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Neurology NP
Info & Q: NP EXAM
| Question | Answer |
|---|---|
| Most headaches are primary or secondary? | Primary |
| Headache Red Flag: Neck stiffness think? | Meningitis |
| Headache Red Flag: Papilledema, blurred disc margin, swelling of the optic nerve think? | Increased Intracranial Pressure |
| Elderly pts that present with new onset of severe headache there is increase risk that it is primary or secondary? | Secondary so they will require 1. thorough neuro exam 2. expensive testing |
| Tension headaches typically are unilateral or bilateral? | Bilateral |
| The two most important factors in establishing a headache diagnosis is? | 1. History of the Headache 2. Family history of Headache |
| Migraine HA are more common in male or female? | Female |
| Migraine HA are more often unilateral or bilateral? | Unilateral |
| Migraine HA might be described as crescendo which means? | Gradual onset getting worse |
| Migraine HA associated symptoms include: | 1. N&V 2. Aura 3. Photophobia (light) 4. Phonophobia (sound) |
| What is prodrome? | The symptoms hours or days before that lead up to the Headache |
| Migraine HA usually last about how long? | 4 to 72 hours |
| What is postdrome? | The symptons that occur after the Headache |
| What are the first line drugs to tx Migraine HA? | 1. NSAID 2. ASA 3. Acetominophin |
| During a Migraine HA what happens to the cerebral arteries? | They dilate |
| Mechanism of action for triptans? | Vasoconstriction |
| What is the oldest triptan on the market? | Imitrex |
| What is other class of drug is good to give with a triptan for the treatment of Headaches? | NSAID |
| What are 2 typical pts we should be very cautious when RX triptans to Headaches and Why? | 1. Cardiac pts because triptans vasoconstrict 2. Psych pts because of serotonin syndrome |
| When pts need prophylaxis tx for Migraine HA we should use what? | 1. Beta Blockers (lol) 2. Calcium Channel Blockers (dipine) |
| HA accompanied by cloudy vision and eye pain think? | Glaucoma |
| Why do we do an eye exam on pt with c/o HA? | Looking for papilledema which might indicate increased intracranial pressure |
| Cluster HA are unilateral or bilateral? | Unilateral |
| Cluster HA last about how long? | 30 to 90 minutes |
| Cluster HA affect which nerve? | CN V: Trigeminal Nerve |
| Tension HA are unilateral or bilateral? | Bilateral |
| Tension HA characteristics include? | 1. pressure 2. tightness 3. bandlike |
| What is the classic triad for meningitis? | 1. Fever 2. Altered mental status 3. Nuchal Rigidity 4. HA |
| When you see nuchal rigidity think? | Meningitis |
| Anybody in your office that may have been exposed to meningitis should take what for prophylaxis? | 1. Ciprofloxacin if not pregnant 2. Rifampin |
| What is the name of the vaccine for meningitis? | Menactra |
| If a pt present with c/o of low back pain and incontinence think? | ER - cauda equina syndrome |
| MRIs are good for assessing? | 1. soft tissue that stays still |
| CTs are good for assessing? | 1. a cavity 2. something that moves that can't stop; ie chest |
| When assessing low back pain that radiates we think sciatica, do this test to assess for nerve root compression which means a disc problem. | 1. Straight leg raise to assess L4/L5 and L5/S1 2. Positive confirms |
| A pt with a hx of TIA should take what prophylactic? | ASA daily |
| Which Cranial Nerves are responsible for eye movement? | CN III: Oculomotor CN IV: Trochlear CN VI: Abducens |
| Which Cranial Nerve is for vision? | CN II: Optic |
| Which condition increases the risk of TIA; atrial fib or v-tach? | 1. Atrial fib yes 2. Vtach death |
| A pt c/o HA but misses his appt then calls you for meds, what should you do? | Get more info because it is cheap, quick and noninvasive |
| A pt c/o HA associated with vomiting but has no nausea, you should think this diff dx and do assessment test? | 1. increased intracranial pressure 2. fundoscopic exam |
| A pt with Bell's palsy may not be able to do what? | blink |
| Drug-Drug Interaction: Ciprofloxacin and ? | 1. theophylline (increase theophylline level) 2. coumadin (increase bleed time) 3. sevelamer (reduce the absorption of cipro - milk and OJ will reduce absorp also) |
Created by:
dprest
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