Neurology and Endocrinology

Question 1

What are the three layers of the meninge in order from inside to outside?

Answer 1

-Pia mater
-Arachnoid mater
-Dura mater

Question 2

Which portion of the brain is primarily responsible for temperature control?

Answer 2

Hypothalamus

Question 3

What is the formula for determining cerebral perfusion pressure?

Answer 3

CPP = MAP - ICP

Question 4

Your patient has a core body temperature of 39°C. You would expect this patient to have a _________ cerebral blood flow (CBF).

Answer 4

increased

Question 5

What is the hallmark symptom associated with a vertebra-basilar artery occlusion/rupture?

Answer 5

Vertigo

Question 6

You are treating a 14-year-old female with a head injury. Your patient’s ICP is 12mmHg. Her ICP is ________.

Answer 6

within normal range

Question 7

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?

Answer 7

Every 5 minutes

Question 8

There are three main contents within the cranium. What are they and in what percentages?

Answer 8

80% brain, 10% blood, 10% cerebral spinal fluid (CSF)

Question 9

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?

Answer 9

20

Question 10

What is the only clinical indication in ICP management for hyperventilating a head-injured patient?

Answer 10

You suspect brainstem herniation

Question 11

T/F: A subdural hematoma typically results from venous bleeding, while an epidural hematoma typically results from arterial bleeding.

Answer 11

True

Question 12

To meet the definition of a transient ischemic attack, the symptoms must resolve within ____ hours.

Answer 12

24

Question 13

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.

Answer 13

3

Question 14

You patient suffered a spinal cord injury at C5. What would you suspect about the patient’s breathing?

Answer 14

This patient may have diaphragmatic breathing, but will not have use of intercostal muscles.

Question 15

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?

Answer 15

Brown-Sequard

Question 16

What signs and symptoms should raise your suspicion of the potential for neurogenic shock?

Answer 16

Bradycardia with hypotension

Question 17

What intracranial pressure monitor is most frequently used?

Answer 17

Intraventricular catheter

Question 18

T/F: Intraventricular catheters allow CSF to be drained from the catheter, reducing ICP.

Answer 18

True

Question 19

T/F: Intraparenchymal monitoring devices allow CSF to be drained from the catheter, reducing ICP.

Answer 19

False

Question 20

Which is easier to place, the subarachnoid screw/bolt or an intraventricular catheter (IVC)?

Answer 20

the subarachnoid screw/bolt

Question 21

What device would be used for monitoring ICP when the ventricles are very small, collapsed, or shifted?

Answer 21

the subarachnoid screw/bolt

Question 22

What is referred to as the “master” gland of the endocrine system because it controls the function of all other endocrine glands?

Answer 22

Pituitary gland

Question 23

What disease is caused when the pituitary gland makes too much ACTH, which in turn stimulates the adrenal glands to produce cortisol?

Answer 23

Cushing’s disease

Question 24

You are transporting a patient with pheochromocytoma. What two things are most often secreted from the tumorous gland?

Answer 24

Epinephrine and Noepinephrine

Question 25

What are the two most dangerous untoward effects of pheochromocytoma?

Answer 25

Severe hypertension and life-threatening cardiac arrythmias

Question 26

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?

Answer 26

Collect urine for analysis and keep specimen cold and in the dark

Question 27

T/F: Type II diabetes used to be known as juvenile onset diabetes.

Answer 27

False, it used to be known as adult onset diabetes

Question 28

In children aged 1 - 4 with Type I diabetes, deaths related to their condition are most often the result of:

Answer 28

DKA and subsequent shock

Question 29

Hyperglycemia is clinically defined as a blood glucose level of >____ mg/dL.

Answer 29

200

Question 30

Using the dextrose “Rule of 50”, you are able to administer dextrose to a toddler in what dose?

Answer 30

2 mL/kg of D25

Question 31

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.

Answer 31

30

Question 32

T/F: Patient’s with Type II diabetes mellitus will require insulin for the rest of their life.

Answer 32

False, they MAY require insulin for the rest of their life

Question 33

A DKA patient will be acidotic or alkalotic? With a pH of _____

Answer 33

acidotic, <7.3

Question 34

T/F: Most patients in DKA will be hyperkalemic.

Answer 34

False, most patient’s in DKA will be hypokalemic

Question 35

What is the most important cause of morbidity and mortality in DKA patients that must be aggressively prevented?

Answer 35

cerebral edema

Question 36

The use of an insulin bolus is controversial in managing of DKA. Why?

Answer 36

Insulin can worsen the hypokalemia this is frequently seen in DKA

Question 37

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.

Answer 37

True

Question 38

Patient in a thyroid storm will often present with a body temperature that is profoundly ________.

Answer 38

hyperthermic

Question 39

T/F: Myxedema coma is a true life-threatening cardiovascular and metabolic emergency.

Answer 39

True

Question 40

T/F: Patients with myxedema coma can present bradycardic, hypotensive, and in profound shock.

Answer 40

True

Question 41

T/F: Diabetes insipidus is often called the “water diabetes” and results in abnormal urine output, fluid intake, and thirst.

Answer 41

True