neurological emergencies Flashcards
The primary initial treatment in the management of either blunt or penetrating trauma to the head is:
Question 1 options:
A)
High-dose steroid treatment.
B)
Supportive care of the airway, breathing, and circulation.
D)
Mannitol.
D)
Furosemide.
supportive care of the airway breathing and circulation
Mannitol, an osmotic diuretic, exerts its actions by:
Question 2 options:
A)
Drawing fluid from the intracellular space to the extracellular space.
B)
Promoting hemostasis of broken blood vessels.
C)
Stimulating the kidneys to remove sodium and water from the circulation reducing circulating volume.
D)
Decreasing circulating volume in the intravascular space.
drawing fluid from the intracellular space to the extracellular space
Status epilepticus can BEST be described as:
Question 3 options:
A)
A continuous seizure lasting for 30 minutes or more without an intervening period of consciousness.
B)
A seizure characterized by prolonged postictal phases followed by a brief period of consciousness.
C)
More than two seizures in one day.
D)
A generalized tonic-clonic seizure.
a continuous seizure lasting for 30 min or more without an intervening period of consciousness
Which of the statements BEST describes a partial, or focal, seizure?
Question 4 options:
A)
Partial seizures involve a period of rigidity followed by convulsive activity and flaccidity until the patient gradually returns to consciousness.
B)
Simple partial seizures are referred to as absence seizures.
C)
Simple partial seizures are localized and do not pose a significant threat to the neurological system.
D)
Simple partial seizures are described in terms of alterations in consciousness or behavior.
simple partial seizures are described in terms of alterations in consciousness or behavior
You are at the scene of a patient with a decreased level of consciousness that is having repetitive twitching of the left arm. This type of activity is BEST described as a/an:
Question 5 options:
A)
Complex, partial seizure.
B)
Generalized tonic-clonic seizure.
C)
Absence seizure.
D)
Status epilepticus.
complex partial seizure
Which of the following medications inhibit the influx of sodium into the cells decreasing the ability of the cell to depolarize and propagate seizures?
Question 6 options:
A)
Diazepam (Valium)
B)
Phenytoin (Dilantin)
C)
Gabapentin (Neurontin)
D)
Lorazepam (Ativan)
phenytoin dilantin
Which of the following statements regarding the use of benzodiazepines is INCORRECT?
Question 7 options:
A)
Benzodiazepines are dangerous to the patient and should be used with extreme caution due to a narrow therapeutic index.
B)
Benzodiazepines have an onset of action of 1-5 minutes when given parenterally.
C)
Benzodiazepines act on the CNS by interacting with GABA receptor sites.
D)
Benzodiazepines are primarily used for skeletal muscle relaxation, preprocedure sedation, and anticonvulsant activity.
Benzodiazepines are dangerous to the patient and should be used with extreme caution due to a narrow therapeutic index
________ is an antidote for benzodiazepine overdose and should be available when benzodiazepines are used.
Question 8 options:
A)
Flumazenil (Romazicon)
B)
Sodium bicarbonate
C)
Naloxone (Narcan)
D)
Dextrose 50% (D50)
Flumanzenil ( Romazicon)
You are treating a patient who is experiencing status epilepticus. After initial management of the airway, breathing, and circulation, which of the following treatment modalities is MOST correct?
Question 9 options:
A)
Diazepam 5-10 mg IV
B)
Mannitol, 1.5-2.0 g/kg IV
C)
Romazicon 0.2 mg IV
D)
Naloxone 0.2-0.4 mg IV
Diazepam 5-10 mg IV
Prior to cardioversion, lorazepam may be given because:
Question 10 options:
A)
It is an effective pain medication.
B)
It will prevent any seizure activity that may result from the procedure.
C)
It produces an amnesia-like effect.
D)
It is an effective antiarrhythmic.
it produces an anesthesia like effect
You have administered two doses of diazepam for a patient who is experiencing generalized seizures but the medication is ineffective at stopping the seizure. You should consider the administration of which of the following?
Question 11 options:
A)
Romazicon to reverse the effects of the benzodiazepines.
B)
Reducing the dosage of diazepam for subsequent doses.
C)
Consider the administration of phenytoin.
D)
No further treatment is necessary.
consider the administration of phenytoin
In addition to its anticonvulsant activity, phenytoin is also indicated in the treatment of cardiac arrhythmias due to:
Question 12 options:
A)
Digitalis toxicity.
B)
Benzodiazepine overdose.
C)
Narcotic overdose.
D)
Hypoxia.
digitalis toxicity
When administering Dilantin, you should give it:
Question 13 options:
A)
50 mg/min IM injection only.
B)
No faster than 50 mg/min, with a loading dose of 10-20 mg/kg.
C)
Diluted with dextrose 5% in water (D5W) over 10 minutes.
D)
Rapidly, 50 mg over 15 seconds.
no faster than 50 mg/min with a loading dose of 10-20 mg/kg
The half-life of phenobarbitol is:
Question 14 options:
A)
24-48 hours.
B)
10-12 hours.
C)
1-2 hours.
D)
2-6 days.
2-6 days
A common precaution to the use of anticonvulsant medications is:
Question 15 options:
A)
Only a single dose of anticonvulsant medications should be used due to the long half-life of the medications.
B)
The effects of alcohol will potentiate the effects of the medication given, therefore the paramedic should use with caution if alcohol use is suspected.
C)
Benzodiazepine medications have a very narrow therapeutic index and should be used sparingly in the prehospital setting to avoid overdosage.
D)
The effects of anticonvulsant medications can be antagonized utilizing naloxone, therefore, they should only be used if naloxone is on hand.
the effects of alcohol will potentiate the effects of the medication given therefore the paramedic should use with caution if alcohol use is suspected
