Pretest Questions Flashcards
Where do mycotic aneurysms occur?
Over cerebral convexities
What causes mycotic aneurysms?
Usually bacterial infections from drug use or HIV.
Do hematomas enhance with contrast?
No
Why is levatiracetam better to use than lamotrigine in acute management of seizures?
The dose of lamotrigine must be increased very slowly to prevent steven johnsons syndrome. Over weeks to months.
Amaurosis fugax and cause?
Transient monocular vision loss usually from extracranial carotid artery disease.
Why can’t phenytoin be infused rapidly IV? What to use instead?
Phenytoin infused IV above 50mg/min can cause cardiac arrhythmias or hypotension. Use fosphenytoin instead (can also be given IM).
Course of action if a patient has a first seizure?
Get a brain MRI to rule out a structural lesion.
Lenox Gastaut Syndrome
Mental retardation with multiple seizure types (usually 1-2 Hz spike and wave). Often with a history of infantile spasms.
What drug should be given to patients with a traumatic head injury?
Phenytoin to decrease the incidence of post traumatic seizures
Diffuse axonal injury
Shearing of axonal bundles at the grey white junction due to intense acceleration/deceleration injury.
Mesial temporal sclerosis and treatment?
Most common cause of complex partial seizures in adults. Can be seen on MRI. Can be treated with surgical resection of right anterior temporal lobe.
Jacksonian March
Focal motor seizure that spreads and can secondarily generalize causing LOC and tonic-clonic seizures. Face can be involved early due to proximity of face and thumb on the motor strip.
Myoclonic seizures
Usually happen upon awakening, with light, and with loud sounds. Seen in Benign Juvenile Myoclonic Epilepsy.
Epilepsia Partialis Continua
Focal motor seizure activity that persists (focal motor status epilepticus)
West Syndrome. Associated disease?
Generalized seizure disorder in infants with recurrent spasms. Can be associated with tuberous sclerosis (ash-leaf spots, cardiac rhabdomyomas, angiofibromas).
Triptans side effect
Vasospasm so don’t give to patients with CAD
Migraine abortive medications
Triptans, ergots, etc
Migrane preventative medications
Beta blockers, amytriptyline, nifedapine, topamax, valproate.
How to abort cluster headaches
100% O2, triptans, ergots
Trigeminal neuralgia can caused by? Associated disease?
Aneurysm of superior cerebellar artery can press on V. Can be associated with MS
Pseudotumor cerebri, cause?
Increased intracranial pressure causes headaches, optic disk atrophy (pallor), tinnitus. Vit A overdose, idiopathic in obese women
How to treat pseudotumor cerebri? Diagnose?
Acetazolamide, VP shunts. Opening pressure >250 mm H2O.
Classic vs common migraine?
Classic has aura
Basilar Migraine
Women>Men, visual changes for 10-30 mins, then headache. Can cause coma, psychosis, transient quadriplegia.
Essentially just a migraine with super intense consequences.