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PAR3011 - MEDICAL > Week 5 > Flashcards

Week 5 Flashcards

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USMLE® Step 1 flashcards
1
Q

Define a seizure?

A

A seizure is a transient alteration of brain function
due to uncontrolled depolarisation of cerebral
neurons

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2
Q

what are clinical signs of seizures?

A 
alterations to: 
sensation, 
movement,
awareness or consciousness, 
behaviour and perception.
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3
Q

What is epilepsy

A

Epilepsy is a condition encompassing a
broad range of seizure disorders and is diagnosed
in patients suffering recurrent seizures (Huff
& Fountain, 2011). Epilepsy is one of the most
common serious neurological dysfunctions

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4
Q

What is the third most common neurological

disorder in older people after dementia and stroke

A

epilepsy

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5
Q

What causes seizure activity

A

Seizure activity is the result of abnormal or uncontrolled neuronal depolarisation.

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6
Q

Define status epilepticus

A

‘a prolonged seizure lasting longer than five minutes’ or

‘multiple seizures occurring back to back without full recovery of consciousness in between’.

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7
Q

What are the types of febrile seizures?

A

Simple

Complex

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8
Q

What is a simple febrile seizure?

A 
Simple febrile seizures
are generalised, last less
than 15 minutes and occur
no more than once in
24 hours. They represent
the majority of febrile seizures and carry few
risks.
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9
Q

What are complex febrile seizures?

A

Complex febrile seizures last longer than 15 minutes, occur more than once within 24 hours and may display a focal component.

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10
Q

WHat are the clinical classifications of seizures?

A

Partial seizures:

  • simple partial
  • complex partial

Generalised seizures

Unclassifiable seizure types

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11
Q

WHat are the types of Generalised seizures?

A 
Absence seizures
Myoclonic seizures
Clonic seizures
Tonic seizures
Tonic–clonic seizures
Atonic seizures
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12
Q

What are the types of simple partial seizures?

A 
Motor symptoms
Sensory symptoms
Special sensory symptoms
Autonomic symptoms
Psychic symptoms
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13
Q

What are the types of complex partial seizures?

A

Simple partial onset followed by impaired consciousness

Impairment of consciousness at onset

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14
Q

What are the common causes of provoked seeizures?

A 
Drugs of abuse
Infections/Inflammatory
Iatrogenic
Metabolic disorders
Lesions
Systemic causes
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15
Q

Define Partial seizures

A

Partial seizures generally involve only one
hemisphere of the brain and originate from
a particular cortical area of the brain.

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16
Q

Define simple partial seizures

A

Simple
partial seizures affect one part of the brain with
no impact on consciousness

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17
Q

Define complex partial seizures

A

complex
partial seizures affect more than one part of the
brain and may result in impairment or clouding
of consciousness.

18
Q

Define generalised seizures

A

involve both hemispheres of
the brain and do not originate from one cortical
area. Generalised seizures always result in an
alteration to consciousness.

19
Q

what are some differential diagnosis for seizures?

A
  • Syncope
  • Stroke
  • Traumatic head injury
  • migrane with aura
  • movement disorder such as parkinsons
  • toxic or metabolic encephalopathy
  • sleep disorders
  • psychogenic
20
Q

what percentage of australians experience epilepsy?

A

3-3.5%

21
Q

Epilepsy has an increased risk of death. what are some causes of this increased risk?

A

– underlying brain disease, eg tumour or infection.
– seizures in dangerous positions => drowning, burns, or head injury.
– prolonged seizures (status epilepticus).
– sudden and unexplained causes.
– cardiac arrest during a seizure.
– suicide.

22
Q

What is the pathophys of epilepsy?

A

A group of neurones act as a focus for seizure activity, possibly due to changes in membrane potential stimulated by hypoxia, hyperthermia, hypoglycaemia, hyponatremia, brain injury and some drugs.

The primary cause may be a
defect in the GABA inhibitory
system or abnormality in excitatory transmission.

23
Q

What is a seizure?

A

• A seizure results from widespread and
uncoordinated discharge of CNS neurones.

• Characterised by a sudden but transient
alteration in brain function, usually involving
“motor, sensory, autonomic, or psychic clinical
manifestations and an alteration in level of
arousal.”

• The seizure may produce focal or generalised
clinical signs.

24
Q

What are some triggers for seizures?

A
  • Alcohol ‐ Reduces the effect of medication
  • Diet – Caffeine, Low BSL
  • Infection/Illness ‐ High temp
  • Lack of sleep
  • Menstruation
  • Smells / sounds
  • Missed normal medication
  • Other drugs
  • Stress
  • Severe changes to ambient temp
  • Photosensitivity ‐ Flickering light (Ambulance strobes!!!!!!!)
25
Q

What are the main causes of partial seizures?

A

stroke
tumour
head injury

26
Q

what is an absence seizure?

A 
– Awareness and responsiveness are
impaired
– Pt simply stare, eyes may roll
back/eyelids flutter, may be hand
movements.
– Start suddenly & cannot be interrupted
– Last a few seconds then stop suddenly
=> continue with activity
– Last < 10 seconds
– Can occur many times during day
27
Q

What is an Atonic seizure?

A 
– Known as “drop attacks”
– affect muscle tone => Pt
collapses to ground
– usually remains conscious
– can cause
head/facial/other injury
=> unprotected fall
– Recovery quite quick
28
Q

What is a myoclonic seizure

A 
– Brief, shock‐like jerks of a
muscle/group of muscles
– Lasting a second or two
– Can be one, sometimes many
will occur within a short
timeframe
29
Q

What is a tonic seizure?

A 
– muscle tone is greatly increased
– body, arms, or legs make sudden
stiffening movements
– often occur in clusters during
sleep, but can occur when Pt
awake => “heavy” fall
– duration < 20 sec
– remain conscious
30
Q

what is a tonic-clonic seizure?

A

– body stiffens & fall to the ground (tonic phase)
– may cry/groan (air forced past the vocal cords)
– tongue/cheek may be bitten => bloody saliva
– limbs begin to jerk in strong, symmetrical, rhythmic
movements (clonic phase)
– Pt may dribble from the mouth, facial cyanosis/red,
loss of bladder and/or bowel control
– Tonic‐clonic seizures generally last 1 to 3 minutes
– On regaining consciousness Pt confused,
drowsy, agitated or depressed
– May C/o headache & want to sleep
– Drowsiness can last for hours

31
Q

What is a secondary generalised seizure?

A

– Seizure activity spreads from focal point
across to both sides of brain => initially a
partial seizure
– Episode so brief Pt has no recall or
recognises it
– Lasts 1‐3 minutes
– Similar to primary generalized seizures
– Occur in 30% of Pts with partial seizures

32
Q

What are the 3 phases of generalised seizures?

A

preictal
ictal
postictal

33
Q

explain the preictal phase of generalised seizures?

A

– Period just before seizure. May involve aura, restlessness, nervousness, wandering.

34
Q

explain the ictal phase of generalised seizures?

A

– Seizure period (eg tonic/ clonic) lasting a few seconds to minutes

35
Q

explain the postictal phase of generalised seizures?

A

– Period after seizure (disorientation, confusion, salivation, unresponsiveness, incontinence).

36
Q

what is status epilepticus?

A

• Is a neurological emergency characterised by a
series of convulsions, rapidly repeated without
intervals of consciousness, which if untreated
may lead to hypoxia, hyperthermia, cerebral
damage and death.

37
Q

what are the effects of benzodiazapines?

A 
– Anxiolytic
– Muscle relaxant
– Anticonvulsant
– Hypnotic
– Memory impairment
38
Q

How do anticonvulsants work?

A 
Enhance GABA transmission
• Increase frequency of openings of GABA
channels.
• increase opening time of GABA
channels.
• increase receptor affinity for GABA.
GABA (y-aminobutyric acid) is the
main inhibitory CNS transmitter.
39
Q

What are the adverse effects of benzodiazapines?

A
  • CNS depression (including hypotension, respiratory depression, drowsiness leading to sedation,
    impaired coordination and ataxia (mainly in the elderly), confusion and memory
    loss)
  • Dependence may develop
  • addictive effects
40
Q

Define a febrile convulsion

A

“Seizures associated with fever in the absence
of CNS infection or acute electrolyte imbalance
in a young child (between 6 months and 6
years)

PAR3011 - MEDICAL (32 decks)

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