Question 1

A patient with a Glasgow Coma Scale score of 10 is classified as having a mild degree of coma.

Accepted Answer

A Glasgow Coma Scale score of 10 is classified as a moderate degree of coma, not mild. A score of 13-15 is considered mild, 9-12 is considered moderate, and 3-8 is considered severe.

Question 2

The most important preventative measure for hemorrhagic stroke is&#10;A) anticoagulation.&#10;B) blood pressure control.&#10;C) thrombolytics.&#10;D) management of dysrhythmias.

Accepted Answer

Blood pressure control is the most important preventative measure for hemorrhagic stroke as it decreases the risk of bleeding and subsequent stroke. Anticoagulation and thrombolytics are useful for ischemic stroke but can worsen bleeding in hemorrhagic stroke. Management of dysrhythmias may be useful in preventing ischemic stroke but is not specific to hemorrhagic stroke prevention.

Question 3

Clinical manifestations of a stroke within the right cerebral hemisphere include&#10;A) cortical blindness.&#10;B) right visual field blindness.&#10;C) expressive and receptive aphasia.&#10;D) left-sided muscle weakness and neglect.

Accepted Answer

Damage to the right cerebral hemisphere can result in left-sided muscle weakness and neglect, meaning that the person may be unaware of the left side of their body or neglect it in their movements. Cortical blindness (A) and right visual field blindness (B) are more likely to occur with damage to the occipital lobe in the brain, while expressive and receptive aphasia (C) are associated with damage to the left cerebral hemisphere, which is responsible for language processing in most people.

Question 4

Glutamate can damage neurons when it accumulates in synapses after brain injury because it opens calcium channels.

Accepted Answer

Glutamate is an excitatory neurotransmitter that can cause damage to neurons if it accumulates in excessive amounts in the synapse. This is especially problematic after brain injury because glutamate can activate calcium channels, leading to an influx of calcium ions into the neuron, which can ultimately cause cell death.

Question 5

Which of the following groups of clinical findings indicates the poorest neurologic functioning?&#10;A) Spontaneous eye opening, movement to command, oriented to self only&#10;B) Eyes open to light touch on shoulder, pupils briskly reactive to light bilaterally&#10;C) Assumes decorticate posture with light touch, no verbal response&#10;D) No eye opening, responds to painful stimulus by withdrawing

Accepted Answer

Decorticate posturing indicates severe brain injury and poor neurologic functioning, as it suggests damage to the corticospinal tract.

Question 6

Risk factors for hemorrhagic stroke include&#10;A) atherosclerosis.&#10;B) dysrhythmias.&#10;C) acute hypertension.&#10;D) sedentary lifestyle.

Accepted Answer

Intracerebral hemorrhage is a hemorrhage within the brain parenchyma and usually occurs in the context of severe and often longstanding hypertension.Risk factors for stroke are similar to those for other atherosclerotic vascular disease.Cardiac disease complicated by atrial fibrillation is an important risk factor for embolic stroke.Sedentary lifestyle is not a risk factor for hemorrhagic stroke.

Question 7

In the acute phase of stroke, treatment is aimed at&#10;A) stabilization of respiratory and cardiovascular function.&#10;B) risk factor modification.&#10;C) prevention of bedsores and contractures.&#10;D) neurologic rehabilitation.

Accepted Answer

In the acute phase of stroke, the priority is to stabilize respiratory and cardiovascular function. This includes monitoring vital signs, ensuring adequate oxygenation, and controlling blood pressure to prevent further brain damage. Risk factor modification, prevention of bedsores and contractures, and neurologic rehabilitation are important aspects of stroke management but are not the primary focus in the acute phase.

Question 8

Cerebral aneurysm is most frequently the etiology of&#10;A) embolic stroke.&#10;B) subarachnoid hemorrhage.&#10;C) subdural hemorrhage.&#10;D) meningitis.

Accepted Answer

Cerebral aneurysm is most commonly associated with subarachnoid hemorrhage, which occurs when the weakened wall of the aneurysm ruptures and bleeds into the space between the brain and the skull. Aneurysms do not typically cause embolic stroke, subdural hemorrhage, or meningitis.

Question 9

Secondary injury after head trauma refers to&#10;A) brain injury due to the initial trauma.&#10;B) focal areas of bleeding.&#10;C) brain injury due to the body's response to tissue damage.&#10;D) injury as a result of medical therapy.

Accepted Answer

Secondary injury after head trauma refers to the damage and dysfunction that occur in the brain after the initial traumatic injury. This is caused by the body's response to the tissue damage, which can include inflammation, swelling, and reduced blood flow to the affected area. This secondary injury can lead to further damage to brain tissue and worsen the overall outcome of the initial injury. Focal areas of bleeding and injury as a result of medical therapy may also occur, but these are not typically included in the definition of secondary injury.

Question 10

An increase in PaCO₂ or acidemia would be expected to decrease cerebral blood flow.

Accepted Answer

An increase in PaCO2 or acidemia typically causes cerebral vasodilation, leading to an increase in cerebral blood flow.

Question 11

The brain contributes 2% of body weight and uses 20% of the body's oxygen consumption.

Accepted Answer

The answer of The brain contributes 2% of body weight...

Question 12

Acceleration-deceleration movements of the head often result in polar injuries in which&#10;A) injury is localized to the site of initial impact.&#10;B) widespread neuronal damage is incurred.&#10;C) bleeding from venules fills the subdural space.&#10;D) focal injuries occur in two places at opposite poles.

Accepted Answer

The answer of Acceleration-deceleration movements of the head often result...

Question 13

An example of inappropriate treatment for head trauma would be&#10;A) head elevation.&#10;B) free water restriction.&#10;C) hypoventilation.&#10;D) bed rest.

Accepted Answer

The answer of An example of inappropriate treatment for head...

Question 14

Leakage of CSF from the nose or ears is commonly associated with&#10;A) epidural hematoma.&#10;B) temporal skull fracture.&#10;C) basal skull fracture.&#10;D) cerebral aneurysm.

Accepted Answer

The answer of Leakage of CSF from the nose or...

Question 15

The stroke etiology with the highest morbidity and mortality is&#10;A) intracranial hemorrhage.&#10;B) thrombosis.&#10;C) embolization.&#10;D) cardiac arrest.

Accepted Answer

The answer of The stroke etiology with the highest morbidity...

Question 16

Manifestations of acute brain ischemia (Cushing reflex) are due primarily to&#10;A) parasympathetic nervous system activation.&#10;B) sympathetic nervous system activation.&#10;C) autoregulation.&#10;D) loss of brainstem reflexes.

Accepted Answer

The answer of Manifestations of acute brain ischemia (Cushing reflex)...

Question 17

Subarachnoid hemorrhage is usually managed with volume expansion and blood pressure support to enhance cerebral perfusion. This is necessary because subarachnoid hemorrhage predisposes to&#10;A) cerebral vasospasm.&#10;B) hypotension.&#10;C) excessive volume loss.&#10;D) increased intracranial pressure.

Accepted Answer

The answer of Subarachnoid hemorrhage is usually managed with volume...

Question 18

Rupture of a cerebral aneurysm should be suspected if the patient reports&#10;A) ringing in the ears.&#10;B) transient episodes of numbness.&#10;C) transient episodes of vertigo.&#10;D) sudden, severe headache.

Accepted Answer

The answer of Rupture of a cerebral aneurysm should be...

Question 19

The physiologic change most likely to lead to an increase in intracranial pressure is&#10;A) cerebral vasodilation.&#10;B) hypernatremia.&#10;C) respiratory hyperventilation.&#10;D) sleep.

Accepted Answer

The answer of The physiologic change most likely to lead...

Question 20

Unless contraindicated, a patient who experiences signs and symptoms of transient ischemic attack should immediately ingest an aspirin.

Accepted Answer

The answer of Unless contraindicated, a patient who experiences signs...

Question 21

The most important determinant for prescribing therapy for acute stroke is&#10;A) location of ischemia.&#10;B) thrombotic versus embolic cause.&#10;C) ischemic versus hemorrhagic cause.&#10;D) age of the patient.

Accepted Answer

The answer of The most important determinant for prescribing therapy...

Question 22

Epidural bleeding is&#10;A) associated with widespread vascular disruption.&#10;B) located between the arachnoid and the dura mater.&#10;C) usually due to venous leakage.&#10;D) characterized by a lucid interval immediately after injury.

Accepted Answer

The answer of Epidural bleeding is&#10;A) associated with widespread vascular...

Question 23

Encephalitis is usually&#10;A) due to a bacterial infection in the CNS.&#10;B) fatal.&#10;C) due to a viral infection in brain cells.&#10;D) asymptomatic.

Accepted Answer

The answer of Encephalitis is usually&#10;A) due to a bacterial...

Question 24

John is a college student living in a dormitory. He comes to the clinic complaining of a headache and confusion. John is found to have a fever of 102°F. This information is most consistent with A) encephalitis. B) meningitis. C) skull fracture. D) cerebral ischemia.

Accepted Answer

The answer of John is a college student living in...

Deck 44: Acute Disorders of Brain Function