A 45-year-old male patient present to the emergency department with a severe head injury following a car accident. His Glasgow Coma Scale (GCS) score is 8, and he shows signs of increased intracranial pressure (ICP). Which of the following interventions should be prioritized to manage his ICP?
Administering mannitol intravenously
Encouraging the patient to hyperventilate
Administering a high-dose corticosteroid
Performing a lumbar puncture immediately
The Correct Answer is A
A. Administering mannitol intravenously: Mannitol is an osmotic diuretic that helps reduce ICP by drawing fluid out of brain tissue and decreasing cerebral edema, making it a priority intervention.
B. Encouraging the patient to hyperventilate: Controlled hyperventilation may reduce ICP temporarily by lowering CO₂ levels and causing cerebral vasoconstriction. However, it should only be done cautiously under close monitoring, and other ICP management techniques like mannitol administration take priority.
C. Administering a high-dose corticosteroid: Corticosteroids are generally ineffective for reducing ICP in traumatic brain injury and are typically not recommended in this scenario.
D. Performing a lumbar puncture immediately: Lumbar puncture is contraindicated in cases of increased ICP because it may lead to brain herniation due to the sudden release of pressure.
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Related Questions
Correct Answer is A
Explanation
A. Otosclerosis. Otosclerosis is a common cause of conductive hearing loss, typically due to abnormal bone growth around the stapes in the middle ear.
B. Acoustic neuroma. Acoustic neuroma is associated with sensorineural hearing loss, not conductive hearing loss.
C. Meniere's disease. Meniere's disease usually causes sensorineural hearing loss, often accompanied by vertigo and tinnitus.
D. Presbycusis. Presbycusis is age-related sensorineural hearing loss and does not result in conductive hearing loss.
Correct Answer is D
Explanation
A. Include high-fat foods to maintain weight. High-fat foods can worsen symptoms in ulcerative colitis by increasing bowel irritation and causing malabsorption. A balanced diet that is low in fat is usually recommended.
B. Eat three large meals a day to ensure adequate nutrition. Large meals can increase digestive workload and exacerbate symptoms. Smaller, more frequent meals are generally better tolerated.
C. Increase intake of dairy products to boost calcium levels. Many patients with ulcerative colitis are lactose intolerant or sensitive to dairy, which can worsen symptoms. Calcium can be obtained from other sources if needed.
D. Consume a low-fiber diet to minimize bowel irritation. A low-fiber diet can reduce mechanical irritation in the bowel, which is beneficial during flare-ups of ulcerative colitis.
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