Week 2 SBL Learning Issues

Question 1

What are some common triggers for seizures?

Answer 1

• Specific time of day/night
• Stress
• Flashing lights
• Sleep deprivation
• Alcohol
• Menstrual cycle

(Basically: a nightclub full of ovulating women)

Question 2

What are some factors (not triggers) that can affect seizure threshold?

Answer 2

• Brain tumour
• Age
• Neurodegenerative diseases

Question 3

What are seizure auras?

Answer 3

A sense that one is about to have a seizure:
- Swirling colours
- Rising nausea
- Sense of impending doom

Question 4

Using a mnemonic, recall headache red flags

Answer 4

SNOOPP
S: Systemic symptoms and signs (fever, weight loss, myalgia)
N: Nauseau
O: Sudden onset
O: Older
P: Progressive (worse than past)
P: Postural, papilloedema, precipitators (ICP)

Question 5

What is the role of the reticular formation in consciousness?

Answer 5

• Projects into thalamus and cerebral cortex
• Controls which stimuli reach conscious awareness

Question 6

What are the three symptoms in the Cushing Reflex?

Answer 6

• Irregular respiratory rate
• Decreased HR
• Increased BP

Question 7

Explain the mechanism of cushing’s reflex

Answer 7

Trigger: Raised ICP
1. Cerebral iscahemia from decreased CPP causes sympathetic increase in BP + HR
2. Parasympathetic nervous system counteracts HR increase, causing bradycardia
3. Raised ICP compresses respiratory centre, causing irregular RR

Question 8

What type of seizures cause incontinence?

Answer 8

Atonic

Question 9

T1 vs T2 MRI

Answer 9

T1: Enhances fatty tissue, decreases water

T2: Enhances water

Question 10

How is Glioblastoma diagnosed?

Answer 10

• Neurological exam
• CT/MRI (MRI is preferrable)

Question 11

What are the mainstays of glioblastoma treatment?

Answer 11

• Surgery
• Radiation
• Chemotherapy

Question 12

Who is on a multidisciplinary glioblastoma team?

Answer 12

• Pathologist
• Oncologist
• Psychologist
• Oncology nurses
• Palliative care specialists
• Neurologist

Question 13

Use a pnemonic to explain how to deliver bad news

Answer 13

SPIKES
Setting: make sure it’s appropriate
Perspective: What do they know?
Invitation: How much do they want to know?
Knowledge: Tell them that
E: Empathy
S: Strategy -> explain what we’re going to do about it