Obj. 21 - Altered Consciousness - LL

Question 1

What is the diagnosis of your patient who’s laying in a hospital bed with TOTAL CESSATION of cerebral and brainstem neuronal functioning + IRREVERSIBILITY of brain injury.

Answer 1

BRAIN DEATH

Question 2

What the state of being roused by vigorous and repeated stimuli but lapses back into unresponsiveness when the stimuli is stopped?

Answer 2

STUPOR

Question 3

What is the state of being “unarousable” and “unresponsive”?

Answer 3

COMA

Question 4

What is the name of the scale used to evaluate Comas?

Answer 4

Glascow Coma Scale

Question 5

If patient is in a comatose state what IV meds are given without delay?

Answer 5

Dextrose
Naloxone
Thiamine

Question 6

What imaging should be done on a comatose patient right away?

Answer 6

Noncontrast CT - to r/o intracranial hemorrhage, brain herniation or other lesions.

Question 7

If a patient was initially comatose and then develops some response to stimuli and occasional eye openings but does not seem to recognize their environment or have evidence of higher mental activity, they are now deemed to be in a:

Answer 7

Persistent Vegetative State

Question 8

What is the prognosis for patients in a “persistent vegetative state”

Answer 8

will die in months or years

Question 9

If a patient has complete paralysis of all 4 extremities and lower cranial nerves (can’t vocalize), but have VERTICAL eye movements intact as well as respiration, hearing and consciousness, what is this state and where is the injury located?

Answer 9

Locked-in syndrome

Pons (PPRF - center for horizontal gaze is located here)

Question 10

For a patient to be diagnosed with “delirium”, they must have restlessness, agitation, hallucinations in COMBINATION with what systemic symptoms?

Answer 10

fever, tachycardia, HTN, sweating