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C101 SACA CERTIFICATION EXAM,GOOD SCORES IS GUARANTEED /LATEST .

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C101 SACA CERTIFICATION EXAM,GOOD SCORES IS GUARANTEED /LATEST . A common ergonomic practice to reduce injuries is to __________. - CORRECT ANSWERS -Rotate tasks among employees Which classification of hardhat is designed for use in areas of low clearance and provides minimal impact resistance...

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  • September 28, 2024
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  • 2024/2025
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  • Headache and Neurologic, SAEM Peds,Quality
  • Headache and Neurologic, SAEM Peds,Quality
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Headache and Neurologic, SAEM Peds,Quality Document
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A 36 year old woman presents to the emergency department two hours after the sudden
onset of a severe occipital headache and nausea. She has a history of migraine
headaches that typically occur in the right frontal area and are associated with an aura.
Her temperature is 98.8 degrees Fahrenheit, her neck is supple, and her neurological
exam is normal. A non-contrast CT scan of her head is normal. Of the options below,
what is the next step in her management?

A. Consult a neurologist for evaluation of atypical migraines.
B. Perform a lumbar puncture to rule out the possibility of subarachnoid hemorrhage.

C. Discharge her home with prochlorperazine and close instructions to return if her
symptoms worsen.
D. Observe for 6 hours, administer acetaminophen and normal saline, and discharge
home if she feels better.
E. Observe for 6 hours and then obtain a repeat CT scan; if normal, discharge home. -
CORRECT ANSWERS -The answer is B. Sudden onset headache with nausea,
vomiting, photophobia, or neck stiffness should raise the concern for spontaneous
subarachnoid hemorrhage. Sensitivity of a non-contrast CT scan varies with respect to
many factors (e.g. time since bleed) but is generally in the range of 90%; therefore, if
the clinical suspicion is high, a lumbar puncture should be performed and a cell count
for red blood cells done.

Which of the following descriptors of epidural hematoma is FALSE?
A. Present in only about 1% of severe head injury patients

B. Most often a result of a skull fracture that traverses a venous sinus
C. Biconcave blood collection between the skull and dura
D. Immediate surgical evacuation is indicated
E. Classically associated with a "lucid" interval prior to coma - CORRECT ANSWERS -
The answer is B. Epidural hemorrhage is most often associated with skull fracture
across the course of the middle meningeal artery.

Epidural hematomas are least likely in which age group?
A. Children less than 2 years
B. Prevalence is the same throughout age groups
C. Adults excluding elderly
D. Children between 8 and 14
Generally speaking, a patient with a TIA history who presents with a new stroke, likely
has which kind of stroke?
A. thrombotic
B. there is equal likelihood for any stroke type
C. hemorrhagic

, D. hypoperfusion

E. embolic - CORRECT ANSWERS -The answer is A. TIAs are associated with
increased risk for thrombotic strokes, the result of ulceration of cerebral artery plaque.
Patients with TIA have a 5 to 6% percent chance per year of having a stroke.
Antiplatelet therapy reduces risk of stroke in these patients.

Which of the following is not a known complication of subarachnoid hemorrhage in the
immediate several weeks following the initial bleed?
A. rebleeding
B. hydrocephalus

C. hypernatremia
D. seizure
E. cerebral artery vasospasm - CORRECT ANSWERS -C


E. Elderly - CORRECT ANSWERS -The answer is A. Epidural hematoma (EDH) is less
likely in children and elderly because of the close attachment of the dura to the
periostium of the skull. This is especially true of children less than 2 years because of
the added elasticity of the skull.

Which of the following symptoms is not associated with epidural hematomas?
A. Severe headache
B. Neurologic deficits
C. Nausea
D. Sleepiness
E. Hemotympanum - CORRECT ANSWERS -The answer is E. Although
hemotympanum may be found in a patient with an epidural hematoma, it is specifically
associated with basilar skull fracture.

A 21-year-old woman presents to the emergency department with fevers, headache,
neck stiffness, and mild confusion over the past several days. Her temperature is 38.0 C
(100.4 F), pulse 106, and blood pressure 116/74. On physical exam she looks ill, and
her neck is stiff. Her neurologic exam is normal. A lumbar puncture reveals 105 WBC
and 1240 RBC in tube #1 and 126 WBC and 1360 RBC in tube #4; all white cells are
lymphocytes. The CSF protein is 68 and the glucose is 78. This patient most likely has
which of the following?

A. HSV encephalitis
B. Pneumococcal meningitis
C. Subarachnoid hemorrhage
D. Subdural hematoma - CORRECT ANSWERS -A

Which of the following are potential complications of bacterial meningitis?
A. Seizure disorder

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