Clin Med: Neuro III Flashcards
(40 cards)
1
Q
How is epilepsy defined?
A
2 or more unprovoked seizures more than 24 hrs apart
2
Q
A
3
Q
A
4
Q
A
5
Q
A
6
Q
A
7
Q
A
8
Q
A
9
Q
Non pharm tx for epilepsy
A
avoidance of triggers
- sleep deprivation
- caffeine
- fever
- alcohol
10
Q
1st line drug for focal seizures
A
- Carbamazepine/Oxcarbazepine
- Lamotrigine
- Phenytoin
11
Q
1st line drugs for absence seizures
A
Ethosuximide
12
Q
1st line drug for tonic-clonic seizures
A
- Lamictal
- Levetiracetam
13
Q
Define status epilepticus
A
seizure that last >5mins or multiple seizures in a row w/ incomplete recovery in b/t
14
Q
1st line tx for status epilepticus
A
IV diazepam (or lorazepam)
15
Q
2nd line tx for status epilepticus
A
fosphenytoin or phenytoin
16
Q
3rd line tx for status epilepticus
A
barbiturates
17
Q
4th line/refractory tx for status epilepticus
A
propofol
18
Q
Bact
A
19
Q
A
20
Q
A
21
Q
A
22
Q
A
23
Q
When is a PE sign seen with a specific bacterial meningitis?
A
Meningococcal meningitis
- rash
24
Q
CT prior to lumbar puncture if:
A
- immunocompromised
- hx of CNS dz (such as stroke, mass lesion, focal infx)
- papilledema
- focal neurologic deficit
- new onset seizure ≤ 1 wk prior to presentation
- abnormal level of consciousness
25
What is a normal ICP?
20 mmHg
26
CSF analysis: Bacterial
Opening pressure:
Appearance:
Protein:
Glucose:
Gram stain:
Glucose CSF ratio:
WBC:
Opening pressure:
Appearance:
Protein:
Glucose:
Gram stain:
Glucose CSF ratio:
WBC:
27
Opening pressure:
Appearance:
Protein:
Glucose:
Gram stain:
Glucose CSF ratio:
WBC:
Opening pressure:
Appearance:
Protein:
Glucose:
Gram stain:
Glucose CSF ratio:
WBC:
28
Opening pressure:
Appearance:
Protein:
Glucose:
Gram stain:
Glucose CSF ratio:
WBC:
Opening pressure:
Appearance:
Protein:
Glucose:
Gram stain:
Glucose CSF ratio:
WBC:
29
Opening pressure:
Appearance:
Protein:
Glucose:
Gram stain:
Glucose CSF ratio:
WBC:
Opening pressure:
Appearance:
Protein:
Glucose:
Gram stain:
Glucose CSF ratio:
WBC:
30
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32
33
34
35
Empiric Tx given in bacterial meningitis to decr risk of hearing loss & mortality
Dexamethasone
36
What else should be managed w/ bacterial meningitis?
- fluid & electrolytes
- (+/-) ICP monitoring
37
Who should receive the meningococcal vaccine?
- 11 & 12 yo
- booster at 16 yo
38
Which adults should receive the meningococcal vaccine?
- no spleen
- HIV
- microbiologist
- travel to place where it is common
- population at incr risk
- close courters (college military)
39
40
Prophylaxis Tx for Meningococcal meningitis
**- Ciprofloxacin (adults only)**
- Rifampin (all ages)
