NR572 FINAL PAPER 2026 ACCURATE
ANSWER SET
◉Indications of lumbar puncture. Answer: CSF sample for
examination; pressure measurements (NPH); reduction in CSF
pressure:; -infections; -SAH; -Inflammatory conditions; -MS; -
carcinomatosis; Spinal anesthetics, antitumor agents, antibiotics;
radio-opaque substance radioactive agent:; -cryptococcal
meningitis; -hydrocephalus with communication between all
ventricles; -pseudotumor cerebri; -drug administration; Imaging; -
myelography; -radionuclide cisternography
◉Contraindications of performing LP. Answer: • Increased risk of
fatal cerebellar or transtentorial herniation; • Coagulopathy; •
Infection over puncture site; • Spinal block requiring sample above
lesion
◉Common complications of lumbar puncture. Answer: -Sciatic pain
during needle insertion; -Slowing of fluid removal (elevate patient
head)
◉How is chronic meningitis diagnosed?. Answer: On LP/CSF
analysis or contrast MRI/CT showing leakage into meninges.
Meningeal biopsy if CSF not diagnostic.
,◉Differentials for chronic meningitis. Answer: -Partially treated
suppurative meningitis; -Paranmeningeal infection; -Mycobacterium
TB; -Lyme; -Syphilis; -HIV; -HSV; -Malignancy; -SLE; -Behcet's
◉Indications for swallow evaluation. Answer: -Hx of dysphasia; -
Observed dysphasia; -Suspected aspiration; -Decreased oral intake; -
Parenteral/enteral feeding
◉Medicare coverage of hospice. Answer: • Prognosis of six months
or less if illness runs normal course; • Falls under Medicare Part A
◉Three common causes of acute ischemic stroke. Answer: 1- Anoxic
injury; 2- Thrombosis in situ; 3- Thrombotic embolism
◉In ischemic stroke, what area of damage is irreversible?. Answer:
Tissue death at occluded artery (infarction core)
◉Penumbra. Answer: Area around infarct, salvageable if blood flow
restored
◉Risk factors for ischemic stroke. Answer: -Advanced age; -HTN
◉More risk factors for ischemic stroke. Answer: -HLD, DM, oral
contraceptives, obesity, prior TIAs, tobacco, MI, alcohol, sedentary
,lifestyle, sickle cell, stimulant drugs, family hx CVA, cardiac
abnormalities
◉Subjective signs of ischemic stroke. Answer: -Decreased LOC,
dysarthria, facial droop, aphasia, diplopia, visual deficits, sensory
deficits, ataxia, hemiparesis, vertigo
◉Critical timeline info for CVA. Answer: "Last known well"
◉BE FAST. Answer: Balance, Eyes, Face, Arms, Speech, Time
◉ACA. Answer: Anterior cerebral artery
◉MCA. Answer: Middle cerebral artery
◉PCA. Answer: Posterior cerebral artery
◉Objective symptoms of ACA stroke. Answer: -Urinary incontinence;
-Speech perseveration; -Disinhibition; -Gait apraxia; -Primitive
reflexes; -Altered mental status; -Impaired judgment; -Contralateral
leg>arm weakness
, ◉Objective symptoms of MCA stroke. Answer: -Gaze preference; -
Agnosia; -Ipsilateral hemianopsia; -Contralateral
hemiparesis/hypesthesia
◉Objective symptoms of PCA stroke. Answer: -Impaired memory; -
Cortical blindness; -Altered mental status; -Contralateral
homonymous hemianopsia; -Visual agnosia
◉Visual agnosia. Answer: Inability to recognize objects
◉Contralateral homonymous hemianopsia. Answer: Loss of vision in
contralateral visual field
◉Contralateral hypesthesia. Answer: Decreased touch perception on
one side
◉Agnosia. Answer: Inability to recognize familiar objects
◉DDx for ischemic stroke. Answer: -Drug toxicity; -Brain tumors; -
Hypertensive encephalopathy; -Conversion disorder
◉Conversion disorder. Answer: Somatoform disorder with real
symptoms and no physiological basis
ANSWER SET
◉Indications of lumbar puncture. Answer: CSF sample for
examination; pressure measurements (NPH); reduction in CSF
pressure:; -infections; -SAH; -Inflammatory conditions; -MS; -
carcinomatosis; Spinal anesthetics, antitumor agents, antibiotics;
radio-opaque substance radioactive agent:; -cryptococcal
meningitis; -hydrocephalus with communication between all
ventricles; -pseudotumor cerebri; -drug administration; Imaging; -
myelography; -radionuclide cisternography
◉Contraindications of performing LP. Answer: • Increased risk of
fatal cerebellar or transtentorial herniation; • Coagulopathy; •
Infection over puncture site; • Spinal block requiring sample above
lesion
◉Common complications of lumbar puncture. Answer: -Sciatic pain
during needle insertion; -Slowing of fluid removal (elevate patient
head)
◉How is chronic meningitis diagnosed?. Answer: On LP/CSF
analysis or contrast MRI/CT showing leakage into meninges.
Meningeal biopsy if CSF not diagnostic.
,◉Differentials for chronic meningitis. Answer: -Partially treated
suppurative meningitis; -Paranmeningeal infection; -Mycobacterium
TB; -Lyme; -Syphilis; -HIV; -HSV; -Malignancy; -SLE; -Behcet's
◉Indications for swallow evaluation. Answer: -Hx of dysphasia; -
Observed dysphasia; -Suspected aspiration; -Decreased oral intake; -
Parenteral/enteral feeding
◉Medicare coverage of hospice. Answer: • Prognosis of six months
or less if illness runs normal course; • Falls under Medicare Part A
◉Three common causes of acute ischemic stroke. Answer: 1- Anoxic
injury; 2- Thrombosis in situ; 3- Thrombotic embolism
◉In ischemic stroke, what area of damage is irreversible?. Answer:
Tissue death at occluded artery (infarction core)
◉Penumbra. Answer: Area around infarct, salvageable if blood flow
restored
◉Risk factors for ischemic stroke. Answer: -Advanced age; -HTN
◉More risk factors for ischemic stroke. Answer: -HLD, DM, oral
contraceptives, obesity, prior TIAs, tobacco, MI, alcohol, sedentary
,lifestyle, sickle cell, stimulant drugs, family hx CVA, cardiac
abnormalities
◉Subjective signs of ischemic stroke. Answer: -Decreased LOC,
dysarthria, facial droop, aphasia, diplopia, visual deficits, sensory
deficits, ataxia, hemiparesis, vertigo
◉Critical timeline info for CVA. Answer: "Last known well"
◉BE FAST. Answer: Balance, Eyes, Face, Arms, Speech, Time
◉ACA. Answer: Anterior cerebral artery
◉MCA. Answer: Middle cerebral artery
◉PCA. Answer: Posterior cerebral artery
◉Objective symptoms of ACA stroke. Answer: -Urinary incontinence;
-Speech perseveration; -Disinhibition; -Gait apraxia; -Primitive
reflexes; -Altered mental status; -Impaired judgment; -Contralateral
leg>arm weakness
, ◉Objective symptoms of MCA stroke. Answer: -Gaze preference; -
Agnosia; -Ipsilateral hemianopsia; -Contralateral
hemiparesis/hypesthesia
◉Objective symptoms of PCA stroke. Answer: -Impaired memory; -
Cortical blindness; -Altered mental status; -Contralateral
homonymous hemianopsia; -Visual agnosia
◉Visual agnosia. Answer: Inability to recognize objects
◉Contralateral homonymous hemianopsia. Answer: Loss of vision in
contralateral visual field
◉Contralateral hypesthesia. Answer: Decreased touch perception on
one side
◉Agnosia. Answer: Inability to recognize familiar objects
◉DDx for ischemic stroke. Answer: -Drug toxicity; -Brain tumors; -
Hypertensive encephalopathy; -Conversion disorder
◉Conversion disorder. Answer: Somatoform disorder with real
symptoms and no physiological basis
