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Clin med exam 2 > Seizures and Syncope > Flashcards

Seizures and Syncope Flashcards

1
Q

Syncope

A

means losing consciousness/passing out/fainting

the whole brain does not get blood

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2
Q

___ is the most common cause of fainting

A

vasovagal

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3
Q

Vasovagal

A

when brain overreacts to a trigger

brain shuts down heart (neurocardiogenic syncope)

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4
Q

Triggers for vasovagal syncope

A

a lot

emotional stress
blood being drawn or sight of blood 
fear 
gastrointestinal illness
bowel movements 
heat 
pain 
standing for a long time 
standing up quickly 
trauma
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5
Q

What is the most common cause of syncope in younger adults?

A

vasovagal

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6
Q

Vasovagal warning features

A 
diaphoresis (excessive sweating) 
tunnel vision 
dizziness/light headed
turning pale 
nausea
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7
Q

Shaking/jerking caused by syncope is called

A

convulsive syncope

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8
Q

How long before bouncing back to normal after syncope?

A

5 min

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9
Q

Vasovagal tx

A 
avoid triggers 
hydration 
volume expanders like fludrocortisone (steroid)- conserve fluids
vasoconstrictors like midodrine 
SSRIs in some pts
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10
Q

Orthostatic hypotension

A

pass out after standing up

get dizzy when standing

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11
Q

Orthostatic hypotension symptoms

A

pots- postural orthostatic tachycardia syndrome

dizziness 
heat palpitations 
sweating 
chest pain 
fatigue 
sob
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12
Q

Orthostatic hypotension causes

A

hypovolemia-
cardiac impairment
vasodilation

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13
Q

Postural hypotension

A

drop in systolic BP by 20 or diastolic by 10 after standing for 3 min

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14
Q

What can cause syncope?

A

Medications

cardiac (arrhythmia)

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15
Q

What test tests for POTS

A

tilt table test

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16
Q

Carotid sinus syncope

A

common in elderly

slowing of HR and fall in BP
poor blood perfusion

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17
Q

Myoclonus =

A

muscle jerk

seizure meds can make it worst

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18
Q

Epilepsy is most commonly diagnosed by what ages?

A

before 20

after 65

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19
Q

Epilepsy means at least __ seizures

A

2

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20
Q

Seizure types

A

partial (small, remains conscious)

complex (confused, lose consciousness)

generalized= tonic clonic (all over, unconsciousness)

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21
Q

Temporal lobe seizure symptoms cause

A

nausea and deja vu

22
Q

Frontal lob seizures cause

A

personality changes

23
Q

Generalized tonic- clonic seizure phases

A

tonic- shift

clonic- shake

post-ictal confusional fatigue- out

24
Q

Seizures typically have ___ symptoms for at least 15 minutes

A

post-ictal (post seizure)

25
Q

Seizures can result in

A

tongue biting

incontinence

26
Q

_____ is weakness after a seizure

A

Postictal paralysis (Todd’s)

27
Q

____ is when seizures last more than 5 minutes

A

status epilepticus

28
Q

What should you do when someone has a seizure?

A

Roll on side

keep things away

2-3 minutes

29
Q

Generalized tonic- clonic seizure causes

A 
brain tumor
trauma 
alcohol or drugs
low glucose, calcium or magnesium 
stroke
30
Q

What should be ordered for new onset seizure patients?

A

MRI brain with and without gadolinium

-gliobastoma can cause seizures

31
Q

What can causes seizures?

A

anything that scars the brain

ischemic strokes
head bleeds
tumors
hippocampal sclerosis 
atrophy 
tbi
32
Q

EEGs can ____ but cannot ____

A

can catch a seizure disorder

cannot rule out a seizure

33
Q

Low ___, ____, and ____ can cause seizures

A

sodium
magnesium
calcium

NOT potassium

34
Q

_________ are spells associated with emotional situations

A

psychogenic non epileptic seizures

events correlate with normal EEG activity

it is not faking a seizure !- it is how brain processes stress

35
Q

How long to seizures typically last?

A

1-3 min

36
Q

What type of seizure is the most common?

A

Partial

then generalized and nonepileptic

37
Q

Eyes in stokes vs seizures

A

in strokes eyes are away from stroke side

in seizures eyes are toward seizing side

38
Q

What three questions can you ask patients that have a breakthrough seizure?

A

miss doses of medications?

how has sleep been?

changes in stress?

39
Q

What medications can cause seizures?

A

wellbutrin (bupropion)
abx
tramadol

40
Q

Seizure tx starts after ____

A

2 spells

41
Q

What medication is great for headaches and seizures?

A

topiramate (topamax)

se: forget words

42
Q

What seizure med is good for clinic but slow for hospitals

A

Lamictal (lamotrigine)- great med for mood and IQ

se: itchy rash

43
Q

What seizure med is good in hospitals because it works fast and does not hurt

A

Keppra (levetiracetam)

se: makes you cranky and depressed

44
Q

What meds are used in pregnancy for seizures?

A

Keppra (levetiracetam)

Lamictal (lamotrigine)

45
Q

What med if effective for seizures but causes weight gain?

A

Valproic acid (depakote)

not good in pregnancy

46
Q

What med is good for trigeminal neuralgia and seizures?

A

carbamazepine/ tegretol

47
Q

What medications are typically not strong enough for seizures?

A

Gabapentin and lyrica (pregabalin)

se: leg swelling

48
Q

What meds are band-aids for seizures but fast?

A

benzos (ativan/lorazepam) and valium/midazolam

49
Q

What is used in the ICU for seizures?

A

propofol

versed (midazolam) drip

50
Q

What med helps with seizures and essential tumors?

A

primidone

51
Q

What works like a pacemaker that stops seizures?

A

vagus nerve stimulator

Clin med exam 2 (12 decks)

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