EMT Chapter 18: Neurologic Emergencies Quiz

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Questions and Answers

What is the least likely cause of a generalized (tonic-clonic) seizure in a 40-year-old patient without a history of seizures?

  • Intracranial bleeding
  • A brain tumor (correct)
  • Epilepsy (correct)
  • A serious infection

A patient who is experiencing aphasia is:

  • Usually conscious but has slurred speech (correct)
  • Unable to produce or understand speech (correct)
  • Experiencing a right hemispheric stroke (correct)
  • Not able to swallow without choking (correct)

A patient who is possibly experiencing a stroke is not eligible for thrombolytic therapy if he or she:

  • Has had a prior heart attack
  • Has bleeding within the brain (correct)
  • Is older than 60 years of age (correct)
  • Has a GCS score that is less than 8 (correct)

A patient with an altered mental status is:

<p>Not thinking clearly or is incapable of being aroused (A), Typically alert but is confused as to preceding events (B), Usually able to be aroused with a painful stimulus (C), Completely unresponsive to all forms of stimuli (D)</p> Signup and view all the answers

Components of the Cincinnati pre-hospital Stroke Scale include:

<p>Arm drift, speech, and facial droop (B), Speech, pupil, and memory (C), Arm drift, memory, and grip strength (D)</p> Signup and view all the answers

Febrile seizures:

<p>Are also referred to as absence seizures (A), Often result in permanent brain damage (B), Occur when a child's fever rises slowly (D)</p> Signup and view all the answers

Muscle control and body coordination are controlled by the:

<p>Cerebrum (A), Cerebellum (B)</p> Signup and view all the answers

Status epilepticus is characterized by:

<p>Generalized seizures that last less than 5 minutes (A), Prolonged seizures without a return of consciousness (B), Profound tachycardia and total muscle flaccidity (D)</p> Signup and view all the answers

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:

<p>Cerebellum (A), Brainstem (B)</p> Signup and view all the answers

The spinal cord exits the cranium through the:

<p>Foramen magnum (A)</p> Signup and view all the answers

The three major parts of the brain are:

<p>Cerebrum, cerebellum, and brainstem (A), Midbrain, cerebellum, and spinal cord (B), Cerebellum, medulla, and occiput (C), Brain stem, midbrain, and spinal cord (D)</p> Signup and view all the answers

When you assess for arm drift in a patient with a suspected stroke, you should:

<p>Observe movement of the arms for approximately 2 minutes (A), Expect to see one arm slowly drift down to the patient's side (C), Ask the patient to hold his or her arms up with the palms down (D)</p> Signup and view all the answers

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

<p>Respiratory distress (B)</p> Signup and view all the answers

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

<p>Nasal discharge of blood (A), Sudden, severe headache (C), Confusion and weakness (D)</p> Signup and view all the answers

Which of the following conditions would MOST likely affect the entire brain?

<p>Block cerebral artery in the frontal lobe (A), Respiratory failure or cardiopulmonary arrest (B), Reduced blood supply to the left hemisphere (D)</p> Signup and view all the answers

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?

<p>Slow onset of symptoms (B), History of migraines (C)</p> Signup and view all the answers

Which of the following is characteristic of a focal-onset aware seizure?

<p>Normal level of consciousness (A), Absence of breathing (B)</p> Signup and view all the answers

Which of the following most accurately describes the cause of an ischemic stroke?

<p>Narrowing of a carotid artery (A), Blockage of a cerebral artery (B), Rupture of a cerebral artery (C)</p> Signup and view all the answers

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. What is the MOST immediate priority?

<p>Asking his wife when she noticed the symptoms (A), Documenting all of his current medications (B), Administering glucose to rule out hypoglycemia (C)</p> Signup and view all the answers

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

<p>Hypoglycemia (C)</p> Signup and view all the answers

You are dispatched to a residence for a 66-year-old male who allegedly suffered a massive stroke. What should you do first?

<p>Obtain a blood glucose sample to rule out hypoglycemia (A), Perform CPR for 5 minutes before applying the AED (B), Initiate CPR and attach an AED as soon as possible (C), Assess the patient for facial droop and hemiparesis (D)</p> Signup and view all the answers

Law enforcement has summoned you to a nightclub for a 22-year-old female found unconscious. What should you do?

<p>Assist ventilations, perform a rapid exam, and prepare for immediate transport (A), Place a bite block in her mouth in case she has a seizure and transport at once (B)</p> Signup and view all the answers

During the primary assessment of a semi-conscious 70-year-old female, what should you prioritize?

<p>Insert a nasopharyngeal airway and assist ventilations (A), Ask family members if the patient has a history of a stroke (C)</p> Signup and view all the answers

Which of the following MOST accurately describes a focal onset aware seizure?

<p>A seizure that is not preceded by an aura (A), A seizure that causes the patient to stare blankly (B), A seizure that begins in one extremity (D)</p> Signup and view all the answers

Interruption of cerebral blood flow may result from all of the following, except:

<p>An embolism (A), Cerebral vasodilation (B), A thrombus (C), An acute arterial rupture (D)</p> Signup and view all the answers

Which of the following patients would MOST likely demonstrate typical signs of infection, such as fever?

<p>A 3-month-old female who was born prematurely (A), An 88-year-old male with chronic renal problems (B), A 35-year-old female in the later stages of AIDS (C)</p> Signup and view all the answers

Flashcards

Generalized Seizures

Seizures affecting the whole brain; causes include epilepsy, tumors, bleeding, or infections.

Aphasia

Inability to understand or produce speech, often from stroke or brain injury.

Thrombolytic Therapy Contraindication

Contraindicated treatment for stroke patients experiencing brain bleeding.

Altered Mental Status

Indicates a state of confusion and unresponsiveness.

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Cincinnati Stroke Scale

Rapid stroke assessment tool, including arm drift, speech, and facial droop.

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Febrile Seizures

Seizures in children caused by fever; generally benign but require evaluation.

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Chronic Alcoholism Risks

Increases risk of brain bleeding and hypoglycemia due to liver issues.

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Cerebellum Function

Controls muscle coordination; breathing/heart rate are managed by the brainstem.

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Major Brain Parts

Cerebrum, cerebellum, and brainstem.

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Status Epilepticus

Prolonged seizures without return to consciousness; requires immediate intervention.

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Hypertension

Significant risk factor for hemorrhagic stroke.

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Foramen Magnum

The opening where the spinal cord exits the skull.

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GCS Score of 12

Indicates a semi-conscious state with weak response.

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Sudden Severe Headache Signs

May indicate ruptured aneurysm; neck stiffness suggests meningitis.

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Focal-Onset Aware Seizures

Seizures without loss of consciousness, may involve blank staring.

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Ischemic Stroke

Stroke due to blocked artery; quick assessment is crucial.

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CPR and Stroke

Begin CPR when stroke patient is unresponsive.

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Headache Assessment

Clinical context is key; signs can be atypical.

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Stroke Mimics

These can mimic stroke but have different treatments.

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Cerebellum

The area of the brain responsible for muscle control and coordination.

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Status Epilepticus

A prolonged seizure without a return to consciousness.

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Ruptured Aneurysm

A sudden, severe headache indicates a ruptured aneurysm.

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Seizure

Prolonged seizures puts someone into status epilepticus.

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Hypertension

High blood pressure

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Stroke

A stroke occurs when blood supply to brain is cut-off

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Intracranial bleed

Bleeding within the skull

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Study Notes

Seizures and Stroke

  • Generalized seizures in adults can be caused by epilepsy, brain tumors, intracranial bleeding, or serious infections; least likely cause is epilepsy.
  • Aphasia indicates an inability to produce or understand speech, typically arises from stroke or brain injury.
  • Thrombolytic therapy is contraindicated in patients with bleeding within the brain.

Mental Status and Assessment

  • Altered mental status can indicate confusion and may include the inability to respond to stimuli.
  • Cincinnati pre-hospital Stroke Scale includes arm drift, speech, and facial droop as key components for assessing stroke.

Febrile Seizures and Risk Factors

  • Febrile seizures typically occur in children and are generally benign, but evaluation is necessary.
  • Chronic alcoholism is associated with an increased risk of intracranial bleeding and hypoglycemia due to liver abnormalities.

Brain Function and Anatomy

  • The cerebellum is responsible for muscle control and coordination, while basic functions like breathing and heart rate are regulated by the brainstem.
  • Major parts of the brain include the cerebrum, cerebellum, and brainstem.

Emergency Response

  • Status epilepticus is characterized by prolonged seizures without a return to consciousness; immediate intervention is critical.
  • Hypertension is the most significant risk factor for hemorrhagic stroke.

Neurological Assessment

  • The spinal cord exits the skull through the foramen magnum.
  • A Glasgow Coma Scale score of 12 indicates a semi-conscious state with focused but weak responses.

Clinical Signs and Conditions

  • Sudden, severe headaches suggest a ruptured aneurysm; neck stiffness may indicate meningitis or serious infection.
  • Focal-onset aware seizures maintain consciousness but may cause blank staring.

Ischemic Stroke and Interventions

  • Ischemic stroke results from blockage of a cerebral artery; quick assessment of onset symptoms is crucial for patient management.
  • CPR should be initiated immediately if a patient is unresponsive and suspected of having a stroke.

Additional Considerations

  • Not all patients with a headache will exhibit classic infection signs; assessment requires clinical context.
  • Hypoglycemia, hypovolemia, and postictal states can mimic stroke symptoms but differ in management approaches.

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