NRSRGRY - NR EMRGNCS

Question 1

Normal ICP

Answer 1

4-14 mmHg

Question 2

Sustained levels above this pressure level can injure the brain

Answer 2

20mmHg

Question 3

What is the Monroe-Kellie doctrine?

Answer 3

Doctrine that states that the cranial vault is a rigid structure and therefore the total volume of the contents determine ICP

Question 4

Types of brain herniation during raised intracranial pressure

Answer 4

Uncal herniation
Subfalcine herniation
Central transtentorial herniation
Tonsilar herniation

Question 5

What is Cushing’s triad?

Answer 5

HIB
Hypertension
Irregular respiration
Bradycardia

Question 6

Management of Raise ICP

Answer 6

AMS
Airway protection and adequate ventilation
Mannitol
Surgery

Question 7

Types of surgery for raised ICP

Answer 7

VCC
ventriculostomy
craniotomy
craniectomy

Question 8

Posterior fossa lesions can cause mass effect that can rapidly kill patients in 2 ways:

Answer 8

Acute obstructive hydrocephalus

Brain stem compression

Question 9

What are the symptoms of brain stem compression (4)

Answer 9

BHAP
Brain Death
Hypertension
Agitation
Progressive Obtundation

Question 10

Management for stroke with focal neurologic deficit at a clearly defined time of onset

Answer 10

Emergent head CT
Thrombolytic therapy (rTPA) for acute stroke <3 hours without hemorrhage on CT

Question 11

What stroke is ammenable for rTPA

Answer 11

acute stroke <3 hours without hemorrage on CT

Question 12

Uncontrolled synchronous organization of neuronal electrical activity

Answer 12

Seizure