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Old DOOS > Neuro Lecture 1 > Flashcards

Neuro Lecture 1 Flashcards

1
Q

One organ without pain receptors?

A

Brain

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2
Q

<p>

| Three divisions of the nervous system </p>

A

<p>

| Central Peripheral Enteric</p>

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3
Q

Which cranial nerves aren’t peripheral nerves?

A

CN II (optic) because they are surrounded by dura mater

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4
Q

Which has more neurons, enteric or spinal cord?

A

Enteric

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5
Q

What neurotransmitter does the enteric nervous systemic use?

A

Serotonin

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6
Q

what deals with neurology disorders commonly diagnosed in childhood? Ex- cerebral palsy

A

Child neurology

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7
Q

If a child has a tremor, whom should they be seen by?

A

An adult neurologist

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8
Q

How are most diagnoses made?

A

By history

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9
Q

laboratory, diagnostic, and imaging findings must be…

A

clinically correlated

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10
Q

In neurology do you diagnose based on labs?

A

No, must all be clinically correlated

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11
Q

What is a seizure?

A

Hypersynchronous brain activity

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12
Q

What is epilepsy?

A

An abnormally low seizure threshold.

A tendency for “unprovoked” seizures

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13
Q

How many people will have a seizure in their lifetime?

A

10%

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14
Q

Is a seizure caused by strobe lights provoked or unprovoked?

A

Unprovoked

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15
Q

What age ranges are more prone to seizures?

A

under 2 and over

65 years

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16
Q

<p>

| Why are males at more risk for seizures?</p>

A

<p>

| Less neurons since testosterone kills brain cells</p>

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17
Q

What is remission in epilepsy?

A

Gone 2-5 years without a seizure (includes being on meds)

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18
Q

What diet can help with seizures that aren’t controlled by meds?

A

ketogenic

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19
Q

What is the difference b/w generalized and focal seizures?

A

Focal is on one part of the brain, generalized is throughout

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20
Q

What does convulsive mean?

A

Involve positive motor activity

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21
Q

simple partial seizure

A

starts in a locus and spreads contiguous

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22
Q

What type seizure that spreads to a non-contiguous area. Change in mental status (90% of time), look like staring spells.

A

Complex partial seizure

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23
Q

What type seizure is a focal motor seizure. Ex- rhythmic jerking on their hand. There is a simple partial seizure in the motor strip.

A

Simple partial seizure

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24
Q

What is a simple partial seizure in a non-motor area called? Ex- see sparkling lights, weird feelings they can’t tell the difference b/w big and little things.

A

An aura

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25
Q

Is an aura a feeling you get before a seizure?

A

No, it is a seizure going on

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26
Q

What are the 2 types of generalized seizures?

A

Non-convulsive

Convulsive

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27
Q

What are seizure where a person then totally falls limp to the ground. Absence seizure of the muscles.

A

Atonic generalized seizure

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28
Q

What does a clonic seizure look like?

A

Rhythmic jerking movements

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29
Q

What is a single non-rhythmic jerk?

A

Myoclonic

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30
Q

What type generalized convulsive seizure is often found in infants, looks like colic?

A

Spasm

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31
Q

What type seizure is usually at night and is bicycling in bed with an outstretched arm.

A

Hypermotor

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32
Q

What do secondarily generalized convulsive seizures look like?

A

GTC (generalized tonic clonic seizures)

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33
Q

Does an EEG diagnose epilepsy?

A

No, history does

34
Q

How many people will become epileptic sometime in their life?

A

3%

35
Q

How are EEGs described?

A

Nonspecific and nonsensitive

36
Q

What does the EEG record?

A

Superficial cortex

37
Q

Where will an EEG not capture seizures?

A

In sulci or deeper in the brain

38
Q

What type seizures can has normal or abnormal EEGs?

A

focal onset

39
Q

what type seizures are typically long? (>20 sec)

A

Focal seizures

40
Q

What type seizures are typically short? (<20 seconds)

A

generalized seizures

41
Q

which type seizures tend to morph?

A

Focal onset seizures

42
Q

What is the phase after a seizure where a patient is confused, sleepy, can’t talk?

A

post-ictal state

43
Q

What type epilepsy usually has a post-ictal phase?

A

Focal-onset

44
Q

If someone has a starting spell, what are 2 types seizures they could have?

A 
Complex partial (focal) 
absence (generalized)
45
Q

Kid is constantly falling?

A

Atonic seizure

46
Q

What med is only used for atonic and absence epilepsy?

A

ETS (Ethosuximide)

47
Q

2 meds only used for partial onset seizures?

A

CBZ (carbamazepine)

OXC (Oxcarbazepine)

48
Q

Will you get a mixture of focal and generalized seizures?

A

No, very rare

49
Q

What happens if you give CBZ to a person with generalized seizures?

A

status epilepticus

50
Q

what is a seizure that is too long?

A

status epilepticus

51
Q

What is the first line treatment for status epilepticus ?

A

Benzos- if at home DZP (rectal gel)

if in hosptial- LZP (lorazepam)

52
Q

What is second line treatment for status epilepticus?

A

Any appropriate anti-epileptic drug you can push

53
Q

What 2 drugs can’t you push therefore can’t give for status epilepticus?

A

Phenytoin (PHT)

lamotrigine (LTG)

54
Q

what does lamotrigine given too fast lead to?

A

Steven-Johnson’s syndrome

55
Q

What can phenytoin given through IV lead to?

A

Heart stopping (alkaline solution)

56
Q

how long about does it take for anti-epileptic drugs to be therapeutic once given?

A

20 minutes or so

57
Q

What is the 3rd line treatment for status epilepticus?

A

Coma (about 1/3 of these kids will never come out)

58
Q

If someone presents seizing, what should you assume?

A

Status epilepticus

59
Q

What can the benzos suppress and lead to having to do what?

A

Suppress breathing, have to intubate

60
Q

Which seizure types can go into status epilepticus?

A

All of them

61
Q

What things can look like seizures but aren’t?

A 
Provoked convulsions
febrile convulsions  (type of provoked) 
Tic disorders 
self stimulation 
movement disorders 
migraine variants 
pseudoseizure (stress rxn) 
Syncope
62
Q

If two appropriate anticonvulsant medications at reasonable doses have not controlled the seizures, what is this called?

A

Intractable seizure

63
Q

What do you do for people with intractable epilepsy?

A

Pre surgical workup, Video EEG and high- resolution MRI of the brain.
May be candidates for epilepsy surgery or vagal nerve stimulation (VNS) therapy

64
Q

What does VNS do?

A

Stimulates the left vagus nerve then actively stimulates the brain stem and cause changes in neurotransmitter concentration. Makes about 1/3 of patients seizure free

65
Q

If a person failed two meds, then a third med worked, what is it classified as?

A

Intractable epilepsy in remission.

66
Q

What is catamenial epilepsy?

A

Have an increase in seizures 3 days before menstrual period.

67
Q

What drug is a strong mood destabilizer?

A

Levetiracetam (levetiRageAttack)

68
Q

Do P450 inducers affect peak?

A

No

69
Q

What do P450 inducers affect?

A

1/2 life and averages become shorter

70
Q

If you take a medication with carbamazepine what might need to happen?

A

Need to take that other med more times a day

71
Q

What is a potent P450 inducer?

A

Carbamazepine

72
Q

How will carbamazepine affect OCPs?

A

reduces 1/2 life

73
Q

What is ethosuximide used for?

A

Absence and atonic seizures

74
Q

What are some side effects of ethosuximide?

A

N/V/D abdominal cramping
tastes really bad, most kids can’t keep it down
(remember “sucks”)

75
Q

What is the most potent mood stabilizer?

A

Lamotrigine

76
Q

What does the same thing as carbamazepine but with fewer sider effects?

A

Oxcarbazepine

77
Q

What drug causes gingival hyperplasia? and hirsutism?

A

Phenytoin

78
Q

What drug will lower your IQ by 10-20 points? Also is an appetite suppressant.

A

Topiramate (Topamax)

79
Q

What drug is an appetite inducer? Also causes polycystic ovaries.

A

Valproic acid

80
Q

What is like topamax, but less side effects?

A

Zonisamide (but is an aromatic sulfa drug)

Old DOOS (21 decks)

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