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2010-03-26 22:50:19
MS2 Exam 3

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  1. What problem is characterized by unilateral pain in the lips, gums, cheeks or forehead?
    How is it triggered?
    Trigeminal Neuralgia

    Chewing, Touching face, Talking, Hot/Cold Exposure
  2. What are the anti-seizure drugs for trigeminal neuralgia?
    • Carbamazapine (Tegretol)
    • Gabapentin (Neurontin)
  3. Carbamazipine (Tegretol):
    What are you monitoring for?
    Therapeutic level?
    Bone marrow suppression


    Sedation, Decrease LOC, Gait instability, Anemia
  4. Bell's Palsy is a unilateral paralysis of what cranial nerve?
    VII (Facial Nerve)
  5. Bell's Palsy:
    Associated with?
    Typical recovery time?
    Clinical presentation?
    Herpes Virus

    6 months

    • Pain behind ear
    • Inability to close eye/facial droop
  6. What are the drugs to treat Bell's Palsy?
    • Anti-Virals:
    • Acyclovir (Zovirax)
    • Valacyclovir (Valtrex)
    • Famiciclovir (Famvir)

  7. Guillain-Barre Syndrome is inflammation of _______ and is a cell-mediated immune reaction triggered by ______, ______, ______.
    Peripheral nerves

    • Viral Infection
    • Neoplasms
    • Immunizations
  8. Guillain-Barre Syndrome causes _______.
  9. Guillain-Barre Syndrome progression:
    Starts as?
    Then as?
    Finally as?

    • Paralysis
    • Pain

    Respiratory Paralysis
  10. The main complication with Guillain-Barre Syndrome?
    Respiratory Failure
  11. What are the two main things to monitor for with Guillain-Barre Syndrome?
    Respiratory Status

    Swallowing and nutrition
  12. What is the difference between primary and secondary injury of the spinal cord?
    Primary - Initial disruption of the cord

    Secondary - Damage from ischemia, inflammation, toxic metabolites and edema
  13. Spinal vs. Neurogenic Shock
    Spinal - Decreased reflexes and flaccid paralysis BELOW level of injury

    • Neurogenic - Loss of vasomotor tone from sympathetic disruption
    • (Causes bradycardia and hypotension)
  14. Incomplete Lesions:
    Central Cord Syndrome characteristics
    • Motor weakness and sensory loss
    • Usually cervical
    • Upper extremity loss > lower extremity loss
  15. Incomplete Lesions:
    Anterior Cord Syndrome characteristics
    • Loss of motor function
    • Pain and temperature sensaiton below injury
    • Sensation, touch, position and vibration intact
  16. Incomplete Lesions:
    Brown-Sequard Syndrome characteristics
    • Unilateral cord damage
    • Ipsilateral loss of motor, position and vibratory sense
    • Contralateral loss of pain and temperature below injury
  17. Incomplete Lesions:
    Posterior Cord Syndrome characteristics
    Loss of proprioception below injury
  18. What syndrome is damage to the lowest portion of cord and lumbar or sacral nerve roots?
    Cauda Equina
  19. What high dose drug prevents secondary damage to the cord?
    Methylprednisolone (Solu-Medrol)
  20. During emergent care, why do we need to maintain the MAP of 80-90?
    What is used to maintain it?
    To keep BP up to perfuse the cord

  21. Any injury above C4 requires ________
    Mechanical Ventilation
  22. What problem is a stimulus below lesion causes an unopposed reflex sympathetic stimulation?
    Autonomic Dysreflexia
  23. A 36y/o male has been admitted to the neuro unit for Guillain-Barre Syndrome. Which assessment should the nurse make?

    A) Peripheral Sensation
    B) Respiatory Rate and Effort
    C) Blood Pressure
    D) Peripheral Strength
    B) Respiatory Rate and Effort
    (this multiple choice question has been scrambled)
  24. The nurse is preparing to administer Methylprednisolone (Solu-Medrol) to a patient with an acute spinal cord injury. The patient ask what the medicaiton is for. The nurse responds

    A) To decrease the inflammatory response and prevent secondary cord damage
    B) To speed the healing process and encourage regeneration of axons
    C) To prevent infection
    D) To reduce pain and fever
    A) To decrease the inflammatory response and prevent secondary cord damage
    (this multiple choice question has been scrambled)