Ch 17 Neurologic Emergencies

Question 1

Altered mental status

Answer 1

Any deviation from alert and oriented to person, place, time, event; deviation from a patient’s normal

Question 2

Aneurysm

Answer 2

Swelling or enlargement of the wall of a blood vessel that results from weakening of the vessel wall

Question 3

Aphasia

Answer 3

Inability to understand and/or produce speech

Question 4

Atherosclerosis

Answer 4

Calcium and cholesterol build up inside the walls of the blood vessels, forming plaque, potentially leading to a partial or complete blockage of blood flow

Question 5

Aura

Answer 5

Sensation experiences before a seizure, serves as a warning sign

Question 6

CVA

Answer 6

Cerebrovascular accident/stroke; interruption of blood flow to the brain that results in the loss of brain function

Question 7

Coma

Answer 7

State of profound unconsciousness from which the patient cannot be roused

Question 8

Delerium

Answer 8

Temporary change in mental status characterized by disorganized thoughts, inattention, memory loss, disorientation, striking changes in personality and affect, hallucinations, delusions or a decreased LOC

Question 9

Dysarthria

Answer 9

Slurred speech

Question 10

Embolus

Answer 10

Blood blot or other substance in the circulatory system that travels to a blood vessel causing a blockage

Question 11

Epilepsy

Answer 11

Disorder of abnormal electrical discharges in the brain, causing seizure and possible loss of consciousness

Question 12

Febrile seizures

Answer 12

Seizures that result from sudden high fevers, most often seen in children

Question 13

Generalized (tonic-clonic) seizures

Answer 13

Seizure characterized by severe twitching of all of the body’s muscles that may last several minutes or more; formally grand mal seizures

Question 14

Hemiparesis

Answer 14

Weakness on one side of the body

Question 15

Hemorrhagic stroke

Answer 15

Stroke that occurs as a result of bleeding inside the brain

Question 16

Hypoglycemia

Answer 16

Abnormally low blood glucose level

Question 17

Incontinence

Answer 17

Loss of bowel or bladder control; may be the result of generalized seizure

Question 18

Ischemia

Answer 18

Lack of oxygen that deprives tissues of necessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occurred

Question 19

Ischemic stroke

Answer 19

Stroke that occurs when blood flow to a particular part of the brain is cut off by a blockage (blood clot) inside a blood vessel

Question 20

Partial (focal) seizure

Answer 20

Seizure affecting a limited portion of the brain

Question 21

Postictal state

Answer 21

Period following a seizure that lasts 5 to 30 minutes; characterized by labored respirations and some degree of altered LOC

Question 22

Seizure

Answer 22

Neuralgic episode episode caused by surge of electrical activity in the brain; can be a convulsion characterized by generalized; uncoordinated muscular activity and can be associated with loss of consciousness

Question 23

Status epilepticus

Answer 23

Conditions where seizures recur every few minutes or lasts longer than 30 minutes

Question 24

Syncope

Answer 24

Fainting spell or transient loss of consciousness

Question 25

Thrombosis

Answer 25

Blood clot (arterial or venous) When the clot occurs in a cerebral artery, it may result in interruption of cerebral blood flow and subsequent stroke

Question 26

TIA

Answer 26

Transient ischemic attack; Disorder of the brain where brain cells temporarily stop functioning because of insufficient oxygen, causing stroke-like symptoms that resolve completely within 24 hours of onset

Question 27

The brain is sensitive to changes in:

Answer 27

Temperature, glucose, oxygen

Question 28

The three major parts of the brain are the:

Answer 28

Cerebrum, cerebellum, and brain stem

Question 29

Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion?

Answer 29

The pain is worse when bending over

Question 30

``` Interruption of cerebral blood flow may result from all of the following, EXCEPT: a thrombus an embolism cerebral vasodilation an acute arterial rupture ```

Answer 30

cerebral vasodilation

Question 31

The MOST significant risk factor for a hemorrhagic stroke is:

Answer 31

Hypertension

Question 32

``` Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? Intercranial bleeding Hypovolemia Hypoglycemia Postictal state ```

Answer 32

Hypovolemia

Question 33

Which of the following MOST accurately describes a simple partial seizure? A seizure that causes the patient to stare blankly A seizure that begins in one extremity A seizure that is not preceded by an aura A generalized seizure without incontinence

Answer 33

A seizure that begins in one extremity

Question 34

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? Hyperventilation and hypersalivation A gradually decreasing level of consciousness A rapidly improving level of consciousness Confusion and fatigue

Answer 34

Confusion and fatigue

Question 35

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:

Answer 35

Transport the child to the hospital and reassure the mother en route

Question 36

Headache red flags

Answer 36

``` Sudden onset symptoms Explosive/thunderclap pain Altered mental status Age >50 Depressed immune system (high risk of infection) Neurologic deficits Neck stiffness/pain Fever Changes in vision One-sided paralysis or weakness ```

Question 37

Tension headaches

Answer 37

Caused by muscle contractions in head or neck and attributed to stress Squeezing, dull, ache

Question 38

Migraine headaches

Answer 38

Caused by changes in blood vessel size at the base of the brain, common in women, and usually have a history Nausea, vomiting, visual warning signs

Question 39

Sinus headaches

Answer 39

Caused by pressure as a result of fluid accumulation in the sinus cavities Cold-like symptoms, increased pain when bending over or moving head

Question 40

An incident with multiple patients reporting a headache may indicate

Answer 40

Carbon monoxide poisoning

Question 41

Bacterial meningitis

Answer 41

Inflammation of the meninges cause by bacterial infection