PHCP 2 Flashcards by Xei Lee

a chronic disorder that causes unprovoked, recurrent unprovoked seizures.

EPILEPSY

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sudden rush of electrical activity.

SEIZURE

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2 Main Types of Seizures

-General
-Partial or Focal

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Seizure Etiology

HHVAG
* High fever
* Head trauma
* Very low blood sugar
* Alcohol withdrawal
* Genetic

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didn’t loss the consciousness of the patient. It includes:
- Changes in the sense of taste, smell, sight, hearing or touch.
- Dizziness with the tingling and twitching sensation of the limbs

Simple seizure

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involves the loss of
awareness. It includes the:
- Staring blankly
- Unresponsiveness
- Performing repetitive movements

Complex Partial Seizure

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Aka petit mal seizure which involves stare blank, lip smacking,
repetitive movements and usually short loss of awareness.

Absence seizures

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-muscle stiffness.

Tonic seizures

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Loss of muscle control and cause sudden falling down.

Atonic seizures

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-repeated, jerky muscle movement of face, neck and arms.

Clonic seizures

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-Spontaneous quick twitch of arms and legs.

Myoclonic seizures

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Aka Grand mal seizures
- Causes stiffening and shaking of body
- Loss of bladder or bowel control
- Biting of tongue
- Loss of consciousness
- Can’t remember what happened or you feel slightly ill for few
hours.

Tonic-clonic seizures

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Most common used test for epilepsy

EEG (Electroencephalogram)

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*Invasive procedure.
*It gives electric stimulation that runs through your neck to prevent seizures.

Vagus nerve stimulator

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*Provides high fat and low carbohydrate diet
*The goal is to force the body to use fat for energy instead of glucose.

*Ketogenic Diet

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The area of the brain that causes seizure activity can be
removed or altered

Brain Surgery (Resection)

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*Anti-epileptic (anti-convulsant) drugs
To reduce the episode of seizure

Levetiracetam, Lamotrigine, Topimirate, VPA,
Carbamazepine and Ethosuximide

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*This diet is also high fat and involves a controlled carb intake.

*Modified Atkins Diet

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means continuous state of seizure.

Status Epilepticus

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It is a medical emergency when a seizure hits ____ mark

5 mins

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2 Types of Status Epilepticus

convulsive and non-convulsive type

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-more common and dangerous.
-involves tonic-clonic and sometime referred as grand mal

Convulsive type

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“Epileptic twilight” state
- Doesn’t lose the consciousness

Non-convulsive type

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Status Epilepticus
EM - buccal administration

Midazolam-

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Status Epilepticus EM - rectal administration

Diazepam

any alteration in mental or physical functioning related to blow to the head.

Head injury

a leading cause of death and disability in trauma patients

Traumatic brain injury

Generate numerical summed score for eye, motor and verbal abilities.

GLASGOW COMA SCALE SCORE

due to shearing of the olfactory nerves at the cribriform plate.

Anosmia

The total intercranial volume is a sum of brain tissue, cerebral spinal fluid, venous blood and arterial blood.

Monro-kellie hypothesis

is to measures the patient’s level of consciousness, attention and orientation.

Bedside cognitive testing-

An imaging test used to check the presence of tumors and abnormalities in the brain based on the brain wave patterns.

EEG electroencephalogram

common, recurrent, primary headache of moderate to severe intensity that interferes with normal functioning and is associated with GI, neurologic and autonomic symptoms.

Migraine

Acute antimigraine drugs - agonist of vascular and neuronal 5HT1 receptor subtypes.

Ergot Alkaloids and Triptan Derivative

* Recurring unilateral episodes of throbbing head pain. * Associated with nausea, vomiting and sensitivity to light, sound and/ or movement.

Migraine

A recurring headache that strikes after or at the same time as sensory disturbances.

Migraine aura (classic migraine)

First line treatment for mild to moderate migraine attacks is

Simple Analgesics NSAIDs

most common type of primary headache and more common in women than men.

Tension-Type Headache

unpleasant, subjective, sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.

Pain

are pain sensing nerve cells. It can be located in either somatic or visceral

NOCICEPTORS

acts as relay station and passes the impulses to the central structure.

Thalamus

Neurotransmitter such as _______ will bind to the receptors mu, delta and kappa

enkephalins, dynorphins and B-endorphins

resulted from nerve damage.

NEUROPATHIC PAIN

refers to the abnormal operation of the nervous system

FUNCTIONAL PAIN

Sharp or dull, burning, shock-like tingling, shooting radiating, fluctuating intensity, varying location and occur in a timely relationship with an obvious noxious stimulus

ACUTE PAIN

first line agent for moderate to severe pain.

*Morphine

Morphine causes respiratory depression that why it’s given with

Naloxone

has highly characteristic neuropathologic findings and clinical presentation. This includes: * Motor deficits * Mental deterioration

PARKINSON’S DISEASE

2 known hallmarks in the substantia nigra pars compacta:

1. Loss of neurons 2. Presence of lewy bodies - Alpha-synuclein

The inhibition of thalmus is resulted from inactivation of

dopamine-1 and dopamine-2

The tremor exhibited by the patients with Parkinson’s disease is due to degeneration of

nigrostriatal dopamine neurons

Tremor is present mostly in the hands and sometimes characterize as pin- rolling

Resting tremor

Neuroimaging for PD SPECT scan aka

Dopamine transporter (DAT Scan)

Placing electrodes that are surgically implanted in the brain.

Deep Brain Stimulation (DBS)

protects the conversion of dopamine outside the brain.

Levodopa

*Carbidopa-Levodopa infusion is administered through the

feeding tube

*Help prevents the breakdown of brain dopamine

*MAO-B inhibitors

It prolongs the effect of levodopa therapy by blocking an enzyme that breaks down dopamine

COMT inhibitors

This medication help control the tremor associated with Parkinson’s disease.

*Anticholinergics

Provide short-term relief of symptoms of mild, early-stage Parkinson’s disease.

*Amantadine

implant electrodes into specific part of the brain. * The electric pulses from the heart is send to the brain to reduce Parkinson’s disease symptoms.

Deep Brain stimulation

It is an ancient form of Chinese exercise, flowing motions that may improve flexibility, balance and muscle strength

Tai chi

focuses on the muscle posture, balance and thinking about how you use muscles and reduce muscle tension.

* Alexander technique

It is a progressive disorder that causes brain cells to waste away or degenerate.

ALZHEIMER'S DISEASE

Beta amyloid, a large protein leftover fragment which disrupts the cell to cell communications

Plaque

Tau proteins, that initiates the neuron’s transport system of nutrients and essential materials are being deformed and cause “Neurofibrillary tangles” that causes disrupts the transport system.

Tangles

TX for Alzheimer's Boost Cell to cell communication

Cholinesterase inhibitors

TX for Alzheimer's Slows the progression

Memantine (Namenda)

frequently have intense, excessive and persistent worry and fear about everyday situations.

Anxiety

Fear and often avoid places or situations that feel trapped, helpless or embarrassed.

AGORAPHOBIA

(Anxiety Type) Caused by physical health problem.

ANXIETY DISORDER DUE TO MEDICAL CONDITION

Persistent and excessive anxiety and worry about activities or events – event ordinary or routine issues.

Generalized Anxiety Disorder

Repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes.

PANIC DISORDER

Failure of children to speak in certain situation.

SELECTIVE MUTISM

Related to separation from parents or others who have parental roles.

SEPARATION ANXIETY DISORDER

Due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.

SOCIAL ANXIETY DISORDER

Exposed to a specific object or situation and desire to avoid it. Phobias provoke panic attacks in some people.

SPECIFIC PHOBIAS

Intense anxiety or panic that are a direct result of misusing drugs.

SUBSTANCE-INDUCED ANXIETY DISORDER

Compare symptoms of Anxiety to the criteria in _____ by American Psychiatric Association

Diagnostic and Statistical Manual of Mental Disorder (DSM-5)

Also known as Manic depression

Bipolar Disorder

Severe high and low moods and changes in sleep, energy, thinking and behavior * These feelings involves irritability and impulsive or reckless decision making

BIPOLAR DISORDER

A constant sense of hopelessness. * May feel difficulty to work, study, eat and enjoy friends and activities

MAJOR DEPRESSIVE DISORDER

may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning and can be disabling.

SCHIZOPHRENIA

group of conditions that affect the ability to sleep well on a regular basis.

Sleep Disorders

when insomnia happens on a regular basis for at least one month

Chronic

when insomnia occurs periodically

Intermittent,

when insomnia lasts for just a few nights at a time

Transient

*Pauses in breathing during sleep. *Causes less oxygen causing to wake up at night.

SLEEP APNEA

abnormal movements and behaviors during sleep.

Parasomnias

*Overwhelming need to move the legs. *This accompanied by tingling sensation in the legs.

RESTLESS LEG SYNDROME

*Sleep attacks *Feel suddenly extremely tired and fall asleep without warning * It causes sleep paralysis

NARCOLEPSY

evaluates oxygen levels, body movements and brain waves.

*Polysomnography

assesses electrical activity in the brain.

*Electroencephalogram–

A direct activate the brain’s reward system causes feeling of pleasure

SUBSTANCE-RELATED ABUSE

*Persistent eating behavior that negatively impact your health, your emotion and ability to function in important areas of life

EATING DISORDER

*Characterized by abnormally low body weight, intense fear of gaining weight and distorted perception of weight or shape. *They excessively limit calories or use other methods to lose weight.

ANOREXIA NERVOSA