INSTRUCTIONS READ EACH QUESTION GIVE IT YOUR BEST SHOT GOOD LUCK! Israel Alfonso, MD

INSTRUCTIONSREAD EACH QUESTION GIVE IT YOUR BEST SHOT GOOD LUCK! Israel Alfonso, MD

INFANCY INCLUDES FROM:

A. BIRTH TO 1 MONTH OF AGE

B. 1 MONTH TO 1 YEAR OF AGE

C. 1 YEAR TO 6 YEARS OF AGE

D. 6 YEARS TO 12 YEARS OF AGE

SHOW ME THE QUESTION AGAINGO TO THE NEXT QUESTIONI WANT TO SEE THE CLUE, ANYWAY

I WANT TO TRY AGAINJUST GIVE ME THE ANSWERGIVE ME A CLUE

CLASSIFICATION OF EPILEPSY BY AGENEONATAL PERIOD (UP TO 1 MONTH)INFANCY (1 MONTH TO 1 YEAR)EARLY CHILDHOOD (1 YEAR TO 6 YEARS)LATE CHILDHOOD (FROM 6 TO 13 YEARS)ADOLESCENCE (FROM 13 TO 20 YEARS)

INFANCY INCLUDES FROM:

A. BIRTH TO 1 MONTH OF AGE

B. 1 MONTH TO 1 YEAR OF AGE

C. 1 YEAR TO 6 YEARS OF AGE

D. 6 YEARS TO 12 YEARS OF AGE

2. SYNDROMIC CLASSIFICATION OF SEIZURES IS BASED ON:

A. AGE

B. COURSE

C. SEIZURE TYPE

D. ALL OF THE ABOVE

CLASSIFICATION OF EPILEPSYAGENEONATESINFANTSCHILDHOODEARLYLATEADOLESCENCE

CLASSIFICATION OF EPILEPSYSEIZURE TYPEGENERALIZEDFRONTALPARTIALPARIETALTEMPORALOCCIPITALSYNDROME ?YESN0INSULA

CLASSIFICATION OF EPILEPSYAGENEONATESINFANTSCHILDHOODEARLYLATEADOLESCENCESYNDROME ?YESN0

CLASSIFICATION OF EPILEPSYCAUSEINHERITEDOTHERSSYNDROME ?YESN0

CLASSIFICATION OF EPILEPSYCOURSEGOODBADSYNDROME ?YESN0

2. SYNDROMIC CLASSIFICATION OF SEIZURES IS BASED ON:

A. AGE

B. COURSE

C. SEIZURE TYPE

D. ALL OF THE ABOVE

3. SYNDROMIC CLASSIFICATION OF SEIZURES IS BETTER THAN OTHER CLASSIFICATIONS:

A. TRUE

B. FALSE

SYNDROMEAGESEIZURE TYPECAUSECOURSECLINICALUNKNOWNFAMILIALOTHERSEEGEFFECTIVE AEDNEUROLOGICAL EXAMNORMALABNORMALIF YOU KNOW 2 FACTORS, YOU KNOW ALL

3. SYNDROMIC CLASSIFICATION OF SEIZURES IS BETTER THAN OTHER:

A. TRUE

B. FALSE

4. WHICH OF THE FOLLOWING SEIZURE TYPES IS NOT FREQUENTLY ENCOUNTERED IN NEONATES?

A. GENERALIZED SEIZURES

B. FOCAL SEIZURES

C. MULTIFOCAL SEIZURES

D. MYOCLONIC SEIZURES

E. SUBTLE SEIZURES

THIS IS A VERY RARE TYPE OF SEIZURESTHIS IS A VERY FREQUENT TYPE OF SEIZURES (IT IS A LONG VIDEO, LOOK AT LEFT FOOT)

4. WHICH OF THE FOLLOWING SEIZURE TYPES IS NOT FREQUENTLY ENCOUNTERED IN NEONATES?

A. GENERALIZED SEIZURES

B. FOCAL SEIZURES

C. MULTIFOCAL SEIZURES

D. MYOCLONIC SEIZURES

E. SUBTLE SEIZURES

5. ALL SEIZURES IN NEONATES ARE EPILEPTIC.

A. TRUE

B. FALSE

CLINICAL SEIZURESELECTRICAL SEIZURESEPILEPTICNONEPILEPTICCLASSIFICATION OF SEIZURESNO ANTIEPILEPTIC DRUGS

5. ALL SEIZURES IN NEONATES ARE EPILEPTIC.

A. TRUE

B. FALSE

6. AICARDI SYNDROME IS CHARACTERIZED BY ALL OF THE FOLLOWING, EXCEPT: A. COLOBOMAS OF THE IRIS

B. RETINAL LACUNAE C. ABSENCE OF THE CORPUS CALLOSUM

D. TESTICULAR TUMOR

AICARDI SYNDROMEAGENESIS OF THE CORPUS CALLOSUMRETINAL LACUNAE

6. AICARDI SYNDROME IS CHARACTERIZED BY ALL OF THE FOLLOWING, EXCEPT: A. COLOBOMAS OF THE IRIS

B. RETINAL LACUNAE C. ABSENCE OF THE CORPUS CALLOSUM

D. TESTICULAR TUMOR

7. A NEONATE WITH HYPOCALCEMIC SEIZURES RESISTANT TO CALCIUM SHOULD MAKE YOU THINK OF:

A. HYPOMAGNESEMIA

B. DIGEORGE SYNDROME

C. TUBEROUS SCLEROSIS

D. INCONTINENTIA PIGMENTI

INTRAMUSCULAR MAGNESIUM0.2 mL/kg

7. A NEONATE WITH HYPOCALCEMIC SEIZURES RESISTANT TO CALCIUM SHOULD MAKE YOU THINK OF:

A. HYPOMAGNESEMIA


C. TUBEROUS SCLEROSIS

D. INCONTINENTIA PIGMENTI

8. HYPOCALCEMIA IN AN INTERICTALLY ALERT GOOD LOOKING LEAN NEONATES IS LIKELY TO BE DO TO

A. HIGH-PHOSPHATE FEEDINGS


C. MATERNAL DIABETES

D. HYPOMAGNESEMIA

9. A YELLOWISH (XANTHOCHROMATIC) SUPERNATANT CSF SUGGESTS ALL OF THE FOLLOWING, EXCEPT:

A. JAUNDICE

B. SUBARACHNOID BLEED

C. INTRAVENTRICULAR BLEED

D. XANTHINE OXIDASE DEFICIENCY

CSFJAUNDICESUBARACHNOID BLEEDINTRAVENTRICULAR BLEEDCAROTINEMIA

9. A YELLOWISH (XANTHOCHROMATIC) SUPERNATANT CSF SUGGESTS ALL OF THE FOLLOWING, EXCEPT:

A. JAUNDICE

B. SUBARACHNOID BLEED

C. INTRAVENTRICULAR BLEED

D. XANTHINE OXIDASE DEFICIENCY

10. FAILURE TO RESPOND TO 200 MG OF IV PYRIDOXINE EXCLUDES THE POSSIBILITY OF PYRIDOXINE RESPONSIVE SEIZURES.

A. TRUE

B. FALSE

PYRIDOXINE DEPENDENCYMONITOR PATIENT, MAY STOP BREATHING IT MAY TAKE HOURS FOR EEG TO BE NORMAL (NOT SECONDS)FAILURE OF IV; TRY 20 MG/D PO FOR 6 WK

10. FAILURE TO RESPOND TO 200 MG OF IV PYRIDOXINE EXCLUDES THE POSSIBILITY OF PYRIDOXINE RESPONSIVE SEIZURES.

A. TRUE

B. FALSE

11. WHICH OF THE FOLLOWING SYNDROME DO NOT OCCUR IN THE NEONATAL PERIOD

A. BENIGN FAMILIAL NEONATAL SEIZURESB. OHTAHARA SYNDROME

C. LANDAU-KLEFFNER SYNDROME

D. GELASTIC SEIZURES

EPILEPSY SYNDROMES OF NEONATAL - ONSETBENIGN NEONATAL CONVULSIONSBENIGN NEONATAL FAMILIAL CONVULSIONSOHTAHARA SYNDROME (EARLY INFANTILE EPILEPTIC ENCEPHALOPATHY WITH BURST SUPPRESSION) GELASTIC SEIZURES**HYPOGLYCEMIA, HYPOCALCEMIA, PYRIDOXINE , FOLINIC ACID , MENINGITIS, HYPERAMMONEMIA, BIOTINIDASE , STROKE, BRAIN MALFORMATION MAPLE SYRUP URINE DISEASE

11. WHICH OF THE FOLLOWING SYNDROME DO NOT OCCUR IN THE NEONATAL PERIOD

A. BENIGN FAMILIAL NEONATAL SEIZURESB. OHTAHARA SYNDROME

C. LANDAU-KLEFFNER SYNDROME

D. GELASTIC SEIZURES

12. A 5-DAY-OLD NEONATE STARTS HAVING SEIZURES, NEUROLOGICAL EXAMINATION IS NORMAL. THE MOST LIKELY DIAGNOSIS IS BENIGN NEONATAL SEIZURES.

A. TRUE

B. FALSE

SEIZURE TYPE: EEG: TREATMENT: BENIGN NEONATAL CONVULSIONSCLONIC, APNEA, NEVER TONIC THETA POINTU ALTERNANT (NOT SPECIFIC)DIAGNOSIS OF EXCLUSIONONSET OF SEIZURES AT 5 DAYS OF AGE (FIFTH DAY FITS)NORMAL NEUROLOGICAL EXAMINATIONNO ETIOLOGY (LOOK HARD FOR ONE)PHENOBARBITAL

BENIGN NEONATAL CONVULSIONSAGESEIZURE TYPECAUSEGOODCLINICALUNKNOWNFAMILIALOTHERSEEGPHENOBARBITALNEUROLOGICAL EXAMNORMALABNORMAL< 1MNORMALNOT TONIC

12. A 5-DAY-OLD NEONATE STARTS HAVING SEIZURES, NEUROLOGICAL EXAMINATION IS NORMAL. THE MOST LIKELY DIAGNOSIS IS BENIGN NEONATAL SEIZURES.

A. TRUE

B. FALSEBENIGN NEONATAL SEIZURES (5 DAY SEIZURES) IS A DIAGNOSIS OF EXCLUSION

13. BENIGN FAMILIAL NEONATAL SEIZURES ARE CHARACTERIZED BY ALL OF THE FOLLOWING EXCEPT:

A. NORMAL EEG BACKGROUND

B. NO DETECTABLE CAUSE

C. POSITIVE FAMILY HISTORY OF SEIZURE DURING THE NEONATAL PERIOD

D. LINKED TO CHROMOSOME 15

SEIZURE TYPE: EEG: TREATMENT: BENIGN NEONATAL FAMILIAL CONVULSIONSCLONIC, APNEA, NEVER TONIC NONEDIAGNOSIS: FAMILY HISTORY OF NEONATAL CONVULSION ONSET OF SEIZURES AT 2 TO 3 DAYS OF AGE (

BENIGN FAMILIAL NEONATAL CONVULSIONSAGESEIZURE TYPECAUSEGOODCLINICALUNKNOWNFAMILIALOTHERSEEGPHENOBARBITALNEUROLOGICAL EXAMNORMALABNORMAL< 1MNORMALNOT TONIC

13. BENIGN FAMILIAL NEONATAL SEIZURES ARE CHARACTERIZED BY ALL OF THE FOLLOWING EXCEPT:

A. NORMAL EEG BACKGROUND

B. NO DETECTABLE CAUSE

C. POSITIVE FAMILY HISTORY OF SEIZURE DURING THE NEONATAL PERIOD

D. LINKED TO CHROMOSOME 15

14. A 3-DAY-OLD NEONATE STARTS HAVING SEIZURES, NEUROLOGICAL EXAMINATION IS NORMAL; THE FATHER, WHO IS MENTALLY RETARDED ALSO HAD SEIZURES AS A NEONATE. THE MOST LIKELY DIAGNOSIS IS BENIGN FAMILIAL NEONATAL CONVULSIONS.

A. TRUE

B. FALSE

BENIGN FAMILIAL NEONATAL CONVULSIONSAGESEIZURE TYPECAUSEGOODCLINICALUNKNOWNFAMILIALOTHERSEEGPHENOBARBITALNEUROLOGICAL EXAMNORMALABNORMAL< 1MNORMALNOT TONIC

14. A 3-DAY-OLD NEONATE STARTS HAVING SEIZURES, NEUROLOGICAL EXAMINATION IS NORMAL; THE FATHER, WHO IS MENTALLY RETARDED ALSO HAD SEIZURES AS A NEONATE. THE MOST LIKELY DIAGNOSIS IS BENIGN FAMILIAL NEONATAL CONVULSIONS.

A. TRUE

B. FALSE

15. FAMILIAL BENIGN NEONATAL CONVULSION IS LINKED TO CHROMOSOMES:

A. 7 AND 4

B. 16 AND 12

C. 20 AND 8

D. 23 AND 58

16. FAMILIAL BENIGN NEONATAL CONVULSION IS A _______ DISORDER.

A. SEX LINKED RECESSIVE

B. AUTOSOMAL RECESSIVE

C. AUTOSOMAL DOMINANT

D. SEX LINKED DOMINANT

17. WHAT EEG PATTERN IS CHARACTERISTIC OF OHTAHARA SYNDROME?

A. BURST SUPPRESSION PATTERN

B. GENERALIZED 3-PER-SECOND SPIKE AND WAVE

C. HYPSARHYTHMIA

D. FOCAL SHARP WAVES IN THE CENTROTEMPORAL REGION

OHTAHARA SYNDROMEAGESEIZURE TYPECAUSECOURSECLINICALUNKNOWNFAMILIALOTHERSEEGAED ARE INEFFECTIVE< 1MBURST SUPPRESSION PATTERNPOOR

OHTAHARA SYNDROMEBURST SUPPRESSION PATTERNBURSTBURSTSUPPRESSIONBURST

17. WHAT EEG PATTERN IS CHARACTERISTIC OF OHTAHARA SYNDROME?



C. HYPSARHYTHMIA


18. OHTAHARA SYNDROME IS A BENIGN CONDITION.

A. TRUE

B. FALSE

SEIZURE TYPE: EEG: SEARCH FOR ETIOLOGY: WOODS LAMP, METABOLIC DISORDERS (BIOTINIDASE), TRIALS OF B6 & FOLINIC ACID; ANTIEPILEPTIC DRUGS NOT EFFECTIVE, BUT TRYOHTAHARA SYNDROME (EARLY INFANTILE EPILEPTIC ENCEPHALOPATHY WITH BURST SUPPRESSION) TONIC AND OTHERS BURST SUPPRESSION (ESTABLISHES DIAGNOSIS)VARIETIES: IDIOPATHIC (RARE) SYMPTOMATICCRYPTOGENICEXAMCAUSENEGATIVENONEABNORMALNONEPRESENTEITHERPROGNOSIS: POOR

18. OHTAHARA SYNDROME IS A BENIGN CONDITION.

A. TRUE

B. FALSE

19. GIGGLING IN A NEONATE CAN BE A SIGN OF

A. MENINGITIS

B. HYPOTHALAMIC HAMARTOMA

C. TEMPORAL LOBE SCLEROSIS

SEIZURE TYPE: EEG: TREATMENT: GELASTIC SEIZURESBRIEF EPISODES OF PLEASANT LAUGHTER AND GIGGLING, FACIAL FLUSHING AND MYDRIASISNORMAL, EVEN DURING EPISODESSURGERY, PHENOBARBITALETIOLOGY: HYPOTHALAMIC HAMARTOMA

19. GIGGLING IN A NEONATE CAN BE A SIGN OF

A. MENINGITIS

B. HYPOTHALAMIC HAMARTOMA

C. TEMPORAL LOBE SCLEROSIS

20. WHICH OF THE FOLLOWING EPILEPTIC SYNDROMES DO NOT USUALLY OCCUR DURING INFANCY?

A. FEBRILE SEIZURES

B. WEST SYNDROME

C. TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOOD

D. MYOCLONIC EPILEPSY OF JANZ

EPILEPSY SYNDROMES OF ONSET - DURING INFANCYWEST SYNDROME (INFANTILE SPASM) FEBRILE SEIZURES BENIGN MYOCLONIC EPILEPSY OF INFANCY

20. WHICH OF THE FOLLOWING EPILEPTIC SYNDROMES USUALLY OCCUR DURING INFANCY?

A. FEBRILE SEIZURES

B. WEST SYNDROME

C. TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOOD

D. MYOCLONIC EPILEPSY OF JANZ

21. A 2-MINUTE SEIZURE IN A 3-YEAR-OLD WITH MENINGITIS AND HIGH FEVER MAY SHOULD BE CLASSIFIED AS:

A. A SIMPLE FEBRILE SEIZURES

B. A COMPLEX FEBRILE SEIZURES

C. NONE OF THE ABOVE

SIMPLE FEBRILE SEIZURES FEBRILE SEIZURES SEIZURE THAT OCCURS BETWEEN 3 MONTHS AND 5 YEARS OF AGE (PEAK 14-18 M), ASSOCIATED WITH FEVER, WITHOUT INTRACRANIAL DEMONSTRABLE PATHOLOGY LESS THAN 15 MINUTES GENERALIZED NO RECURRENCE IN 48 HOURSNORMAL NEUROLOGICAL EXAMINATIONCOMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROLDIAZEPAM (PO): 0.33 MG/KG Q 8 HOURSDIASTAT 2.5;5;10 MG (RECTAL): < 10 MGPHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG 2-5 0.55-11 0.3>12 0.2DIASTAT

21. A 2-MINUTE SEIZURE IN A 3-YEAR-OLD WITH MENINGITIS AND HIGH FEVER MAY CAN BE CLASSIFIED AS:

A. A SIMPLE FEBRILE SEIZURES

B. A COMPLEX FEBRILE SEIZURES

C. NONE OF THE ABOVE

22. AT WHAT AGE ARE FEBRILE SEIZURES MOST FREQUENT?

A. 6 TO 10 MONTHS

B. 14 TO 18 MONTHS

C. 24 TO 28 MONTHS

D. 36 TO 40 MONTHS

SIMPLE FEBRILE SEIZURES FEBRILE SEIZURES SEIZURE THAT OCCURS BETWEEN 3 MONTHS AND 5 YEARS OF AGE (PEAK 14-18 M), ASSOCIATED WITH FEVER, WITHOUT INTRACRANIAL DEMONSTRABLE PATHOLOGY LESS THAN 15 MINUTES GENERALIZED NO RECURRENCE IN 48 HOURSNORMAL NEUROLOGICAL EXAMINATIONCOMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROLDIAZEPAM (PO): 0.33 MG/KG Q 8 HOURSDIASTAT 2.5;5;10 MG (RECTAL): < 10 MGPHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG 2-5 0.55-11 0.3>12 0.2DIASTAT

22. AT WHAT AGE ARE FEBRILE SEIZURES MOST FREQUENT?

A. 6 TO 10 MONTHS

B. 14 TO 18 MONTHS

C. 24 TO 28 MONTHS

D. 36 TO 40 MONTHS

23. THE FEBRILE SEIZURE GENE HAS BEEN MAPPED TO CHROMOSOME 19p AND 8q13-21 IN SOME FAMILIES.

A. TRUE

B. FALSE

SIMPLE FEBRILE SEIZURES FEBRILE SEIZURES IN LARGE FAMILIES LINKED TO 19 AND 8. SOMETIMES AUTOSOMAL DOMINANT. AFFECT 3 TO 4 % OF KIDS LESS THAN 15 MINUTES GENERALIZED NO RECURRENCE IN 48 HOURSNORMAL NEUROLOGICAL EXAMINATIONCOMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROLDIAZEPAM (PO): 0.33 MG/KG Q 8 HOURSDIASTAT 2.5;5;10 MG (RECTAL): < 10 MGPHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG 2-5 0.55-11 0.3>12 0.2DIASTATTHINK, CNS PROBLEMS

23. THE FEBRILE SEIZURE GENE HAS BEEN MAPPED TO CHROMOSOME 19p AND 8q13-21 IN SOME FAMILIES.

A. TRUE

B. FALSE

24. ORGANIC CNS PATHOLOGY IS MORE LIKELY IN PATIENTS WITH:

A. BENIGN ROLANDIC EPILEPSY

B. SIMPLE FEBRILE SEIZURE

C. EPILEPSY OF JANZ

D. COMPLEX FEBRILE SEIZURES

SIMPLE FEBRILE SEIZURES FEBRILE SEIZURES IN LARGE FAMILIES LINKED TO 19 AND 8. SOMETIMES AUTOSOMAL DOMINANT. AFFECT 3 TO 4 % OF KIDS LESS THAN 15 MINUTES GENERALIZED NO RECURRENCE IN 48 HOURSNORMAL NEUROLOGICAL EXAMINATIONCOMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROLDIAZEPAM (PO): 0.33 MG/KG Q 8 HOURSDIASTAT 2.5;5;10 MG (RECTAL): < 10 MGPHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG 2-5 0.55-11 0.3>12 0.2DIASTATTHINK, CNS PROBLEMS

24. ORGANIC CNS PATHOLOGY SUCH AS INFECTIONS OR TOXIC PROCESS IS MORE LIKELY IN PATIENTS WITH:


B. SIMPLE FEBRILE SEIZURE

C. EPILEPSY OF JANZ

D. COMPLEX FEBRILE SEIZURES

25. ALL OF THE FOLLOWING ARE RISK FACTORS FOR EPILEPSY AS A COMPLICATION OF FEBRILE SEIZURES, EXCEPT:

A. COMPLEX FEBRILE SEIZURES

B. ONSET BEFORE 9 MONTHS OF AGE

C. OCCURRENCE DURING LOW-GRADE TEMPERATURE

D. FAMILY HISTORY OF EPILEPSY

NO RISK FACTORS FEBRILE SEIZURES DURATION: MORE THAN 15 MINUTES FOCALRECURRENCE IN 48 HOURSABNORMAL NEUROLOGICAL EXAMINATIONEPILEPSY: 1% RISK FACTORS FAMILY HISTORY OF EPILEPSYDEVELOPMENTAL DELAYTHE PRESENCE OF SEVERAL OF THIS FACTORS MAKES THE RISK OF EPILEPSY: 9%

25. ALL OF THE FOLLOWING ARE RISK FACTORS FOR EPILEPSY AS A COMPLICATION OF FEBRILE SEIZURES, EXCEPT:

A. COMPLEX FEBRILE SEIZURES

B. ONSET BEFORE 9 MONTHS OF AGE

C. OCCURRENCE DURING LOW-GRADE TEMPERATURE

D. FAMILY HISTORY OF EPILEPSY

26. AN EEG IS INDICATED IN PATIENTS WITH THE FIRST SIMPLE FEBRILE SEIZURE.

A. TRUE

B. FALSE

27. AN EFFECTIVE AND SAFE METHOD TO REDUCE FEBRILE SEIZURES IS:

A. RECTAL DIAZEPAM AT THE ONSET OF FEVER

B. ORAL DIAZEPAM AT THE ONSET OF FEVER

C. RECTAL VALPROATE ACID AT THE ONSET OF FEVER

D. DAILY ORAL PHENOBARBITAL

SIMPLE FEBRILE SEIZURES FEBRILE SEIZURES IN LARGE FAMILIES LINKED TO 19 AND 8. SOMETIMES AUTOSOMAL DOMINANT. AFFECT 3 TO 4 % OF KIDS LESS THAN 15 MINUTES GENERALIZED NO RECURRENCE IN 48 HOURSNORMAL NEUROLOGICAL EXAMINATIONCOMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROLDIAZEPAM (PO): 0.33 MG/KG Q 8 HOURS FROM FEVER ONSET TO FINISHDIASTAT 2.5;5;10 MG (RECTAL): < 10 MGPHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG 2-5 0.55-11 0.3>12 0.2DIASTATTHINK, CNS PROBLEMS

27. AN EFFECTIVE AND SAFE METHOD TO REDUCE FEBRILE SEIZURES IS:

A. RECTAL DIAZEPAM AT THE ONSET OF FEVER

B. ORAL DIAZEPAM AT THE ONSET OF FEVER

C. RECTAL VALPROATE ACID AT THE ONSET OF FEVER

D. DAILY ORAL PHENOBARBITAL

28. THE FOLLOWING STATEMENTS ABOUT TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOOD ARE TRUE, EXCEPT:

A. OCCURS BETWEEN 6 MONTHS AND 4 YEARS OF AGE

B. MENTAL RETARDATION IS FREQUENT

C. LANGUAGE AND EMOTIONAL PROBLEMS ARE FREQUENT

D. FAMILY HISTORY OF EPILEPSY IN A THIRD OF CASES

TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOODNORMAL EEG BACKGROUNDFAST SPIKE WAVES COMPLEX > 2.5 Hz50 % ARE SEIZURE FREE AFTER FEW YEARS33 % POSITIVE FAMILY HISTORYOFTEN DEVELOP PROBLEMS WITH:LEARNING AND LANGUAGEEMOTIONS AND BEHAVIORMENTAL RETARDATION IS RARE

SEIZURE TYPE: EEG: TREATMENT: TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOODUPPER LIMB MYOCLONUS, AWAKE AND SLEEPGB: NORMAL, ICTAL GENERALIZED SPIKE & WAVEDIAGNOSIS: EXCLUDE SLEEP MYOCLONUS (NO ICTAL ONSET OF SEIZURES: 6 MONTHS TO 3 YEARS OF AGENORMAL NEUROLOGICAL EXAMINATIONNO ETIOLOGYVALPROIC ACID ?FAMILY HISTORY OF SEIZURES (SOMETIMES)EEG CHANGES)

28. THE FOLLOWING STATEMENTS ABOUT TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOOD ARE TRUE, EXCEPT:

A. OCCURS BETWEEN 6 MONTHS AND 4 YEARS OF AGE

B. MENTAL RETARDATION IS FREQUENT

C. LANGUAGE AND EMOTIONAL PROBLEMS ARE FREQUENT

D. FAMILY HISTORY OF EPILEPSY IN A THIRD OF CASES

29. ALL THE SPASMS IN INFANTS WITH INFANTILE SPASM LOOK THE SAME.

A. TRUE

B. FALSE

WEST SYNDROME (INFANTILE SPASM) GENERALIZED FLEXOR SPASMPARTIAL LEFT ARM SPASMHIP FLEXION SPASMHEAD DROP

29. ALL THE SPASMS IN INFANTS WITH INFANTILE SPASM LOOK THE SAME.

A. TRUE

B. FALSE

30. ALL OF THE FOLLOWING ARE POSSIBLE CAUSES OF WEST SYNDROME, EXCEPT:

A. TUBEROUS SCLEROSIS

B. FEBRILE SEIZURES

C. A NEONATAL STROKE

D. HYPOXIC ISCHEMIC ENCEPHALOPATHY

SEIZURE TYPE: EEG: SEARCH FOR ETIOLOGY: WOODS LAMP, METABOLIC DISORDERS (BIOTINIDASE), TRIALS OF B6 & FOLINIC ACID; ANTIEPILEPTIC DRUGS EFFECTIVE (ACTH, VPA, VIGABATRIN [BLINDNESS] FOR TUBEROUS SCLEROSIS); FREQUENTLY HISTORY OF OHTAHARA SYNDROMEWEST SYNDROME (INFANTILE SPASM) FLEXOR SPASM, EXTENSION SPASM, OTHERS (SOMETIMES PRECEDED BY CRY)VARIETIES: IDIOPATHIC (RARE) SYMPTOMATICCRYPTOGENICEXAMCAUSENEGATIVENONEABNORMALNONEPRESENTEITHERHYPSARHYTHMIA (ESTABLISHES DIAGNOSIS)PROGNOSIS: POOR NOT PRODUCED BY IMMUNIZATIONS! *

SEIZURE TYPE: EEG: WEST SYNDROME (INFANTILE SPASM) FLEXOR SPASM, EXTENSION SPASM, OTHERS (SOMETIMES PRECEDED BY CRY)VARIETIES AS PER NELSON SYMPTOMATICCRYPTOGENIC NEURO EXAMNORMALIF NOT CRYPTOGENICPREGNANCYBADHYPSARHYTHMIA (ESTABLISHES DIAGNOSIS)PROGNOSIS*NORMALBIRTH HISTORYDEVELOPMENTBRAIN CT & MRI RISK FACTORSNORMALNORMALNORMALNONEGOOD


A. TUBEROUS SCLEROSIS

B. FEBRILE SEIZURES

C. A NEONATAL STROKE

D. HYPOXIC ISCHEMIC ENCEPHALOPATHY


A. PYRIDOXINE DEPENDENCY

B. LISSENCEPHALY

C. CONGENITAL INFECTIONS

D. IMMUNIZATIONS

32. A THERAPEUTIC TRIAL OF B6 AND FOLINIC ACID SHOULD BE INSTITUTED IN ALL INFANTS WITH WEST SYNDROME. A. TRUE

B. FALSE

32. A THERAPEUTIC TRIAL OF B6 AND FOLINIC ACID SHOULD BE INSTITUTED IN ALL INFANTS WITH WEST SYNDROME. A. TRUE

B. FALSE (NOT IF AN ALTERNATIVE CAUSE IS KNOW)

33. THE DIFFERENTIAL DIAGNOSIS OF MYOCLONIC ACTIVITY IN A NEUROLOGICALLY NORMAL INFANT INCLUDES:

A. BENIGN MYOCLONIC EPILEPSY OF EARLY CHILDHOOD

B. WEST SYNDROME

C. SLEEP MYOCLONUS

D. ALL OF THE ABOVE

SEIZURE TYPE: EEG: TREATMENT: TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOODUPPER LIMB MYOCLONUS, AWAKE AND SLEEPGB: NORMAL, ICTAL GENERALIZED SPIKE & WAVEDIAGNOSIS: EXCLUDE SLEEP MYOCLONUS (NO ICTAL ONSET OF SEIZURES: 6 MONTHS TO 3 YEARS OF AGENORMAL NEUROLOGICAL EXAMINATIONNO ETIOLOGYVALPROIC ACID ?FAMILY HISTORY OF SEIZURES (SOMETIMES)EEG CHANGES)

33. THE DIFFERENTIAL DIAGNOSIS OF MYOCLONIC ACTIVITY IN A NEUROLOGICALLY NORMAL INFANT INCLUDES:

A. BENIGN MYOCLONIC EPILEPSY OF EARLY CHILDHOOD

B. WEST SYNDROME

C. SLEEP MYOCLONUS

D. ALL OF THE ABOVE

34. WHAT EEG PATTERN IS CHARACTERISTIC OF WEST SYNDROME?



C. HYPSARHYTHMIA


34. WHAT EEG PATTERN IS CHARACTERISTIC OF WEST SYNDROME?


B. GENERALIZED 3 PER SECOND SPIKE AND WAVE

C. HYPSARHYTHMIA


35. ALL OF THE FOLLOWING SYNDROMES MAY PRESENT DURING EARLY CHILDHOOD, EXCEPT

A. LENNOX GASTAUT SYNDROME

B. LANDAU KLEFFNER SYNDROME

C. SLOW SLEEP STATUS D. OHTAHARA SYNDROME

EPILEPSY SYNDROMES OF ONSET - DURING EARLY CHILDHOODLENNOX-GASTAUT SYNDROMELANDAU-KLEFFNER SYNDROME SLOW SLEEP STATUS SYNDROME TYPICAL MYOCLONIC EPILEPSY OF EARLY INFANCY

35. ALL OF THE FOLLOWING SYNDROMES MAY PRESENT DURING EARLY CHILDHOOD, EXCEPT

A. LENNOX GASTAUT SYNDROME

B. LANDAU KLEFFNER SYNDROME

C. SLOW SLEEP STATUS D. OHTAHARA SYNDROME

36. WHICH OF THE SEIZURE TYPES ARE MOST PREVALENT CHILDREN WITH LENNOX GASTAUT SYNDROME ?

A. ABSENCE OR HEAD DROPS

B. RIGHT ARM PARTIAL SEIZURES

C. LEFT ARM CONVULSIONS

D. GENERALIZED TONIC-CLONIC SEIZURES

LENNOX-GASTAUT SYNDROMEPARTIAL SEIZUREHEAD DROPDROP ATTACK

36. WHICH OF THE SEIZURE TYPES ARE MOST PREVALENT CHILDREN WITH LENNOX GASTAUT SYNDROME ?

A. ABSENCE OR HEAD DROPS

B. RIGHT ARM PARTIAL SEIZURES

C. LEFT ARM CONVULSIONS

D. GENERALIZED TONIC-CLONIC SEIZURES

37. MOST CHILDREN WITH LENNOX GASTAUT SYNDROME ARE:

A. MENTALLY RETARDED

B. AUTISTIC

C. HEMIPLEGIC

D. ALL OF THE ABOVE

LENNOX-GASTAUT SYNDROMEPARTIAL SEIZUREHEAD DROPDROP ATTACK

37. MOST CHILDREN WITH LENNOX GASTAUT SYNDROME ARE:

A. MENTALLY RETARDED

B. AUTISTIC

C. HEMIPLEGIC

D. ALL OF THE ABOVE

38. LENNOX GASTAUT SYNDROME IN A CHILD WITH A NORMAL NEUROLOGICAL EXAMINATION, NORMAL DEVELOPMENT AND MULTIPLE HYPOPIGMENTED SPOTS SHOULD BE CLASSIFIED AS:

A. CRYPTOGENIC

B. SYMPTOMATIC

C. IDIOPATHIC

EEG: SEARCH FOR ETIOLOGY: WOODS LAMP, METABOLIC DISORDERS, TRIAL OF B6; ANTIEPILEPTIC DRUGS INEFFECTIVE, BUT TRY! FREQUENTLY HISTORY OF WEST SYNDROMELENNOX-GASTAUT SYNDROMESEIZURE TYPE: ABSENCE, ATONIC & MYOCLONIC FITSVARIETIES: IDIOPATHIC (RARE) SYMPTOMATICCRYPTOGENICEXAMCAUSENEGATIVENONEABNORMALNONEPRESENTEITHERSPIKE OR POLYSPIKE AND WAVES (1 TO 2.5 Hz)FREQUENT STATUS EPILEPTICUSGENERALIZED (MAXIMALLY FRONTAL)PROGNOSIS: POOR

38. LENNOX GASTAUT SYNDROME IN A CHILD WITH A NORMAL NEUROLOGICAL EXAMINATION, NORMAL DEVELOPMENT AND MULTIPLE HYPOPIGMENTED SPOTS SHOULD BE CLASSIFIED AS:

A. CRYPTOGENIC

B. SYMPTOMATIC

C. IDIOPATHIC

39. AN IV TRIAL OF PYRIDOXINE SHOULD BE PREFORMED WHILE CONDUCTING AN EEG AND WHILE THE PATIENT IS BEING MONITORED.

A. TRUE

B. FALSE

PYRIDOXINE IN A PATIENT WITH PYRIDOXINE DEPENDENCY LEADS TO A SUDDEN PRODUCTION OF GABA A SUDDEN PRODUCTION OF GABA IS AS IF THE PATIENT IS GETTING A DOSE OF BENZODIAZEPINE IV BENZODIAZEPINE MAY PRODUCE RESPIRATORY ARREST

39. AN IV TRIAL OF PYRIDOXINE SHOULD BE PREFORMED WHILE CONDUCTING AN EEG AND WHILE THE PATIENT IS BEING MONITORED.

A. TRUE

B. FALSE

40. THE CLINICAL FINDING THAT SHOULD MAKE YOU CONSIDER THE POSSIBILITY OF LANDAU KLEFFNER SYNDROME IS:

A. LEFT ARM SEIZURES

B. REGRESSION OF PREVIOUSLY ACQUIRED LANGUAGE

C. GENERALIZED SEIZURES PRECEDED BY ABDOMINAL PAIN

SEIZURE TYPE: EEG: TREATMENT: LANDAU-KLEFFNER SYNDROME ABSENCE, TONIC-CLONIC, PARTIAL, NONE SHARPS AND SPIKE-WAVE COMPLEXES IN THE CENTRAL, TEMPORAL AND PARTIAL REGIONSREGRESSION OF PREVIOUSLY ACQUIRED LANGUAGEBEHAVIORAL DYSFUNCTION (AUTISTIC LIKE BEHAVIOR) COGNITIVE DYSFUNCTIONTEGRETOL, CORTICOSTEROIDS, EEG GUIDED SUBPIAL SURGICAL TRANSECTION

40. THE CLINICAL FINDING THAT SHOULD MAKE YOU CONSIDER THE POSSIBILITY OF LANDAU KLEFFNER SYNDROME IS:


B. REGRESSION OF PREVIOUSLY ACQUIRED LANGUAGE

C. GENERALIZED SEIZURES PRECEDED BY ABDOMINAL PAIN

41. ALL OF THE FOLLOWING EPILEPTIC SYNDROMES SHOULD BE CONSIDERED IN A CHILD WITH REGRESSION OF PREVIOUSLY ACQUIRED LANGUAGE, AUTISTIC-LIKE BEHAVIOR AND SHORT ATTENTION SPAN, EXCEPT:

A. LANDAU KLEFFNER SYNDROME

B. SLOW SLEEP STATUS C. OHTAHARA SYNDROME

SEIZURE TYPE: EEG: TREATMENT: SLOW SLEEP STATUS SYNDROME ABSENCE, TONIC-CLONIC, PARTIAL, NONE CONTINUOS GENERALIZED SPIKE-WAVE COMPLEXES DURING NON-REM SLEEPREGRESSION OF PREVIOUSLY ACQUIRED LANGUAGEBEHAVIORAL DYSFUNCTION (AUTISTIC LIKE BEHAVIOR) COGNITIVE DYSFUNCTION (LEARNING DISABILITIES)VALPROIC ACID

SEIZURE TYPE: EEG: SEARCH FOR ETIOLOGY: WOODS LAMP, METABOLIC DISORDERS (BIOTINIDASE), TRIALS OF B6 & FOLINIC ACID; ANTIEPILEPTIC DRUGS NOT EFFECTIVE, BUT TRYOHTAHARA SYNDROME (EARLY INFANTILE EPILEPTIC ENCEPHALOPATHY WITH BURST SUPPRESSION) TONIC AND OTHERS BURST SUPPRESSION (ESTABLISHES DIAGNOSIS)VARIETIES: IDIOPATHIC (RARE) SYMPTOMATICCRYPTOGENICEXAMCAUSENEGATIVENONEABNORMALNONEPRESENTEITHERPROGNOSIS: POOR

41. ALL OF THE FOLLOWING EPILEPTIC SYNDROMES SHOULD BE CONSIDERED IN A CHILD WITH REGRESSION OF PREVIOUSLY ACQUIRED LANGUAGE, AUTISTIC-LIKE BEHAVIOR AND SHORT ATTENTION SPAN, EXCEPT:

A. LANDAU KLEFFNER SYNDROME

B. SLOW SLEEP STATUS C. OHTAHARA SYNDROME

42. ALL THE FOLLOWING EPILEPTIC SYNDROMES FREQUENTLY OCCUR IN LATE CHILDHOOD, EXCEPT:


B. PYKNOLEPSIES

C. WEST SYNDROME

D. BENIGN OCCIPITAL EPILEPSY

EPILEPSY SYNDROMES OF ONSET - DURING LATE CHILDHOODBENIGN ROLANDIC SEIZURES PETIT MAL, PYKNOLEPSYBENIGN OCCIPITAL EPILEPSY

42. ALL THE FOLLOWING EPILEPTIC SYNDROMES FREQUENTLY OCCUR IN LATE CHILDHOOD, EXCEPT:


B. PYKNOLEPSIES

C. WEST SYNDROME

D. BENIGN OCCIPITAL EPILEPSY

43. IN CHILDREN WITH BENIGN ROLANDIC EPILEPSY, SPEECH ARREST IS USUALLY FOLLOWED BY:


B. RIGHT ARM SEIZURES

C. GENERALIZED SEIZURES

SEIZURE TYPE: EEG: TREATMENT: BENIGN ROLANDIC EPILEPSYFACIAL-ORAL-PHARYNGEAL SEIZURES, JACKSONIAN SPREAD, GENERALIZATION AT NIGHT ONLY (NIGHT SEIZURES) PERI-ROLANDIC SPIKES AND SHARP WAVES (HORIZONTAL DIPOLE), ACTIVATED BY SLEEP AND SHIFTING FROM SIDE TO SIDETEGRETOL, TRILEPTAL (DO NOT TREAT AFTER THE FIRST ONE)SPEECH ARREST DURING THE DAY OR GUTTURAL NOISES AT NIGHT FOLLOWED BY UPPER LIMB CONVULSIONS NORMAL NEUROLOGICAL EXAMINATIONSEIZURES STOP BY 16 YEARS OF AGE

43. IN CHILDREN WITH BENIGN ROLANDIC EPILEPSY, SPEECH ARREST IS USUALLY FOLLOWED BY:


B. RIGHT ARM SEIZURES (LANGUAGE IS ON THE LEFT)

C. GENERALIZED SEIZURES

44. BENIGN OCCIPITAL EPILEPSY MAY BE ASSOCIATED WITH:

A. CELIAC DISEASE

B. MAPLE SYRUP URINE DISEASE

D. DIABETES MELLITUS

SEIZURE TYPE: EEG: TREATMENT: BENIGN OCCIPITAL EPILEPSYOCCIPITAL LOBE SEIZURES REPETITIVE OCCIPITAL DISCHARGES ON EYE CLOSURETEGRETOL, TRILEPTALSIMPLE OR COMPLEX HALLUCINATIONS, VISUAL DISTORTIONS, HEMIANOPSIA, AND AMAUROSIS WITH PRESERVATION OF CONSCIOUSNESSDO NOT MISDIAGNOSE AS MIGRAINEMAYBE ASSOCIATED WITH CELIAC DISEASE AND - OCCIPITAL LOBE CALCIFICATIONNORMAL NEUROLOGICAL EXAMINATION

44. BENIGN OCCIPITAL EPILEPSY MAY BE ASSOCIATED WITH:

A. CELIAC DISEASE

B. MAPLE SYRUP URINE DISEASE

D. DIABETES MELLITUS

45. WHICH OF THE FOLLOWING EPILEPTIC SYNDROMES SHOULD YOU CONSIDER IN A 5-YEAR-OLD CHILD WITH ABSENCE, NO AURA AND NO POSTICTAL CONFUSION?

A. PETIT MAL

B. PSYCHOMOTOR SEIZURES

C. SIMPLE PARTIAL SEIZURES

SEIZURE TYPE: EEG: TREATMENT: PETIT MAL, PYKNOLEPSYABSENCE, AUTOMATISMS, SMALL JERKS 3 Hz SPIKES AND WAVES, TRIGGER BY HV30 TO 40 % DEVELOP GENERALIZED CONVULSIONS LATERNORMAL NEUROLOGICAL EXAMINATIONGENETIC PREDISPOSITIONETHOSUXIMIDE, VALPROATENO AURA NO POST-ICTAL CONFUSION

PETIT MAL, PYKNOLEPSYFFFFOOO

SEIZURE TYPE: EEG: TREATMENT: PSYCHOMOTOR SEIZURESABSENCE, CONVULSIONSFOCAL TEMPORAL OR FRONTAL SPIKESTEMPORAL LOBE SCLEROSIS (FEBRILES SEIZURES ?)ABNORMAL NEUROLOGICAL EXAMINATIONFRONTAL LOBE TUMORSTEGRETOL OR VALPROIC ACIDAURA: TEMPORAL LOBE: METALLIC SMELL FRONTAL LOBE : ABNORMAL BEHAVIOR POST-ICTAL CONFUSION

45. WHICH OF THE FOLLOWING EPILEPTIC SYNDROMES SHOULD YOU CONSIDER IN A 5-YEAR-OLD CHILD WITH ABSENCE, NO AURA AND NO POSTICTAL CONFUSION?

A. PETIT MAL

B. PSYCHOMOTOR SEIZURES

C. SIMPLE PARTIAL SEIZURES

46. COMPLEX PARTIAL SEIZURES ALWAYS COINCIDE WITH THE ONSET OF AN ALTERED STATE OF CONSCIOUSNESS.

A. TRUE

B. FALSE

SIMPLE PARTIAL SEIZURES (SENSORY OR MOTOR PHENOMENA WITHOUT LOSS OF CONSCIOUSNESS)COMPLEX PARTIAL SEIZURES (ALTER STATE OF CONSCIOUSNESS)GENERALIZED SEIZURES

46. COMPLEX PARTIAL SEIZURES ALWAYS COINCIDE WITH THE ONSET OF AN ALTERED STATE OF CONSCIOUSNESS.

A. TRUE

B. FALSESOME NEUROLOGIST DO NOT AGREE WITH THIS ANSWER!

47. AN INFANT THAT PRESENTS WITH PROLONGED AND REPETITIVE ALIMENTARY AUTOMATISM AND A BLANK STARE IS LIKELY TO HAVE?

A. WEST SYNDROME

B. INFANTILE SPASM

C. COMPLEX PARTIAL SEIZURES

D. SIMPLE PARTIAL SEIZURES

INFANT ONSET EPILEPSIESSYNDROMESOTHERSCOMPLEX PARTIAL SEIZURESSIMPLE PARTIAL SEIZURESEPILEPSY SYNDROMES OF ONSET DURING INFANCYWEST SYNDROME (INFANTILE SPASM) FEBRILE SEIZURES BENIGN MYOCLONIC EPILEPSY OF INFANCYOTHER EPILEPSYALIMENTARY AUTOMATISM

SEIZURE TYPE: EEG: TREATMENT: PSYCHOMOTOR SEIZURESABSENCE, CONVULSIONSFOCAL TEMPORAL OR FRONTAL SPIKESTEMPORAL LOBE SCLEROSIS (FEBRILES SEIZURES ?)ABNORMAL NEUROLOGICAL EXAMINATIONFRONTAL LOBE TUMORSTEGRETOL OR VALPROIC ACIDAURA: TEMPORAL LOBE: METALLIC SMELL FRONTAL LOBE : ABNORMAL BEHAVIOR POST-ICTAL CONFUSION

47. AN INFANT THAT PRESENTS WITH PROLONGED AND REPETITIVE ALIMENTARY AUTOMATISM AND A BLANK STARE IS LIKELY TO HAVE?

A. WEST SYNDROME

B. INFANTILE SPASM

C. COMPLEX PARTIAL SEIZURES

D. SIMPLE PARTIAL SEIZURES

48. WHICH OF THE FOLLOWING AUTOMATISM IS LESS FREQUENT IN OLDER CHILDREN WITH COMPLEX PARTIAL SEIZURES?

A. PICKING AT CLOTHING

B. RUBBING OBJECTS

C. FEARFUL BEHAVIOR

D. LIP SMACKING

TEMPORAL LOBE SEIZURESRIGHT ARM TONIC THEN CONFUSIONABNORMAL BEHAVIOR

FEARFEARRAGESECONDARY GENERALIZEDTONIC POSTUREHEAD TURNINGFRONTAL (PREMOTOR) LOBE SEIZURES

48. WHICH OF THE FOLLOWING AUTOMATISM IS LESS FREQUENT IN OLDER CHILDREN WITH COMPLEX PARTIAL SEIZURES?

A. PICKING AT CLOTHING

B. RUBBING OBJECTS

C. FEARFUL BEHAVIOR

D. LIP SMACKING

49. A NORMAL INTERICTAL ROUTINE EEG EXCLUDES THE POSSIBILITY OF COMPLEX PARTIAL SEIZURES.

A. TRUE

B. FALSE

A NORMAL INTERICTAL ROUTINE EEG OCCURS IN 20% OF INFANT AND CHILDREN WITH COMPLEX PARTIAL SEIZURES.MRI ALL PATIENTS WITH COMPLEX PARTIAL SEIZURES. POSSIBLE FINDINGS ARE TUMORS, CYSTS, ARTERIOVENOUS MALFORMATIONS, INFARCTION IN THE FRONTAL OR TEMPORAL LOBE OR MESIAL TEMPORAL SCLEROSIS

49. A NORMAL INTERICTAL ROUTINE EEG EXCLUDES THE POSSIBILITY OF COMPLEX PARTIAL SEIZURES.

A. TRUE

B. FALSE

50. RASMUSSEN ENCEPHALITIS IS A FREQUENT CAUSE OF:


B. EPILEPSY OF JANZ

C. EPILEPSIA PARTIALIS CONTINUA

D. OHTAHARA SYNDROME

RASMUSSEN ENCEPHALITISNO CAUSE KNOWNEPILEPSIA PARTIALISCONTINUAPOOR PROGNOSIS

50. RASMUSSEN ENCEPHALITIS IS A FREQUENT CAUSE OF:


B. JANZ SYNDROME

C. EPILEPSIA PARTIALIS CONTINUA

D. OHTAHARA SYNDROME

51. THE HALLMARK OF JANZ SYNDROME IS:A. SPEECH ARREST B. MYOCLONIC JERKS WITHIN 30 MINUTES OF AWAKENING

C. ROLANDIC SEIZURES

D. MENTAL RETARDATION

EPILEPSY SYNDROMES OF ONSET - DURING ADOLESCENCEJANZS SYNDROME (JUVENILE MYOCLONIC EPILEPSY)

SEIZURE TYPE: EEG: TREATMENT: (JUVENILE MYOCLONIC EPILEPSY)MYOCLONIC SEIZURES WITHIN 30 MINUTES OF AWAKENING, SOMETIMES PRECEDED BY ABSENCE 3.5 TO 6 MULTI-SPIKE AND WAVE COMPLEXES DURING SEIZURES AND INTERICTALLY (MAYBE TRIGGER BY PHOTIC)VALPROIC ACID (CLONAZEPAM)BILATERAL SINGLE OR REPETITIVE JERKING MOVEMENTS OF THE ARMSDO NOT STOP MEDICATIONLINKED TO CHROMOSOME 6NORMAL NEUROLOGICAL EXAMINATIONJANZS SYNDROME

(JUVENILE MYOCLONIC EPILEPSY)JANZS SYNDROMEMYOCLONIC JERK TRIGGER BY PHOTIC STIMULATION

51. THE HALLMARK OF JANZ SYNDROME IS:A. SPEECH ARREST B. MYOCLONIC JERKS WITHIN 30 MINUTES OF AWAKENING

C. ROLANDIC SEIZURES

D. MENTAL RETARDATION

52. JUVENILE MYOCLONIC EPILEPSY IS LINKED TO:A. 20q B. 8qC. 6pD. 21q

SEIZURE TYPE: EEG: TREATMENT: (JUVENILE MYOCLONIC EPILEPSY)MYOCLONIC SEIZURES WITHIN 30 MINUTES OF AWAKENING, SOMETIMES PRECEDED BY ABSENCE 3.5 TO 6 MULTI-SPIKE AND WAVE COMPLEXES DURING SEIZURES AND INTERICTALLY (MAYBE TRIGGER BY PHOTIC)VALPROIC ACID (CLONAZEPAM)BILATERAL SINGLE OR REPETITIVE JERKING MOVEMENTS OF THE ARMSDO NOT STOP MEDICATIONLINKED TO CHROMOSOME 6NORMAL NEUROLOGICAL EXAMINATIONJANZS SYNDROME

52. JUVENILE MYOCLONIC EPILEPSY IS LINKED TO:A. 20q B. 8qC. 6pD. 21q

53. WHICH OF THE FOLLOWING STRUCTURES HAS AN INTEGRAL ROLE IN THE DEVELOPMENT OF GENERALIZED SEIZURES?

A. GLOBUS PALLIDUS

B. RED NUCLEUS

C. SUBSTANTIA NIGRA

D. CAUDATE NUCLEUS

GLOBUS PALLIDUSRED NUCLEUSSUBSTANTIA NIGRAPUTAMENCLAUSTRUMCAUDATE NUCLEUS

53. WHICH OF THE FOLLOWING STRUCTURES HAS AN INTEGRAL ROLE IN THE DEVELOPMENT OF GENERALIZED SEIZURES?

A. GLOBUS PALLIDUS

B. RED NUCLEUS

C. SUBSTANTIA NIGRA

D. CAUDATE NUCLEUS

54. THE MINIMUM WORK-UP FOR THE FIRST AFEBRILE SEIZURE, IN AN OTHERWISE HEALTHY CHILD, SHOULD INCLUDE ALL OF THE FOLLOWING, EXCEPT:

A. FASTING GLUCOSEB. MAGNESIUM

C. EEG

D. AMMONIA

THE MINIMUM WORK-UP FOR THE FIRST AFEBRILE SEIZURE IS IN AN OTHERWISE HEALTHY CHILD SHOULD INCLUDE ALL OF THE FOLLOWING: (1) FASTING GLUCOSE, (2) CALCIUM, (3) MAGNESIUM, (4) SERUM ELECTROLYTES, (5) EEG.

54. THE MINIMUM WORK-UP FOR THE FIRST AFEBRILE SEIZURE, IN AN OTHERWISE HEALTHY CHILD, SHOULD INCLUDE ALL OF THE FOLLOWING, EXCEPT:

A. FASTING GLUCOSEB. MAGNESIUM

C. EEG

D. AMMONIA

55. INTERICTAL EEG RECORDINGS ARE NORMAL IN APPROXIMATELY ___ PERCENT OF PATIENTS WITH FIRST AFEBRILE SEIZURE.

A. 20

B. 40

C. 60

D. 80

40%NORMAL

55. INTERICTAL EEG RECORDINGS ARE NORMAL IN APPROXIMATELY ___ PERCENT OF PATIENTS WITH FIRST AFEBRILE SEIZURE.

A. 20

B. 40

C. 60

D. 80

56. BEFORE SCHEDULING A ROUTINE EEG, THE SEIZURE MEDICATION SHOULD BE STOPPED.

A. TRUE

B. FALSE

57. MRI OF THE BRAIN SHOULD BE DONE IN ALL PATIENTS WITH AFEBRILE SEIZURES.

A. TRUE

B. FALSE

MRI OF THE BRAIN SHOULD BE DONE IN PATIENTS WITH AFEBRILE SEIZURES IF AN INTRACRANIAL LESION IS SUSPECTED

57. MRI OF THE BRAIN SHOULD BE DONE IN ALL PATIENTS WITH AFEBRILE SEIZURES.

A. TRUE

B. FALSE

58. NO ANTIEPILEPTIC DRUGS ARE INDICATED AFTER THE FIRST AFEBRILE CONVULSION IF ALL OF THE FOLLOWING CONDITIONS ARE TRUE, EXCEPT:

A. A POSITIVE FAMILY HISTORY OF SEIZURES

B. NORMAL NEUROLOGICAL EXAMINATION

C. NORMAL EEG

D. A COOPERATIVE AND COMPLIANT FAMILY

A POSITIVE FAMILY HISTORY OF SEIZURES IS AN INDICATION TO TREAT

58. NO ANTIEPILEPTIC DRUGS ARE INDICATED AFTER THE FIRST AFEBRILE CONVULSION IF ALL OF THE FOLLOWING CONDITIONS ARE TRUE, EXCEPT:

A. A POSITIVE FAMILY HISTORY OF SEIZURES

B. NORMAL NEUROLOGICAL EXAMINATION

C. NORMAL EEG

D. A COOPERATIVE AND COMPLIANT FAMILY

59. MONITORING OF ANTICONVULSANT LEVELS SHOULD BE DONE IN ALL OF THE FOLLOWING SITUATIONS, EXCEPT:

A. AT THE ONSET OF ANTICONVULSANT THERAPY

B. DURING ACCELERATED GROWTH SPURTS

C. IN PATIENTS WITH COGNITIVE OR PHYSICAL DISABILITIES

D. IN PATIENTS TAKING CARBAMAZEPINE

MONITORING OF ANTICONVULSANT LEVELS SHOULD BE DONE: (1) AT THE ONSET OF ANTICONVULSANT THERAPY, (2) DURING ACCELERATED GROWTH SPURTS, (3) NONCOMPLIANT FAMILIES, (4) TIME OF STATUS EPILEPTICUS, (5) FOR PATIENTS IN POLYTHERAPY, (6) SEIZURES THAT CHANGE, (7) UNCONTROLLABLE SEIZURES, (8) SIGNS OF DRUG TOXICITY, (9) IN PATIENTS WITH LIVER OR KIDNEY PROBLEMS, AND (10) IN PATIENTS WITH COGNITIVE OR PHYSICAL DISABILITIES

59. MONITORING OF ANTICONVULSANT LEVELS SHOULD BE DONE IN ALL OF THE FOLLOWING SITUATIONS, EXCEPT:

A. AT THE ONSET OF ANTICONVULSANT THERAPY

B. DURING ACCELERATED GROWTH SPURTS

C. IN PATIENTS WITH COGNITIVE OR PHYSICAL DISABILITIES

D. IN PATIENTS TAKING CARBAMAZEPINE

60. ALL OF THE FOLLOWING ARE RISK FACTORS FOR SEIZURE RECURRENCE AFTER 2 SEIZURE-FREE YEARS EXCEPT:

A. AGE GREATER THAN 12 YEARS AT ONSET OF SEIZURES

B. A HISTORY OF NEONATAL SEIZURES

C. A NEUROLOGIC DYSFUNCTION

D. AGE LESS THAN 12 YEARS AT ONSET OF SEIZURES

THE FOLLOWING ARE RISK FACTORS FOR SEIZURE RECURRENCE AFTER 2 SEIZURE-FREE YEARS: (1) AGE GREATER THAN 12 YEARS AT ONSET OF SEIZURES, (2) A HISTORY OF NEONATAL SEIZURES, (3) A NEUROLOGIC DYSFUNCTION, (4) NUMEROUS SEIZURES BEFORE ACHIEVING SEIZURE CONTROL

60. ALL OF THE FOLLOWING ARE RISK FACTORS FOR SEIZURE RECURRENCE AFTER 2 SEIZURE-FREE YEARS EXCEPT:

A. AGE GREATER THAN 12 YEARS AT ONSET OF SEIZURES

B. A HISTORY OF NEONATAL SEIZURES

C. A NEUROLOGIC DYSFUNCTION

D. AGE LESS THAN 12 YEARS AT ONSET OF SEIZURES

61. THE PROCESS OF WEANING ANTIEPILEPTIC DRUGS SHOULD OCCUR FOR:

A. 1 TO 3 MONTHS

B. 3 TO 6 MONTHS

C. 6 TO 9 MONTHS

D. 9 MONTHS TO 1 YEAR

WEANING PROCESS OF ANTIEPILEPTIC DRUGS SHOULD OCCUR FOR:MONTH612390

61. THE PROCESS OF WEANING ANTIEPILEPTIC DRUGS SHOULD OCCUR FOR:

A. 1 TO 3 MONTHS

B. 3 TO 6 MONTHS

C. 6 TO 9 MONTHS

D. 9 MONTHS TO 1 YEAR

62. BENZODIAZEPINES EXERT ANTICONVULSANT ACTIVITY BY:

A. OPENING CHLORIDE CHANNELS

B. BLOCKING SODIUM-DEPENDENT CHANNELS

C. DECREASING THE POLARIZATION- DEPENDENT CALCIUM UPTAKED. INCREASING GABA TURNOVER

MUST SEIZURE MEDICATION WORK EITHER BY CLOSING Na CHANNELS OR OPENING Cl CHANNELSCl CHANNELSClBARBITURATESBENZODIAZEPINESGABABY OPENING Cl CHANNELS THE MEMBRANE POTENTIAL IS FIXED AT THE NERNST POINT FOR Cl (-60 mV)

= 10 mV+ +NEURONAL MEMBRANE AT RESTDEPOLARIZATIONACTION POTENTIAL: Na CHANNELS ARE OPENHYPER POLARIZATIONNERNST POINT= 73 mVK= 60 mVClNa = + 57 mVNa CHANNELS ARE CLOSED+ 50 mVMUST SEIZURE MEDICATION WORK EITHER BY CLOSING Na CHANNELS OR OPENING Cl CHANNELS

62. BENZODIAZEPINES EXERT ANTICONVULSANT ACTIVITY BY:



C. DECREASING THE POLARIZATION- DEPENDENT CALCIUM UPTAKED. INCREASING GABA TURNOVER

63. PATIENTS ON CARBAMAZEPINE SHOULD HAVE CBC WITH DIFFERENTIAL AND LIVER FUNCTION TEST:

A. MONTHLY DURING THE FIRST 3 TO 4 MONTHS OF THERAPY

B. EVERY 3 MONTHS DURING THERAPY

C. ONCE A YEAR

D. NEVER

PATIENTS ON CARBAMAZEPINE SHOULD HAVE CBC AND DIFFERENTIAL AND LIVER FUNCTION TEST MONTHLY DURING THE FIRST 3 TO 4 MONTHS OF THERAPY (AS PER NELSON)MUST NEUROLOGIST DO NOT AGREE WITH THIS STATEMENT, BUT IS RIGHT FOR EXAM (2002)

CARBAMAZEPINE (CBZ)DOSE/PO START UP/W BY USUAL MAXMG/KG/D 5-10 5-10 15-20 30LEVEL: 4-12 MG/LSIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITISBLOOD: LOW WHITE & RED CELLS &/OR PLATELETSOTHERS: LOW SODIUM, LUPUS LIKE, ARRHYTHMIAINTERACTIONCBZ LOWERS ANTICOAGULANT AND PILL CBZ INCREASED BY ERYTHROMYCIN STOP IF ABSOLUTE NEUTROPHILIC COUNT IS < 1000 CBC & LFT: ONSET, 6 WEEKS, & Q 3-6 MONTHS

63. PATIENTS ON CARBAMAZEPINE SHOULD HAVE CBC WITH DIFFERENTIAL AND LIVER FUNCTION TEST:

A. MONTHLY DURING THE FIRST 3 TO 4 MONTHS OF THERAPY

B. EVERY 3 MONTHS DURING THERAPY

C. ONCE A YEAR

D. NEVER

64. WHICH OF THE FOLLOWING DRUGS RAISES THE LEVEL OF CARBAMAZEPINE?

A. ERYTHROMYCIN

B. PHENYTOIN

C. PHENOBARBITAL

D. VALPROIC ACID

PHENOBARBITALPHENYTOINVALPROIC ACIDCARBAMAZEPINE LEVEL

ERYTHROMYCINCARBAMAZEPINE LEVEL

64. WHICH OF THE FOLLOWING DRUGS RAISES THE LEVEL OF CARBAMAZEPINE?

A. ERYTHROMYCIN

B. PHENYTOIN

C. PHENOBARBITAL

D. VALPROIC ACID

65. TOXICITY DESPITE THERAPEUTIC CARBAMAZEPINE LEVELS IS LIKELY TO OCCUR WHEN ______ IS ADDED.

A. ERYTHROMYCIN

B. PHENYTOIN

C. PHENOBARBITAL

D. VALPROIC ACID

PHENOBARBITALPHENYTOINVALPROIC ACIDCARBAMAZEPINE LEVELEPOXIDE (TOXICITY)

65. TOXICITY DESPITE THERAPEUTIC CARBAMAZEPINE LEVELS IS LIKELY TO OCCUR WHEN ______ IS ADDED.

A. ERYTHROMYCIN

B. PHENYTOIN

C. PHENOBARBITAL

D. VALPROIC ACID

66. CARBAMAZEPINE EXERTS ANTICONVULSANT ACTIVITY BY:



C. BLOCKING CALCIUM CHANNELS ASSOCIATED WITH THALAMOCORTICAL CIRCUITRY

D. INCREASING GABA TURNOVER

MUST SEIZURE MEDICATION WORK EITHER BY CLOSING Na CHANNELS OR OPENING Cl CHANNELSNa CHANNELSNaBY CLOSING Na CHANNELS THE MEMBRANE POTENTIAL DOES NOT MOVES TO THE NERNST POINT FOR Na (+57 mV)CARBAMAZEPINE

66. CARBAMAZEPINE EXERTS ANTICONVULSANT ACTIVITY BY:





67. ETHOSUXIMIDE EXERTS ANTICONVULSANT ACTIVITY BY:





ETHOSUXIMIDE EXERTS ANTICONVULSANT ACTIVITY BY BLOCKING CALCIUM CHANNELS ASSOCIATED WITH THALAMOCORTICAL CIRCUITRY

67. ETHOSUXIMIDE EXERTS ANTICONVULSANT ACTIVITY BY:





68. WHEN A PATIENT RECEIVING LAMOTRIGINE DEVELOPS A RASH, YOU SHOULD:

A. DECREASE THE DOSE BY HALF

B. CONTINUE THE SAME DOSE BUT DO NOT INCREASE

C. STOP THE MEDICATION AND REINTRODUCE IT LATER WHEN THE RASH IS GONE

D. STOP THE MEDICATION AND DO NOT USE IT AGAIN

69. IN A PATIENT RECEIVING PHENOBARBITAL, THE INTRODUCTION OF VALPROIC ACID WILL:

A. INCREASE PHENOBARBITAL LEVEL

B. DECREASE PHENOBARBITAL LEVEL

C. NOT AFFECT PHENOBARBITAL LEVEL

D. ALL OF THE ABOVE

PHENOBARBITAL (PB)DOSE/PO USUAL MAX MG/DMG/KG/D 3-5 250 TR: 15-45 MG/LSIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILUREBLOOD: APLASTIC ANEMIAOTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSIONINTERACTIONPB: LOWERS THEOPHYLLINE, ANTICOAGULANT & PILL BIDQDCONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETSPERSONALITY CHANGES

VALPROIC ACIDPHENOBARBITAL LEVEL

MUST SEIZURE MEDICATION WORK EITHER BY CLOSING Na CHANNELS OR OPENING Cl CHANNELSCl CHANNELSClBARBITURATESBENZODIAZEPINESGABABY OPENING Cl CHANNELS THE MEMBRANE POTENTIAL IS FIXED AT THE NERNST POINT FOR Cl (-60 mV)

69. IN A PATIENT RECEIVING PHENOBARBITAL, THE INTRODUCTION OF VALPROIC ACID WILL:

A. INCREASE PHENOBARBITAL LEVEL

B. DECREASE PHENOBARBITAL LEVEL

C. NOT AFFECT PHENOBARBITAL LEVEL

D. ALL OF THE ABOVE

70. VALPROIC ACID EXERTS ANTICONVULSANT ACTIVITY BY ALL OF THE FOLLOWING, EXCEPT:

A. BLOCKING VOLTAGE-DEPENDENT SODIUM CHANNELS

B. INCREASE CALCIUM-DEPENDENT POTASSIUM CONDUCTANCE

C. DECREASE THE POLARIZATION-DEPENDENT UPTAKE

MUST SEIZURE MEDICATION WORK EITHER BY CLOSING Na CHANNELS OR OPENING Cl CHANNELS, BUT A FEW WORK BY INCREASING PERMEABILITY TO POTASSIUMNa CHANNELSBY CLOSING Na CHANNELS THE MEMBRANE POTENTIAL DOES NOT MOVES TO THE K NERNST POINT (-73 mV)VALPROIC ACIDK CHANNELSBY OPENING K CHANNELS THE MEMBRANE POTENTIAL MOVES TOWARD THE Na NERNST POINT (+57 mV)

VALPROIC ACID (VPA)DOSE/PO START UP/W BY USUAL MAXMG/KG/D 15 5-10 20-30 60TR: 50-130 MG/LSIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITISBLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROMEINTERACTIONVPA LEVEL ARE INCREASED BY SALICYLATES TIDQIDCBC, AMMONIA, AMYLASE & LFT: ONSETCBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINECONTRAINDICATIONS: PORPHYRIA, LIVES DISEASEGIRL > 10 Y: FOLIC ACID

70. VALPROIC ACID EXERTS ANTICONVULSANT ACTIVITY BY ALL OF THE FOLLOWING, EXCEPT:

A. BLOCKING VOLTAGE-DEPENDENT SODIUM CHANNELS

B. INCREASE CALCIUM-DEPENDENT POTASSIUM CONDUCTANCE

C. DECREASE THE POLARIZATION-DEPENDENT UPTAKE

71. IN A PATIENT TAKING MULTIPLE ANTICONVULSANTS INCLUDING VALPROIC ACID, THE PRESENCE OF ABDOMINAL PAIN, ANOREXIA, WEIGHT LOSS, AND WRENCHING SHOULD MAKE YOU CONSIDER:

A. ANGIONEUROTIC EDEMA

B. HEPATOTOXIC SYNDROME

C. TOXIC EPIDERMAL NECROLYSIS

D. ALL OF THE ABOVE

VALPROIC ACID (VPA)DOSE/PO START UP/W BY USUAL MAXMG/KG/D 15 5-10 20-30 60TR: 50-130 MG/LSIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITISBLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROMEINTERACTIONVPA LEVEL ARE INCREASED BY SALICYLATES TIDQIDCBC, AMMONIA, AMYLASE & LFT: ONSETCBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINECONTRAINDICATIONS: PORPHYRIA, LIVER DISEASEGIRL > 10 Y: FOLIC ACID

71. IN A PATIENT TAKING MULTIPLE ANTICONVULSANTS INCLUDING VALPROIC ACID, THE PRESENCE OF ABDOMINAL PAIN, ANOREXIA, WEIGHT LOSS, AND WRENCHING SHOULD MAKE YOU CONSIDER:

A. ANGIONEUROTIC EDEMA

B. HEPATOTOXIC SYNDROME

C. TOXIC EPIDERMAL NECROLYSIS

D. ALL OF THE ABOVE

72. BEFORE INITIATING VALPROIC ACID IN A 2-YEAR-OLD, WHICH OF THE FOLLOWING SHOULD BE RULED OUT:

A. METABOLIC DISORDERS

B. CARDIAC DISORDERS

C. KIDNEY DISORDERS

D. ENDOCRINOPATHIES

BEFORE INITIATING VALPROIC ACID IN A 2-YEAR-OLD, METABOLIC DISORDERS SHOULD BE RULE OUT BY OBTAINING: (1) AMMONIA, (2) AMINO ACIDS, (3) BLOOD GASES, (4) LACTATE TO PYRUVATE RATIO, (5) URINE ORGANIC ACIDS, AND (6) FREE AND TOTAL SERUM CARNITINE.

72. BEFORE INITIATING VALPROIC ACID IN A 2-YEAR-OLD, WHICH OF THE FOLLOWING SHOULD BE RULED OUT:

A. METABOLIC DISORDERS

B. CARDIAC DISORDERS

C. KIDNEY DISORDERS

D. ENDOCRINOPATHIES

73. WHICH OF THE FOLLOWING MEDICINES SHOULD BE GIVEN TO A PATIENT YOUNGER THAN 2 YEARS OF AGE TAKING VALPROIC ACID?

A. VITAMIN B6

B. CARNITINE

C. VITAMIN B12

D. VITAMIN B1

74. ACTH AND PREDNISONE ARE EQUALLY AFFECTIVE IN THE TREATMENT OF INFANTILE SPASMS:

A. TRUE

B. FALSE

PREDNISONEACTHSUCCESS FOR CRYPTOGENIC AND SYMPTOMATIC WEST SYNDROME70 %I DO NOT THINK SO, BUT

74. ACTH AND PREDNISONE ARE EQUALLY AFFECTIVE IN THE TREATMENT OF INFANTILE SPASMS:

A. TRUE

B. FALSE

75. ALL OF THE FOLLOWING DRUGS LOWER THEOPHYLLINE LEVELS, EXCEPT:

A. PHENOBARBITAL

B. PHENYTOIN

C. PRIMIDONE

D. VALPROIC ACID

PRIMIDONE (PRM)TR: PB: 15-45 MG/LSIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILUREBLOOD: AGRANULOCYTOSIS, MEGALOBLASTIC ANEMIAOTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSIONINTERACTIONPB: LOWERS THEOPHYLLINE, ANTICOAGULANT & PILL TIDQIDCONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETSPERSONALITY CHANGES DOSE/PO START UP/W BY USUAL MAXMG/D 50-60 50 375-750 2000

PHENYTOIN (PHT)DOSE/PO USUAL MAX MG/DMG/KG/D 3-5 300 TR: 10-20 MG/LSIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILUREBLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA,OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE)INTERACTIONPHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & PILL BIDTIDCONTRAINDICATIONS: CONDUCTION HEART PROBLEMS .5-3 MG/L (FREE)LYMPHADENOPATHY, LEARNING PROBLEMSMEGALOBLASTIC ANEMIA

75. ALL OF THE FOLLOWING DRUGS LOWER THEOPHYLLINE LEVELS, EXCEPT:

A. PHENOBARBITAL

B. PHENYTOIN

C. PRIMIDONE

D. VALPROIC ACID

76. THE HIGHEST DOSE OF ORAL PHENOBARBITAL IN A CHILD SHOULD NOT EXCEED: A. 250 MG PER DAY

B. 250 MG/KG PER DAY

C. 500 MG PER DAY

D. 500 MG/KG PER DAY

76. THE HIGHEST DOSE OF ORAL PHENOBARBITAL IN A CHILD SHOULD NOT EXCEED: A. 250 MG PER DAY

B. 250 MG/KG/DAY

C. 500 MG/ DAY

D. 500 MG/KG/DAY

77. A 3-YEAR-OLD BOY WITH STATIC ENCEPHALOPATHY MANIFESTED BY MENTAL RETARDATION, SPASTIC QUADRIPARESIS AND SEIZURES DEVELOPS DYSTONIC POSTURES. WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS IS HE LIKELY USING?

A. PHENOBARBITAL

B. PHENYTOIN

C. PRIMIDONE D. VALPROIC ACID

78. LARYNGOSPASM AND BRONCHOSPASM ARE COMPLICATIONS OF:

A. PHENOBARBITAL

B. PHENYTOIN

C. CARBAMAZEPINE

D. VALPROIC ACID

79. WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS SHOULD BE AVOIDED IN PATIENT WITH CARDIAC DISEASE?

A. PHENOBARBITAL

B. PHENYTOIN

C. CARBAMAZEPINE

D. VALPROIC ACID

80. A CHILD JUST AFTER CARDIAC SURGERY IS USING ORAL ANTICOAGULATION. WHICH OF THE FOLLOWING DRUGS SHOULD YOU INITIATE IF HE HAS A SEIZURE? A. PHENOBARBITAL

B. PHENYTOIN

C. OXCARBAMAZEPINE

D. VALPROIC ACID

OXCARBAMAZEPINE (OXC)DOSE/PO START UP IN USUAL WEIGHT (KG) G/D MG/KG/D 8-10 2 W 20-29:.9;29-39:1.2;>39:1.8 TR: 12-30 MG/L*SIDE EFFECTS CNS: HEADACHE, DIZZINESS, ATAXIA, DIPLOPIA GI: NAUSEA, VOMITINGOTHERS: LOW SODIUMINTERACTIONOXC: LOWERS PILL BIDTIDSERUM SODIUM * 10-MONOHYDROXYL METABOLITE (MHD)

80. A CHILD JUST AFTER CARDIAC SURGERY IS USING ORAL ANTICOAGULATION. WHICH OF THE FOLLOWING DRUGS SHOULD YOU TRY TO INITIATE IF HE HAS A SEIZURE? A. PHENOBARBITAL

B. PHENYTOIN

C. OXCARBAMAZEPINE

D. VALPROIC ACID

81. WHICH OF THE FOLLOWING DRUGS SHOULD BE AVOIDED DURING INFANCY BECAUSE OF THE POSSIBILITY OF HEPATIC FAILURE?

A. PHENOBARBITAL B. PHENYTOIN C. PRIMIDONE D. VALPROIC ACID

82. A 12-YEAR-OLD WITH STATIC ENCEPHALOPATHY ON CARBAMAZEPINE DEVELOPS SUDDEN DETERIORATION IN HIS MENTAL STATUS AND RECURRENT SEIZURES. WHICH OF THE FOLLOWING TESTS SHOULD YOU ORDER TO DETERMINE THE CAUSE OF THE SUDDEN DETERIORATION OF MENTAL STATUS?

A. CBC WITH DIFFERENTIAL

B. LIVER FUNCTION TEST

C. ELECTROLYTES

D. AMMONIA LEVEL

82. A-12-YEAR OLD WITH STATIC ENCEPHALOPATHY ON CARBAMAZEPINE DEVELOPS SUDDEN DETERIORATION IN HIS MENTAL STATUS AND RECURRENT SEIZURES. WHICH OF THE FOLLOWING TESTS SHOULD YOU ORDER TO DETERMENT THE CAUSE OF THE SUDDEN DETERIORATION OF MENTAL STATUS?

A. CBC WITH DIFFERENTIAL

B. LIVER FUNCTION TEST

C. ELECTROLYTES

D. AMMONIA LEVEL

83. WHICH ANTIBIOTIC CAN PRODUCE DIPLOPIA AND ATAXIA IN A CHILD TAKING CARBAMAZEPINE?A. PENICILLINB. AUGMENTINC. SULFAD. ERYTHROMYCIN

84. LYMPHADENOPATHY IS A COMPLICATION OF WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS: A. OXCARBAMAZEPINE B. PHENOBARBITAL C. VALPROIC ACID D. PHENYTOIN

85. GUM HYPERTROPHY IS AN UNAVOIDABLE COMPLICATION OF PHENYTOIN THERAPY?

A. TRUE

B. FALSE

86. FOLIC ACID SHOULD BE USED IN ALL FEMALES OVER 14 YEARS OF AGE WHO ARE TAKING WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS?

A. PRIMIDONE

B. PHENOBARBITAL

C. VALPROIC ACID

D. PHENYTOIN

PHENOBARBITAL (PB)DOSE/PO USUAL MAX MG/DMG/KG/D 3-5 250 TR: 15-45 MG/LSIDE EFFECTS CNS: LETHARGY, H

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INSTRUCTIONS READ EACH QUESTION GIVE IT YOUR BEST SHOT GOOD LUCK! Israel Alfonso, MD