Shadow Health EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS LATEST UPDATE!!!!

EXAM

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SANS '21 '22 '22 '23 '23 '24: Trauma 2026 A+ GRADE A
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SSURED COMPLETE SOLUTIONS AND VERIFIED ANSWE zm zm zm zm zm




RS (F0987) zm




QUESTION 1 zm




(Bank #1) A LP in a pt with pseudotumor cerebri will show which of the following? -
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Elevated opening pressure -Pleocytosis -Elevated IgG index -Low glucose -High protein
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ANSWER

Elevated opening pressure. Pseudotumor cerebri is a disorder of idiopathic intracranial hypertension
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m(IIH). It often affects young, obese women who p/w H/A, papilledema, and elevated LP opening pre
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ssure. The chemical and cellular composition of the CSF is usually normal. 1st line Rx is typically ad
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ministration of acetazolamide wwo furosemide. If vision is acutely threatened, temporary CSF draina
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ge by LP or LD may allow a trial of these diuretics. Options for more permanent treatment are optic
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nerve sheath (ONS) fenestration and VPS. Although the latter is the gold standard, it's often fraught
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mw complications over time in this pt population. The venous sinuses and jugular veins should be im
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aged as stenting can be considered for stenosis as an alternative to VPS.
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QUESTION 2 zm




Which of the following tests is most appropriate for differentiating b/w a traumatic L
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P and a pre-existing SAH? -CSF protein -CSF color -CSF cell count -CSF clarity -
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CSF glucose zm




ANSWER

CSF color. Xanthochromia refers to the yellow-
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orange discoloration of CSF, most often caused by lysis of RBCs. Discoloration begins after RBCs hav
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e been in spinal fluid for about 2h. While it sometimes can be seen visually, detection of xanthrochr
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omia via spectrophotometry is the most reliable method of determining whether a SAH has occurred
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.



QUESTION 3 zm

, Which of the following is the current "gold standard" for ICP monitoring & mgt? -
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There is no gold standard for ICP monitoring. -LP -TCD -
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Fiberoptic intraparenchymal monitor -EVD w/fluid coupled pressure transducer
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ANSWER

EVD. The gold standard for ICP monitoring and mgt is the EVD with a fluid coupled pressure transd
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ucer. Fiberoptic monitors can also monitor ICP accurately, but do not allow for removal of spinal flu
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id. Fiberoptic monitors historically suffer from measurement drift and cannot be recalibrated unless
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replaced. LP allows for CSF drainage & pressure measurements in pts w/ communicating hydroceph
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alus. It is not accurate in patients with non-communicating hydrocephalus.
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QUESTION 4 zm




(Bank #1) Severe hypomagnesemia is most likely to produce which of the following? -
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Hyperkalemia -Hypotension -Ventricular arrhythmias -Hypoactive reflexes -
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Hypercalcemia
ANSWER

Ventricular arrhythmias. Discussion: Mg prevents increases in action potential duration and prolonga
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tion of membrane repolarization. These changes commonly occur after myocardial ischemia and can
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lead to ventricular arrhythmias. A-
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Fib can also be provoked by hypoMg. Magnesium causes presynaptic inhibition leading to a depressa
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nt effect on the CNS. HypoMg results in renal potassium loss and also suppresses PTH hormone rele
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ase and activity. HypoMg therefore often occurs in conjunction w/hypokalemia & hypocalcemia. Hyp
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oMg can be associated w/HTN rather than HoTN. References: 1. Agus MS, Agus ZS. Cardiovascular a
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ctions of magnesium. Crit Care Clin. 2001 Jan;17(1):175-86. 2. Handb Clin Neurol. 2017;141:705-713.
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QUESTION 5 zm




The mean arterial blood pressure (MAP) at normal resting heart rate is best approxi
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mated by which of the following formulas, where SBP is the systolic pressure and DBP
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the diastolic pressure? -MAP = DBP + 1/4(SBP-DBP) -MAP = SBP - 1/2(DBP) -
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MAP = DBP + 1/3(SBP-DBP) -MAP = DBP + 1/2(SBP-DBP) -MAP = SBP - 1/3(DBP)
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ANSWER

MAP = DBP + 1/3(SBP-
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DBP). MAP is average arterial pressure throughout 1 cardiac cycle (systole and diastole). MAP is infl
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uenced by CO and SVR. Most commonly used formula to estimate MAP is: MAP = DBP + 1/3(SBP-
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DBP), where SBP = systolic blood pressure and DBP = diastolic blood pressure.
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QUESTION 6 zm




What are the (5) 'high risk factors for neurosurgical intervention' to get CTH followin
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g CHI?
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ANSWER