Dementia, Delirium, Syncope, and Seizures

Question 1

What drug is used for agitation/psychotic-like delirious behavior?

Answer 1

Haloperidol

Question 2

What is the triad for normal pressure hydrocephalus?

Answer 2

dementia, gait disturbances, urinary incontinence

Question 3

Alzheimer Disease - pathology

Answer 3

quantity of senile plaques and neurofibrillary tangles

Question 4

Alzheimer Disease - MRI Findings

Answer 4

• diffuse cortical atrophy

- enlargement of ventricles

Question 5

Vascular Dementia - pathology

Answer 5

multi-infarct dementia and diffuse white matter disease

Question 6

Vascular Dementia - MRI findings

Answer 6

show multiple smaller areas of ischemic damage

Question 7

Dementia with Lewy bodies - Diagnostic Criteria

Answer 7

• parkinsonism
• prominent, fully formed visual hallucinations
• substantial fluctuations in alertness or cognition

Question 8

Dementia with Lewy bodies - MRI findings

Answer 8

generalized atrophy and white matter changes

Question 9

Treatment for Obstructive Sleep Apnea - General

Answer 9

weight loss, exercise, avoiding alcohol and sedatives, sleeping in non-supine

Question 10

Treatment for Obstructive Sleep Apnea - mild to moderate

Answer 10

• CPAP or BiPAP

- Oral appliance

Question 11

Treatment for Obstructive Sleep Apnea - Severe

Answer 11

• CPAP
• UPPP
• Tracheostomy

Question 12

Central Sleep Apnea - Breathing

Answer 12

Cheyenne-Stokes Breathing

Question 13

Narcolepsy

Answer 13

involuntary “sleep attacks” at any time of the day, lasting several minutes

Question 14

Narcolepsy - Cataplexy

Answer 14

loss of muscle tone that generally occurs with an intense emotional stimulation

Question 15

Narcolepsy - Sleep paralysis

Answer 15

patient cannot move when waking up

Question 16

Narcolepsy - Hypnagogic Hallucinations

Answer 16

vivid hallucinations (auditory or visual) that are like “dreams” while awake

Question 17

Narcolepsy - Treatment

Answer 17

• modafinial
• methylphenidate (ritalin) or amphetamines
• planned naps during the day (to prevent sleep attacks)

Question 18

Turning your head with a tight t-shirt on

Answer 18

Carotid Sinus Hypersensitivity

Question 19

Simple Partial/Focus Seizures

Answer 19

consciousness remains intact

Question 20

Complex Partial Seizures

Answer 20

• consciousness is impaired

- accompanied by posticidal confusion

Question 21

Generalized Seizures

Answer 21

• characterized by loss of consciousness

- involves disruption of the electrical activity in the entire brain

Question 22

Tonic-Clonic (Grand Mal) Seizure

Answer 22

• bilaterally symmetric and without focal onset

- begins with sudden loss of consciousness

Question 23

Tonic phase

Answer 23

patient becomes rigid

Question 24

Clonic phase

Answer 24

muscular jerking of the limbs and body

Question 25

Absence Seizures (petit mal seizures)

Answer 25

-patients “stares off into space” and then returns to normal activity after a few seconds

Question 26

Absence Seizures - treatment

Answer 26

Ethosuximide

Question 27

Status Epilepticus

Answer 27

continuous seizure activity > 5-10 minutes or >2 seizures without full recovery

• always check finger stick blood glucose
• consider pyridoxine (B6) for INH toxicity

Question 28

Status Epilepticus - First Line Treatment

Answer 28

lorazepam, diazepam, midazolam

Question 29

Status Epilepticus - Second Line Treatment

Answer 29

phenytoin or fosphenytoin

Question 30

Status Epilepticus - Third Line Treatment

Answer 30

pentobarbital