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Flashcards in seizures, Cohen I Deck (46)
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1
Q
% population that will lose consciousness at least once in lifetime
A
50%
2
Q
found down
A
slang loss of consciousness
3
Q
syncope
A
loss of consciousness from lack of blood flow to brain
4
Q
faint
A
syncope likely vaso vagal
due to bradycardia and hypotension via vagus nerve
5
Q
seizure
A
neurological changes due to a sudden electrical discharge in brain
6
Q
important questions for someone who lost consciousness
A
light headedness, dizziness, loss of vision, nausea, sweating, pallor or gray color, shaking or convulsion, open or closed eyes, standing or lying or sitting positions, unprotected fall or gradual
duration of unconsciousness
speed of recovery to normal consciousness
previous LOC?
7
Q
consciousness requires
A
functioning brain stem and one cerebral hemisphere
8
Q
brain is absolutely dependent on
A
minimum blood pressure
glucose concentration
partial P of O2
9
Q
what to make sure to measure in patient who suffers syncope
A
EKG
10
Q
Vaso vagal syncope is caused by combination of
A
sympathetic withdrawal (vasodilation)
increased PAN activity (bradycardia)
11
Q
vaso vagal syncope precipitated by
A
-hot or crowded environment, ETOH, extreme fatigue, severe pain, hunger, prolonged standing, emotional or stressful situation
- church services, funerals, athletic activities
- blood drawing, insertion of IV line, dental work
12
Q
period unconsciousness in vaso vagal syncope
A
less than a minute
full recovery within 5 minutes
13
Q
patient Sx vaso vagal syncope
A
cold and sweaty
light and woozy dizzy
vision dims
voice muffled
ears ring
palpitations
difficulty breathing
nausea
increased perspiration
numbness in hands
14
Q
do vaso vagal syncope patients bite tongue or have urinary incontinence
A
no
15
Q
CV syncope
A
decreased/insufficient CO caused by arrhythmias or structural cardiac abnormality
16
Q
cardiac arrhythmias that can lead to CV syncope
A
bradyarrhythmias
tachyarrhythmias
17
Q
structural cardiac abnormality that can cause CV syncope
A
L ventricular myocardial path of various causes caused dec motility
flow obstruction
18
Q
stroke volume impairments causing CV syncope
A
aortic stenosis
idiopathic subaortic hypertrophic cardiomyopathy
mitral valve prolapse
19
Q
common cause syncope and sudden death in high school and college athletes
A
idiopathic subaortic hypertrophic cardiomyopathy
20
Q
very common cause CV syncope in young women
A
mitral valve prolapse
21
Q
cough syncope
A
repeated coughing
may increase thoracic P and lower venous return to right atrium
22
Q
micturition syncope
A
elderly patients
almost always men who stand to urinate late at night
LOC due to vagal response needed to urinate in patients who are sleepy
23
Q
other disorders that may resemble syncope
A
hypoglycemia
anemia
hypoxia
diminished CO2 d/t hyperventilation
anxiety attacks
hysterical fainting
seizure
24
Q
seizure
A
widespread electrical discharge originating in neurons in cerebral Cx causing abrupt loss or decline in consciousness, new movements, altered bodily sensation or unusual psychic feeling
25
Q
what mediates seizures
A
ion channels
Na K Ca and NT
glutamate, GABA
26
Q
Epilepsy
A
2+ spontaneous seziures
unprovoked!!
27
Q
Lunatic definition
A
patient with seizure once a mo
28
Q
preferred term to epileptics
A
seizure disorder
29
Q
2 most common causes of provoked seizures
A
1 hypoglycemia
2 alcohol withdrawal (less than 48 hours after stopped drinking)
30
Q
common causes provoked seizures
A
hypoNa, hypoMg, hypoCa
hypoxia
fever
benzo withdrawal
illicit drugs
prescription drugs
head trauma
brain tumors
brain hemorrhages
strokes
31
Q
idiopathic epilepsies
A
have seizures for unknown reasons
32
Q
patient with first seizures should be evaluated for
A
full Hx
physical exam
neuro exam
MRI of brain and full blood tests
33
Q
Dx seizure disorder
A
unless strong evidence from Hx, due to reliable witnesses of 2+ unprovoked seizures
34
Q
can seizure patient have normal EEG
A
yes
35
Q
partial seizure
A
1 cerebral hemisphere "focal"
36
Q
generalized tonic clonic seizure
A
grand mal
37
Q
status epilepticus
A
1 seizure after another
38
Q
when do generalized tonic clonic seizures begin
A
adolescence and in 20s
never in infants <5 mo
39
Q
before tonic clonic seizure
A
aura
40
Q
tonic phase of generalized seizure
A
clenching or tightening of mm in fixed position
arms flexed, legs extended
breathing mm can lock
mouth can close quickly causing biting of tongue or lip
loss of urinary and rarely bowel continence
41
Q
eyes roll up and open at start of seizure
A
tonic clonic seizure
42
Q
clonic phase generalized seizure
A
repetitive synchronous movements of the arms and or legs
43
Q
tonic clonic seizure time duration
A
lasts 2 minutes with gradual slowing of movements
respiration resumes
unresponsive for 5+ minutes
slowly gain orientation after
no memory of seizure
may be combative or agitated at time
44
Q
post ictal seizure
A
confusion for hours after tonic clonic seizure
45
Q
vitals for tonic clonic seizures
A
HR increase
O2 saturated
BP increase
pupils dilate no reaction to light
metabolic acidosis with decline in HCO3
46
Q
Todds paralysis
A
patients remain weak on one side for another day due to seizures focus itself