ABEM Neurological & Psychiatric Disorders — Questions and Answers

Question 1: What is a seizure?

Heart spasm
Brain activity (Correct answer)
Muscle fatigue
Low oxygen

Correct answer: Brain activity

A seizure is fundamentally a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. It is caused by uncontrolled electrical discharges in the brain, which can manifest in various ways, including altered consciousness, involuntary movements, or sensory disturbances.

Question 2: How to treat status epilepticus?

Epinephrine
Lorazepam (Correct answer)
Insulin
Digoxin

Correct answer: Lorazepam

Status epilepticus is a medical emergency characterized by prolonged or recurrent seizures without full recovery of consciousness between episodes. Benzodiazepines, such as lorazepam, are the first-line treatment because they act rapidly to suppress seizure activity by enhancing the effect of GABA, an inhibitory neurotransmitter in the brain.

Question 3: What is stroke sign?

Arm rash
Facial droop (Correct answer)
High fever
Itchy eyes

Correct answer: Facial droop

Facial droop is a classic and easily recognizable sign of a stroke, often affecting one side of the face. It occurs due to damage to the brain areas that control facial muscles. This symptom is part of the FAST mnemonic (Face, Arm, Speech, Time) and indicates a need for urgent medical evaluation for potential stroke.

Question 4: What is psychosis?

Low BP
Muscle cramps
Delusions or hallucinations (Correct answer)
Nausea

Correct answer: Delusions or hallucinations

Psychosis is a severe mental disorder characterized by a loss of contact with reality. Its hallmark symptoms include delusions (fixed, false beliefs not amenable to change in light of conflicting evidence) and hallucinations (perceiving things that are not actually present, such as hearing voices or seeing things). These symptoms indicate a significant disruption in thought processes and perception.

Question 5: What is priority in head trauma?

Draw labs
Spine and GCS (Correct answer)
Feed patient
Check pulse

Correct answer: Spine and GCS

In head trauma, ensuring cervical spine immobilization is paramount to prevent further neurological injury, as concurrent spinal cord injury is common. Assessing the Glasgow Coma Scale (GCS) is crucial for evaluating the patient's level of consciousness and neurological status, which guides immediate management and helps monitor changes over time. These are critical components of the primary survey in trauma.

Question 6: What causes altered mental status?

Only drugs
Multiple causes (Correct answer)
Blood loss
Anxiety

Correct answer: Multiple causes

Altered mental status (AMS) is a broad term indicating a change in a person's usual level of awareness or responsiveness. It can be caused by a wide array of medical conditions, including metabolic disturbances (e.g., hypoglycemia, electrolyte imbalances), infections, drug overdose, head injuries, stroke, hypoxia, and psychiatric conditions. Therefore, a thorough diagnostic workup is essential to identify the underlying cause.

Question 7: What tool evaluates mental status?

BMI
GCS (Correct answer)
ABG
CBC

Correct answer: GCS

The Glasgow Coma Scale (GCS) is a standardized neurological assessment tool used to objectively measure a person's level of consciousness. It evaluates eye-opening, verbal response, and motor response, providing a numerical score that helps clinicians assess the severity of brain injury or altered mental status and monitor changes over time.

Question 8: What is suicide risk factor?

Good grades
History of attempt (Correct answer)
Sibling illness
No insurance

Correct answer: History of attempt

A history of previous suicide attempts is one of the strongest predictors and highest risk factors for future suicide. Individuals who have attempted suicide before are at a significantly increased risk of making another attempt, underscoring the importance of recognizing this history and providing ongoing support and intervention.

Question 9: What helps de-escalate agitated patient?

Yelling
Restraints only
Verbal de-escalation (Correct answer)
Sedation first

Correct answer: Verbal de-escalation

Verbal de-escalation techniques are the preferred first-line approach for managing agitated patients, aiming to reduce their distress and prevent escalation to physical aggression. This involves using calm, respectful communication, active listening, empathy, and offering choices to help the patient regain control and cooperate with care. It prioritizes patient safety and autonomy over immediate physical restraint or sedation.

ABEM Neurological & Psychiatric Disorders

What is a seizure?