Weekly Checkpoint - Integrated iRAT Flashcards
A patient presents with acute onset of visual hallucinations, agitation, and confusion. Which one of the following is the most appropriate initial step?
A. Administering antipsychotic medication
B. Starting benzodiazepines
C. Initiating psychotherapy
D. Conducting a thorough medical evaluation
D. Conducting a thorough medical evaluation
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Explanation: Acute psychosis can be caused by various medical conditions, and it is crucial to identify and treat any underlying medical issues first.
A 75-year-old male with a history of hypertension and diabetes is brought to the emergency department by his family due to sudden confusion and agitation.
Which of the following features is more indicative of delirium rather than primary psychosis?
A. Visual hallucinations
B. Gradual onset
C. Incoherent speech
D. Auditory hallucination
A. Visual hallucinations
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Explanation: Delirium typically presents with a sudden onset and fluctuating course, often with visual hallucinations, whereas primary psychosis usually has a more gradual onset and may include auditory hallucinations.
Which of the following is a common cause of delirium in hospitalized elderly patients?
A. Schizophrenia
B. Major depressive disorder
C. Dehydration
D. Antipsychotic medication
C. Dehydration
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Explanation: Dehydration is a common cause of delirium in elderly patients, especially in a hospital setting.
In the context of delirium, which of the following is a reversible cause that should be addressed?
A. Electrolyte imbalance
B. Chronic schizophrenia
C. Major depressive disorder
D. Alzheimer’s disease
A. Electrolyte imbalance
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Explanation: Electrolyte imbalance is a reversible cause of delirium and should be corrected.
Which of the following CSF findings would you expect in a patient with tuberculous meningitis?
A. Normal glucose, elevated protein, neutrophilic pleocytosis
B. Low glucose, elevated protein, lymphocytic pleocytosis
C. Elevated glucose, elevated protein, neutrophilic pleocytosis
D. Normal glucose, normal protein, lymphocytic pleocytosis
B. Low glucose, elevated protein, lymphocytic pleocytosis
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Explanation: Tuberculous meningitis typically presents with low glucose, elevated protein, and lymphocytic pleocytosis in the CSF.
Which of the following CSF findings is most consistent with bacterial meningitis?
A. Low glucose, elevated protein, neutrophilic pleocytosis
B. Elevated glucose, normal protein, neutrophilic pleocytosis
C. Elevated glucose, elevated protein, lymphocytic pleocytosis
D. Normal glucose, normal protein, lymphocytic pleocytosis
A. Low glucose, elevated protein, neutrophilic pleocytosis
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Explanation: Bacterial meningitis typically presents with low glucose, elevated protein, and neutrophilic pleocytosis in the CSF.
A 25-year-old patient presents with fever, headache, neck stiffness, and photophobia. A diagnosis of bacterial meningitis is confirmed.
Which one of the following is the most appropriate initial management step?
A. Administer corticosteroids
B. Discharge with analgesia
C. Initiate broad-spectrum antibiotics
D. Start antiviral therapy
C. Initiate broad-spectrum antibiotics
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Explanation: Initiating broad-spectrum antibiotics is the most appropriate initial management step in suspected bacterial meningitis to cover potential pathogens.
Which of the following is a potential complication of prolonged status epilepticus?
A. Hypotension
B. Hyperglycemia
C. Weight gain
D. Permanent neurological damage
D. Permanent neurological damage
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Explanation: Prolonged status epilepticus can lead to permanent neurological damage due to sustained neuronal activity and metabolic stress.
A 30-year-old patient presents with continuous seizure activity for more than 5 minutes. Which of the following is the most appropriate initial management step?
A. Administer lorazepam intravenously
B. Start phenytoin orally
C. Perform an immediate CT scan
D. Wait for the seizure to stop spontaneously
A. Administer lorazepam intravenously
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Explanation: Administering lorazepam intravenously is the most appropriate initial management step for status epilepticus to quickly control the seizure activity.
Which one of the following neurotransmitters is most likely to produce an inhibitory postsynaptic potential (IPSP) in the central nervous system?
A. Glycine
B. NMDA
C. GABA
D. Glutamate
C. GABA
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Rationale:
GABA (gamma-aminobutyric acid) is the primary inhibitory neurotransmitter in the central nervous system. It typically produces inhibitory postsynaptic potentials (IPSPs) by opening Cl- channels, leading to hyperpolarization of the neuron. Glutamate and NMDA are excitatory neurotransmitters, while glycine, although inhibitory, is more commonly associated with inhibitory signaling in the spinal cord rather than the central nervous system.
