T3 - Probs of CNS (Brain) (Josh) Flashcards Preview

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Flashcards in T3 - Probs of CNS (Brain) (Josh) Deck (64)
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1

Risk factors for Headaches

ETOH

Environmental allergies

Meds

Intense odors / bright lights

Fatigue / Sleep Depr.

Depression

Emotional/Physical Stress; Anxiety

Menstrual Cycle; Oral Contraceptive use

Foods

2

Which foods increase risk for headaches?

Tyramine
- aged cheese, meats, etc

Caffiene

MSG

Nitrites

Milk products

3

Describe the characteristics of a Migraine Headache.

Intense, UNILATERAL pain

Worsens w/ mvmt

Photophobia or Phonophobia

4

What are the categories of a Migraine?

Aura (classic migraine)

No Aura (most common)

Atypical

5

What are the Phases of an Aura Migraine?

Prodrome

Aura

Termination

6

How long does a No Aura Migraine last?

How long does an Atypical Migraine last?

4-72 hrs

longer than 72 hrs

7

What are characteristics of a Cluster Headache?

Trigeminal Autonomic Cephalalgia

Brief, Intense, UNILATERAL pain

Non-throbbing or BORING pain

30 mins to 2 hrs in length

Occurs daily for 4-12 wks

No warning

8

What is the patho of a Cluster Headache?

vasoreactivity and neruogenic inflammation

9

Which headache?

- Tearing of eye w/ nasal congestion

- Facial sweating

Drooping eyelid (ptosis) and eyelid edema

- Miosis

- Facial pallor

- N/V

- Pacing, walking, and rocking activities

Cluster Headache

10

What meds for Abortive treatment for Migraine?

Mild
- Acetaminophen
- NSAIDs (ibuprofen; naproxen)
- Migraine specific OTC formulations
- Antiemetics

Severe
- Triptans
- Ergotamines
- Isometheptenes

11

Which meds for Preventive treatment for Migraine?

NSAIDs

Beta Blockers (propanolol; timolol)

CCBs (verapamil)

Antiepileptics (topiramate

Avoiding triggers

12

What non-pharmacological treatments for Migraines?

O2 Therapy (100% for short time)

Complimentary and Alternative Therapy (yoga, etc)

Consistent sleep/wake cycle

Review triggers such as bursts of anger or excessive physical activity

Deep brain stimulation or surgery as last resort

13

Triggers for Migraines.

Tyramine foods (pickles, caffeine, ETOH, aged cheese, artificial sweeteners, NUTS)

MSGs

Meds
- Ranitidine
- Estrogen
- Nitro
- Nifedipine

Anger

Lack of sleep/rest

14

Triggers for Cluster Headaches.

Anger outburst

Anxiety w/ prolonged anticipation

Excessive physical activity; fatigue

Altered sleep-wake cycles

15

What are the different types of Generalized Seizures?

Tonic-Clonic

Tonic

Clonic

Absence

Myoclonic

Atonic

16

Characteristics of a Tonic-Clonic Seizure.

Both cerebral hemispheres

2-5 mins

Loss of consciousness

Incontinent

Biting of Tongue

Post-ictal period with fatigue, lethargy, and confusion

17

What is the Tonic stage and what is the Clonic stage?

Tonic = abrupt increase in muscle tone with loss of consciousness

Clonic = muscle contraction and relaxation

18

Which seizure involves staring off in space (looks like day-dreaming) and happens in kids?

Absence

19

Which seizure involves brief jerking or stiffening of extremities?

Myoclonic

20

Which seizure involves a sudden loss of muscle tone?

Atonic

21

What are the two classifications of Partial Seizures?

Complex Partial

Simple Partial

22

Characteristics of a Complex Partial Seizure?

Loss of consciousness for 1-3 mins

Automatisms can occur

Amnesia post seizure

AKA: Psychomotor or Temporal Lobe Seizures

***more common in older adults

23

Characteristics of Simple Partial Seizure?

Remains CONSCIOUS throughout

Aura may occur

One sided mvmt in extremities

Unusual sensations (DEJA VU)

Can have autonomic symptoms

Pain or offensive smell

24

Risk factors for Seizures

Metabolic Disorders

Acute ETOH withdrawal

Electrolyte disturbances

Heart Disease

High Fever

Stroke

Substance Abuse

25

What are some meds we can give for an Acute Seizure?

Lorazepam (ativan)

Diazepam (valium)

Diastat

IV Phenytoin or Fophenytoin

26

Which med is the DOC for acute Seizure treatment?

Lorazepam (Ativan)

***can be given IV
***few s/e than Diazepam

27

What do we need to remember about Phenytoin?

don't administer w/ Warfarin

28

What is Status Epilepticus?

prolonged seizure (5-30 mins) or repeated seizures over course of 30 mins

29

What is emergency treatment for Status Epilepticus?

Establish Airway

ABGs

IV push of lorazepam (or diazepam)

Rectal diazepam

Loading dose of IV Phenytoin

30

Which type of Meningitis is most common?

Bacterial (due to overcrowded living conditions)