Chapter 17

Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of:

12

You are performing GCS on a pt who opens her eyes in response to pain, is confused in her responses to questions, and has abnormal flexion. What is this pt GCS score and corresponding state of dysfunction?

9 = moderate dysfunction.

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?

A 17-year-old male with anxiety

What is the difference between a stroke and a transient ischemic attack ?

A TIA resolves completely within 24 hours of onset.

What criteria must be met for a patient to have status epilepticus ?

A seizure that last more than 30 min.

Components of the Cincinnati Prehospital Stroke Scale include:

Arm drift, speech, and facial droop.

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to:

Ask his wife when she noticed the symptoms.

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:

Assist ventilation perform a rapid exam, and prepare for immediate transport.

What happens when blood flow to a particular part of the brain is cut off by a blockage, resulting in tissue damage?

Ischemic stroke.

Which of the following MOST accurately describes the cause of an ischemic stroke?

Blockage of a cerebral artery

Muscle control and body coordination are controlled by the:

Cerebellum

You are treating a patient who is exhibiting slurred speech, facial droop, and a inability to move his left arm. Which neurological examination emphasizes these possibles stroke signs?

Cincinnati prehospital stoke scale.

You are examining a patient whose signs include lip smacking, jerking of the left arm, and agitation. Based on these signs, what type of seizure is this pt experiencing ?

Complex partial

A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min. Treatment should include:

Dimming the lights in the back of the ambulance and transporting without lights and siren.

The anterior aspect of the cerebrum controls:

Emotion

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:

Epilepsy

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?

History of migraines

Which of the following mimics a stroke and also causes a seizure ?

Hypoglycemia does.

Which of the following conditions is NOT a common cause of seizures?

Hypotension

You are dispatched to a home where you find a 70-year-old man. He is exhibiting facial drooping and, when you ask him to tell you what day it is, he says "January." Which part of the brain is most likely to have been affected ?

Left hemisphere (Aphasia)

Which of the following medications would indicate that a patient has a history of seizures?

Levetiracetam (Keppra)

________ affect(s) the entire brain, often causing anxiety, restlessness, and confusion.

Low oxygen levels in the bloodstream

What is the name of the condition when the patient forgets about the injured side after a stroke?

Neglect

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to:

Obtain a description of how the seizure developed

Status epilepticus is characterized by

Prolonged seizures without a return of consciousness.

A generalized (tonic-clonic) seizure is characterized by:

Severe twitching of all the body's muscles.

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

Sudden severe headache

Successful treatment of a stroke depends on whether:

Thrombolytic therapy is given within 3 hours of symptoms beginning.

A patient who is experiencing aphasia is:

Unable to produce or understand speech.

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

Usually have an altered mental status or decreased level or consciousness

Which of the following is a metabolic cause for a seizure ?

hypoglycemia