Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BMB Test 3 > B7-049 Coma > Flashcards

B7-049 Coma Flashcards

(78 cards)

Start Studying
1
Q

midline structural lesions of the […] can affect the RAS on both sides, leading to coma

A

diencephalon (thalamic area)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

an occlusion of […] artery could cause diencephalic coma

A

top of basilar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

midline structural process affecting the brain stem

A

subtentorial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

space occupying lesion pushing the brain down and compressing the RAS causing coma

A

supratentorial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

diffuse toxic process affecting the entire cortex leading to coma

A

metabolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

two stages of supratentorial lesion

A
  1. diencephalic stage (early)
  2. midbrain stage (late)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

cortex and RAS working completely fine, but in coma

A

psychogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

psychological stressors precedes coma

A

pyschogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

delirium w/o focal signs precedes coma

A

metabolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

sudden onset coma [2]

A

diencephalic
subtentorial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

focal signs precede coma

A

supratentorial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

hemorrhage in the pons is an example of process causing […] coma

A

subtentorial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

neurologic examination in coma involves [4]

A

level of consciousness
pupils
extraocular movements
motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

the pupillary parasympathetic system is […] to toxic-metabolic processes

A

resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

the pupillary sympathetic system is […] to toxic-metabolic processes

A

sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

almost all patients with coma will experience […] dysregulation

A

sympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pupils will be mid-range and reactive in patients experiencing […] coma

A

psychogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

pupils will be small and reactive in patients experiencing […] coma [3]

A

metabolic
diencephalic
early stage supratentorial

(due to unopposed parasympathetic stimulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

pupils will be mid-range and unreactive in patients experiencing […] coma [2]

A

late stage supratentorial
subtentorial

(due to loss of both sympathetic and parasympathetic systems)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

unreactive pupils tell you the […] system is not working

A

parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

if the pupils are small, this tells you the […] system is intact

A

parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

small pupils are typically […]

A

reactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

fast eye movements (saccades) require that the […] is intact

A

frontal eye fields

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

if you have fast eye movements, your […] is intact

A

cerebral cortex

(not in coma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
fast eye movements is [...] to toxic metabolic processes
sensitive
26
slow eye movements indicates [...] is working
brainstem
27
slow eye movements is [...] to toxic metabolic processes
moderately sensitive
28
the presence of slow eye movement means that
there is no brainstem lesion (the absence does not necessarily mean there is though)
29
intact slow movements means the [...] is intact
brainstem
30
normal oculocephalic reflex
eyes continue to point in the same direction while head is turned side to side (brainstem is working)
31
what do you expect to see when cold calorics is used on a patient in a coma if their brainstem is intact?
slow tonic movements of the eye toward the side being irrigated
32
which method would be best to test the eye movements of a patient in a coma with neck trauma?
cold calorics (don't want to move their head side to side as with oculocephalic)
33
if you are doing cold calorics on a patient in a coma and you see saccades, the patient is [...]
not in a coma (frontal eye field is working)
34
if you're suspicious a patient is in psychogenic coma, what eye movement test is helpful in determining that?
cold calorics (will have fast saccades --> not in true coma)
35
intact fast eye movements intact slow eye movements
psychogenic
36
absent fast eye movements intact or abnormal slow eye movements
metabolic
37
absent fast eye movements intact slow eye movements [2]
diencephalic early stage supratentorial | brainstem intact
38
absent fast eye movements abnormal slow eye movements [2]
late supratentorial subtentorial
39
[...] motor findings characterize most patients in coma, regardless of cause
bilateral symmetric (bilateral corticospinal tract findings)
40
localized response is a [...] prognostic indicator for a patient in a coma
good
41
flexion of upper extremities extension of lower extremities
decorticate posturing
42
extension of upper extremities extension of lower extremities
decerebate posturing
43
motor responses in coma [3]
localized response decorticate posturing decerebate posturing
44
does decorticate or decerebate posturing have a worse prognosis?
decerebate
45
a lesion between the cortex and the red nucleus causes [...] posturing
decorticate
46
a lesion between the red nucleus and the vestibular nuclei causes [...] posturing
decerebate
47
motor response that might be seen with patients in a psychogenic or metabolic coma
localized response (don't put too much stock in abnormal posturing though)
48
motor response that might be seen with patients in a diencephalic or early supratentorial coma
decorticate posturing (don't put too much stock in abnormal posturing though,**not specific**)
49
motor response that might be seen with patients in a late supratentorial or subtentorial coma
decerebate posturing (don't put too much stock in abnormal posturing though)
50
a CT can help diagnose a [...] mass lesion
supratentorial
51
what types of coma will have an intact brainstem? [4]
psychogenic metabolic diencephalic early supratentorial
52
what types of coma will not have an intact brainstem? [2]
late supratentorial subtentorial
53
most common cause of coma
metabolic
54
workup for toxic metabolic coma should include [4]
routine labs stat lumbar puncture EEG for seizure hx MRI
55
patients with [...] will open their eyes to pain
stupor
56
the neurologic exam on a normal person would be most like the neurologic exam of a patient in what type of coma?
psychogenic
57
in most patients with coma, the [...] system controlling pupillary [...] is affected
sympathetic dilation
58
the presence of fact eye movements indicates the [...] is intact
frontal eye fields
59
most important element of neurologic examination to determine the cause of coma
pupillary activity
60
the pathological absence of consciousness
coma
61
the physiologic absence of consciousness
sleep
62
patients with [...] will open their eyes to speech
lethargy
63
patients in [...] will not open their eyes
coma
64
differential for subtentorial coma
pontine or cerebellar hemorrhagic stroke (would see on CT) basilar artery ischemic stroke (would not see on CT)
65
how would you determine if it is psychogenic?
look for fast eye movements look for eye tracking (mirror in front of face)
66
what would you do to differentiate a metabolic vs diencephalic stroke?
look for obvious toxic metabolic cause (labs) if none, stat CT angiogram to look for top of the basilar occlusion
67
most common cause of metabolic coma in ER
drugs
68
eyes look toward the brain lesion when the lesion is in the [...]
frontal eye fields (seen in MCA stroke)
69
eyes look away from the brain lesion (toward the hemiplegia) when the lesion is in the [...]
PPRF
70
bilateral mammilary body lesions would be seen in [...] syndrome
Wernicke-Korsakoff
71
bilateral amygdalal lesions are seen in
HSV-1 encephalitis (causes hyperphagia, hypersexuality, hyperorality)
72
is decorticate posturing a specific finding?
apparently not can be seen in toxic metabolic processes and structural processes involving the RAS
73
the appropriate study to look for a supratentorial process in the ER is
non-contrast CT
74
[...] eye movements can only be present when consciousness is preserved
fast
75
fast eye movements require intact
frontal eye fields
76
an overdose of [...] could cause coma with fixed dilated pupils
anticholinergics (amytriptyline, diphenhydramine, etc)
77
most causes of metabolic coma would not affect the [...]
pupils
78
hallmark of psychogenic coma
presence of fast eye movements

BMB Test 3 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions