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Neuro - Pathology > Black-outs > Flashcards

Black-outs Flashcards

1
Q

important history of collapse

A

before: any trigger? sitting standing?
collapse itself: recollection/conscious? warning symptoms?
after: first recollection. tongue biting. incontinence? muscle pains?

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2
Q

what compliment to the patient’s history may be useful

A

a 3rd party account

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3
Q

3 categories of syncope (passing out)

A

reflex
orthostatic
cardiogenic

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4
Q

dehydration is what type of syncope

A

orthostatic

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5
Q

arrhythmia is what type of syncope

A

cardiogenic

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6
Q

what type of syncope occurs when someone sees a needle or blood

A

reflex

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7
Q

what type of syncope is triggered by peeing

A

reflex

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8
Q

endocrine causes of syncope fit into what category

A

orthostatic

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9
Q

how does cardiac syncope cause you do pass out

A

there is a low cardiac output so poor brain perfusion

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10
Q

what is syncope

A

passing out due to poor brain perfusion

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11
Q

how does epilepsy cause a black out

A

neuronal excitation that is abnormal

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12
Q

what is epilepsy

A

a tendency to recurrent seizures

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13
Q

5 primary generalised seizures

A 
Absence
Generalised tonic-clonic 
Juvenile myoclonic
Atonic
Myoclonic
(AGJAM)
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14
Q

what is a seizure

A

sudden, uncontrolled electrical disturbance in the brain

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15
Q

what differs in the time preceding a primary generalised seizures vs a focal/partial seizure

A

primary have no warning; partial can have an aura

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16
Q

which seizure type is most common <25 years

A

primary generalised

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17
Q

what is a focal seizure

A

it is focussed to just one part of the brain

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18
Q

features of a generalised tonic clonic seizure

A 
groaning sound
tonic phase (rigid)
clonic phase (jerking of all limbs)
eyes are open, maybe rolled back
foaming
lasts a few minutes but groggy for ~30 after
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19
Q

PMH associated with generalisd tonic clonic seizures

A

complications in birth
brain trauma
meningitis

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20
Q

true/false tongue biting and incontinence are common in tonic clonic seizures

A

true

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21
Q

what happens in an absence seizure

A

sudden arrest of activity maybe with staring or eye-lid fluttering

22
Q

true/false tonic clonic seizure have a trigger

A

false - they’re unpredictable

23
Q

true/false absence seizures have a trigger

A

true - commonly hyperventilation or photo stimulation (like how you always think of epilepsy)

24
Q

true/false absence seizures have a trigger

A

true - commonly hyperventilation or photo stimulation (like how you always think of epilepsy)

25
Q

triggers of juvenile myoclonic epilepsy

A

alcohol and sleep deprivation

26
Q

when in life does juvenile myoclonic epilepsy present

A

adolescence/early adulthood

27
Q

features of juvenile myoclonic seizures

A

can be like absence or GTC seizures

28
Q

a teen keeps on dropping things and experiencing brief jerks in his limbs in the morning. what does he have

A

juvenile myoclonic epilepsy - this is a features called early morning myoclonus

29
Q

two key types of partial seizure

A

simple and complex

30
Q

what happens during a simple focal seizure

A 
strange feeling
intense fear/joy
stiffness/twitching in parts of body
de ja vu
tingling in legs/arms
unusual smells/tastes
31
Q

what are simple focal seizures also known as

A

auras

32
Q

what can a simple focal seizure be a sign of

A

another seizure is about to happen

33
Q

features of a complex focal seizure from patient perspective

A
  • may begin with a simple focal seizure (rising feeling in tummy, de ja vu etc)
  • seizures occurs and they have no recollection of it
  • disorientated afterwards
34
Q

which type of seizures do you remain conscious of

A

simple focal

35
Q

features of a complex focal seizure from witness account

A
  • sudden arrest of activity
  • staring blankly
  • lip smacking/picking at clothes
36
Q

investigations that can be done in seizures

A

EEG
CT/MRI (can show a focal lesion)
Video-telemetry (EEG + video)

37
Q

22% of people with _____ have epilepsy

A

learning disabilities

38
Q

first line drug treatment of primary generalised epilepsies

A

sodium valproate, lamotrigine and levetiracetam

39
Q

first line drug treatment of focal or secondary seizures

A

lamotrigine, carbamazepine, levetiracetam

40
Q

what drug that may be used to treat trigeminal neuralgia and trigeminal autonomic cephalalgia is used in treatment of focal/secondary seizures

A

carbamazepine

41
Q

2 drugs used in primary generalised and focal seizures

A

lamotrigine and levetiracetam

42
Q

ethosuximide is only used in which seizure type

A

absence seizures

43
Q

when is lorazepam or midazolam used in epilepsy

A

to treat acutely (and in status epilepticus)

44
Q

what is status epilepticus

A

prolonged/recurrent tonic clonic seizures lasting <30 mins with no recovery period between

45
Q

1st line treatment of status epilepticus

A

midazolam, lorazepam, diazepam (same as for normal seizures in acute)

46
Q

2nd line for status epilepticus

A

valproate

47
Q

3rd line for status epilepticus

A

anaesthesia

48
Q

how long does someone have to wait after a single seizure to be allowed to drive again

A

6 months (5 years heavy goods!)

49
Q

true/false to be allowed to drive a heavy goods/public vehicle they must be seizure free for 5 years and be on medication

A

true

50
Q

when are epileptic patients allowed to drive a car

A

only when they are seizure free for a year
OR
have had only post-sleep seizures for a year

51
Q

how long till an epileptic have drive a heavy goods or public vehicle

A

10 years seizure free!

Neuro - Pathology (12 decks)

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