Neuro K Coma

Question 1

Coma anatomy

Answer 1

Dysfunction of both hemispheres or the Reticular Activating System

Question 2

Persistent Vegitative State definition

Answer 2

Complete lack of awareness, but preservation of some autonomic function (brainstem)

Question 3

1 reason for seizure recurrence

Answer 3

Noncompliance

Question 4

Coma history -> Cause

1. Sudden Onset
2. Hemiparesis
3. Protracted downhill course
4. Preceded by confusion

Answer 4

1. Brainstem stroke, subarachnoid hemorrhage
2. Intracerebral hemorrhage
3. Tumor, Abscess, Chronic Subdural
4. Metabolic, Drugs

Question 5

Cranial nerve exit mnemonic

Answer 5

2244
2- above brainstem
2- midbrain
4- pons
4- medulla

Question 6

Pupillary constriction

Answer 6

CN 3 Midbrain

Question 7

Vestibular system

Answer 7

CN 8 Pons

Question 8

Pons lesion pupils

Answer 8

Pinpoint (para fine, sympa destroyed)

Question 9

Midbrain lesion pupils

Answer 9

Midposition, fixed

Question 10

Coma nystagmus

Answer 10

Slow deviation, no nystagmus (no frontal lobe)

Question 11

COWS

Answer 11

Opposite for comatose (mnemonic is for nystagmus, not deviation)

Question 12

Shotgun Tx for ER coma

Answer 12

Glucose, Thiamine, Naloxone

Question 13

Glasgow Coma Scale - 3 Measurements

Answer 13

1. Eyes
2. Verbal
3. Motor

Question 14

Coma time length

Answer 14

4 weeks max

Question 15

Definition of death

Answer 15

Cessation of brain function

Question 16

Coma definition

Answer 16

Not responsive, but some brainstem reflexes

Question 17

3 Findings of Brain Death

Answer 17

1. Coma
2. Absence of Brainstem reflexes
3. Apnea

Question 18

Positive apnea test

Answer 18

PCO2 > 60

Question 19

Breathing apparatus in brainstem

Answer 19

Pons & Medulla