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ACNP II Exam 3 (Neurological Disorders) – Qs And As
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ACNP II Exam 3 (Neurological Disorders) – Qs And As
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ACNP II Exam 3 (Neurological Disorders) – Qs And AsWhat is the most common cause of traumatic brain injury?
a. falls
b. blunt force trauma
c. motor vehicle accidents Right Ans - Falls
You're treating a patient with closed head injury. What are the treatment
goals? Right Ans - control ICP
neuro-protection
managing symptoms
Patient presents with limb weakness, visual field deficit and pupillary
abnormality to the ED. What other clinical finding is consistent with closed
head injury? Right Ans - Horner syndrome - decreased pupil size, drooping
eyelid and decreased sweating on affected side of face
What is coup and contra-coup in closed head injury? Right Ans - coup -
injury at the site of injury
contre-coup - injury from brain rebounding and hitting opposite side of skull
Epidural hematoma is known for 'Talk and die phenomena" where victim
does not display tell-tale brain injury symptoms and manifest hours later.
Where is the most common site of epidural hematoma? Right Ans -
temporal fossa
Patient suffered an injury to the temporal fossa in MVA and had few minutes
of LOC. He is now awake but complains of headache , vomiting and
drowsiness. What clinical signs would indicate temporal lobe herniation?
Right Ans - decreasing LOC
ipsilateral pupillary dilation, and contralateral hemiparesis
Patient with epidural hematoma has good prognosis if treatment is initiated
prior to: Right Ans - bilateral pupillary dilation
What intervention is required for patient who suffered epidural hematoma
after MVA? Right Ans - surgical evacuation of hematoma
, Patient presents with headache and homonymous hemianopia after a fall at
home 2 hours ago. What diagnosis can be obtained from this history? Right
Ans - subdural hematoma
Elderly patient presents with confusion, memory and loss of sensation after a
fall about a month ago. The top of skull is tender to palpation. CT of head
reveals chronic subdural hematoma. What intervention should be expected?
Right Ans - craniotomy to evacuate blood and to prevent brain herniation
You suspect intracerebral hematoma of patient who suffered a fall 5 days ago
and presents with decreased LOC. What diagnostic exam can confirm this
diagnosis? Right Ans - CT/MRI and cerebral angiography
Infection is a significant complication of open head injury involving a
compound skull fracture. What is the relations ship between fever and
ICP/CPP? Right Ans - Fever causes increase in ICP and CPP
Patient suffered open head injury of missile and presents with ecchymosis
around the eyes, ears and nose and leaking fluid from nose. What type of
fracture is suspected? Right Ans - basilar skull fracture
Patient underwent debridement and bone graft after open head injury. In
order to reduce ICP what pharmacological agents are used? Right Ans -
dehydrating agents, osmotic diuretic
T/F: Diffuse axonal injury is NOT associated with increased intracranial
hypertension immediately after injury Right Ans - T
Three most common post-traumatic brain syndrome are: Right Ans - post-
concussion syndrome, post traumatic seizures, chronic traumatic
encephalopathy
What type of brain injury has the highest risk for post traumatic seizures?
Right Ans - open brain injury
What pharmacological agent should be initiated after severe TBI at the time of
injury? Right Ans - anti seizure such as phenytoin
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