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BMB Test 3 > B7-053 CBCL Seizures > Flashcards

B7-053 CBCL Seizures Flashcards

1
Q

involuntary synchronous stiffening of the limbs

A

tonic convulsion

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2
Q

involuntary synchronous semi-rhythmic movements of the limbs

A

clonic convulsion

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3
Q

[…] is often associated with a brief convulsion

A

syncope

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4
Q

syncope due to convulsion is usually caused by

A

transient hypotension

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5
Q

[seizure or convulsive syncope]
prolonged standing

A

convulsive syncope

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6
Q

[seizure or convulsive syncope]
valsalva

A

convulsive syncope

(straining for bowel movement/urination)

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7
Q

[seizure or convulsive syncope]
in response to pain, blood

A

convulsive syncope

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8
Q

[seizure or convulsive syncope]
tunnel vision, distant hearing

A

convulsive syncope

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9
Q

[seizure or convulsive syncope]
focal onset

A

seizure

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10
Q

[seizure or convulsive syncope]
tongue biting on side

A

seizure

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11
Q

[seizure or convulsive syncope]
prolonged unconsciousness

A

seizure

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12
Q

[seizure or convulsive syncope]
postictal confusion

A

seizure

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13
Q

[seizure or convulsive syncope]
incontinence

A

seizure

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14
Q

types of focal onset seizures [3]

A

focal onset with retained awareness
focal onset with impaired awareness
focal onset to bilateral tonic-clonic

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15
Q

broad classifications of seizures based on manifestations [3]

A

simple motor seizure
complex movement or behavior seizure
auras

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16
Q

types of generalized onset seizures [2]

A

motor: tonic-clonic (grand mal), myoclonic

nonmotor: absences (petite mal)

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17
Q

[…] seizures do not have auras

A

generalized

(focal might, but generalized does not)

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18
Q

types of unknown onset seizures [3]

A

motor
nonmotor
unclassified

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19
Q

intrinsic tendency of the brain to have seizures

A

epilepsy

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20
Q

[…] or more unprovoked seizures constitutes a diagnosis of epilepsy

A

two

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21
Q

seizures typically onset […] after ischemic stroke

A

1 year

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22
Q

about 20% of patients will develop […] following ischemic stroke

A

epilepsy

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23
Q

focal onset seizures
localized EEG abnormalities
usually acquired

A

focal epilepsies

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24
Q

if they find the scar causing focal epilepsy it is called

A

non-cryptogenic

(if they don’t find it, it is called cryptogenic)

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25
Q

the typical cause of focal epilepsies in middle age patients is

A

tumor

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26
Q

the typical cause of focal epilepsies in elderly patients is

A

old stroke

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27
Q

temporal lobe focal epilepsy that starts in the hippocampus is called

A

mesial temporal sclerosis

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28
Q

frontal lobe focal epilepsy that starts in the motor cortex is called

A

supplementary motor

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29
Q

types of focal epilepsies [4]

A

temporal lobe
frontal lobe
parietal lobe
occipital lobe

(temporal and frontal are more common)

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30
Q

common visible causes of focal epilepsies [3]

A

post traumatic scarring
tumor
old stroke

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31
Q

generalized onset seizures
bilateral symmetric EEG abnormalities
often genetic

A

generalized epilepsy

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32
Q

genetic generalized epilepsies [3]

A

childhood absence
juvenile absence
juvenile myoclonic epilepsy

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33
Q

causes of generalized epilepsy due to severe brain damage at a young age [2]

A

infantile spasms
Lennox-Gaustaut syndrome

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34
Q

treatments for patients refractive to epileptic drugs [2]

A

epilepsy surgery
electrical stimulation of nervous system

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35
Q

drugs that only prevent either focal onset or generalized onset seizures are called

A

narrow spectrum

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36
Q

drugs that only prevent both focal onset and generalized onset seizures are called

A

broad spectrum

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37
Q

only narrow spectrum drug for generalized epilepsy

A

ethosuximide

(other narrow spectrums are for focal)

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38
Q

modifies synaptic release of GABA by binding to SV2A

A

levtriracetam

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39
Q

inhibit T-type Ca+ channels [2]

A

ethosuximide
valproic acid

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40
Q

drugs that tend to be efficacious for absence seizures [2]

A

ethosuximide
valproic acid

(inhibit T-type Ca+ channels)

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41
Q

decrease excitatory neurotransmission by binding to voltage gate Ca++ channels [1]

A

gabapentin

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42
Q

what type of seizure is associated with abnormal T-type calcium channel activity?

A

absence

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43
Q

increases the affinity of GABA receptors for GABA, which increases the likelihood of channel opening

A

benzos

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44
Q

DOC for status epilepticus

A

benzos

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45
Q

effective for 2-3 weeks due to tolerance to anticonvulsant effects

limited to short term treatment

A

benzos

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46
Q

bind to binding site on GABA to increase channel open time

A

barbituates

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47
Q

DOC of tonic-clonic seizures [2]

A

barbiturates
valproic acid

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48
Q

abrupt withdrawal can precipitate status epilepticus

A

phenobarbital

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49
Q

prolongs inactivation of Na+ channels and decreases glutamate release

50
Q

DOC for tonic-clonic and partial seizures
less sedating than barbiturates

51
Q

why should you initially order phenytoin at low doses?

A

zero order kinetics

(small dose increases cause large changes in toxicity and concentration)

52
Q

why is phenytoin debatable as a first line choice? [2]

A

extensive side effect profile
zero order kinetics

53
Q

increases inactivation of Na+ channels and decreases release of glutamate

A

carbamazepine

54
Q

DOC for partial seizures
relatively safe and non-toxic

A

carbamazepine

55
Q

binds to synaptic vesicular protein SV2A

A

levetiracetam

56
Q

effective in refractory partial seizures when used in combination with other drugs

A

gabapentin

57
Q

DOC for absence seizures [2]

A

ethosuximide
valproic acid

58
Q

which drug should be used in a epilepsy patient with bipolar disorder?

A

lamotrigine

59
Q

which drug should be used in a epilepsy patient with recurrent migrains?

A

topiramate

60
Q

common side effects of phenytoin [2]

A

gait ataxia
nystagmus

61
Q

common side effects of carbamazepine/oxcarbazepine [2]

A

double vision
hyponatremia

62
Q

common side effects of lamotrigine [2]

63
Q

common side effects of levetiracetam [1]

A

irritability

64
Q

common side effects of valproic acid [2]

A

teratogen
tremor

65
Q

breakthrough seizures are commonly caused by [3]

A

non-adherence
intercurrent infection
drug interaction

66
Q

liver enzyme inducers [3]

A

phenytoin
phenobarbital
carbamazepine

(increase oral contraceptive metabolism)

67
Q

liver enzyme inhibitor

A

valproic acid

68
Q

medications that lower the seizure threshold

A

tramadol
buproprion
penicillin, cephalosporins, metronidazole
cyclosporin/tacrilimus
stimulants

69
Q

when should surgical treatment of epilepsy be considered?

A

patients who have failed greater than three seizure medications

70
Q

what type of seizures are an indication for surgical treatment of epilepsy?

A

focal

(resection of epileptogenic zone)

71
Q

most common causes of seizure due to electrolyte imbalance [2]

A

hyponatremia
hypokalemia

72
Q

when can a patient drive following seizure in Kansas?

A

must be seizure free for at least 6 months

73
Q

aura represents the […] of seizure

74
Q

valproic acid is a […] spectrum antiepileptic drug

75
Q

ethosuximide is a […] spectrum antiepileptic drug

76
Q

one of the first side effects of phenytoin toxicity

77
Q

a small change in […] dosage can have large effects on serum drug levels

A

phenytoin

(zero order kinetics)

78
Q

cerebral edema is associated with what electrolyte imbalance?

A

hyponatremia

79
Q

common cause of seizure in diabetic patients

A

hypoglycemia

80
Q

first line treatment of acute seizures

81
Q

benzodiazepines target […] receptors

82
Q

next best step for a patient with intractable epilepsy who has failed several medications

A

epilepsy surgery evaluation

83
Q

appropriate dose of benzodiazepines for status epilepticus

84
Q

[…] and […] form the core workup of patients with suspected epilepsy

A

EEG
MRI brain

85
Q

seizures with a predominant laughing semiology

A

gelastic seizures

(caused by hypothalamic hamartoma in kids)

86
Q

considered the most efficacious medication for generalized epilepsy

A

valproic acid

87
Q

which medication should be used with caution in women of child bearing age due to the risk of teratogenicity?

A

valproic acid

88
Q

SJS is a side effect of

A

lamotrigine

89
Q

carbamazepine is a […] spectrum antiseizure medication

90
Q

childhood […] epilepsy can be mistaken for ADHD

91
Q

a clinical test of […] can support a diagnosis of childhood absence epilepsy

A

hyperventilation

92
Q

new onset seizures later in adulthood should raise suspicion for

A

brain tumor

93
Q

test that can be used to confirm a diagnosis of epilepsy, but doesn’t tell you etiology

94
Q

imaging modality more sensitive for brain tumors

95
Q

subacute onset of confusion with clinically observable seizures in the temporal lobe

A

herpes encephalitis

(order LP to confirm, treat empirically with antibiotics)

96
Q

lamotrigine is a […] spectrum antiseizure medication

97
Q

decreases glutamate release via SV2A

A

levetiracetam

98
Q

most common cause of breakthrough seizures

A

medication non-adherence

99
Q

has dual use in migraine control

A

topiramate

100
Q

has dual use in the treatment of bipolar disorder

A

lamotrigine

101
Q

common side effect of levetiracetam

A

agitiation

102
Q

hyponatremia can be a side effect of what antiseizure medication?

A

carbamazepin/oxcarbazepine

103
Q

focal seizures most commonly originate in the […] lobe

A

medial temporal

104
Q

continuous (>5 min) or recurring seizures without interictal return to baseline consciousness that may result in brain injury

A

status epilepticus

105
Q

most common causes of seizures in children <18

A

genetic
infection (febrile)
trauma
congenital
metabolic

106
Q

most common causes of seizures 18-65

A

tumor
trauma
stroke
infection

107
Q

most common causes of seizures >65

A

stroke
tumor
trauma
metabolic
infection

108
Q

disorder of recurrent, unprovoked seizures

109
Q

3 Hz spike and wave discharges

A

absence seizures

110
Q

short and frequent episodes of blank stare, no postictal confusion

A

absence seizures

111
Q

can be triggered by hyperventilation

A

absence seizures

112
Q

quick, repetitive jerks
no loss of consciousness

113
Q

alternating stiffening and movement
postictal confusion
urinary incontinence
tongue biting

A

tonic-clonic

114
Q

carbamazepine is a […] spectrum seizure medication for […] seizures

A

narrow
focal

115
Q

gabapentin is a […] spectrum seizure medication for […] seizures

A

narrow
focal

116
Q

penytoin is a […] spectrum seizure medication for […] seizures

A

narrow
focal

117
Q

ethosuximide is a […] spectrum seizure medication for […] seizures

A

narrow
absence

(only narrow spectrum for generalized seizures)

118
Q

valproate is a […] spectrum seizure medication

119
Q

lamotrigine is a […] spectrum seizure medication

120
Q

levetiracetam is a […] spectrum seizure medication

121
Q

topiramate is a […] spectrum seizure medication

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