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neurology fa + step 2 > FA seizures > Flashcards

FA seizures Flashcards

1
Q

partial (focal) seizures - often preceded by / types

A

seizure aura

  1. simple partial
  2. complex partial
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2
Q

simple vs complex seizure according consciousness

A

simple - intact

complex - impaired

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3
Q

Generilized seizures - types and characteristics

A
  1. absence (petit mal) - 3 hz, no postictal confusion,
    blank stare
  2. myoclonic - quick, repetitive jerks
  3. tonic clonic (grand mal) - alternating stiffening and movement
  4. tonic - stiffening
  5. atonic - drop seizures (falls to floor), commonly mistaken for fainting
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4
Q

epilepsy with fever?

A

FEBRILE SEIZURES ARE NOT EPILEPSY

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5
Q

ethosuximide - side effects

A
  1. GI 2. fatigue 3. headache 4. urticaria

5. Stevens-Johnson

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6
Q

epilepsy - benzodiazepines - drugs and clinical use

A
  • lorazepam / diazepam
    1. 1st line for acute status epilepticus
    2. also for eclampsia seizure
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7
Q

phenytoin - mechanism

Fosphenytoin?

A

Na+ channel inactivation
ZERO kinetic order
- phenytoin for parental use

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8
Q

phenytoin - clinical use

A
  1. simple seizure
  2. complex seizure
  3. tonic clonic seizure (1st line)
  4. status epilepticus (1st line for prophylaxis)
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9
Q

Phenytoin - side effects

A

A. Neurologic 1. nystagmus 2. diplopia 3. ataxia 4. sedation 5. peripheral neuropathy
B. Dermatologic 1. gingival hyperplasia 2. hirsutism
3. Stevens-Johnson syndrome 4. DRESS syndrome
C. Musculosceletal: 1. SLE like syndrome 2. osteopenia
D. Hematologic: Megalobl anemia
E. Reproductive: teratogenesis (fetal hydantoin syndrome)
F. Other: c P-450 induction

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10
Q

carbamazepine - clinical use

A
  1. simple seizure (1st line)
  2. complex seizure (1st line)
  3. tonic clonic
  4. 1st line for trigeminal neuralgia
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11
Q

Carbamazepine - side effects

A
  1. diplopia 2. ataxia 3. blood dyscrasias (agranulocytosis, aplastic anemia) 4. liver toxicity
  2. teratogenesis 6. induction of P-450 7. SIADH
  3. Stevens-Johnson syndrome
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12
Q

Valproic acid - mechanism of action

A
  1. Na+ channel inactivation

2. increase GABA concentration by inhibiting GABA transaminase

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13
Q

Valproic acid - side effects

A
  1. GI 2. distress 3. rare but fatal hepatotoxicity (messure LFTs) 4. teratogenesis (neural tube defects) 5. tremor 6. weight gain 7. pancreatitis
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14
Q

Valproic acid - clinical use

A
  1. simple
  2. complex
  3. tonic-clonic (1st line)
  4. absence
  5. myoclonic
  6. bipolar disorder
  7. migraine prophylaxis
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15
Q

gabapentin - mechanism

A
  1. primarily inhibits high voltage activated Ca2+ channels

2. designed as GABA analogs

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16
Q

gabapentin - clinical use

A
  1. simple seizures
  2. complex
  3. peripheral neuropathy
  4. postherpetic neuralgia
17
Q

Gabapentin - side effects

A

sedation

ataxia

18
Q

phenobarbital - clinical use

A
  1. simple
  2. complex
  3. tonic clonic
  4. 1st line in neonates
19
Q

topiramate - mechanism

A
  1. blocks Na+ channels

2. increase GABA action

20
Q

topiramate - clinical use

A
  1. simple
  2. complex
  3. tonic - clonic
  4. migraine prevention
  5. idiopathic intracranial hypertension (pseudotumor cerebri)
21
Q

topiramate - side effects

A
  1. sedation
  2. mental dulling
  3. kidney stones
  4. weight loss
22
Q

lamotrigine - mechanism / SE

A

blocks voltage gated Na+ channels

- Steven Johnson Syndrome (must be titrated slowly)

23
Q

lamotigine - clinical use

A
  1. simple seizure
  2. complex
  3. tonic-clonic
  4. absence
24
Q

levetiracetam - mechanism of action

A

unknown. may modulate GABA and glutamine release

25
Q

levetiracetam - clinical use

A
  1. simple seizure
  2. complex
  3. tonic-clonic
26
Q

tiagabin - mechanism of action / clinical use

A

increases GABA by inhibiting reuptake

- partial

27
Q

vigabatrin - mechanism of action / clinical use

A

increase GABA by IRREVERSIBLY inhibiting GABA tranasmaminase
- partial

28
Q

epilepsy drug that induce P-450

A
  1. phenytoin
  2. Carbamazepine
  3. phenobarbital
29
Q

trigeminal neuralgia - 1st line treatment

A

carbamazepine

30
Q

eplepsy drugs with nystagmus

A

phenytoin

31
Q

eplepsy drugs with diplopia

A

phenytoin and carbamazepine

32
Q

eplepsy drugs with Steven Johnson syndrome

A
  1. phenytoin
  2. carbamazepine
  3. Lamotrigine
  4. ethosuximide
33
Q

1st line treatment for tonoclonic seizures

A
  1. Phenytoin

2. Valproic acid

34
Q

eplepsy drugs - status epilepticus 1st line

A

acute - benzodiazepines

prophylaxis - phenytoin

35
Q

initial diagnostic workup of a 1st time seizure in an adult should include

A
  1. basic blood tests (electrolytes, glucose, Ca2+, Mg2+, CBC renal + liver),
  2. toxicology screen
    if unprovoked –> further evaluation with neuroimaging and EEG
36
Q

CT after a seizure - contrast or not

A

not

neurology fa + step 2 (8 decks)

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