Order Neurological Disease In Pregnancy

Order Neurological Disease In Pregnancy
Order 5978039
Order Neurological Disease In Pregnancy
1. A 31-year-old female who is 34 weeks pregnant is involved in a high-speed RTA. She
is immobilized by paramedics at the scene
and transferred to your emergency department. She is GCS 15/15 but becomes hypotensive and tachycardic. What action would
you take immediately?
a. Place in left lateral position
b. Manually push the uterus to the left
c. Start a vasopressor
d. Intermittent fetal monitoring
e. Continuous cardiotocography
f. Fetal blood sampling
2. Which one of the following is a major potential risk to the fetus exposed to MRI
sequences employing time-varying gradient
electromagnetic fields?
a. Developmental delay
b. Acoustic noise damage
c. Magnetophosphenes
d. Peripheral nerve and muscle stimulation
e. Implant
3. A 31-year-old female who is 28 weeks pregnant presents to your emergency department
with a self-terminating tonic-clonic seizure
and currently has postictal confusion. She is
under close monitoring for her hypertension
and proteinuria. Which one of the following
would you administer first?
a. Lorazepam
b. Diazepam
c. Valproate
d. Magnesium
e. Phenytoin
f. Levetiracetam
4. Women with aneurysmal subarachnoid hemorrhage 10 weeks pregnant and oculomotor
palsy. She agrees to DSA and coil embolization
and the aneurysm is secured. Postoperatively
she asks about the possibility of terminating
her fetus due to the probable harmful effects
of the radiation exposure required in her treatment. Which one of the following actions
would you take in the first instance?
a. Organize a medical termination while she
is still an inpatient
b. Explain that the likely dose was much
lower than the generally accepted threshold for causing fetal harm
c. Recommend amniocentesis
d. Advise her to discuss the risks with a
medical physicist
e. Arrange an obstetric review
EXTENDED MATCHING ITEM (EMI)
QUESTIONS
Order Neurological Disease In Pregnancy
5. Shunt malfunction in pregnancy:
a. Cesarean section under epidural anesthesia
b. Cesarean section under GA
c. CT or MRI during pregnancy
d. Induced hypocarbia
e. Magnesium sulfate
f. Preconception CT or MRI
g. Prophylactic antibiotics
h. Revision of ventriculoperitoneal shunt
i. Shunt tap for pressure and CSF MCS
j. Vaginal delivery with assisted second
stage
k. Ventriculoatrial shunt or third
ventriculostomy
For each of the following descriptions, select the
most appropriate answers from the list above.
Each answer may be used once, more than once
or not at all:
1. A 32-year-old with VP shunt placement
8 years ago for hydrocephalus following
foramen magnum decompression is considering pregnancy.
2. A 36-year-old with VP shunt is undergoing
a planned vaginal delivery with assisted
second stage.
3. A 23-year-old with VP shunt develops
headache, nausea, vomiting and a single
generalized tonic-clonic seizure which
self-terminates after 1 min. She does not
have a pre-existing diagnosis of epilepsy
and is not on antiepileptics. Blood pressure
is 140/90 and urine dip shows 2 leukocytes, negative nitrites, no ketones and no
protein.
6. Neurological disease in pregnancy:
a. Cerebral venous sinus thrombosis
b. Choriocarcinoma
c. Chorea gravidarum
d. Idiopathic intracranial hypertension
e. Lymphocytic hypophysitis
f. Lymphoma
g. Pituitary macroadenoma
h. Pre-eclampsia/Eclampsia
i. Reversible posterior leukoencephalopathy syndrome
j. Sheehan’s syndrome
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