Neuro Dunphy Assessment Exam Questions and Answers

Neuro Dunphy Assessment Exam Questions and Answers Viral Meningitis Defined - Answer-An inflammation of the membranes (meninges) surrounding your brain and spinal cord caused by virus infants<1 yr, children 5-10yrs Viral Meningitis Subjective - Answer-a. HA, N/V, Neck stiffness, fever, photophobia b. Nuchal rigidity, Brudsinski's sign ( knee to head with neck bend), Protein mildly elevated in CSF ( 50-250 vs >250 in Bacterial), WBC 5-100, CSF Glucose normal. c. Enterovirus: most common fecal-oral, GI tract, attacks CNS in warm months, (Less common: HSV2, HIV Arbovrius- West Nile, St Louis, East/west Equine encephalitis - Mosquito bite. Meds, Malignancy, sex ( syphilis) d. Supportive care, hydration, antipyretics, Bacterial Meningitis Defined - Answer-An inflammation of the membranes (meninges) surrounding your brain and spinal cord caused by bacteria Bacterial Meningitis Subjective - Answer-a. High fever, mental status changes, nuchal rigidity, Photophobia,N/V, Rash(palpable purpura), Arthritis, Abnormal # of WBCs in CSF b. Strep Pneumo, Neisseria Meningitidis, Listeria (50-60yr's, immunodificient), Haemophilus Influenzae (Staph in hospital nosocomial) c. Physical: Bulging Fontanelles: Hydrocephalus, loss of vision/ hearing, Hemorrhagic Adrenitis: bleeding into adrenals- adrenal fail. CSF:WBC>1000, Protein elevated, ½ norm glucose level ( <40mg/dl) d. After Blood Cx's obtained, and positive gram stain from CSF: Begin Vancomycin + Rocephin or other ( 3rd gen Cephalsporin) add Dexamethasone to reduce Hear/vision loss) , True medical emergency: Generalized Seizures Defined - Answer-Both sides of brain yielding one or more characteristics: Tonic (increased tone) Clonic (Jerking motion) Myoclonic seizures Absence seizures Defined - Answer-staring spells, atonic Partial/Focal Seizures Defined - Answer-Originates in one part of brain. Simple ( may remain conscious, sudden sense of emotional change) or Complex: LOC/ altered consciousness, lip smacking.