Neuro

Question 1

Hypertension, bradycardia, and respiratory depression are called what? What is this a sign of?

Answer 1

Cushing’s reflex; elevated intracranial pressure

Question 2

A 23 year old man who comes into the ER after a blunt head trauma in MVA with progressive drowiness, weakness on the right side of body, and a change in BP from 95/80 to 160/90 and change of pulse from 120 to 50 indicates what neurological issue?

Answer 2

Uncal herniation caused by elevated cerebral pressure from epidural hematoma

Question 3

Ipsilateral hemiparesis, ipsilateral mydriasis, ptosis, contralateral homonymous hemianopsia, and altered LOC are signs of what?

Answer 3

Uncal herniation

Question 4

When is the Rinne test normal? Abnormal?

Answer 4

air conduction is heard twice as long as bone conduction when vibrating fork goes near external auditory meatus. Abnormal when BC is greater than AC, indicating a conductive hearing loss

Question 5

This is considered when during the Weber test, the vibration lateralizes to the unaffected ear because the affected ear can’t sense the vibration; and during the Rinne, AC is greater than BC in both ears

Answer 5

sensorineural hearing loss

Question 6

This is used to treat early Parkinson symptoms in younger patients.

Answer 6

Trihexyphenidyl

Question 7

A patient with several episodes of vomiting and starts to have blood in the last episode with a NG suction showing bright red blood indicates this.

Answer 7

Mallory-Weiss (rupture of submucosal arteries in the distal esophagus and proximal stomach)

Question 8

These interventions lower intracranial pressure

Answer 8

head elevation, sedation, IV mannitol (take free water from brain tissue thus osmotic diuresis), hyperventilation, removal of CSF

Question 9

Pallor, weak pulses, and immediate spontaneous return of neuro function indicates this cause of LOC

Answer 9

syncope

Question 10

Parkinsonism, autonomic dysfunction, and widespread neuro signs are signs of this.

Answer 10

Multiple System Atrophy (Shy-Drager)

Question 11

Atrophy of caudate is associated with this.

Answer 11

Huntington’s

Question 12

Atrophy of lenticular nucleus is associated with this.

Answer 12

Wilson’s

Question 13

Atrophy of frontal and/or temporal lobes are associated with this.

Answer 13

Pick’s

Question 14

This disease associated with increased intracranial pressure in an alert patient, no neuro signs except 6th nerve palsy, no intracranial HTN seen in imaging, and only increased CSF opening pressure is managed with this.

Answer 14

vision loss prevention and acetazolaminde (which inhibits choroid plexus carbonic anhydrase leading to decrease CSF production)

Question 15

This is used to treat a patient who is inpatient and has severely elevated intracranial pressure

Answer 15

Mannitol

Question 16

This is used to treat idiopathic intracranial pressure outpatient.

Answer 16

Acetazolamide

Question 17

This is done for patients with refractory intracranial HTN or progressive vision loss.

Answer 17

Surgical intervion with optic nerve sheath decomprssion or lumboperitoneal shunting

Question 18

Bacterial meningitis can have these long-term neurologic sequelae.

Answer 18

hearing loss, loss of cognitive fuxn, seizures, mental retardation, spasticity or paresis