ER Neurology

1. Emergencies of the nervous system affect the CNS, which consists of...

Brain and spinal cord

Spinal cord

Brain

Diencephalon

2. Seizures can have metabolic causes.

True

False

Ex: Glycemia

Explanation

Ex: Glycemia

3. ICP stands for...

Intracranial Pressure

Intracephalic Pressure

Intracardiac Pressure

Intracorneal Pressure

4. Maintaining normal MAP decreases chances of ischemic injury.

True

False

5. Which drug reduces ICP and blood viscosity, increasing cerebral profusion?

Mannitol

Furosemide

Diazepam

Dexamethasone

6. Opisthononic position is most commonly seen with a dramatic increase of , leading to brain stem ___.

ICP, herniation

ICP, inflammation

CIP, herniation

CIP, inflammation

7. What is the suggested prognosis for a score of III on the Modified Glascow Scale?

Good

Grave

Guarded

I told you not to eat the goddamn apple!

8. Cerebral Perfusion =.......?

MAP-ICP

MAP+ICP

ICP-MAP

ICP+MAP

9. How many cranial nerve pairs are there ?

12

11

10

14

10. What is the Modified Glascow Scale?

Tool to predict the outcome or prognosis in head trauma patients.

Tool to predict how long the patient will be in a coma.

Scale that determines the patient's level of consciousness.

Review based on worldwide statistics detailing how much fun visiting Glascow would be on a scale of 1 to 10.

11. What is the suggested prognosis for a score of II on the Modified Glascow Scale?

Guarded

Grave

Good

Call the dwarves we need a glass coffin.

12. ___ is a new drug in vet medicine. Useful as third drug adjunct for refractory canine epilepsy. It may cause changes in behavior, somnolence and GI effects. It doesn't induce hepatic enzymes.

Levetiracetam

Phenobarbitol

Diazepam

KBr

13. What is the suggested prognosis for a score of I on the Modified Glascow Scale?

Grave

Guarded

Good

Sleeping Beauty

Where's prince charming when you need him?

Explanation

Where's prince charming when you need him?

14. This nerve extends from L4 to SL6. It is well protected by the muscle in this region. If damaged, it will show signs such as the inability to support weight and the absence of the patellar reflex.

Femoral nerve

Sciatic nerve

Brachial plexus

Radial nerve

15. Signs of head injuries: Muscular

Neck rigidity and pain

Neck rigidity

Neck and shoulder rigidity

Face immobile

16. Signs of head injuries: Eyes.

Anisocoria and PLR

Mydriasis and PLR

Just PLR

Palpebral reflex and PLR

17. _ may help to reduce ICP further and is usually given after _.

Furosemide, Mannitol

Mannitol, Furosemide

Diazepam, Mannitol

Dexamethasone, Mannitol

18. This nerve supplies the distal, cranial, and lateral surface of the forearm and the dorsal surface of the forepaw. It also supports weight. If this nerve is damaged, inability to bear weight on a leg or righting the displaced paw may be observed.

Radial nerve

Brachial plexus

Sciatic nerve

Ulnar nerve

19. What is the FIRST thing you address in head trauma patients?

Hypoxia

Stabilizing the patient's spinal cord

Administering fluids and treating shock

Controling the bleeding

You'd think that maybe we could address both hypoxia and the blood spurting all over the place at the same time....

Explanation

You'd think that maybe we could address both hypoxia and the blood spurting all over the place at the same time....

20. ICP: Treating the ____ and not the brain specifically often results in _ ICP.

Systemic injury, reduced

Systemic injury, increased

Trauma, reduced

Trauma, increased

21. DAMNIT ! Yelled the angry vet tech while assessing that golden retriever a car just ran over an hour ago. How unprofessional of her....

Degenerative type diseases, Anomalies, Metabolic diseases, Neoplasia/Nutrition, Inflammatory/Infection/Infarctions/Idiopathic, Trauma

Degenerative type diseases, Abnormalities, Metabolic diseases, Nausea, Inflammatory/Infection/Infarctions/Idiopathic, Trauma

Degenerative type diseases, Anomalies, Myopathy, Neonatal, Inflammatory/Infection/Infarctions/Idiopathic, Trauma

Differential type diseases, Abnormalities, Metabolic diseases, Neoplasia/Nutrition, Inflammatory/Infection/Infarctions/Idiopathic, Thoracic injury

Overkill.....?

Explanation

Overkill.....?

22. Hypotension is the cause of ongoing secondary brain trauma, causing _ and _.

Ischemia, hypoxia

ICP, hypoxia

Ischemia, nerve damage

Hypoxia, nerve damage

23. What main categories are included in the Modified Glascow Scale?

Motor activity, brain stem reflexes, level of consciousness

Motor activity, PNS reflexes, level of consciousness

Depression or delirium, Brain stem reflexes, level of consciousness

Neuron activity, brain stem reflexes, level of consciousness

24. are transient disturbances of the brain function that have a sudden onset and cease spontaneously. _ are characterized by involuntary muscle contractions, limb activity, mastication, salivation, pupil dilation and excretion.

Seizures, convulsions

Convulsions, seizures

Focal seizures, epileptic seizures

Partial seizures, generalized seizures

25. Partial seizures begin in a _ of the brain. Generalized seizures involve ___.

Focal, both hemispheres

Focal, one hemisphere

Local, both hemispheres

Local, one hemisphere

26. Postural reactions include...

Proprioceptive positioning, hopping, placing

Propprioceptive positioning, walking, placing

Proprioceptive positioning, reflexes, placing

Proprioceptive positioning, hopping, walking

27. When reporting seizures, you report...(Check all that apply)

Start

During

Intervals between

Recovery

Overall time

Before seizure

12 hours after seizure

Submit

28. Signs of head injuries: External injuries to the _____.

Face and skull

Neck and skull

Face and neck

Eyes

29. Hypotension must be treated in cases of increased ICP.

True

False

It should be treated WITHOUT increasing ICP.

Explanation

It should be treated WITHOUT increasing ICP.

30. This nerve extends from L6 to T2. It is responsible for the action of withdrawal, and it supplies the dorsal surface of the paw. It can be damaged when pelvic fractures occur. Incorrectly performing IM injections can also damage this nerve.

Sciatic nerve

Brachial plexus

Radial nerve

Femoral nerve

31. A patient's forelimbs and hindlimbs are rigid, with the head and neck arched backward. What's this condition called?

Opisthononic position

Autochtonic position

Opisthomic position

Opisthotonic position

And now to figure out how you actually pronounce this lovely word.

Explanation

And now to figure out how you actually pronounce this lovely word.

32. _____ has a potent antiepileptic effect against focal/generalized seizures. It may cause hepatotoxicity, PU/PD, weight gain, paradoxical hyperexcitability.

Phenobarbital

KBr

Diazepam

Levetiracetam

33. ___ is used for treating chronic seizures.

Potassium Bromide (KBr)

Diazepam

Phenobarbital

Propofol

34. This nerve extends from C6 to T2. If damaged, it exhibits signs such as the inability to bear weight on a leg, righting a displaced paw, and dysfunction in the forearm and forepaw.

Brachial plexus

Radial nerve

Sciatic nerve

Femoral nerve

35. Epilepsy: __seizure pattern originating primarily from the _.

Recurrent, brain

Generalized, brain

Partial, brain stem

Recurrent, brain stem

36. Check the drugs used to control seizures.

Diazepam (IV boluses, +/- CRI)

Phenobarbital CRI

Propofol CRI

Pentobarbital CRI

Atropine (IV)

Dexamethasone (IV q24h)

Submit

37. Generalized seizures.

Tonic-Clonic

Absence

Cluster

Status epilepticus

Submit

38. Modified Glascow Scale: Check the elements that are included in Motor Activity.

Normal gait/spinal reflexes

Hemiparesis, tetraparesis

Recumbent

Normal PLR

Occasional periods of alertness

Submit

39. Check all the elements of a neurological exam.

Assessing mentation, gait and posture

Postural reactions

Cranial nerve exam

Palpation (skin, muscles, skeleton)

Spinal reflexes

Sensation (Superficial and deep pain)

Alertness

Behavior

Submit

40. What are the different state of consciousness levels?

Alertness, depression, confusion, delirium, semicoma, coma

Alertness, confusion, delirium, semicoma, coma

Alertness, lethargy, depression, confusion, semicoma, coma

Alertness, depression, confusion, delirium, semicoma, coma

41. Neurological head injuries include...(Check all that apply)

Superficial lacerations

Concussions

Fractures

Intracranial and extracranial hemorrhage

Intracranial and extracranial pressure

Hydrocephalus

Broken jaw

Submit

42. After addressing hypoxia, what are the most important things to treat in head trauma patients? (Check all that apply)

Control any bleeding

Treat shock

Frequently check vital signs

Frequently check neurological signs

Treat pain

Treat neurological symptoms

Submit

43. Modified Glascow Scale: Check the elements included in Brain Stem Reflexes.

Normal PLR

Normal oculocephalic reflexes

Bilateral unresponsive miosis

Pinpoint pupils

Occasional periods of alertness

Semicomatic

Reduced to absent oculocephalic reflexes

Submit

Er Neurology

1. Emergencies of the nervous system affect the CNS, which consists of...

2.

What first name or nickname would you like us to use?

2. Seizures can have metabolic causes.

3. ICP stands for...

4. Maintaining normal MAP decreases chances of ischemic injury.

5. Which drug reduces ICP and blood viscosity, increasing cerebral profusion?

6. Opisthononic position is most commonly seen with a dramatic increase of ____, leading to brain stem _______.

7. What is the suggested prognosis for a score of III on the Modified Glascow Scale?

8. Cerebral Perfusion =.......?

9. How many cranial nerve pairs are there ?

10. What is the Modified Glascow Scale?

11. What is the suggested prognosis for a score of II on the Modified Glascow Scale?

12. ___ is a new drug in vet medicine. Useful as third drug adjunct for refractory canine epilepsy. It may cause changes in behavior, somnolence and GI effects. It doesn't induce hepatic enzymes.

13. What is the suggested prognosis for a score of I on the Modified Glascow Scale?

14. This nerve extends from L4 to SL6. It is well protected by the muscle in this region. If damaged, it will show signs such as the inability to support weight and the absence of the patellar reflex.

15. Signs of head injuries: Muscular

16. Signs of head injuries: Eyes.

17. ___ may help to reduce ICP further and is usually given after ___.

18. This nerve supplies the distal, cranial, and lateral surface of the forearm and the dorsal surface of the forepaw. It also supports weight. If this nerve is damaged, inability to bear weight on a leg or righting the displaced paw may be observed.

19. What is the FIRST thing you address in head trauma patients?

20. ICP: Treating the ________ and not the brain specifically often results in _____ ICP.

21. DAMNIT ! Yelled the angry vet tech while assessing that golden retriever a car just ran over an hour ago. How unprofessional of her....

22. Hypotension is the cause of ongoing secondary brain trauma, causing _____ and _____.

23. What main categories are included in the Modified Glascow Scale?

24. ______ are transient disturbances of the brain function that have a sudden onset and cease spontaneously. _______ are characterized by involuntary muscle contractions, limb activity, mastication, salivation, pupil dilation and excretion.

25. Partial seizures begin in a ___ of the brain. Generalized seizures involve _____.

26. Postural reactions include...

27. When reporting seizures, you report...(Check all that apply)

28. Signs of head injuries: External injuries to the _____.

29. Hypotension must be treated in cases of increased ICP.

30. This nerve extends from L6 to T2. It is responsible for the action of withdrawal, and it supplies the dorsal surface of the paw. It can be damaged when pelvic fractures occur. Incorrectly performing IM injections can also damage this nerve.

31. A patient's forelimbs and hindlimbs are rigid, with the head and neck arched backward. What's this condition called?

32. _____ has a potent antiepileptic effect against focal/generalized seizures. It may cause hepatotoxicity, PU/PD, weight gain, paradoxical hyperexcitability.

33. ___ is used for treating chronic seizures.

34. This nerve extends from C6 to T2. If damaged, it exhibits signs such as the inability to bear weight on a leg, righting a displaced paw, and dysfunction in the forearm and forepaw.

35. Epilepsy: ____seizure pattern originating primarily from the ___.

36. Check the drugs used to control seizures.

37. Generalized seizures.

38. Modified Glascow Scale: Check the elements that are included in Motor Activity.

39. Check all the elements of a neurological exam.

40. What are the different state of consciousness levels?

41. Neurological head injuries include...(Check all that apply)

42. After addressing hypoxia, what are the most important things to treat in head trauma patients? (Check all that apply)

43. Modified Glascow Scale: Check the elements included in Brain Stem Reflexes.

6. Opisthononic position is most commonly seen with a dramatic increase of , leading to brain stem ___.

17. _ may help to reduce ICP further and is usually given after _.

20. ICP: Treating the ____ and not the brain specifically often results in _ ICP.

22. Hypotension is the cause of ongoing secondary brain trauma, causing _ and _.

24. are transient disturbances of the brain function that have a sudden onset and cease spontaneously. _ are characterized by involuntary muscle contractions, limb activity, mastication, salivation, pupil dilation and excretion.

25. Partial seizures begin in a _ of the brain. Generalized seizures involve ___.

35. Epilepsy: __seizure pattern originating primarily from the _.