Week 10: Neurological Conditions

Question 1

Define fitting

Answer 1

A period of involuntary muscular convulsion, often followed by a period of profound lethargy, confusion and sleep

Question 2

What are the two types of fitting?

Answer 2

• epileptiform
• non- epileptiform

Question 3

Define epileptiform

Answer 3

Spike or sharp wave activity or other rhythmic waveforms, causing epilepsy

Question 4

Define non-epileptiform

Answer 4

Similar symptoms of an epileptic seizure without any unusual electrical activity in the brain often caused by mental stress or physical condition

Question 5

What are the different causes of a fit?

Answer 5

• generalised
• partial

Question 6

Define generalised

Answer 6

both sides of the brain are used from outset

Question 7

Define partial

Answer 7

Localised area of the brain

Question 8

What are some risks of prolonged seizures

Answer 8

• permanent brain damage
• death
• apnea
• occluded airway
• heart rhythm (bradycardia, tachycardia, ictal asystole)

Question 9

After how long is a seizure considered long?

Answer 9

5 minutes

Question 10

What are the 4 stages of a seizure?

Answer 10

• aura stage
• tonic stage
• clonic stage
• postical stage

Question 11

What are the different types of generalised seizure?

Answer 11

• tonic clonic
• tonic
• atonic
• abscences

Question 12

Define tonic clonic

Answer 12

Rigid, falls, jerks

Question 13

Define tonic

Answer 13

Rigid, falls, but no jerking

Question 14

Define atonic

Answer 14

Sudden loss of muscle tone (drop attack)

Question 15

Define abscences

Answer 15

Brief interruption, blank staring

Question 16

What are the two partial/focal seizure types:

Answer 16

• simple
• complex

Question 17

Define simple

Answer 17

Remain conscious, pins and needles, unusual taste/smell or some other sensory disturbance, localised jerking/sometimes a slight twitch

Question 18

Define complex

Answer 18

Alteration of consciousness, pluck at clothing, fiddle with objects, act confused, lip smacking, chewing, undressing, appear intoxicated

Question 19

What is secondary generalised?

Answer 19

Partial evolves into generalised

Question 20

What symptoms/causes are there of non-epileptiform seizures?

Answer 20

• febrile convulsions
• cardiac arrêt in adults
• hypoglycaemia
• hypoxia
• stoke
• tumour

Question 21

What is alcohol withdrawal seizures?

Answer 21

When someone consumes a lot of alcohol, or when someone whose body is used to having alcohol regularly and suddenly stop or changes their drinking, the brain may react and trigger a seizure

Question 22

What are some treatments for alcohol withdrawal seizures?

Answer 22

Benzodiazepines such as diazepam

Question 23

What is the assessment for a seizure?

Answer 23

• ABCD
• history- head injury/infection
• assess mouth/tongue, any incontinence
• raised temp or rash
• any arrhythmia

Question 24

What is the management for seizures?

Answer 24

• CABCDE
• high flow O2 15L/100%
• lie patient down
• loosen tight clothing
• remove harmful objects
• do not restrain movements
• do not put anything in mouth
• IV access
• use own patient buccal midazolam
• rectal diazepam
• allow the to recover
• take medication to hospital
• Obs
• ATMIST

Question 25

Define a stroke

Answer 25

A stroke is classically characterised as neurological defecit attributed to an acute focal injury of the CNS

Question 26

What are the two different types of stroke?

Answer 26

Transient ischemic attack (TIA) and Cerebrovascular accident (CVA)

Question 27

What is a TIA?

Answer 27

An acute loss of cerebral or ocular function with symptoms lasting less than 24 hours

Question 28

What is a TIA caused by?

Answer 28

An inadequate cerebral or ocular blood supply as a result of low blood flow, ischaemia, or embolism with the disease of the blood vessels, heart or blood

Question 29

Does a TIA cause permanent damage?

Answer 29

A TIA is a temporary interruption in blood flow to an area of the brain that does not last long enough to cause permanent damage to the brain

Question 30

What is a CVA?

Answer 30

Loss of blood flow to the brain, which damages the brain tissue

Question 31

What is a CVA caused by?

Answer 31

Caused by blood clots and broken blood vessels in the brain

Question 32

What can a CVA lead to?

Answer 32

Life changing disabilities or death

Question 33

How are strokes classified?

Answer 33

By their main causes as either ischaemic (most common) or haemorrhagic

Question 34

What is a ischemic stroke?

Answer 34

Obstruction blocks blood flow to part of the brain causing an area to be deprived of blood

Question 35

What causes a hemorrhagic stroke?

Answer 35

Weakened vessel wall ruptures causing bleeding in the brain

Question 36

What are the risk factors of a stroke?

Answer 36

- age - being male - heredity - heart disease - diabetes - smoking etc

Question 37

What are some conditions that can also look like a stroke?

Answer 37

- seizures - migraines - hypo/hyperglycemia - ms/bells palsy/parkinsons - brain tumours - sepsis - trauma

Question 38

What test is used to detect a stroke?

Answer 38

FAST test

Question 39

What does the FAST test look for?

Answer 39

- facial weakness - arm weakness - speech problems - time

Question 40

How long max should you stay on scene if a stroke is suspected?

Answer 40

Less than 25 minutes

Question 41

What should you do if suspected stroke?

Answer 41

- monitor with a 3 lead cardiac monitor to see for arrhythmia - pre alert for patient who were last seen well within 10 hours/ woke up with a stroke

Question 42

What is meningitis?

Answer 42

The meninges covering the brain and spinal cord are infected by bacteria causing inflammation

Question 43

What is septicaemia?

Answer 43

Bacteria in the bloodstream, produces a clinical indication of shock. Deterioration can be rapid, early recognition and prompt treatment improves clinical outcomes

Question 44

What are symtpoms of meningitis?

Answer 44

- irritability - flu like symptoms - neck stiffness - photophobia - haemorrhagic rash - cold mottled skin - reduced O2 saturation - tachycardia - painful joints, muscles and limbs - headaches - seizures - D&V - drowsiness and confusion

Question 45

What is Parkinsons ?

Answer 45

Parkinsons is a disease caused by a loss of nerve cells in the brain, a reduction of dopamine is responsible for the many symptoms of parkinsons

Question 46

What must you make sure if taking a patient with parkinsons into hospital?

Answer 46

That they take their medication as it is imperative that it is taken at the same time of day.