CNRN Exam 2024 Questions and their Correct Solutions

specific condition of small vessels that can lead to lacunar strokes - lipohyalinosis what is the greatest risk factor for lacunar strokes - hypertension tiny areas of ischemic necrosis caused by occlusion of small penetrating arteries - lacunar strokes what percentage of ischemic strokes do lacunar strokes account for - 25% what are the 5 classic syndromes of lacunar strokes - pure motor hemiparesis, ataxic hemiparesis, dysarthria/clumsy hand syndrome, pure sensory stroke, and mixed sensorimotor stroke what is the only non-pain sensitive tissue in the head/brain - brain parenchyma what is the biggest insurmountable obstacle to effective pharmacological treatments for patients with cluster headaches - cigarette smoking subdural hematomas most commonly result from what? - venous bleeding from the tearing of briding veins how is the diagnosis of DAI confirmed - clinical diagnosis, definitively dx requires microscopice examination of the brain tissue. what are classic signs of autonomic dysfunction syndrome and what's the most common intervention - hypertension, tachycardia, tachypnea, and fever---iv morphine what is the MOST common source of infection leading to brain abcesses? - hematogenous spread from distant infected sites, such as PNA, lung abscess, or bacterial endocarditis what group of people have the greatest risk of ICH? - patients with unruptured intracerebral AVM's what is the most important diagnostic test for the pt having a dull headache, superimposed ice pick sensations on the scalp, jaw claudication, and elevated ESR? - temporal artery biopsy--r/o giant cell arteritis what is a potential complication of a CSF leak in basal skull fx's? - the trapping of portions of the frontal meninges b/w the fx edges with a persistent CSF leak requiring surgical intervention what is the best way to accomplish external draining of CSF via an EVD? - drain a few drops/minute and close the drain after 5min or less what is the Tinel's sign - most frequently associated with carpel tunnel, gently tap or percuss over the injured nerve to elicit a sensation of tingling or "pins and needles" in the nerve distribution area. what is the Phalen's sign? - maneuver to diagnose carpel tunnel--hands forced dorsal sides together and wrists flexed to 90deg; positive test causes burning, tingling, or numb sensation over the thumb, index, middle and ring fingers. what is the most common cause of Erb's palsy? - dystocia or abnormal or difficult childbirth or labor what are the most common sign's of erb's palsy? - loss of sensation in the arm and paralysis and atrophy of the deltoid, biceps, and brachialis muscles. how is the management of the GI system in a SCI pt intiated in the ED? - by inserting a NGT d/t the high risk of gastric immotility resulting in distention and an ileus. what is the most common cause of a radial nerve injury - humerus fracture best treatment options for a woman in 3rd trimester of pregnancy with + Tinel's and Phalen's sign is what? - wrist splints and rehab modalities best way to prevent the development of peroneal nerve palsy in a recently immobilized pt is what? - avoiding pressure to the back of the knees during period when pt is immobilized in a recently immbolized pt, they begin to complain of burning on the top of the foot and have unilateral foot drop. what is this - peroneal nerve palsy what is the major difference b/w subdural hematoma and subdural hygroma - subdural hematoma is blood, and subdural hygroma is CSF ideal treatment for low serum Na level is what? - slow normalization w/ 3% saline