Neurology

Question 1

The most important nursing consideration in the care of a patient with an acute neurological injury

Answer 1

Raised Intracranial Pressure

Question 2

Symptoms of raised intracranial pressure

Answer 2

Headache, blurred vision, less alert than usual, vomiting, changes in behaviour, weakness, fatigue, difficulty talking or moving

Question 3

Glasgow Coma Scale

Answer 3

Assesses level of consciousness
Score out of 3-15
Eye opening 1-4
Verbal response 1-5
Motor response 1-6

Question 4

Cranial nerve assessment

Answer 4

Used to identify problems with the cranial nerves by physical examination

Question 5

Types of neurological examinations

Answer 5

Neuroimaging (CT, MRI)
Nerve conduction studies (NCS)
Electroencephalogram (EEG)
Electromyography (EMG)
Lumbar Puncture (LP)

Question 6

What is involved in a lumbar puncture examination?

Answer 6

Spinal needle inserted between L3 and L4 collected CSF fluid to test for meningitis, subarachnoid haemorrhage etc.

Question 7

What else can a lumbar puncture be used for?

Answer 7

To deliver antibiotics or chemotherapy medication directly to the CSF fluid in your spine

Question 8

Intracranial infections/inflammation

Answer 8

Meningitis, encephalitis

Question 9

Meningitis

Answer 9

Inflammation of the meninges - bacterial or viral

Question 10

Encephalitis

Answer 10

Inflammation of the brain - majority of causes are related to childhood diseases such as measles, mumps, rubella, chicken pox

Question 11

Meningococcal disease can cause septicaemia, true or false?

Answer 11

True

Question 12

High risk groups for meningitis

Answer 12

Children under 5 years, teenagers, young adults, students in first year tertiary accommodation

Question 13

The nervous system is limited in the way in which it can respond to injury, true or false?

Answer 13

True

Question 14

Like other infections, the causative agent…

Answer 14

Needs to be found

Question 15

More severe form of meningitis which is a medical emergency

Answer 15

Bacterial meningitis

Question 16

What is the key to a successful outcome in a patient with bacterial meningitis?

Answer 16

Find the causative agent quickly, administer antibiotics promptly

Question 17

The infective process of bacterial meningitis

Answer 17

Inflammation, exudation, white blood cell accumulation, varying degrees of tissue damage

Question 18

What is meningococcal disease caused by?

Answer 18

Bacterium Neisseria meningitidis

Question 19

What should be suspected in a child with fever, seizures, irritability and decrease in consciousness?

Answer 19

Encephalitis

Question 20

Mortality rate for HSV encephalitis if untreated

Answer 20

70%, reduced to 20% if treated

Question 21

High risk groups for encephalitis

Answer 21

Younger children

Question 22

Multiple sclerosis

Answer 22

Disorder of CNS including brain, spinal cord and optic nerves

Question 23

Multiple sclerosis refers to multiple scarring scattered throughout the brain and spinal cord, true or false?

Answer 23

True

Question 24

What is the typical damage in multiple sclerosis referred to as?

Answer 24

Demyelination

Question 25

In young adults, what age do symptoms of multiple sclerosis usually appear?

Answer 25

Between 20 and 50, peak in early 30's. New Zealand current average age is 37

Question 26

Guillain-Barré Syndrome

Answer 26

Autoimmune disorder affecting the nervous system

Question 27

When does onset of Guillain-Barré syndrome usually begin?

Answer 27

Within 10 days of the primary infection

Question 28

Guillain-Barré syndrome is a rare condition affecting 40 to 100 New Zealander's each year, true or false?

Answer 28

True

Question 29

What are the high risk groups for Guillain-Barré syndrome?

Answer 29

Elderly, more commonly men

Question 30

Symptoms of Guillain-Barré syndrome

Answer 30

Muscle weakness, loss of reflexes, numbness or tingling in arms, legs, face and other parts of body. Complete paralysis in severe cases

Question 31

What is the exact cause of Guillain-Barré syndrome?

Answer 31

Unknown, but it seems to occur after a viral or bacterial infection

Question 32

Pathophysiology of Guillain-Barré syndrome

Answer 32

Inflammation and oedema with rapid demyelination and compression of nerve roots within the dural sheath

Question 33

What are the three phases of Guillain-Barré syndrome?

Answer 33

Acute, plateau, recovery

Question 34

If the acute phase lasts too long, what can happen?

Answer 34

The respiratory muscles can become involved and intubation may be required

Question 35

Is Guillain-Barré fatal?

Answer 35

Yes, your body's immune system begins attacking your nerves

Question 36

Epilepsy

Answer 36

Chronic disorder characterised by recurring seizures

Question 37

What is important to learn if you have epilepsy?

Answer 37

Possible triggers for seizures such as stress, lack of sleep, drugs, alcohol, caffeine, light and sensory stimulation, emotions

Question 38

What age does epilepsy usually occur?

Answer 38

Often develops in childhood. However, it can occur to anybody at any age

Question 39

Everyone who has epilepsy was born with it, true or false?

Answer 39

False - it can develop during childhood or adulthood

Question 40

Epilepsy is genetic, what does this mean?

Answer 40

It is due to changes in the DNA that direct brain cell function

Question 41

What can epilepsy be due to?

Answer 41

Damage to brain cells such as after a head injury or illness such as a stroke

Question 42

Cerebral palsy

Answer 42

Damage to the area of the brain that controls muscle tone, affecting movement and posture

Question 43

Is there a cure for cerebral palsy?

Answer 43

No

Question 44

Most cerebral palsy occurs as a result of factors prior to birth, however...

Answer 44

Little is known about these factors

Question 45

For 80% of people with cerebral palsy the cause is...

Answer 45

Unknown

Question 46

Does cerebral palsy worsen over time?

Answer 46

Generally, no. Some signs can worsen or improve overtime though

Question 47

People with cerebral palsy can also have

Answer 47

Visual, hearing, speech and intellectual impairments, and epilepsy

Question 48

Stroke

Answer 48

A disruption of blood flow to the brain

Question 49

Ischemic stroke

Answer 49

Disruption of blood flow to parts of the brain

Question 50

Hemorrhagic stroke

Answer 50

Blood vessels in the brain break, flooding the brain and damaging brain cells

Question 51

What type of stroke is more common in children?

Answer 51

Ischemic stroke

Question 52

Why is an ischemic stroke more common in children?

Answer 52

Lack of oxygen at birth, heart defect, blood disorders such as sickle cell which destroys blood cells and blocks vessels, genetic disorders like Moyamoya, an infection such as meningitis, dehydration, injury to artery

Question 53

What is Moyamoya?

Answer 53

A rare disease that affects arteries in the brain

Question 54

What can cause a hemorrhagic stroke?

Answer 54

An aneurysm, head injury that causes a broken blood vessel, diseases that affect blood clotting such as hemophilia, arteriovenous malformation

Question 55

What is arteriovenous malformation?

Answer 55

A condition in which the blood vessels in the brain do not connect properly

Question 56

3 types of nerves that diabetic neuropathy can affect

Answer 56

Sensory, motor, autonomic

Question 57

Diabetic neuropathy can cause

Answer 57

Pain/numbness, usually to your feet

Question 58

Difference between a head injury and a traumatic brain injury

Answer 58

Head injury involved skull and scalp, TBI must involve brain

Question 59

What groups can experience a traumatic brain injury?

Answer 59

Anyone, at anytime

Question 60

The effects of traumatic brain injuries can be

Answer 60

Temporary or permanent

Question 61

Traumatic brain injury can range from

Answer 61

A mild concussion to severe (extended period of unconsciousness and/or memory loss after the injury)