Consciousness and the Brain

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What is a characteristic of a conscious individual?

Unaware of his surroundings

Aware of himself and his environment (correct)

Unresponsive to psychogenic stimuli

Completely dependent on the brain stem

What is the function of the ascending reticular activating system?

To process sensory information from the classical ascending lemniscal pathways

To transmit information from the brain stem to the cerebral cortex

To receive information from the cerebral cortex

To project diffusely to the cerebral cortex of both sides (correct)

What is the most common cause of coma?

Metabolic disorders

Neurological disorders

Organic causes (correct)

Psychogenic disorders

What is the primary location of the function of consciousness?

Cerebral cortex Signup and view all the answers

What is the difference between delirium and stupor?

Delirium is a state of confusion, while stupor is a state of decreased consciousness Signup and view all the answers

What is the primary mechanism by which local lesions can cause coma?

Acting directly on the brain stem Signup and view all the answers

What is suggested by a sudden or rapid onset, hypertension, focal signs, and signs of meningeal irritation?

Hypertensive encephalopathy Signup and view all the answers

Which of the following is a characteristic feature of diabetic coma?

Air hunger and smell of acetone in breathing Signup and view all the answers

What is suggested by a child or young adult, subacute onset, fever, headache, and vomiting?

Cerebral infection Signup and view all the answers

Which of the following is a characteristic feature of hypoglycemic coma?

Excessive sweating with collapse Signup and view all the answers

What is suggested by a history and signs of injury?

Head injury Signup and view all the answers

Which of the following is a characteristic feature of uraemic coma?

Hissing breathing with urinous odor Signup and view all the answers

What is the score for a patient who withdraws in response to pain on the Glasgow Coma Scale?

4 Signup and view all the answers

What is the primary purpose of a urine analysis in a comatose patient?

To detect underlying diabetic or uremic conditions Signup and view all the answers

What is the primary concern in the management of a comatose patient?

Ensuring good airway and adequate oxygenation Signup and view all the answers

What is the prognosis for a comatose patient with a serious cerebral hemorrhage?

Poor Signup and view all the answers

What is the purpose of placing a comatose patient in a lateral decubitus position?

To help with screening Signup and view all the answers

What is one of the criteria for determining brain death?

Unresponsive to stimuli above the foramen magnum Signup and view all the answers

What is a possible cause of unconsciousness suggested by emotional upset?

Hysterical trance Signup and view all the answers

During physical examination, what is the significance of conjugate deviation in the eyes?

Indicates hemiplegia Signup and view all the answers

What is the purpose of taking a history from the patient's relatives?

To know the patient's background and medical history Signup and view all the answers

What is the significance of a subnormal temperature in a patient with coma?

Indicates all other comas except pontine hemorrhage and cerebral malaria Signup and view all the answers

What is the significance of purulent discharge from the ear in a patient with coma?

Indicates brain abscess Signup and view all the answers

What should be done with circumstantial evidence found during investigation?

It should be scrutinized with care and checked by physical examination Signup and view all the answers

What is the minimum duration of absent brain function required for diagnosing brain death in adults with a known structural cause and without drug intoxication?

At least 6 hours Signup and view all the answers

What is the minimum duration of observation required for diagnosing brain death in infants aged 7 days to 2 months?

At least 48 hours Signup and view all the answers

What is an optional confirmatory study for diagnosing brain death?

EEG isolectric for 30 minutes at maximal gain Signup and view all the answers

What is the minimum temperature required for diagnosing brain death?

Above 34°C Signup and view all the answers

What is present in someone who meets the criteria for brain death?

Purely spinal reflexes Signup and view all the answers