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Year 1/2 > Cognition & Senses 2: Seizures & Head Trauma > Flashcards

Cognition & Senses 2: Seizures & Head Trauma Flashcards

1
Q

GENERALIZED seizure…

____-___ ___ SEIZURE

BILATERAL vs. UNILATERAL

ASYMMETRICAL vs. SYMMETRICAL

usually associated with ____ ____

A

TONIC-CLONIC MOTOR SEIZURE

BILATERAL

SYMMETRICAL

usually associated with AUTONOMIC PHENOMENA

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2
Q

FOCAL SEIZURE

aka ___ SEIZURE

only ____ of the ___ is involved

animal is typically ____ but the ___ can be ALTERED

+/- may or may not be present?

A

aka PARTIAL SEIZURE

only HALF of the HEMISPHERE is involved

animal is typically CONSCIOUS but MENTATION can be ALTERED

+/- MOTOR ACTIVITY MAY OR MAY NOT BE PRESENT

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3
Q

IDIOPATHIC SEIZURES..

= definition

there are NO…

A

= has SUSPECTED GENETIC BASIS for SEIZURE ACTIVITY with often underlying TRANSIENT FUNCTIONAL or NEURO-CHEMICAL ABNORMALITY

there are NO IDENTIFIABLE STRUCTURAL ABNORMALITIES IN THE BRAIN

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4
Q

SYMPATOMATIC EPILEPSY definition

CRYPTOGEIC EPILEPSY definition

A

SYMPATOMATIC EPILEPSY = RECURRENT SEIZURES for which a STRUCTURAL CAUSE is found

CRYPTOGENIC EPILEPSY = RECURRENT SEIZURES thought to be SYMPTOMATIC but NO ETIOLOGY FOUND

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5
Q

how long can the POST-ICTAL state last in DOGS?

A

how long can the POST-ICTAL state last?
= after a seizure, can last up to 72 HOURS in DOGS

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6
Q

what is a CLUSTER SEIZURE?

A

= having 2 OR MORE SEIZURES within a 24 HOUR PERIOD

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7
Q

what is STATUS EPILEPTICUS?

A

= a seizure/ICTAL EVENT >5 minutes OR >3 GENERALIZED SEIZURES within a 24 HOUR PERIOD

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8
Q

6 DDxs for SYMPTOMATIC SEIZURES?

A
  1. NEOPLASIA
  2. MENINGOENCEPHALITIS of UNKNOWN ETIOLOGY
  3. INFECTIOUS ENCEPHALITIS
  4. VASCULAR
  5. ANOMALOUS (HYDROCEPHALUS)
  6. DEGENERATIVE
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9
Q

REACTIVE SEIZURES…

= definition?

5 DDxs?

A

= seizures resulting from an EXTRACRANIAL CAUSE and includes METABOLIC & TOXIC DISORDERS

5 DDxs?
1. HEPATIC ENCEPHALOPATHY
2. HYPOGLYCEMIA
3. HYPOCALCEMIA
4. THIAMINE DEFICIENCY
5. TOXIN

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10
Q

RECTAL TEMP after a GENERALIZED SEIZURE?

abnormal POST-ICTAL behaviors? (2)

A

tends to be HYPOTHERMIC

abnormal POST-ICTAL behaviors?
1. POLYDIPSIA
2. ACTING AS IF BLIND

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11
Q

when does a LONG SEIZURE cause DELETERIOUS ___ & ___ EFFECTS?

A

CEREBRAL & SYSTEMIC EFFECTS

seizures >5 MINUTES

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12
Q

4 SYSTEMIC diseases that can occur from LONG SEIZURES? which one is RARE?

3 INTRACRANIAL changes that can occur from LONG SEIZURES?

A

4 SYSTEMIC?
1. HYPOXEMIA
2. ACIDEMIA
3. MYOCARDIAL INJURY
4. DIC (RARE)

3 INTRACRANIAL
1. CEREBRAL HYPOXIA
2. EDEMA
3. INCREASED ICP

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13
Q

DIAGNOSTICS for SEIZURES?

PCV/TS?

BLOOD GLUCOSE?

LACTATE?

STICK BUN or NOVA CREATININE?

ECG MONITORING?

RADS? what view?

A

PCV/TS = usually DEHYDRATION

BLOOD GLUCOSE = can be HYPOGLYCEMIC from INSULINOMA

LACTATE = can be INCREASED from MUSCLE ACTIVITY

STICK BUN or NOVA CREATININE = assess for RENAL or PRE-RENAL DYSFUNCTION

ECG MONITORING = to ID CARDIAC ARRHYTHMIAS as CAUSE OF EXTRACRANIAL SEIZURE

THORACIC RADS = if RESPIRATORY SYSTEM ABNORMALITIES to RULE OUT PULMONARY EDEMA

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14
Q

seizure WORK-UP to RULE OUT…

CBC/chem?

BRAIN MRI?

CSF ANALYSIS?

A

CBC/chem = to RULE OUT METABOLIC/TOXIC DISEASES

BRAIN MRI = to RULE OUT STRUCTURAL DISEASES

CSF ANALYSIS = if ABNORMAL, use NEUROIMAGING TO NARROW DDxs

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15
Q

3 initial steps for SEIZURE MANAGEMENT?

name ONE example that’s best for the last one

A
  1. ADMINISTER O2
  2. PLACE IV CATH if NOT IN PLACE ALREADY
  3. BENZODIAZEPINES
    –> –PAM SUFFIX, DIAZEPAM IS BEST
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16
Q

giving DIAZEPAM for SEIZURE MANAGEMENT…

____-ACTING; reaches TARGET PLASMA CONCENTRATION in…

wait at least ___ ___ BETWEEN BOLUSES

half-life?

3 routes of ADMINISTRATION?

we should give this when the patient is experiencing ___ ___

A

FAST-ACTING; reaches TARGET PLASMA CONCENTRATION in 10-20 MINUTES

wait at least 5 MINUTES BETWEEN BOLUSES

half-life? = 3 HOURS

3 routes of ADMINISTRATION?
1. IV
2. RECTAL
3. INTRANASAL

we should give this when the patient is experiencing STATUS EPILEPTICUS

17
Q

giving MIDAZOLAM for SEIZURE MANAGEMENT..

half-life when compared to DIAZEPAM?

3 routes of administration? which has the BEST ABSORPTION & BIOAVAILABILITY?

we should give this when the patient is experiencing ___ ___

A

SHORTER HALF-LIFE THAN DIAZEPAM at 1-2 HOURS

3 routes?
1. IM INJECTABLE = BEST ABSORPTION/BIOAVAILABILITY
2. NASAL MUCOSA
3. BRAIN via CRIBIFORM PLATE

we should give this when the patient is experiencing STATUS EPILEPTICUS

18
Q

what should we use as a LONG-TERM MAINTENANCE DRUG for SEIZURES?

2 routes of administration? which has LESS sedative side effects?

how does it work?

distribution to CNS takes UP TO ___ ___ AFTER administartion

A

we should use BARBITURATES (PHENOBARBITAL)

2 routes?
1. IV
2. IM = LESS SEDATIVE SIDE EFFECTS

how does it work? = GABA RECEPTORS ARE ENHANCED to INCREASE INHIBITORY ACTIVITY

distribution to CNS takes UP TO 30 MINS after administration

19
Q

BLOODWORK schedule for PHENOBARBITAL? (2)

A
  1. check blood levels 2-3 WEEKS AFTER STARTING MAINTENANCE DOSE, then EVERY 6 MONTHS AFTER
  2. recheck blood levels 2-3 WEEKS AFTER DOSE ADJUSTMENTS
20
Q

why should we CHECK T4 PRIOR to giving ____?

A

PHENOBARBITAL

can INCREASE METABOLISM OF THYROID HORMONES

21
Q

LEVETIRACETAM

aka brand name?

used for…

half-life?

CAUTION giving to patients with…

A

aka KEPPRA

used for LONG-TERM MAINTENANCE of SEIZURES

half-life = 3 HOURS

CAUTION giving to patients with RENAL DZ

22
Q

what is the LAST RESORT for SEIZURE Tx?

why?

A

INHALANT ANESTHESIA

why? = CESSATION OF PHYSICAL MANIFESTATION OF SEIZURE ONLY

23
Q

TRUE/FALSE

you SHOULD NOT give ZONISAMIDE for SEIZURE Tx with PHENOBARBITAL because it will COMPETE WITH IT for LIVER METABOLISM

A

TRUE

24
Q

TRUE/FALSE

ZONISAMIDE has a HALF-LIFE of 5 hours

A

FALSE, 15 HOUR HALF-LIFE!

25
Q

TRUE/FALSE

POTASSIUM BROMIDE has a HALF-LIFE of 25 DAYS after RECTAL LOADING

A

FALSE, ORAL ADMINISTRATION = 25 DAYS

26
Q

TRUE/FALSE

dogs with SEIZURES due to TOXICOSIS have a MORE FAVORABLE OUTCOME than dogs with SYMPTOMATIC EPILEPSY

A

TRUE

27
Q

TRUE/FALSE

failure to CONTROL SEIZURES within 8 HOURS OF ONSET seems to NEGATIVELY AFFECT OUTCOME

A

FALSE, 6 HOURS

28
Q

CUSHING’S TRIADE

formula? & define the terms

3 steps that can lead to an emergency?

A

CPP = MAP - ICP

CEREBRAL PERFUSION/BLOOD FLOW = BP - ICP

3 steps?
1. when ICP increases, then CEREBRAL BLOOD FLOW DECREASES
2. increased CO2 triggers INCREASED MAP
3. SYSTEMIC HYPERTENSION then causes REFLEX BRADYCARDIA –> REQUIRES INTERVENTION

Year 1/2 (139 decks)

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