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Flashcards in Revision 2 Deck (198)
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61

what does loss of awarness in a seizure mean

it cannot be a simple partial

62

what is a generalised seizure

seizure type characterised by loss of consciousness, widespread motor manifestations of tonic contractions followed by clonic jerking movements, and a suppressed level of arousal following the event (post ecter phase)

May either reflect an underlying generalised-onset epilepsy or focal epilepsy that has secondarily generalised.

63

what are non epileptic seizures

not caused by abnormal electrical activity in brain
can be psychogenic
will not have post ecter phase
movement is not coordinated

64

what treatment for non generalised seizures

(simple and complex partial seizures)
carbamazepine

65

what is the first line Tx for absence seizures

sodium valporate/ ethosuximide

66

1st line for generalised tonic clonic seizure

sodium valporate

67

what is status epilepticus

seizure lasting more than 30 mins

68

what is the Tx for status epilepticus

at 5 mins give IV lorazepam

69

best long term management:
uncontrolled hypertensive who develops a stroke

antihypertensives
BP control

70

best long term management:
patient who has a seizure due to a CVA

carbamazepine

71

best long term management:
patient with an ischaemic stroke is found to have AF

warfarin

72

best long term management:
ischaemic stroke

(acute treatment is aspirin in first 2 weeks)
lifelong clopidogrel

73

most useful Ix to order:
65 y/o male patient presents to the clinic with double vision and ptosis
he has weakness that gets worse during the day

anti AChR (acetylchonine receptor) antibodies
(diagnosis here is myasthenia gravis- antibodies against post synaptic channels, affects the eyes)

74

what are the features of lambert eaton syndrome

auto immune condition against pre synaptic channels
weakness of limb muscles
associated with small cell lung cancer

75

what antibodies for lambert eaton

anti musk

76

which medication:
20 y/o female with tonic clonic seizures which wants to conceive soon

lamotrigine

77

which medication:
patient with epilepsy on medication presents with these SEs- blurred vision, vertigo and blood results reveal a hyponatremia

carbamazepine

78

which medication:
a mother has noticed her 8 y/o daughter has been day dreaming and not paying attention
after discussing with GP an EEG was organised which revealed a 3Hz spike wave

ethosuxomide

79

best management:
58 year pld man with ischaemic heart disease requires treatment for an acute migraine attack that has not responded to paracetamol

high dose NSAIDs with antiemetic

80

best management:
25 year old male who presents with right sided supraorbital pain and ipsilateral ptosis and miosis
pain lasts 30 mins and usually occurs at same time every night

high flow oxygen with SC sumatriptan
(diagnosis is a cluster HA)

long term management for cluster HAs is verapamil

81

what are the features of a cluster HA

Stabbing pain around orbit or in temporal lobe. Have circadian rhythm, last 30 mins to 3 hours.

82

how long do migraines last

5-72 hours if untreated

83

what part of head to migraines affect

are hemicranial

84

best management:
55 year old female patient presents with left sided supraorbital pain with ipsilateral nasal congestion. This occurs about 20 times a day and lasts about 10 minutes

indomethacin
(diagnosis is paroxysmal hemicrania)

85

how is paroxysmal hemicrania different from cluster HAs

occurs more frequently
lasts shorter amount of time

86

how do you control vomiting in a patient with parkinsons

domperidone (is a dopamine antagonist but doesnt cross BBB)

87

what medication:
Patient on therapy for parkinsons develops acute psychosis

quetiapine
pick secondary generation antipsychotics as first gen will worsen parkinsons

88

what medication:
dyskinesia is a SE of this drug used in the treatment of parkinsons

levodopa
acts as dopamine for the brain but over time can cause excessive unwanted movement (dyskensia)

89

how is dyskensia prevented when levodopa is given

not given on its own, given with dopadecarboxylase inhibitor which prevents peripheral conversion of the drug to dopamine

90

what medication:
1st line for parkinsons

levodopa