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119 Cards in this Set
- Front
- Back
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cranial perfusion pressure at which brain is not perfused
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50 mm Hg
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how to calculate cranial perfusion pressure
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1/2 SBP + 2/3 DBP - ICP
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acute tx of increased ICP (3)
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hyperventilation
raise head of bed mannitol |
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mgt of penetrating head injury (3)
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surgical debridement
anticonvulsant if seizures abx |
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def of concussion
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alteration in consciousness with no focal deficits
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pathophys behind concussion
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diffuse axonal injury
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convex hyperdensity on head CT
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epidural hematoma
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concave hyperdensity on head CT
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subdural hematoma
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vessels commonly involved in epidural hematoma
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middle meningial artery
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vessels commonly involved in subdural hematoma
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bridging veins
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does a SAH require drainage
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no
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visual deficit if lesion/mass at optic chiasm
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bitemporal hemianopsia
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3 true glial cells
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astrocytes
oligodendrocytes epyndymal cells |
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obstruction in communicating hydrocephalus
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reabsorption of CSF
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obstruction in non-communicating hydrocephalus
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obstruction in ventricular system
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presentation of normal pressure hydrocephalus
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wet - incontinence
wobbly - ataxia weird - dementia |
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supplements given during pregnancy that reduce dysraphisms
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vit B
folate |
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3 common causes of SAH
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aneurysm
AVM cavernous angioma |
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tx of aneurysm
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coiling (most common)
clipping |
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complications after SAH repair (2)
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rebleeding
arterial vasospasm - blood products cause irritation |
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nerve trapped in carpel tunnel syndrome
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median nerve
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common location for ulnar nerve injury
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medial epicondyle of humerus
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surgical option for Parkinson's if meds not working
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deep brain stimulation to basal ganglia or subthalamic nucleus
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surgical options for epilepsy if meds not working (2)
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temporal lobectomy
vagus nerve stimulation |
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what does SUDEP stand for
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sudden unexpected death in epilepsy
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def of epilepsy
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2+ unprovoked epileptic seizures
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although epilepsy can develop at any age, which ages are most common
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young and old
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what is the most common cause of epilepsy
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idiopathic (65%)
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what are partial (focal) seizures
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start in one part of the brain
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how is a simple partial seizure different than a complex partial seizure
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in a simple partial seizure, the patient has no impaired consciousness
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what is a grand mal seizure
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type of general seizure that has tonic clonic movements
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do absence seizures have a post-ictal period
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no
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EEG finding expected in absence seizures
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3/sec spike and wave
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another name for absence seizure
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petit mal seizure
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how is a simple partial seizure different than a complex partial seizure
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in a simple partial seizure, the patient has no impaired consciousness
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what is a grand mal seizure
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type of general seizure that has tonic clonic movements
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do absence seizures have a post-ictal period
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no
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EEG finding expected in absence seizures
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3/sec spike and wave
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another name for absence seizure
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petit mal seizure
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what should you do if your first AED (anti-epileptic drug) is not controlling a patient's seizures
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add a second drug. if they get better, slowly remove the first drug
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which AED's can you stop abruptly
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NONE!
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other name for dilantin
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phenytoin
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other name for tegretol
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carbemazapine
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which old AED causes autoinduction and what does that mean
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carbemazapine - it induces CYP 450 but is also metabolized by CYP 450
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what should you do if your first AED (anti-epileptic drug) is not controlling a patient's seizures
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add a second drug. if they get better, slowly remove the first drug
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which AED's can you stop abruptly
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NONE!
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other name for dilantin
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phenytoin
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other name for tegretol
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carbemazapine
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which old AED causes autoinduction and what does that mean
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carbemazapine - it induces CYP 450 but is also metabolized by CYP 450
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type of seizures carbemazapine treats
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partial epilepsy
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another name for depakote
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valproic acid
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valproic acid is used to treat what type of seizures
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generalized epilepsy
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tx for absence seizures
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ethosuximide (zarontin)
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another name for ethosuximide
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zarontin
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type of seizures carbemazapine treats
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partial epilepsy
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another name for depakote
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valproic acid
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valproic acid is used to treat what type of seizures
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generalized epilepsy
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tx for absence seizures
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ethosuximide (zarontin)
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another name for ethosuximide
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zarontin
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type of seizures carbemazapine treats
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partial epilepsy
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another name for depakote
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valproic acid
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valproic acid is used to treat what type of seizures
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generalized epilepsy
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tx for absence seizures
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ethosuximide (zarontin)
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another name for ethosuximide
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zarontin
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type of seizures carbemazapine treats
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partial epilepsy
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another name for depakote
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valproic acid
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valproic acid is used to treat what type of seizures
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generalized epilepsy
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tx for absence seizures
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ethosuximide (zarontin)
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another name for ethosuximide
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zarontin
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type of seizures carbemazapine treats
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partial epilepsy
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another name for depakote
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valproic acid
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valproic acid is used to treat what type of seizures
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generalized epilepsy
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tx for absence seizures
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ethosuximide (zarontin)
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another name for ethosuximide
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zarontin
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type of seizures carbemazapine treats
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partial epilepsy
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another name for depakote
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valproic acid
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valproic acid is used to treat what type of seizures
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generalized epilepsy
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tx for absence seizures
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ethosuximide (zarontin)
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another name for ethosuximide
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zarontin
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type of seizures carbemazapine treats
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partial epilepsy
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another name for depakote
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valproic acid
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valproic acid is used to treat what type of seizures
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generalized epilepsy
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tx for absence seizures
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ethosuximide (zarontin)
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another name for ethosuximide
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zarontin
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name the AED with the following SE:
gingival hypertrophy hirsutism Steven Johnson syndrome hepatic toxicity osteopenia/osteoperosis perhipheral neuropathy |
phenytoin (dilantin)
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name the AED with the following SE profile:
diplopia agranulocytosis hepatic failure |
carbemazapine (tegretol)
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AED with the following SE profile:
weight gain tremor alopecia hepatic toxicity |
valproic acid (depakote)
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AED with the following SE:
dizziness drowsiness |
ethosuximide (zarontin)
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def of pharmacokinetics
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what the body does to drugs
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def of pharmacodynamics
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study of what drugs do to the body
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AED used in ER for GTC seizures, especially if risk for status epilepticus
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phenytoin
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signs of phenytoin overdose
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ataxia
nystagmus |
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which AED's come in IV form and are thus good for status epilepticus (3)
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phenytoin
valproic acid phenobarbital |
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which AED's are CYP inducers
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(PCP)
phenytoin carbemazapine phenobarbital |
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AED CYP 450 inhibitors
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valproic acid
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what is lamotrigine used for (5)
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partial and gen seizures
childhood epilepsy bipolar d/o somnolence ataxia |
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another name for lamotrigine
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lamictal
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name that AED:
safe GABA analogue no blood studies required |
gabapentin
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another name for gabapentin
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neurontin
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AED used to treat:
partial epilepsy migraine neuropathic pain panic attacks |
gabapentin (neurontin)
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another name for the AED pregabalin
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lyrica
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another name for the AED levetiracetam
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keppra
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complications of the AED levetiracetam (keppra)
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behavioral: irritable, short-tempered
can worsen any psych problems |
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carbonic anhydrase inhibitor used for partial and generalized seizures
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topiramate (tompamax)
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def of status epilepticus
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recurrent seizures in short period of time without regaining consciousness between episodes
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tx for a patient in status epilepticus having active seizures
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1. lorazopam
2. fosphenytoin 3. if ineffective, more lorazopam 4. phenobarb, VPA, or keppra 5. pentobarb dosed based on continuous EEG 6. midazolam and propofol commonly used |
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surgical option in pharm-resistent epilepsy
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temporal lobectomy
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surgery to prevent generalization of seizures
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corpus callostomy (usually in kids)
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tx option for pharm-resistent epilepsy in patient that's not a surgical candidate
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vagal nerve stimulator
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what is a normal opening pressure in a lumbar puncture
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180-200
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what is normal glucose in LP
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>50
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what is normal protein in an LP
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15-45
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what is the empiric tx for acute bacterial meningitis in baby <1 mo
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ampicillin + cefotaxime
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what is the empiric abx tx for acute bacterial meningitis in 1mo-50 yrs
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vancomycin + 3rd gen cephalasporin
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what is the empiric abx tx for acute bacterial meningitis in someone >50 yrs old
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ampicillin + vancomycin + 3rd gen cephalasporin
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what med should be given with empiric abx in the tx of acute bacterial meningitis
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dexamethasone
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name the late manifestations of syphilllis
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tabes dorsalis:
dorsal column (ToPr VPr) lightening pains Argyll-Robertson pupils pos Rhomberg |
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organism responsible for progressive multifocal leukoencephalopathy
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JC virus
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what is the empiric tx of viral encephalitis
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acyclovir (until herpes simplex ruled out)
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