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seizure Flashcards

0
Q

What two drugs lower threshold of seizure?

A

Wellbutrin wel seizure

Tramadol tremodol

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1
Q

What do you order with new onset seizure?

A 
Ct acute
MRI w/ and w/o contrast (kidney)
EEG 
Electrolytes
Tox screen
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2
Q

New onset seizure

A

MRI w and wo contrast if creatine fine.

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3
Q

Rules about tpa post care

A

No vein puncture
No imaging
No arterial sticks
Always do nih stroke scale

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4
Q

What do you cause a EEG during seizure.

A

Interictal seizure.

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5
Q

Tongue biting is consistent with.

A

Generalized clinic tonic seizure.

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6
Q

Features of generalized seizures

A

Sudden. No warning
1 min
Incontinence

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7
Q

How can you provoke an absence seizure.

A

Hyperventilate for 3 year.

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8
Q

Describe myoclonus 5

A 
Sudden 
Short 
Irregular
Extremities
No loss of conscious
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9
Q

What is it called when brief sudden fall.

A

Sudden loss of muscle tone
Don’t lose conciousness
Have other types of seizure

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10
Q

What suggests partial

A

Automatism

Aura

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11
Q

What are examples of automatism

A

Swallowing
Picking at clothes
Chewing

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12
Q

What can confuse you with seizure vs cardiogenic syncope

A

Cardiogenic can have myoclonus

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13
Q

What do you call it when a partial goes to generalized

A

Partial seizure with secondary generalization.

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14
Q

Why take a blood pressure after seizure.

A

Suggests arrythmia.

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15
Q

How do you differentiate pseudo vs organic seizure.

A

Ammonia capsule

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16
Q

Is Dilantin soluble is glucose.

A

No

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17
Q

Max does of phosphenytoin

A

30 mg/ kg

(15 mg/kg) wait 30 then another another 15

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18
Q

Order of seizures meds in status

A 
Ativan 4
Phosphenytoin 15
Phosphenytoin 15 mg kg iv
Phenobarbital 20 mg/kg 100/ min
Ventilate
Vasopressor 
Propofol
Pentobarbital 5 to 12

Booster dose of pheno 5 mg q 20

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19
Q

If seizure meds bottom out you bp?

A

Dopamine

Saline

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20
Q

Manage seizure

A 
Intimate
Vent
Pulses. Blood pressure
Vitals pulse ox
Iv.  Glu and lab
Thiamine 100 and glucose 50 50
Lay on side pad rails
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21
Q

Max dose of rectal valium

A

20 mg

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22
Q

Time defining status

A

Technically 30

In practice 10

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23
Q

Most important body part for evaluation seizures

A

Tongue

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24
6 Q a for acute seizure.
``` Still? How long? Loc? 1st Any med Diabetic or immuno ```
25
What is the difference between Ativan and Valium.
Valium is quick on quick off Ativan lasts 4 hr 12 time longer Valium lasts 20 min
26
Pt seizing with low glucose tx
50 of 50 | 50 ml of 50w
27
Pt seizing with alcohol history give
Thiamine 100 mg
28
Protocol for acute seizure tx
- Ativan 2 mg x4 (Im, Val paste$ - Phosphenytoin 500 over 5 x 3 ( don't exceed 200 mg min - or 10 mg/kg bolus if on Dilantin
29
What percentage of seizures controlled by Ativan and phosphenytoin
70 percent
30
Testing aphasia after seizure
Count backward from 20
31
Loading dose of phosphenytoin 15 to20 mg kg
15 to 20 mg per kg
32
How to protect against aspiration with stroke.
NG tube
33
When do you of an LP with no MRI
When no mass is found
34
What do you call it when you feel like you don't deserve you success. Waiting for some one to find you out
Imposter syndrome
35
Alheimers associated with
Seizure. | -co2 rarely causes seizure
36
How long do you have to wait before we can do an MRI after a sx with staples.
6 weeks
37
When do night terrors occur
Early in night stage 3 Rem is with strory Have as a kid
38
Does stage three have story
No, only flash of light or quick images
39
When do you seize in sleep stage
Stage 1. When everything discharges | Not stage 3
40
Vertigo and vertigo test
Eng vestibular testing
41
Benign causes of seizures in kids
Breathing holding spells Night terrors Pseudoseizureo
42
What is the problem with EEG
They aren't sensitive 25 to 50 sens 80 specific
43
Associated symptoms of syncope
``` Warm Lightheaded Sweating facial pallor Bounce back fast in and out Flutter ```
44
Can you get seizure like activity with syncopy
Jerking. From hypo perfusion
45
Can tongue biting occur with syncope
Yes but just the tip
46
Seizure symptoms
``` Post octal confusion Aura Repetitive chewing or lips making Lateral biting Anion gap transcient Head turning to one side ```
47
Symptoms of pseudo
``` Side to side head movement Changing symptoms Rapid tecovery Entire body with a logic march!!! No diuresis Tongue biting ```
48
Most common symptoms associated with conversion
Weakness and seizure
49
Percent of pts who have a hemorrhagic stroke who are ct negative and conversion with tpa
0
50
What type of stroke do you have to worry about seizure
Temporal
51
What do you call it when you have amygdala removal
Joubert bucy
52
What do you call a seizure involving laughter.
Gelastic seizures
53
What do you order image w seizure
Coronal flair to see hippocampus | -with contrast
54
Why is reactive seizure treated differently than epilepsy
No meds needed
55
How common febrile seizure
3 percentage
56
What age does febrile seizure occur
3 mo to 5 year
57
What percent of febrile sx get epilepsy
Less than a ten percent chance
58
Define status
2 seizures without recovery Or 5 min of seizure
59
Where did they get the 30 min def for status
30 min bc animal studies | Damaged neurons
60
How long does it take for ldh, pulmonary eds. Rhabdo to occur
30 min
61
Partial seizure assoc with automisms
Complex partial. Loc
62
What do you call it when a partial turns into a general seizure
Secondary generalized from a partial
63
Are absence seizures loc
Poor awareness | Confused
64
Red flag for psychogenic
Side to side | Awake with b/ l movent
65
Signs of status on exam
Rhythm is pupil dilation
66
What percent of status is treated by Ativan
50 percent
67
Ativan is a temporary fix so ehat should you do afterwards
Get them on phosphenytoin
68
Why should you get the on monitor after seizure.
Ncse
69
Dose of phosphenytoin
20 mg kg pe
70
Complication of phosphenytoin
Drop in vitals
71
Why do you have to mix phosphenytoin with saline
Glucose with precipitate
72
Differences bw phosphenytoin and phenytoin
Phos is im Les irritant on veins 3 times as fast But expensive
73
Crmp2 or aka
Collapsin response Mediator protein Inh is neuroprotective
74
Where is the brain region associated with neglect
Inferior parietal
75
Can you get neglect with left parietal
Yes. Not as strong
76
Location of praxis
Parietal
77
What are they looking for on EEG when you give Ativan
Burst suppression
78
What do you use see on an MRI with and without contrast on a patient who has seizures that could suggest a structural issue.
Temporal lobe sclerosis
79
How do we load depakote
2000 mg load | 500 mg q 8 hr
80
Which drugs make myoclonic worse
Dilantin Neurology Neurontin
81
Causes of low sodium levels
Trileptal | Tegretol
82
Breast cancer plus cerebellar atrophy
Paraneoplasm | Subacute cerebellar

Seizure (4 decks)

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