Neurological Disorders - Medical

Question 1

What type of stroke are seizures associated with?

Answer 1

Hemorrhagic

Question 2

What is a Coma?

Answer 2

A deep state of unconsciousness. Patient cannot be aroused by external stimuli

Question 3

What are the six general causes of a coma?

Answer 3

Structural, metabolic, drugs, cardiovascular, respiratory, infection

Question 4

What causes a structural coma

Answer 4

Tumours, abscesses, and pressure from bleeding encroach on the RAS in brain

Question 5

What causes a toxic coma?

Answer 5

Presence of circulating toxins, metabolites or lack of oxygen and glucose. Progressive deterioration. Hypoglycaemia, sepsis, drugs

Question 6

What are some examples of structural causes of a coma?

Answer 6

Inter cranial bleeding, head trauma, brain tumours

Question 7

What are some examples of metabolic causes for coma?

Answer 7

Anoxia, hypoglycaemia, diabetic keto acidosis, thiamine deficiency, kidney and liver failure.

Question 8

What are some drugs that may induce coma?

Answer 8

Barbiturates, narcotics, Hallucinogens (interfere with neurotransmitter), depressants, alcohol.

Question 9

What is a Barbiturate?

Answer 9

Sedative or anesthetic drug

Question 10

What are some examples of narcotics that can induce coma

Answer 10

Morphine, fentanyl

Question 11

How might the cardiovascular system induce a coma

Answer 11

Dysthymia, shock, stroke, hypertensive encephalopathy (sudden raise in BP with headache nausea, seizures )

Question 12

How might the respiratory system induce a coma

Answer 12

COPD (irregular levels of co2/o2), toxic inhalation

Question 13

How might infection induce a coma?

Answer 13

Meningitis (bacterial-fatal, or viral- slow and recoverable), sepsis

Question 14

What does the pneumonic AEIOU TIPS stand for?

Answer 14

The causes for coma;
ACIDOSIS, ALCOHOL
EPILEPSY
INFECTION
OVERDOSE
UREMIA
TRAUMA
INSULIN
PSYCHOSIS
STROKE

Question 15

What does CVA stand for?

Answer 15

Cerebral vascular accident

Question 16

What is a CVA

Answer 16

Sudden alteration in level of consciousness, sensation, and/ or voluntary movement due to obstruction or rupture of an artery in the brain.

Question 17

What are the modifiable risk factors for a stroke?

Answer 17

Hypertension, cigarette smoking, TIA, heart disease, diabetes, high cholesterol

Question 18

What are some non-modifiable risk factors for a stroke?

Answer 18

Age, gender, race, prior strokes, genetics, hypercoagulopathy, high RBC

Question 19

What are the complications of a hemorrhagic stroke?

Answer 19

Rapidly fatal, can’t stop the bleed - often associated with a seizure

Question 20

What are the characteristics of an ischemic stroke?

Answer 20

Blood clot/blockage, rarely lethal in first hour, 80-85% of strokes, clot buster meds (6 hour!)

Question 21

Signs and Symptoms of an ischemic stroke?

Answer 21

hemiplegia, aphasia, numbness, confusion, convulsions, incontinence, double vision, slurred speech, headache, dizziness

Question 22

What is the difference between a throbus and an embolus

Answer 22

thrombus is a blood clot, embolus is an obstruction due to a mass of undissolved matter lodging in a vessel

Question 23

What are some causes of cerebral embolus?

Answer 23

air embolism after thoracic surgery, fat embolism after long bone injuries, gas embolus (diving)

Question 24

What is a TIA

Answer 24

Transient ischemic attack, temporary reduction in blood flow. Lasts minutes to 2 hours, recovery in 24 hours

Question 25

S/S of TIA

Answer 25

related to location of ischemia, weakness, paralysis, numbness in face, speech disturbances,

Question 26

What are some assessments for stroke?

Answer 26

arm/leg drift, smile test, slurred speech, pupils

Question 27

How does a paramedic manage a stroke pt

Answer 27

stroke protocol, ABC, position supine with head elevated, assessment, history collection

Question 28

What 3 things does the LAMS scorecard evaluate?

Answer 28

facial droop, arm drift, grip strength

Question 29

In simplest terms, what is a Seizure?

Answer 29

brain hyperactivity. A temporary alteration in behavior of consciousness caused by the abnormal electrical activity at one or more groups of neurons in the brain

Question 30

What are the 2 types of seizures

Answer 30

Generalized; entire brain, Partial: known focus

Question 31

What is a petit Mal seizure

Answer 31

lapse of consciousness in(often) 4-12 y/o, short lived, no loss of motor activity/posture

Question 32

What is a Tonic Clonic Seizure

Answer 32

Grand Mal, two phases, sudden onset with loss of organized muscle tone

Question 33

What are the characteristics of the tonic phase?

Answer 33

ext. muscle tone activity, flexion, apnea, tongue biting, incontinence (short duration)

Question 34

What are the characteristics of the clonic phase in grand mal?

Answer 34

rigidity then relaxation, convulsions, 1-3 minute, massive ANS discharge- hyperventilation salivation, tachycardia

Question 35

What are the characteristics of postictal phase of Grand Mal

Answer 35

Drowsiness or unconsciousness, Lasts minutes to hours, Followed by confusion and fatigue, Transient neurological deficits

Question 36

What is status Epilepticus

Answer 36

prolonged seizure activity, re occurring before recovery.

Question 37

What is a Simple Partial seizure

Answer 37

Motor (one part of body) or sensory(tingling, numbness, visual, auditory taste, no LOC, may lead to generalized

Question 38

What is a Jacksonian seizure

Answer 38

seizure with brief alteration in movement, sensation or nerve function. head twitches, word repeating, lip smacking

Question 39

What is a complex partial seizure?

Answer 39

arise from focal seizure in temporal lobe. Changes in behavior. preceded by an aura, abnormal repetitive motor behavior, period of amnesia, brief

Question 40

What is the assessment for seizures?

Answer 40

Status on arrival, history of seizures and other significant factors, description of seizure (Onset duration, pattern events prior), head trauma, fever, headache

Question 41

What are the drugs used for Seizures

Answer 41

Dilantin, Valium, Ativan, Versed