Unconsciousness

Question 1

Define unconsciousness

Answer 1

Unresponsiveness/impaired responsiveness or unarousable

Question 2

What is ARAS and its function

Answer 2

Ascending reticular activating system induces and maintains alertness

Question 3

Causes of altered alertness x3

Answer 3

Diffuse bilateral hemisphere damage
Focal lesions in brainstem ie location of ARAS
Impaired O2 delivery > altered cerebral metabolism

Question 4

PR correlations to BP x4

Answer 4

Radial- SBP >90
Brachial- SBP>80
Femoral- SBP>70
Carotid- SBP>60

Question 5

Types of shock x4

Answer 5

Hypovolemic
Cardiogenic
Obstructive
Distributive

Question 6

Brain stem function tests x6

Answer 6

Pupillary light reflex
Corneal reflex
Oculocephalic
Oculovestibular
Gag and cough reflex

Question 7

Causes of small symmetrical pupils reactive to light x2

Answer 7

Drug overdose
Metabolic diseases

Question 8

Cause of medium to dilated symmetrical pupils fixed to light

Answer 8

Brainstem disease

Question 9

Cause of unilateral pupils fixed to light

Answer 9

Intracranial mass > 3rd nerve palsy

Question 10

Causes of bradycardia x2

Answer 10

Heart blocks
Raised intracranial pressure

Question 11

AEIOU TIPS for altered mental state

Answer 11

Alcohol
Epilepsy
Insulin
Overdose
Under dose, uremia
Trauma
Infections
Psychiatric, poisoning
Shock, stoke

Question 12

Causes of coma with focal signs x4

Answer 12

Intracranial hemorrhage
Infarction
Tumor
Abscess

Question 13

Causes of coma without meningism x3

Answer 13

Meningitis
Meningoencephalitis
Subarachnoid hemorrhage

Question 14

Causes of coma without focal signs or meningism x3

Answer 14

Infection
Post ictal state
Anoxic ischemia

Question 15

FUST HUGS IN BED supportive care

Answer 15

Feeding
Analgesia
Sedation
Thrombocytopenia
Head up position
Ulcer prophylaxis
Glucose control
Skin and eye care
IN- indwelling catheter and NGT
Bowel care
Environment
De escalation