CNRN exam 124 Questions with Verified Answers,100% CORRECT

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CNRN exam 124 Questions with Verified Answers Specific condition of small vessels that can lead to lacunar strokes - CORRECT ANSWER lipohyalinosis what is the greatest risk factor for lacunar st... rokes - CORRECT ANSWER hypertension tiny areas of ischemic necrosis caused by occlusion of small penetrating arteries - CORRECT ANSWER lacunar strokes what percentage of ischemic strokes do lacunar strokes account for - CORRECT ANSWER 25% what are the 5 classic syndromes of lacunar strokes - CORRECT ANSWER pure motor hemiparesis, ataxic hemiparesis, dysarthria/clumsy hand syndrome, pure sensory stroke, and mixed sensorimotor stroke what is the only non-pain sensitive tissue in the head/brain - CORRECT ANSWER brain parenchyma what is the biggest insurmountable obstacle to effective pharmacological treatments for patients with cluster headaches - CORRECT ANSWER cigarette smoking subdural hematomas most commonly result from what? - CORRECT ANSWER venous bleeding from the tearing of briding veins how is the diagnosis of DAI confirmed - CORRECT ANSWER clinical diagnosis, definitively dx requires microscopice examination of the brain tissue. what are classic signs of autonomic dysfunction syndrome and what's the most common intervention - CORRECT ANSWER hypertension, tachycardia, tachypnea, and fever---iv morphine what is the MOST common source of infection leading to brain abcesses? - CORRECT ANSWER hematogenous spread from distant infected sites, such as PNA, lung abscess, or bacterial endocarditis what group of people have the greatest risk of ICH? - CORRECT ANSWER patients with unruptured intracerebral AVM's what is the most important diagnostic test for the pt having a dull headache, superimposed ice pick sensations on the scalp, jaw claudication, and elevated ESR? - CORRECT ANSWER temporal artery biopsy--r/o giant cell arteritis what is a potential complication of a CSF leak in basal skull fx's? - CORRECT ANSWER the trapping of portions of the frontal meninges b/w the fx edges with a persistent CSF leak requiring surgical intervention what is the best way to accomplish external draining of CSF via an EVD? - CORRECT ANSWER drain a few drops/minute and close the drain after 5min or less what is the Tinel's sign - CORRECT ANSWER most frequently associated with carpel tunnel, gently tap or percuss over the injured nerve to elicit a sensation of tingling or "pins and needles" in the nerve distribution area. what is the Phalen's sign? - CORRECT ANSWER maneuver to diagnose carpel tunnel--hands forced dorsal sides together and wrists flexed to 90deg; positive test causes burning, tingling, or numb sensation over the thumb, index, middle and ring fingers. what is the most common cause of Erb's palsy? - CORRECT ANSWER dystocia or abnormal or difficult childbirth or labor what are the most common sign's of erb's palsy? - CORRECT ANSWER loss of sensation in the arm and paralysis and atrophy of the deltoid, biceps, and brachialis muscles. how is the management of the GI system in a SCI pt intiated in the ED? - CORRECT ANSWER by inserting a NGT d/t the high risk of gastric immotility resulting in distention and an ileus. what is the most common cause of a radial nerve injury - CORRECT ANSWER humerus fracture best treatment options for a woman in 3rd trimester of pregnancy with + Tinel's and Phalen's sign is what? - CORRECT ANSWER wrist splints and rehab modalities best way to prevent the development of peroneal nerve palsy in a recently immobilized pt is what? - CORRECT ANSWER avoiding pressure to the back of the knees during period when pt is immobilized in a recently immbolized pt, they begin to complain of burning on the top of the foot and have unilateral foot drop. what is this - CORRECT ANSWER peroneal nerve palsy what is the major difference b/w subdural hematoma and subdural hygroma - CORRECT ANSWER subdural hematoma is blood, and subdural hygroma is CSF ideal treatment for low serum Na level is what? - CORRECT ANSWER slow normalization w/ 3% saline and lasix to prevent central pontine myelinolysis what is a common alternative approach to preventing the s/s of carpel tunnel syndrome? - CORRECT ANSWER yoga pain upon straight leg raising in a multi trauma patient may indicate what? - CORRECT ANSWER herniated nucleus pulposus severe sharp pain with passive hip flexion may indicated what? - CORRECT ANSWER hip fracture one MOST important discharge education piece to include to parents taking home a baby with Erb's palsy is what? - CORRECT ANSWER PROM exercises for the affected arm trauma pts being dc'd home following frontal bone fractures need education to avoid... - CORRECT ANSWER Food poisoning anosmia - CORRECT ANSWER the inability to perceive odor or a lack of functioning olfaction Battle's sign - CORRECT ANSWER ecchymosis over the temporal bones--develops typically 12-24hrs following the basal skull fracture advised to avoid glucose-containing IVF in pts with TBI b/c it can contribute to... - CORRECT ANSWER neurotoxic acidosis characteristic finding on EEG in a patient experiencing "staring spells" - CORRECT ANSWER irregular 2.5Hz or less spike-wave pattern the MOST common reason people with MS stop working is... - CORRECT ANSWER cognitive impairment affects 60% of people with MS what is a disadvantage to gamma-knife tx for malignant brain tumors? - CORRECT ANSWER it's unable to detect malig cells that may have infiltrated into surrounding normal tissues the few/main type of primary malignant brain tumor responsive to chemo is what? - CORRECT ANSWER oligodendryglioma the incidence of medulloblastoma increases or decreases with age? - CORRECT ANSWER decreases, unlike most other malig and benign tumors that increase with age why should pts taking methotrexate avoid ASA and NSAIDs? - CORRECT ANSWER they increase serum concentration levels of methotrexate, increasing its 1/2 life, and therefore risking toxicity neurofibromatosis is inherited how? - CORRECT ANSWER autosomal dominant fashion, but as many as 1/3 are spontaneous mutations which tumor will most likely present bitemporal hemianopia? - CORRECT ANSWER pituitary adenoma chemotherapy for primary spinal cord tumors is consider to be? - CORRECT ANSWER experimental what is the most common route for metas malignant tumors of other organs to spread to the CNS? - CORRECT ANSWER via blood circulation complications in childbirth attribute to what % of cerebral palsy cases in the 1980's? - CORRECT ANSWER less than 10% what is the primary/first line treatment for spasticity in pts with cerebral palsy? - CORRECT ANSWER physical therapy elevated maternal serum alpha-fetoprotein is a marker for what? - CORRECT ANSWER spina bifida the most common location for a CNS hemangioblastoma is where? - CORRECT ANSWER the posterior fossa what is Von-Hippel Lindau disease? - CORRECT ANSWER autosomal recessive d/o characterized by multiple benign hemangiomas of the CNS. what is the only fully established risk factor for meningomas? - CORRECT ANSWER radiation exposure what is attributed to the greatest improvement in survival rates of pts with metastatic brain CA? - CORRECT ANSWER RADIOSURGERY untreated syringomyelia can expect what type of progression? - CORRECT ANSWER slow progression with slow accumulation of neurological deficits impaired language function (aphagia) out of proportion to other cognitive deficits is characterized by? - CORRECT ANSWER frontotemporal dementias impaired recent memory out of proportion to remote memory is characterized by? - CORRECT ANSWER Alzheimer's disease what is the best strategy to ensue that a patient with middle stages of Alzheimer's dz can carry out complex instructions? - CORRECT ANSWER both verbal and nonverbal cues simultaneously pt's with _____have a predisposition to generalized sz... - CORRECT ANSWER Stage 3 Alzheimer's dz pt's presenting with impaired memory, broad-based magnetic gait, and urinary incontinence display what d/o? what treatment is indicated? - CORRECT ANSWER NPH...normal pressure hydrocephalus...treatment is VP shunt dementia with a temporal step-wise clinical progression is most likely d/t what? - CORRECT ANSWER multi-infarct dementia what is the single greatest risk factor for the development of pseudotumor cerebri - CORRECT ANSWER obesity The inheritance of ALD is mostly r/t what? - CORRECT ANSWER X linked recessive gene Pts with ALD lack what? - CORRECT ANSWER Enzyme that breaks down VLCFAs What is the most common neurological manifestation of HIV dz? - CORRECT ANSWER Peripheral neuropathy Pts rec'g the following therapies (INH, RIF, EMB, PZA) for HIV should receive supplements of what? - CORRECT ANSWER Vitamin B6 (pyridoxine) RLS can affect people of what age group? - CORRECT ANSWER Any age the inheritance of ALD is nearly always.... - CORRECT ANSWER X-linked recessive patients with adrenoleukodystrophy ALD lack: - CORRECT ANSWER an enzyme that breaks down very long chain fatty acids the most common neurologic manifestation of HIV disease - CORRECT ANSWER peripheral neuropathy the best pharmacologic approach to symptoms of RLS is usually - CORRECT ANSWER cyclic deployment of various classes of medications the GREATEST risk factor for progressive multifocal leukoencephalopathy is what? - CORRECT ANSWER AIDS the MOST common natural history of degenerative disc disease w/o radiculopathy in the lumbar spine is: - CORRECT ANSWER gradual improvement over time patients with multiple system atrophy become overheated and are at significant risk for heat stroke because: - CORRECT ANSWER they fail to sweat back and leg pain associated with lumbar spinal stenosis is usually improved how? - CORRECT ANSWER improves somewhat with walking uphill untreated hydrocephalus in newborns: - CORRECT ANSWER has a 50-60% death rate overall the general term for a document that gives directions concerning a person's health care in the event that he/she can no longer make decisions for him/herself is called... - CORRECT ANSWER advance directive triptans should not be used to abort migraine headaches in patients who: - CORRECT ANSWER have HTN or other risk factors for heart attack or stroke the most effective strategy to date for limiting cognitive impairment in patients with multiple sclerosis is: - CORRECT ANSWER early intervention with disease-modifying agents sympathetic blockade can reduce pain associated with: - CORRECT ANSWER postherpetic neuralgia if a person has one parent with Huntington's disease, his chance of also having Huntington's is: - CORRECT ANSWER 50% antibiotic treatment for neurosyphillis should consist of: - CORRECT ANSWER IV aqueous crystalline PCN-G q4h x 10-14 days when a woman giving birth is known to have MS.... - CORRECT ANSWER she should be given the same options for interventions for pain control for all other women the BEST method for preventing subacute sclerosing pan encephalitis (SSPE) is? - CORRECT ANSWER measles vaccinations patients with idiopathic intracranial HTN should be followed with - CORRECT ANSWER quantitative visual field examination it is common for a pt with narcolepsy experiencing an episode to: - CORRECT ANSWER awaken feeling refreshed, although not necessarily for long careful temperature monitoring following an acute CVA is important b/c - CORRECT ANSWER hyperthermia increases the risk of infarct extension pt's with ALS experience extended survival time and extended time not requiring a tracheostomy when treated with ? - CORRECT ANSWER Riluzole the GREATEST risk factor for multi-infarct dementia is? - CORRECT ANSWER HTN the most sensitive marker for neuromyelitis optical is? - CORRECT ANSWER serum NMO IgG antibody the classic triad of fever, focal abnormalities, and increased ICP are seen in ... - CORRECT ANSWER brain abscesses post polio syndrome can cause - CORRECT ANSWER sleep apnea patient presenting with pure mental neuropathy (numb chin syndrome) is MOST likely to have? - CORRECT ANSWER metastatic cancer a young patient presenting with Bell's palsy should always be evaluated for - CORRECT ANSWER diabetes on EMG examination of a patient with post-polio syndrome, you can expect to see - CORRECT ANSWER evidence of anterior horn disease with increased amplitude and duration with the evoked potentials and increased % of polyphasic potentials a patient with post-polio syndrome most likely had what kind of recovery course from the initial illness - CORRECT ANSWER normal or good recovery course young patients presenting with trigemnal neuralgia should also be evaluated for? - CORRECT ANSWER multiple sclerosis prevention of DVT in the patient hospitalized for GB management is best accomplished how? - CORRECT ANSWER mini doses of heparin the goal of blood pressure management in a patient with aneurysmal SAH awaiting treatment is what? - CORRECT ANSWER keep BP high enough to prevent vasospasm, but low enough to prevent aneurysmal rebleeding a person with a severe throbbing Rt sided headache 3 days post MVA, & transient ipsilateral monocular blindness should be monitored for what? - CORRECT ANSWER partial Horner's syndrome a very common manifestation of carotid dissection r/t neck injury - CORRECT ANSWER partial Horner's syndrome the most appropriate nutritional supplement for a patient with MS and his children - CORRECT ANSWER Vitamin D emphasis is on re-establishing normal movement patterns through having the pt experience the sensations of normal movement - CORRECT ANSWER Bobath neurodevelopment approach to rehab a conscious hemiplegic stroke pt should transfer from chair to bed how? - CORRECT ANSWER orienting the chair at an angle and the unaffected side closest to the bed the most common route by which infective agents enter the CNS is how? - CORRECT ANSWER hematogenous spread what pathogen is most commonly responsible for causing bacterial meningitis in adolescents and young adults? - CORRECT ANSWER Neisseria meningitides effective acute treatment for cluster headaches is what? - CORRECT ANSWER 100% O2 via a non-rebreathing face mask cigarette smoking is an insurmountable obstacle in the pharm tx of which class of headaches? - CORRECT ANSWER cluster headaches treating spasticity in pts with syringomyelia should be balanced so as to not: - CORRECT ANSWER inadvertently increase weakness a tremor that occurs most prominently when the hands are in use is r/t? - CORRECT ANSWER benign essential tremor tremors associated with Parkinson's disease occur primarily when? - CORRECT ANSWER at rest cerebellar tremors primarily are associated when? - CORRECT ANSWER at the end of a movement tremors d/t toxic or metabolic abnorms occur when? - CORRECT ANSWER both at rest and with motion treatment of Parkinson's with Carbidopa, the drug helps how? - CORRECT ANSWER inhibits the enzyme dopa decarboxylase the use of anticholinergic meds to treat Parkinson's helps what? - CORRECT ANSWER often reduces tremors and drooling before deep brain stimulation is used in a Parkinson's pt, they should - CORRECT ANSWER dc PD meds the night before surgery dietary supplement most appropriate for patients with Wilson's disease - CORRECT ANSWER Zinc acetate most prevalent focal dystonia - CORRECT ANSWER torticollis dietary modifications necessary for a pt with hypokalemic periodic paralysis - CORRECT ANSWER avoid high carb meals neuropathic pain follows what pattern typically? - CORRECT ANSWER worse in the evening people with Down syndrome have the GREATEST increased risk of: - CORRECT ANSWER dementia a child with Down syndrome in school is having difficulty learning new material & requiring a great deal of repitition; what test should be considered - CORRECT ANSWER polysomnography (r/o sleep apnea) a baby with Down syndrome is likely to need? - CORRECT ANSWER assistance breast feeding or bottle feeding with manual support of chin and throat assists in preventing opiod tolerance - CORRECT ANSWER dextromethorphan symmetric, bilat distribution of sensory and motor deficits, beginning distally and progressing proximally - CORRECT ANSWER diabetic peripheral neuropathy education on the proper use of crutches can help prevent what type of injury? - CORRECT ANSWER radial nerve entrapment injury MS pts being treated with Tysabri require intensive long-term monitoring why? - CORRECT ANSWER there is a 1/1000 risk of developing progressive multifocal leukoencephalopathy [Show More]

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