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Exam (elaborations)

AG ACNP Review set 4 Questions and Answers

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AG ACNP Review set 4 Questions and Answers

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  • November 11, 2024
  • 63
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AG ACNP Review set 4 Questions and Answers
Spinal Cord Trauma: Management Correct Ans-Methylprednisolone 30mg/kg IV bolus,
followed by an infusion of 5.4mg/kg/hr for 23 hours improves neurologic recovery when
administed within 8 hours of injury

Referral: Neurology/Neurosurgery



Spinal Cord Trauma: Signs and Symptoms

C4 or above Correct Ans-Quadriplegia, may require mechanical ventilation



Spinal Cord Trauma: Signs and Symptoms

C4-C5 Correct Ans-Quadriplegia, control of head, neck, shoulders, trapezius and elbow
flexion



Spinal Cord Trauma: Signs and Symptoms

C5-C6 Correct Ans-Quadriplegia, some extension of wrist, index finger and thumb



Spinal Cord Trauma: Signs and Symptoms

C6-C7 Correct Ans-Elbow extension, capable of feeding, dressing



Spinal Cord Trauma: Signs and Symptoms

C7-T1 Correct Ans-Hand Movement

,Spinal Cord Trauma: Signs and Symptoms

L1-L2 Correct Ans-Lower legs, feet and perineum, continued bowel, bladder and sexual
dysfunction if S2-S4 spinal nerves involved.



Spinal Cord Trauma: Signs and Symptoms

T1-T2 Correct Ans-Paraplegis, upper extemity control but no turnk control



Spinal Cord Trauma: Signs and Symptoms

T11-L1 Correct Ans-Most leg and some foot movemtn, ambulationpossible



Spinal Cord Trauma: Signs and Symptoms

T3-T8 Correct Ans-Some trunk control



Spinal Cord Trauma: Signs and Symptoms

T9-T10 Correct Ans-Bowel and bladder reflex, moves trunk and upper thigh




Status Asthmaticus Correct Ans-Term used to describe severe, acute ashma presenting in an
unremitting poorly responsive, life threatening manner. Clinical findings are not reliable
indicators of the severity of asthma.



Status Asthmaticus: Management Correct Ans-Oxygen, IV D5 1/2NS

Inhalation & parenteral sympathomimetics

Methylprednisolone 60-125mg or hydrocortisone 300mg IV immediately

,Consider Atrovent

Monitor pulse ox continuously

Monitor ABG Q10-20 minutes

Intubate



Subsequent Seizure Prevention Correct Ans-Maintenance doses of long-acting anti-
convulsants

Carbamazepine (Tegretol) Phenytoin (Dilantin)

Phenobarbital (Luminal) Valproic acid (Depakene)

Primidone (Mysoline) Clonazepan (Klonopin)

Dosages should be titrated

Discontinuance should be tapered and never abruptly withdraw



Systemic Lupus Erythematosus (SLE) Correct Ans-Multisystem, inflammatory autoimmune
disorder that affects primarily women of childbearing age



Systemic Lupus Erythematosus (SLE): Lab/Diagnostics Correct Ans-ANA (+) in 95% of
patients

Antiphospholipid antibodies

Anemia, leukopenia, and thromocytopenia are often present



Systemic Lupus Erythematosus (SLE): Management Correct Ans-For mild symptoms: bed
rest, midafternoon naps, avoidance of fatigue, sun protection

, Topical glucocorticoid for isolated skin lesions

NSAIDs, hydroxychloroquine, glucocorticoids and other therapies (DMARTS)



Systemic Lupus Erythematosus (SLE): Signs and Symptoms Correct Ans-Fever, Anorexia,
Malaise, Weight Loss, Butterfly Rash (<50%)

Fingertip lesions, Periungal erythema, Splinter hemorrhages, Alopecia, Raynaud;s phenomenon
in 20% of patients

Joint symptoms often early manifestation, Photosensitivity, Vasculitis, Nephritis, Ocular
manifestations, Pericardial manifestations, Pulmonary manifestations, Abdominal pains, ileus,
peritonitis



Systemic Vascular resistance Correct Ans-The resistance provided by the systemic circulation
against which the left ventricle must pump blood calculated by the following formula (MAP-
mean CVP X 80) / CO, normal is 800-1200 dynes/sec/cm-5



Transient Ischemic Attack (TIA) Correct Ans-Periods of acute cerebral insufficiency lasting
less than 24 hours without an residual deficits. Most resolve in 3 hours



Transient Ischemic Attack (TIA): Causes/General Concepts Correct Ans-Ischemia due
atherosclerosis, thrombus, arterial occulsion, embolus, intracerbral hemorrhage

Cardio-embolic events such as atrial fib, acute MI, endocarditis, valve disease

TIA is indicative of impeding stroke

Approximately 1/3 of patients with TIA will experience cerebral infarction within 5 years

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