
T/F: Type II diabetes used to be known as juvenile onset diabetes.
False, it used to be known as adult onset diabetes
In children aged 1 - 4 with Type I diabetes, deaths related to their condition are most often the result of:
DKA and subsequent shock
Hyperglycemia is clinically defined as a blood glucose level of >____ mg/dL.
200
Using the dextrose “Rule of 50”, you are able to administer dextrose to a toddler in what dose?
2 mL/kg of D25
You are treating a patient who had a blood sugar of 21 mg/dL. You know that is may take up to ____ minutes for the patient’s blood sugar to return to baseline.
30
T/F: Patient’s with Type II diabetes mellitus will require insulin for the rest of their life.
False, they MAY require insulin for the rest of their life
A DKA patient will be acidotic or alkalotic? With a pH of _____
acidotic, <7.3
T/F: Most patients in DKA will be hyperkalemic.
False, most patient’s in DKA will be hypokalemic
What is the most important cause of morbidity and mortality in DKA patients that must be aggressively prevented?
cerebral edema
The use of an insulin bolus is controversial in managing of DKA. Why?
Insulin can worsen the hypokalemia this is frequently seen in DKA
T/F: You are treating a patient with hyperosmolar hyperglycemia state (HHS). You would expect that this patient’s blood sugar would be >600 mg/dL and their pH to be >7.3.
True
Patient in a thyroid storm will often present with a body temperature that is profoundly ________.
hyperthermic
T/F: Myxedema coma is a true life-threatening cardiovascular and metabolic emergency.
True
T/F: Patients with myxedema coma can present bradycardic, hypotensive, and in profound shock.
True
T/F: Diabetes insipidus is often called the “water diabetes” and results in abnormal urine output, fluid intake, and thirst.
True
