MCQs - Unconsciousness

What is Consciousness?

Consciousness is a state of awareness of self and surrounding.

Consciousness =Arousal + Cognition

Arousal is determined by the ascending reticular activating system.

Cognition is determined by the cerebral hemispheres and interaction between the functional areas in cerebral hemispheres.

So Consciousness can be thought of as the result of interaction between the cerebral hemispheres and the reticular activating system.

So we have seen what consciousness is. We don't always think how it will be like to be unconscious. In sleep we are in a state almost similar to unconsciousness but we wake up or will be aroused on some sound, touch or light stimuli.

But people can become unconscious due to various reasons.

Brain is the control center of the central nervous system of an animal located in the skull which is responsible for perception, cognition, attention and memory

Source

What are the Reasons for Unconsciousness?

Trauma/Head Injury

Infections of the Brain

Hypoxemia

Hypoglycemia

Hyperglycemia

Toxins

Seizures

Brain edema

Brain tumor

Bleeding/hematoma formation inside the brain


Knowledge about Unconsciousness

Knowledge about unconsciousness and how to manage it can be lifesaving especially when you work in the emergency department of a hospital.

Here you find few multiple choice questions to test your knowledge about unconsciousness

Neurological Examination of the Unconscious Patient

The content of consciousness include

  • Cognitive functions

  • Emotions

  • Cognitive functions and emotions

------------------------------------------------

Answer: Cognitive functions and emotions

Which of the following functions return when the brainstem starts functioning in a comatose patient after severe head injury?

  • sleep–wake cycles

  • eye opening verbal stimuli

  • normal respiratory control

  • all of the above

---------------------------------------

Answer: all of the above

Pontine lesions affect lateral eye movement and motor control and often spare vertical eye movements and blinking in

  • Locked in syndrome

  • Psychogenic unresponsiveness

  • Stupor

  • Vegetative state

----------------------------

Answer: Locked in syndrome

What is the minimum score of Glasgo Coma Scale?

3

7

10

15

-------------------------

Answer: 3

What is the maximum score of Glasgo Coma Scale?

3

7

10

15

--------------------------

Answer: 15

Generally comas are classified as severe if Glasgow coma scale is

  • < 8

  • < 10

  • < 12

  • < 14

------------------------

Answer: < 8

Hypothermia can also be due to exposure to cold as with inadequate heated rooms in elderly. Warming has to be gradual. Blankets and warmers can be used. Some patients may require peritoneal dialysis with warm fluids.

Hypothermia in a comatose patient can be due to

  • Chlorpromazine

  • Hypopituitarism

  • Hypothyroidism

  • All of the above

--------------------------------

Answer: all of the above

Acetone odor of the breath in a comatose patient is characteristic of

  • Diabetic keto acidosis

  • Hepatic coma

  • Uremic coma

  • Alcohol intoxication

---------------------------------

Answer: Diabetic keto acidosis

Fetor hepaticus in a comatose patient is characteristic of

  • Diabetic keto acidosis

  • Hepatic coma

  • Uremic coma

  • Alcohol intoxication

---------------------------------

Answer: Hepatic coma

Urineferous odour in a comatose patient is characteristic of

  • Diabetic keto acidosis

  • Hepatic coma

  • Uremic coma

  • Alcohol intoxication

---------------------------------

Answer: Uremic coma

Moist skin in a comatose patient may be suggestive of

  • CO poisoning

  • Hypoglycemic coma

  • Endocarditis

  • Meningitis

--------------------------

Answer: Hypoglycemic coma

Bilateral pinpoint reactive pupil in a comatose patient may be suggestive of

  • Atropine infusion

  • Cerebral anoxia

  • Lesions of cranial nerve III

  • Pontine hemorrhage

------------------------------------------

Answer: Pontine hemorrhage

Immediate Management of Unconscious Patient- Important Considerations

  • Attention to the airway. Intubate if required and tracheostomy if coma is prolonged
  • Maintain the oxygen saturation >95%
  • Rapid infusion of fluids and trendelenberg position if the patient has hypotension. Ionotropes may be required if these measures fail to increase blood pressure.
  • Administer antihypertensives if there is hypertension
  • Use warming blankets if the patient has hypothermia and use cooling blankets if the patient has hyperthermia.
  • If you suspect hypoglycemia, 50 ml 50 % dextrose can be given even before the blood sugar is known.
  • Administer naloxone (0.4–2 mg every 3 min intravenously) if opioid intoxication is suspected
  • 3% hypertonic saline infusion if hyonatremia is suspected
  • Saline rehydration infusion followed by parenteral bisphosphonate pamidronate if hypercalcemia is suspected
  • Ventriculostomy to reduce raised intracranial pressure if there is hydrocephalus

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Comments 7 comments

Indian Chef profile image

Indian Chef 3 months ago from New Delhi India

Very informative hub. Thx for publishing.


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thumbi7 16 months ago from India Author

Hi Felisa Daskeo

Thanks for the visit and comment


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Felisa Daskeo 16 months ago from Manila, Philippines

Very informative hub and I learned a lesson today. I don't know the answers but at least I learned some information. Thanks for sharing.


thumbi7 profile image

thumbi7 3 years ago from India Author

Hi suzettenaples

Thanks for the visit


suzettenaples profile image

suzettenaples 3 years ago from Taos, NM

What an interesting and informative hub. I am not a doctor or know too much about the medical field. I was also able to guess a few of the answers correctly from noticing the root of the words. This was fascinating to me. I love learning about the brain and how it works. Thanks for sharing your knowledge of this area with us.


thumbi7 profile image

thumbi7 3 years ago from India Author

Hi DDE,

Thanks for the visit


DDE profile image

DDE 3 years ago from Dubrovnik, Croatia

Most informative and helpful hub on Multiple Choice Questions on Unconsciousness so many questions and such tricky answers. I had a few right still had to learn from your hub before answering the questions.

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