AG ACNP Review set 4 Questions and Answers
Spinal Cord Trauma: Management Correct Ans-Methylprednisolone 30mg/kg IV bolus,
followed by an infusion of 5.4mg/kg/hr for 23 hours improves neurologic recovery when
administed within 8 hours of injury
Referral: Neurology/Neurosurgery
Spinal Cord Trauma: Signs and Symptoms
C4 or above Correct Ans-Quadriplegia, may require mechanical ventilation
Spinal Cord Trauma: Signs and Symptoms
C4-C5 Correct Ans-Quadriplegia, control of head, neck, shoulders, trapezius and elbow
flexion
Spinal Cord Trauma: Signs and Symptoms
C5-C6 Correct Ans-Quadriplegia, some extension of wrist, index finger and thumb
Spinal Cord Trauma: Signs and Symptoms
C6-C7 Correct Ans-Elbow extension, capable of feeding, dressing
Spinal Cord Trauma: Signs and Symptoms
C7-T1 Correct Ans-Hand Movement
,Spinal Cord Trauma: Signs and Symptoms
L1-L2 Correct Ans-Lower legs, feet and perineum, continued bowel, bladder and sexual
dysfunction if S2-S4 spinal nerves involved.
Spinal Cord Trauma: Signs and Symptoms
T1-T2 Correct Ans-Paraplegis, upper extemity control but no turnk control
Spinal Cord Trauma: Signs and Symptoms
T11-L1 Correct Ans-Most leg and some foot movemtn, ambulationpossible
Spinal Cord Trauma: Signs and Symptoms
T3-T8 Correct Ans-Some trunk control
Spinal Cord Trauma: Signs and Symptoms
T9-T10 Correct Ans-Bowel and bladder reflex, moves trunk and upper thigh
Status Asthmaticus Correct Ans-Term used to describe severe, acute ashma presenting in an
unremitting poorly responsive, life threatening manner. Clinical findings are not reliable
indicators of the severity of asthma.
Status Asthmaticus: Management Correct Ans-Oxygen, IV D5 1/2NS
Inhalation & parenteral sympathomimetics
Methylprednisolone 60-125mg or hydrocortisone 300mg IV immediately
,Consider Atrovent
Monitor pulse ox continuously
Monitor ABG Q10-20 minutes
Intubate
Subsequent Seizure Prevention Correct Ans-Maintenance doses of long-acting anti-
convulsants
Carbamazepine (Tegretol) Phenytoin (Dilantin)
Phenobarbital (Luminal) Valproic acid (Depakene)
Primidone (Mysoline) Clonazepan (Klonopin)
Dosages should be titrated
Discontinuance should be tapered and never abruptly withdraw
Systemic Lupus Erythematosus (SLE) Correct Ans-Multisystem, inflammatory autoimmune
disorder that affects primarily women of childbearing age
Systemic Lupus Erythematosus (SLE): Lab/Diagnostics Correct Ans-ANA (+) in 95% of
patients
Antiphospholipid antibodies
Anemia, leukopenia, and thromocytopenia are often present
Systemic Lupus Erythematosus (SLE): Management Correct Ans-For mild symptoms: bed
rest, midafternoon naps, avoidance of fatigue, sun protection
, Topical glucocorticoid for isolated skin lesions
NSAIDs, hydroxychloroquine, glucocorticoids and other therapies (DMARTS)
Systemic Lupus Erythematosus (SLE): Signs and Symptoms Correct Ans-Fever, Anorexia,
Malaise, Weight Loss, Butterfly Rash (<50%)
Fingertip lesions, Periungal erythema, Splinter hemorrhages, Alopecia, Raynaud;s phenomenon
in 20% of patients
Joint symptoms often early manifestation, Photosensitivity, Vasculitis, Nephritis, Ocular
manifestations, Pericardial manifestations, Pulmonary manifestations, Abdominal pains, ileus,
peritonitis
Systemic Vascular resistance Correct Ans-The resistance provided by the systemic circulation
against which the left ventricle must pump blood calculated by the following formula (MAP-
mean CVP X 80) / CO, normal is 800-1200 dynes/sec/cm-5
Transient Ischemic Attack (TIA) Correct Ans-Periods of acute cerebral insufficiency lasting
less than 24 hours without an residual deficits. Most resolve in 3 hours
Transient Ischemic Attack (TIA): Causes/General Concepts Correct Ans-Ischemia due
atherosclerosis, thrombus, arterial occulsion, embolus, intracerbral hemorrhage
Cardio-embolic events such as atrial fib, acute MI, endocarditis, valve disease
TIA is indicative of impeding stroke
Approximately 1/3 of patients with TIA will experience cerebral infarction within 5 years
Spinal Cord Trauma: Management Correct Ans-Methylprednisolone 30mg/kg IV bolus,
followed by an infusion of 5.4mg/kg/hr for 23 hours improves neurologic recovery when
administed within 8 hours of injury
Referral: Neurology/Neurosurgery
Spinal Cord Trauma: Signs and Symptoms
C4 or above Correct Ans-Quadriplegia, may require mechanical ventilation
Spinal Cord Trauma: Signs and Symptoms
C4-C5 Correct Ans-Quadriplegia, control of head, neck, shoulders, trapezius and elbow
flexion
Spinal Cord Trauma: Signs and Symptoms
C5-C6 Correct Ans-Quadriplegia, some extension of wrist, index finger and thumb
Spinal Cord Trauma: Signs and Symptoms
C6-C7 Correct Ans-Elbow extension, capable of feeding, dressing
Spinal Cord Trauma: Signs and Symptoms
C7-T1 Correct Ans-Hand Movement
,Spinal Cord Trauma: Signs and Symptoms
L1-L2 Correct Ans-Lower legs, feet and perineum, continued bowel, bladder and sexual
dysfunction if S2-S4 spinal nerves involved.
Spinal Cord Trauma: Signs and Symptoms
T1-T2 Correct Ans-Paraplegis, upper extemity control but no turnk control
Spinal Cord Trauma: Signs and Symptoms
T11-L1 Correct Ans-Most leg and some foot movemtn, ambulationpossible
Spinal Cord Trauma: Signs and Symptoms
T3-T8 Correct Ans-Some trunk control
Spinal Cord Trauma: Signs and Symptoms
T9-T10 Correct Ans-Bowel and bladder reflex, moves trunk and upper thigh
Status Asthmaticus Correct Ans-Term used to describe severe, acute ashma presenting in an
unremitting poorly responsive, life threatening manner. Clinical findings are not reliable
indicators of the severity of asthma.
Status Asthmaticus: Management Correct Ans-Oxygen, IV D5 1/2NS
Inhalation & parenteral sympathomimetics
Methylprednisolone 60-125mg or hydrocortisone 300mg IV immediately
,Consider Atrovent
Monitor pulse ox continuously
Monitor ABG Q10-20 minutes
Intubate
Subsequent Seizure Prevention Correct Ans-Maintenance doses of long-acting anti-
convulsants
Carbamazepine (Tegretol) Phenytoin (Dilantin)
Phenobarbital (Luminal) Valproic acid (Depakene)
Primidone (Mysoline) Clonazepan (Klonopin)
Dosages should be titrated
Discontinuance should be tapered and never abruptly withdraw
Systemic Lupus Erythematosus (SLE) Correct Ans-Multisystem, inflammatory autoimmune
disorder that affects primarily women of childbearing age
Systemic Lupus Erythematosus (SLE): Lab/Diagnostics Correct Ans-ANA (+) in 95% of
patients
Antiphospholipid antibodies
Anemia, leukopenia, and thromocytopenia are often present
Systemic Lupus Erythematosus (SLE): Management Correct Ans-For mild symptoms: bed
rest, midafternoon naps, avoidance of fatigue, sun protection
, Topical glucocorticoid for isolated skin lesions
NSAIDs, hydroxychloroquine, glucocorticoids and other therapies (DMARTS)
Systemic Lupus Erythematosus (SLE): Signs and Symptoms Correct Ans-Fever, Anorexia,
Malaise, Weight Loss, Butterfly Rash (<50%)
Fingertip lesions, Periungal erythema, Splinter hemorrhages, Alopecia, Raynaud;s phenomenon
in 20% of patients
Joint symptoms often early manifestation, Photosensitivity, Vasculitis, Nephritis, Ocular
manifestations, Pericardial manifestations, Pulmonary manifestations, Abdominal pains, ileus,
peritonitis
Systemic Vascular resistance Correct Ans-The resistance provided by the systemic circulation
against which the left ventricle must pump blood calculated by the following formula (MAP-
mean CVP X 80) / CO, normal is 800-1200 dynes/sec/cm-5
Transient Ischemic Attack (TIA) Correct Ans-Periods of acute cerebral insufficiency lasting
less than 24 hours without an residual deficits. Most resolve in 3 hours
Transient Ischemic Attack (TIA): Causes/General Concepts Correct Ans-Ischemia due
atherosclerosis, thrombus, arterial occulsion, embolus, intracerbral hemorrhage
Cardio-embolic events such as atrial fib, acute MI, endocarditis, valve disease
TIA is indicative of impeding stroke
Approximately 1/3 of patients with TIA will experience cerebral infarction within 5 years
