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What is dysarthria?
Slurred Speech
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What three conditions may present with stroke s/s?
- Hypoglycemia
- Postictal State
- Subdural or Epidural Bleeding
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What is a postictal state or the postictal phase of a seizure?
The reset period of the brain.
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Describe a Epidural bleed.
A LAC or tear of the middle meningeal artery usually caused by blunt trauma, causing bleeding b/w the dura mater and the skull.
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Describe a Subdural bleed.
A venus tear or LAC below the dura mater usually caused by blunt trauma.
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What is a seizure?
Sudden, erratic firing of the neurons of the brain.
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What are the two classifications of seizures?
- Generalized - Affects a large portion of the brain.
- Partial - Affects a limited area of the brain.
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What are the two generalized seizure types?
- Absence (Petit Mal)
- Tonic-Clonic (Grand Mal)
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What are the two partial seizure types?
- Simple partial seizure
- Complex partial seizure
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What is a tonic-clonic (grand mal) seizure?
A seizure characterized by severe twitching of all of the body's muscles that may last several min. or more.
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What is the Aura phase of a seizure?
Sensations experienced before an attack occurs.
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What is the Tonic phase of a seizure?
Steady, rigid muscle contractions with no relaxation.
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What is the hypertonic phase of a seizure?
Arched back and rigidity
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What is the Clonic phase of a seizure?
Rhythmic contraction of major muscle groups.
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What is the post seizure phase?
Major muscles relax
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What are the seven phases of a tonic-clonic seizure?
- Aura
- LOC
- Tonic phase
- Hypertonic phase
- Clonic Phase
- Post seizure
- Postictal
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What is a absence (petit mal) seizure?
A seizure that may be characterized by a brief lapse of attention in which the pt. may stare and does not respond.
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What is the most common pt. of a absence seizure?
A child
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What is a simple partial seizure?
A seizure involving movement or altered sensations in one part of the body; the movement may stay in one body part or may spread to another part in a wave.
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What is a complex partial seizure?
A seizure that involves subtle changes in the LOC that may include confusion, less alertness, hallucinations, and inability to speak.
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What is status Epilepticus?
A seizure that last more than 4 or 5 min. or seizures that recur without a pt. regaining consciousness b/w them.
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What is hyponatremia?
Low sodium levels
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Define FACTS (mnemonic for seizures)
- F - Focus (Generalized or Focal)
- A - Activity (Type of movements)
- C - Color or Cocaine (Cyanosis? Indications of cocaine use?)
- T - Time (How long did the seizure last)
- S - Secondary Information (Meds? Incontinence? Tongue/cheek biting? Events leading up to the seizure)
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What is meningitis?
Inflammation of the meninges.
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What is encephalitis?
Inflammation in the brain
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What is a febrile seizure?
- A seizure that occurs as a result of a sudden high fever.
- **Its not how high the fever gets, but how fast it gets there**
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What is hemiparesis?
Weakness on one side of the body.
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What is lethargy?
Extreme fatigue or drowsiness.
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Define Altered Mental Status (AMS)
Pt. is not thinking clearly or is incapable of being aroused.
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Define Syncope
Fainting - The sudden and temporary LOC with accompanying loss of postural tone.
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Define AEIOU-TIPS (AMS Mnemonic)
- A - Alcohol, Acidosis
- E - Encephalitis, Epilepsy
- I - Insulin
- O - Overdose
- U - Uremia
- T - Trauma
- I - Infection
- P - Psychiatric
- S - Seizure
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Name the two abnormal postures a pt. may demonstrate with painful stimuli that indicates increased ICP.
- Decorticate Posturing
- Decerebrate Posturing
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What is decorticate posturing?
Pt. flexes the arms and curls them toward the chest, points toes, and flexes wrist.
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What is decerebrate posturing?
Pt. points toes, flexes wrist, and extends arms outward.
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What is trismus?
Clenched teeth
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Fibrinolytics can be used in pt. with a CVA if given within __ hrs. of onset of symptoms.
3
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Name and explain the three parts of the Cincinnati Prehospital Stroke Scale (CPSS).
- Facial Droop - Ask pt. to smile and show teeth.
- Arm Drift - Ask pt. to hold arms out with palms up and close eyes.
- Speech - Ask pt. to say "You can't teach an old dog new tricks"
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What is hemiplegia?
Paralysis to one side of the body.
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Pt. with increased ICP needs to maintain a SBP of at least ___.
110 - 120 mm Hg
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What is normal Sp02?
95% - 100%
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What 2 things should be checked with infants who are suspected of having increased ICP?
- "Cats eyes and cats crys"
- Pupil size - oval shape indicates increased ICP
- Crys - High pitched catlike cry indicates increased ICP
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During a seizure, if the pt. is apneic for more than ___ sec, being ventilations.
30
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What is a poison or toxin?
A substance that is toxic by nature, no matter how it gets into the body or in what quantities it is taken.
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What is a drug?
A substance that has some therapeutic effect when given in the appropriate circumstances and in the appropriate dose.
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What is a overdose?
When a drug (licit or illicit) is taken in excess.
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What is toxicology?
The study of toxic or poisonous substances.
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What are the four primary methods of entry for a toxin into the body?
- Ingestion
- Inhalation
- Injection
- Absorption
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What is a toxidrome?
The syndrome-like symptoms of a poisonous agent.
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What is substance abuse?
The self administration of licit or illicit substances in a manner not in accord with approved medical or social practice.
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What is drug abuse?
Any use of drugs that causes physical, psychological, economic, legal, or social harm to the user or to others affected by the drug users behavior.
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What is habituation?
Psychological dependence on a drug.
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What is physical dependence?
A physiological state of adaptation to a drug, usually characterized by tolerance to the drugs effect and a withdrawal syndrome if the drug is stopped.
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What is psychological dependence?
The emotional state of craving a drug to maintain a feeling of well-being.
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What is tolerance?
Physiologic adaptation to the effects of a drug such that increasing larger doses of the drug are required to achieve the same effect.
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What is withdrawal syndrome?
A predictable set of s/s, usually involving altered CNS activity, that occurs after the abrupt cessation of a drug or after rapidly decreasing the usual dosage of a drug.
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What is drug addiction?
A chronic disorder characterized by the compulsive use of a substance resulting in physical, psychological, or social harm to the user, who continues to use the substance despite the harm.
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What is a antagonist?
Something that counteracts the action of something else.
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What is potentiation?
Enhancement of the effect of one drug by another drug.
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What is synergism?
- The action of two substances, in which the total effect is greater than the sum of the independent effects.
- 2+2=5
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What is alcoholism?
A state of physical and psychological addiction to ethanol (ETOH).
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What are delirium tremens (DTs)?
A severe withdrawal syndrome seen in people with alcoholism who are deprived of ethyl alcohol.
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What is a narcotic?
A drug that produces sleep or AMS.
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What are the two main classifications of narcotics?
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What is a opiate?
Natural drugs derived from opium.
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What is a opioid?
Non-opium derived synthetics.
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What are stimulants?
An agent that produces an excited state.
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What is marijuana?
The dried leaves and flower buds of the cannabis sativa plant that are smoked to achieve a high.
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What is a hallucinogen?
An agent that produces false perceptions in any one of the five senses.
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What is synthesthesias?
Crossing of the senses.
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What is a sedative?
A drug that reduces anxiety and calms agitated pt.
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What is a hypnotic?
A drug that produces drowsiness and sleep.
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What are barbiturates?
Potent sedative-hypnotics
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What are benzodiazepines?
The family of sedative-hypnotics most commonly used to treat anxiety, seizures, and alcohol withdrawal.
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What are organophosphates?
A class of chemical found in many insecticides used in agriculture and in the home.
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Define SLUDGEM (mnemonic for nerve agents and organophosphates)
- S - Salivation, Sweating
- L - Lacrimation
- U - Urination
- D - Defecation, Drooling, Diarrhea
- G - Gastric upset and cramps
- E - Emesis
- M - Miosis, Muscle twitching
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Define DUMBELS (mnemonic for nerve agents and organophosphates)
- D- Diarrhea
- U - Urination
- M - Miosis
- B - Bradycardia, Bronchospasm
- E - Emesis
- L - Lacrimation
- S - Seizures, Salivation, Sweating
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What is carbon monoxide (CO)?
An odorless, highly poisonous gas that results from incomplete oxidation of carbon in combustion.
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What are caustics?
Chemicals that are acids or alkalis.
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What is gamma-hydroxybutyrate (GHB)?
- A sedative and CNS depressant
- Date rape drug
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What are hydrocarbons?
Compounds made up principally of hydrogen and carbon atoms mostly obtained from the distillation of petroleum.
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What are tricyclic antidepressants (TCAs)?
A group of drugs used to treat severe depression and manage pain.
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What are monoamine oxidase inhibitors (MAOIs)?
Psychiatric medications used primarily to treat atypical depression by increasing norepinephrine and serotonin levels in the CNS.
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What are selective serotonin reuptake inhibitors (SSRIs)?
A class of antidepressant that inhibits the reuptake of serotonin.
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What is lithium?
The cornerstone drug for the Tx of bipolar disorder.
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What are salicylates?
Aspirinlike drugs
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What are the top three food poison toxins?
- Salmonella
- Listeria
- Toxoplasma
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What is dieffenbachia?
- A common house plant that resembles "elephant ears"; ingestion leads to burns of the mouth and tongue and possibly paralysis of the vocal cords and N/V.
- AKA Dumb Cane
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What is behavior?
How a person functions or acts in response to his or her environment.
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What is a behavioral crisis?
The point at which a persons reactions to events interfere with activities of daily living (ADL).
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What are activities of daily living (ADL)?
- The basic activities a person usually accomplishes during a normal day.
- Ex: eating, dressing
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What is depression?
A persistent feeling of sadness, despair, and discouragement.
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What is a mental disorder?
An illness with psychological or behavioral symptoms that may result in impaired function.
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What are the two categories of mental disorders?
- Organic (Physical)
- Functional (Psychological)
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What is organic brain syndrome?
A temporary or permanent dysfunction of the brain, caused by a disturbance in the physical or physiologic functioning of brain tissue.
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What is altered mental status (AMS)?
A change in the way a person thinks or behaves.
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What is a functional disorder?
A disorder in which there is no known physiologic reason for the abnormal functioning of an organ or system.
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What is psychogenic?
symptom of illness that is caused by mental factors as opposed to physical ones.
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What is psychosis?
A mental disorder characterized by the loss of contact with reality.
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