ADVANCED PHARMACOLOGY NSG 533 CORE EXAM
MANUAL QUESTIONS AND ANSWERS RATED A+
✔✔Cerebral Perfusion Pressure - ✔✔CPP = MAP - ICP Normal = 50-150. Less than 50
is not adequate for cerebral perfusion. Will be reduced by an increase in ICP.
✔✔Intracranial hypotension - ✔✔loss of CSF volume. Can result in sagging of brain
tissue away from the skull (CSF provides support in ventricles) damage to bridging
veins and dura, hemorrhage
✔✔Intracranial Hypertension - ✔✔ICP > 15-20mmHg. Sustained ICP >20-25mmHg
warrants treatment, ICP >40 is severe and life threatening.
✔✔Cerebral edema - ✔✔swelling of the brain; can be caused by osmotic changes
(acute hyponatremia), hypertensive encephalopathy, tumor related, cytotoxic, acute
ischemic stroke, hepatic failure
✔✔Herniation - ✔✔shift in brain tissue from one compartment to another caused by
pressure differences between compartments.
✔✔Subfalcine (cingulate) herniation - ✔✔herniation syndrome
lateral displacement of frontal or parietal lobe across the Falx; may see contralateral or
ipsilateral leg weakness; may compress anterior cerebral artery
✔✔Uncal Herniation - ✔✔intracranial hypertension, medial temporal lobe pushes
through tentorium cerebelli
✔✔Central Herniation - ✔✔Movement of the diencephalon, midbrain, and pons
inferiorly, caused by a lesion in the cerebrum, exerting pressure on the diencephalon.
This movement stretches the branches of the basilar artery, causing brainstem ischemia
and edema. If uncorrected will see dilated pupils, loss of brainstem reflexes due to
transtentorial herniation
✔✔Tonsillar Herniation - ✔✔cerebellum thru foramen magnum; kills by resp/cv
depression
✔✔Meningitis - ✔✔inflammation of the meninges covering brain and spinal cord
✔✔viral meningitis - ✔✔aseptic meningitis; lower mortality rate; 90% enteroviruses:
coxsackie virus, echo virus, fecal /oral route, respiratory: peak in summer and fall
months
✔✔Bacterial Meningitis - ✔✔inflammation of the protective membranes covering the
brain and spinal cord caused by various types of bacteria. Life threatening neurological
, emergency; patients can present in septic shock; endotoxin and inflammatory mediators
initiate a CSF inflammatory response and edema formation; see increased ICP,
reduction in cerebral perfusion and/or brain death
✔✔encephalitis - ✔✔inflammation of the brain (usually by virus, herpes)
✔✔mylitis - ✔✔infection/inflammation of the spinal cord
✔✔ventriculitis - ✔✔inflammation of the ventricles of the brain
✔✔Neisseria meningitidis - ✔✔bacteria; common cause for meningitis in adults
✔✔H. influenzae - ✔✔bacteria; common cause for meningitis in neonates
✔✔Viral CSF - ✔✔normal glucose, normal/high protein, few mononuclear cells
✔✔Bacterial CSF - ✔✔low glucose, high protein, many mononuclear cells
✔✔Infectious Signs of Meningitis - ✔✔Fever, tachycardia, chills
✔✔meningeal irritation signs - ✔✔severe throbbing headache, severe photophobia,
nuchal rigidity, positive kernigs/brudzinski signs
✔✔Neurologic signs of meningitis - ✔✔Focal signs, ↓ in consciousness, CN palsies,
seizures
✔✔seizure - ✔✔sudden, transient disturbances in brain function resulting from an
abnormal firing of nerve impulses d/t increased excitatory synaptic neurotransmitters
(glutamate++, aspartate); Ionic excitation with inflow of Na, Ca+++ may or may not be
associated with convulsion
✔✔Hippocampal sclerosis - ✔✔temporal lobe epilepsy; loss of neurons in Ammon's
horn of the hippocampus; unclear cause possibly related to birth or early childhood
trauma or multiple seizures; elevated glutamate causes damage
✔✔temporal lobe epilepsy - ✔✔seizures begin in the temporal lobe of the brain;
refractory to treatment; due to HS, tumor, cortical dysplasia, vascular malformations or
unable to determine
✔✔simple partial seizure - ✔✔a partial seizure, starting from a focus and remaining
localized, that does not produce loss of consciousness: motor or sensory
✔✔Simple complex seizure - ✔✔partial seizure that may produce loss of
consciousness; temporal lobe origin or causes secondary generalization
MANUAL QUESTIONS AND ANSWERS RATED A+
✔✔Cerebral Perfusion Pressure - ✔✔CPP = MAP - ICP Normal = 50-150. Less than 50
is not adequate for cerebral perfusion. Will be reduced by an increase in ICP.
✔✔Intracranial hypotension - ✔✔loss of CSF volume. Can result in sagging of brain
tissue away from the skull (CSF provides support in ventricles) damage to bridging
veins and dura, hemorrhage
✔✔Intracranial Hypertension - ✔✔ICP > 15-20mmHg. Sustained ICP >20-25mmHg
warrants treatment, ICP >40 is severe and life threatening.
✔✔Cerebral edema - ✔✔swelling of the brain; can be caused by osmotic changes
(acute hyponatremia), hypertensive encephalopathy, tumor related, cytotoxic, acute
ischemic stroke, hepatic failure
✔✔Herniation - ✔✔shift in brain tissue from one compartment to another caused by
pressure differences between compartments.
✔✔Subfalcine (cingulate) herniation - ✔✔herniation syndrome
lateral displacement of frontal or parietal lobe across the Falx; may see contralateral or
ipsilateral leg weakness; may compress anterior cerebral artery
✔✔Uncal Herniation - ✔✔intracranial hypertension, medial temporal lobe pushes
through tentorium cerebelli
✔✔Central Herniation - ✔✔Movement of the diencephalon, midbrain, and pons
inferiorly, caused by a lesion in the cerebrum, exerting pressure on the diencephalon.
This movement stretches the branches of the basilar artery, causing brainstem ischemia
and edema. If uncorrected will see dilated pupils, loss of brainstem reflexes due to
transtentorial herniation
✔✔Tonsillar Herniation - ✔✔cerebellum thru foramen magnum; kills by resp/cv
depression
✔✔Meningitis - ✔✔inflammation of the meninges covering brain and spinal cord
✔✔viral meningitis - ✔✔aseptic meningitis; lower mortality rate; 90% enteroviruses:
coxsackie virus, echo virus, fecal /oral route, respiratory: peak in summer and fall
months
✔✔Bacterial Meningitis - ✔✔inflammation of the protective membranes covering the
brain and spinal cord caused by various types of bacteria. Life threatening neurological
, emergency; patients can present in septic shock; endotoxin and inflammatory mediators
initiate a CSF inflammatory response and edema formation; see increased ICP,
reduction in cerebral perfusion and/or brain death
✔✔encephalitis - ✔✔inflammation of the brain (usually by virus, herpes)
✔✔mylitis - ✔✔infection/inflammation of the spinal cord
✔✔ventriculitis - ✔✔inflammation of the ventricles of the brain
✔✔Neisseria meningitidis - ✔✔bacteria; common cause for meningitis in adults
✔✔H. influenzae - ✔✔bacteria; common cause for meningitis in neonates
✔✔Viral CSF - ✔✔normal glucose, normal/high protein, few mononuclear cells
✔✔Bacterial CSF - ✔✔low glucose, high protein, many mononuclear cells
✔✔Infectious Signs of Meningitis - ✔✔Fever, tachycardia, chills
✔✔meningeal irritation signs - ✔✔severe throbbing headache, severe photophobia,
nuchal rigidity, positive kernigs/brudzinski signs
✔✔Neurologic signs of meningitis - ✔✔Focal signs, ↓ in consciousness, CN palsies,
seizures
✔✔seizure - ✔✔sudden, transient disturbances in brain function resulting from an
abnormal firing of nerve impulses d/t increased excitatory synaptic neurotransmitters
(glutamate++, aspartate); Ionic excitation with inflow of Na, Ca+++ may or may not be
associated with convulsion
✔✔Hippocampal sclerosis - ✔✔temporal lobe epilepsy; loss of neurons in Ammon's
horn of the hippocampus; unclear cause possibly related to birth or early childhood
trauma or multiple seizures; elevated glutamate causes damage
✔✔temporal lobe epilepsy - ✔✔seizures begin in the temporal lobe of the brain;
refractory to treatment; due to HS, tumor, cortical dysplasia, vascular malformations or
unable to determine
✔✔simple partial seizure - ✔✔a partial seizure, starting from a focus and remaining
localized, that does not produce loss of consciousness: motor or sensory
✔✔Simple complex seizure - ✔✔partial seizure that may produce loss of
consciousness; temporal lobe origin or causes secondary generalization
