Neuro

Question 1

Epilepsy/seizure types

Answer 1

focal - one side of the brain
generalized - both sides of the brain
focal aware / simple partial = no loss of consciousness
impaired awareness / complex partial = loss of consciousness
status epilepticus - seizure lasting 5+ minutes

Question 2

Anti-seizure drugs

Answer 2

are CNS depressants
can cause bone loss, increased fracture risk
use Ca supplements, Vit. D
fetoxic: clonazepam, phenobarbital, primidone, phenytoin, fosphenytoin, carbamazepine, valproate

Question 3

Treatments

Answer 3

levetiracetam (Keppra) - s/e: irritability, weakness, dizziness
lamotrigine (Lamictal) - s/e: skin rash, skin rxns
carbamazepine (Tegretol) - test for HLA-B 1502, s/e: SJS/TEN, aplastic anemia, agranulocytosis
oxcarbazepine (Trileptal) - test HLA-B 1502, s/e: SJS/TEN, hyponatremia
phenobarbital - s/e: dependence, resp depression, hangover
phenytoin (Dilantin) - s/e: diplopia, blurred vision, nystagmus
topiramate (Topamax) - s/e: weight loss
lacosamide (Vimpat) - s/e: arrhythmia risk
valproate (Depakene) - s/e: weight gain
ethosuximide (Zarontin) - used for absence seizures
status epilepticus tx: benzo injection, diazepam rectal (Diastat)

Question 4

Stroke s/sx

Answer 4

FAST

facial droop, arm is weak, slurred speech, time essential (call 911)

Question 5

stroke modifiable risk factors

Answer 5

HTN, dyslipidemia, DM, sodium restrict, weight loss, a-fib, limit alcohol intake

Question 6

early management of ischemic stroke

Answer 6

fibrinolytic (clot buster) - tPA (Alteplase, Activase)
confirm clot, c/i w/ hemorrhage
treat w/in 3hrs, max 4/5 hrs from onset
aspirin 325 24-48 hrs after onset to prevent recurrence

Question 7

antiplatelet therapy

Answer 7

for noncardioembolic stroke or TIA, reduces risk of recurrent stroke - aspirin or clopidogrel

Question 8

hemorrhagic stroke

Answer 8

reverse anticoagulants being used

reduce intracranial pressure - mannitol (osmitrol)