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Neurological Emergencies Flashcards

6 cards from real CEN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 Neurological Emergencies flashcards as text

  1. Which clinical sign differentiates a herniation syndrome from a metabolic cause of coma?

    Answer: Unilateral fixed and dilated pupil

    A unilateral fixed and dilated pupil (blown pupil) indicates compression of cranial nerve III from uncal herniation, a structural cause, unlike the symmetric findings seen in metabolic coma.

  2. A patient with increased intracranial pressure (ICP) is being managed. Which intervention is most appropriate as a temporizing measure?

    Answer: Elevate head of bed to 30 degrees and hyperventilate to PaCO2 35 mmHg

    Head-of-bed elevation to 30 degrees improves venous drainage, and mild hyperventilation (PaCO2 35 mmHg) causes cerebral vasoconstriction to temporize elevated ICP.

  3. What is the NIH Stroke Scale (NIHSS) primarily used for in the emergency setting?

    Answer: Quantifying neurological deficits and guiding thrombolysis decisions

    The NIHSS quantifies neurological deficits on a standardized scale and helps guide tPA eligibility and treatment decisions in acute ischemic stroke.

  4. A patient post-trauma has a GCS of 8. According to current guidelines, what intervention is most appropriate?

    Answer: Intubate to protect the airway

    A GCS ≤8 is the clinical threshold for airway compromise; endotracheal intubation is indicated to protect the airway and provide controlled ventilation.

  5. Which medication is first-line for treatment of an acute hypertensive encephalopathy with a BP of 240/140 mmHg?

    Answer: IV labetalol or nicardipine with goal of 20–25% MAP reduction in 1 hour

    Hypertensive encephalopathy requires controlled BP reduction of 20–25% in the first hour using IV agents like labetalol or nicardipine to prevent cerebral hypoperfusion.

  6. A patient presents with sudden onset severe vertigo, nausea, and inability to walk. Head impulse test is negative and there is direction-changing nystagmus. What diagnosis should be suspected?

    Answer: Cerebellar stroke

    A negative head impulse test with direction-changing nystagmus and inability to walk are central (not peripheral) signs suggesting cerebellar stroke requiring urgent MRI.