Neuro trauma p.1
This triad of vital sign changes signals impending brain herniation.
What is Cushing’s triad (hypertension, bradycardia, irregular respirations)?
Rationale:
A late, life-threatening sign of increased ICP indicating brainstem compression.
A patient with clear drainage from the nose after head trauma should be suspected of having this.
What is a CSF leak (rhinorrhea)?
Rationale:
Indicates basilar skull fracture → risk for meningitis.
This post-seizure phase is characterized by confusion, sleepiness, and muscle soreness.
What is the postictal state?
Rationale:
After seizures, patients often experience altered consciousness and neurologic fatigue
This disease involves antibodies attacking acetylcholine receptors at the neuromuscular junction.
What is myasthenia gravis?
Rationale:
This leads to muscle weakness due to impaired neuromuscular transmission
This early symptom of Alzheimer disease involves subtle memory loss.
What is forgetfulness?
Rationale:
Often hidden early but progressively worsens.
This type of hematoma is associated with a “lucid interval” followed by rapid deterioration.
What is an epidural hematoma?
Rationale:
Arterial bleed → rapid ICP rise → emergency.
This condition results from decreased ADH and leads to excessive urine output in TBI patients.
What is diabetes insipidus (DI)?
Rationale:
Common endocrine complication of TBI.
This medication is given IV first-line to stop status epilepticus.
What is lorazepam (or diazepam/midazolam)?
Rationale:
Benzodiazepines rapidly suppress seizure activity
In MG, this crisis is caused by overmedication and results in severe weakness and excess secretions.
What is a cholinergic crisis?
Rationale:
Too much acetylcholine leads to muscle weakness and respiratory failure
This acronym represents the four cardinal signs of Parkinson disease.
What is TRAP ?
(Tremor, Rigidity, Akinesia/Bradykinesia, Postural instability)
This doctrine explains that an increase in one intracranial component must be compensated by a decrease in another.
What is the Monro-Kellie doctrine?
Rationale:
Brain + blood + CSF must stay balanced to maintain normal ICP.
This reflex involves dorsiflexion of the great toe and indicates corticospinal tract damage.
What is the Babinski reflex?
Rationale:
Abnormal in adults → neurologic damage.
This medication is used to treat spasticity in MS patients.
What is baclofen?
Rationale:
Baclofen reduces muscle hypertonicity and improves mobility
This syndrome presents with ascending paralysis starting in the lower extremities.
What is Guillain-Barré syndrome (GBS)?
Rationale:
Weakness progresses upward and can lead to respiratory failure
This PD symptom is described as a “pill-rolling” movement at rest.
What is a resting tremor?
Rationale:
Classic early PD sign; disappears with purposeful movement.
This medication is the gold standard osmotic diuretic used to reduce cerebral edema.
What is mannitol?
Rationale:
Pulls fluid out of brain tissue → ↓ ICP.
This type of skull fracture is associated with Battle sign and raccoon eyes.
What is a basilar skull fracture?
This is the first-line medication used to treat MG.
What is pyridostigmine?
Rationale:
It enhances acetylcholine availability at the neuromuscular junction
This hallmark MG symptom worsens with activity and improves with rest.
What is muscle weakness?
Rationale:
Fatigability is the key feature of MG
This nursing intervention helps improve gait in Parkinson patients.
What is encouraging wide-based gait and heel-to-toe walking?
Rationale:
Helps prevent falls and improves coordination.
A nurse should avoid inserting this type of tube in a patient with a basilar skull fracture.
What is a nasogastric (NG) tube?
Rationale:
Risk of intracranial insertion through fractured cribriform plate.
This type of brain injury involves widespread axonal damage and often results in immediate coma.
What is diffuse axonal injury?
Rationale:
Caused by acceleration/deceleration forces.
This medication is the gold standard treatment for PD that converts to dopamine in the brain.
What is levodopa (with carbidopa)?
Rationale:
Levodopa → dopamine; carbidopa prevents peripheral breakdown.
This classic MS symptom is described as an electric shock sensation down the spine when the neck is flexed.
What is Lhermitte sign?
Rationale:
It is a hallmark sensory symptom of MS
This neurotransmitter is decreased in Alzheimer disease.
What is acetylcholine?
Rationale:
Essential for memory and learning.