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

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Presentation on theme: "INSTRUCTIONS READ EACH QUESTION GIVE IT YOUR BEST SHOT GOOD LUCK! Israel Alfonso, MD."— Presentation transcript:

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

2 1. 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

3 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

4 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

5 CLASSIFICATION OF EPILEPSY BY AGE NEONATAL 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)

6 1. 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

7 2. SYNDROMIC CLASSIFICATION OF SEIZURES IS BASED ON: A. AGE B. COURSE C. SEIZURE TYPE D. ALL OF THE ABOVE

8 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

9 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

10 CLASSIFICATION OF EPILEPSY AGE NEONATES INFANTS CHILDHOOD EARLY LATE ADOLESCENCE

11 CLASSIFICATION OF EPILEPSY SEIZURE TYPE GENERALIZED FRONTAL PARTIAL PARIETAL TEMPORAL OCCIPITAL SYNDROME ? YES N0 INSULA

12 CLASSIFICATION OF EPILEPSY AGE NEONATES INFANTS CHILDHOOD EARLY LATE ADOLESCENCE SYNDROME ? YES N0

13 CLASSIFICATION OF EPILEPSY CAUSE INHERITED OTHERS SYNDROME ? YES N0

14 CLASSIFICATION OF EPILEPSY COURSE GOOD BAD SYNDROME ? YES N0

15 2. SYNDROMIC CLASSIFICATION OF SEIZURES IS BASED ON: A. AGE B. COURSE C. SEIZURE TYPE D. ALL OF THE ABOVE

16 3. SYNDROMIC CLASSIFICATION OF SEIZURES IS BETTER THAN OTHER CLASSIFICATIONS: A. TRUE B. FALSE

17 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

18 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

19 SYNDROME AGE SEIZURE TYPE CAUSE COURSE CLINICAL UNKNOWN FAMILIAL OTHERS EEG EFFECTIVE AED NEUROLOGICAL EXAM NORMALABNORMAL IF YOU KNOW 2 FACTORS, YOU KNOW ALL

20 3. SYNDROMIC CLASSIFICATION OF SEIZURES IS BETTER THAN OTHER: A. TRUE B. FALSE

21 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

22 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

23 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

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

25 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

26 5. ALL SEIZURES IN NEONATES ARE EPILEPTIC. A. TRUE B. FALSE

27 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

28 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

29 CLINICAL SEIZURES ELECTRICAL SEIZURES EPILEPTICNONEPILEPTIC CLASSIFICATION OF SEIZURES NO ANTIEPILEPTIC DRUGS

30 5. ALL SEIZURES IN NEONATES ARE EPILEPTIC. A. TRUE B. FALSE

31 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

32 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

33 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

34 AICARDI SYNDROME AGENESIS OF THE CORPUS CALLOSUM RETINAL LACUNAE

35 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

36 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

37 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

38 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

39 INTRAMUSCULAR MAGNESIUM 50 % SOLUTION (MgSO ) mL/kg

40 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

41 8. HYPOCALCEMIA IN AN INTERICTALLY ALERT GOOD LOOKING LEAN NEONATES IS LIKELY TO BE DO TO A. HIGH-PHOSPHATE FEEDINGS B. DIGEORGE SYNDROME C. MATERNAL DIABETES D. HYPOMAGNESEMIA

42 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

43 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

44

45 8. HYPOCALCEMIA IN AN INTERICTALLY ALERT GOOD LOOKING LEAN NEONATES IS LIKELY TO BE DO TO A. HIGH-PHOSPHATE FEEDINGS B. DIGEORGE SYNDROME C. MATERNAL DIABETES D. HYPOMAGNESEMIA

46 9. A YELLOWISH (XANTHOCHROMATIC) SUPERNATANT CSF SUGGESTS ALL OF THE FOLLOWING, EXCEPT: A. JAUNDICE B. SUBARACHNOID BLEED C. INTRAVENTRICULAR BLEED D. XANTHINE OXIDASE DEFICIENCY

47 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

48 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

49 CSF JAUNDICE SUBARACHNOID BLEED INTRAVENTRICULAR BLEED CAROTINEMIA

50 9. A YELLOWISH (XANTHOCHROMATIC) SUPERNATANT CSF SUGGESTS ALL OF THE FOLLOWING, EXCEPT: A. JAUNDICE B. SUBARACHNOID BLEED C. INTRAVENTRICULAR BLEED D. XANTHINE OXIDASE DEFICIENCY

51 10. FAILURE TO RESPOND TO 200 MG OF IV PYRIDOXINE EXCLUDES THE POSSIBILITY OF PYRIDOXINE RESPONSIVE SEIZURES. A. TRUE B. FALSE

52 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

53 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

54 PYRIDOXINE DEPENDENCY MONITOR 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

55 10. FAILURE TO RESPOND TO 200 MG OF IV PYRIDOXINE EXCLUDES THE POSSIBILITY OF PYRIDOXINE RESPONSIVE SEIZURES. A. TRUE B. FALSE

56 11. WHICH OF THE FOLLOWING SYNDROME DO NOT OCCUR IN THE NEONATAL PERIOD A. BENIGN FAMILIAL NEONATAL SEIZURES B. OHTAHARA SYNDROME C. LANDAU-KLEFFNER SYNDROME D. GELASTIC SEIZURES

57 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

58 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

59 EPILEPSY SYNDROMES OF NEONATAL - ONSET BENIGN NEONATAL CONVULSIONS BENIGN NEONATAL FAMILIAL CONVULSIONS OHTAHARA 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

60 11. WHICH OF THE FOLLOWING SYNDROME DO NOT OCCUR IN THE NEONATAL PERIOD A. BENIGN FAMILIAL NEONATAL SEIZURES B. OHTAHARA SYNDROME C. LANDAU-KLEFFNER SYNDROME D. GELASTIC SEIZURES

61 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

62 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

63 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

64 SEIZURE TYPE: EEG: TREATMENT: BENIGN NEONATAL CONVULSIONS CLONIC, APNEA, NEVER TONIC THETA POINTU ALTERNANT (NOT SPECIFIC) DIAGNOSIS OF EXCLUSION ONSET OF SEIZURES AT 5 DAYS OF AGE (FIFTH DAY FITS) NORMAL NEUROLOGICAL EXAMINATION NO ETIOLOGY (LOOK HARD FOR ONE) PHENOBARBITAL

65 BENIGN NEONATAL CONVULSIONS AGE SEIZURE TYPE CAUSE GOOD CLINICAL UNKNOWN FAMILIAL OTHERS EEG PHENOBARBITAL NEUROLOGICAL EXAM NORMALABNORMAL < 1M NORMALNOT TONIC

66 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 BENIGN NEONATAL SEIZURES (5 DAY SEIZURES) IS A DIAGNOSIS OF EXCLUSION

67 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

68 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

69 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

70 SEIZURE TYPE: EEG: TREATMENT: BENIGN NEONATAL FAMILIAL CONVULSIONS CLONIC, APNEA, NEVER TONIC NONE DIAGNOSIS: FAMILY HISTORY OF NEONATAL CONVULSION ONSET OF SEIZURES AT 2 TO 3 DAYS OF AGE ( <4 WEEKS) NORMAL NEUROLOGICAL EXAMINATION NO ETIOLOGY PHENOBARBITAL IN FIRST DEGREE RELATIVES WITH NORMAL DEVELOPMENT (14 % MAY HAVE SEIZURES AS ADULTS BUT NO MENTAL RETARDATION) AUTOSOMAL DOMINANT, LINKAGE: 20p AND 8p SEIZURES STOP USUALLY BY 6 WEEKS

71 BENIGN FAMILIAL NEONATAL CONVULSIONS AGE SEIZURE TYPE CAUSE GOOD CLINICAL UNKNOWN FAMILIAL OTHERS EEG PHENOBARBITAL NEUROLOGICAL EXAM NORMALABNORMAL < 1M NORMALNOT TONIC

72 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

73 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

74 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

75 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

76 SEIZURE TYPE: EEG: TREATMENT: BENIGN NEONATAL FAMILIAL CONVULSIONS CLONIC, APNEA, NEVER TONIC NONE DIAGNOSIS: FAMILY HISTORY OF NEONATAL CONVULSION ONSET OF SEIZURES AT 2 TO 3 DAYS OF AGE ( <4 WEEKS) NORMAL NEUROLOGICAL EXAMINATION NO ETIOLOGY PHENOBARBITAL IN FIRST DEGREE RELATIVES WITH NORMAL DEVELOPMENT (14 % MAY HAVE SEIZURES AS ADULTS BUT NO MENTAL RETARDATION) AUTOSOMAL DOMINANT, LINKAGE: 20p AND 8p SEIZURES STOP USUALLY BY 6 WEEKS

77 BENIGN FAMILIAL NEONATAL CONVULSIONS AGE SEIZURE TYPE CAUSE GOOD CLINICAL UNKNOWN FAMILIAL OTHERS EEG PHENOBARBITAL NEUROLOGICAL EXAM NORMALABNORMAL < 1M NORMALNOT TONIC

78 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

79 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

80 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

81 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

82

83 SEIZURE TYPE: EEG: TREATMENT: BENIGN NEONATAL FAMILIAL CONVULSIONS CLONIC, APNEA, NEVER TONIC NONE DIAGNOSIS: FAMILY HISTORY OF NEONATAL CONVULSION ONSET OF SEIZURES AT 2 TO 3 DAYS OF AGE ( <4 WEEKS) NORMAL NEUROLOGICAL EXAMINATION NO ETIOLOGY PHENOBARBITAL IN FIRST DEGREE RELATIVES WITH NORMAL DEVELOPMENT (14 % MAY HAVE SEIZURES AS ADULTS BUT NO MENTAL RETARDATION) AUTOSOMAL DOMINANT, LINKAGE: 20p AND 8p SEIZURES STOP USUALLY BY 6 WEEKS

84 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

85 16. FAMILIAL BENIGN NEONATAL CONVULSION IS A _______ DISORDER. A. SEX LINKED RECESSIVE B. AUTOSOMAL RECESSIVE C. AUTOSOMAL DOMINANT D. SEX LINKED DOMINANT

86 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

87 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

88 SEIZURE TYPE: EEG: TREATMENT: BENIGN NEONATAL FAMILIAL CONVULSIONS CLONIC, APNEA, NEVER TONIC NONE DIAGNOSIS: FAMILY HISTORY OF NEONATAL CONVULSION ONSET OF SEIZURES AT 2 TO 3 DAYS OF AGE ( <4 WEEKS) NORMAL NEUROLOGICAL EXAMINATION NO ETIOLOGY PHENOBARBITAL IN FIRST DEGREE RELATIVES WITH NORMAL DEVELOPMENT (14 % MAY HAVE SEIZURES AS ADULTS BUT NO MENTAL RETARDATION) AUTOSOMAL DOMINANT, LINKAGE: 20p AND 8p SEIZURES STOP USUALLY BY 6 WEEKS

89 16. FAMILIAL BENIGN NEONATAL CONVULSION IS A _______ DISORDER. A. SEX LINKED RECESSIVE B. AUTOSOMAL RECESSIVE C. AUTOSOMAL DOMINANT D. SEX LINKED DOMINANT

90 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

91 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

92 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

93 OHTAHARA SYNDROME AGE SEIZURE TYPE CAUSE COURSE CLINICAL UNKNOWN FAMILIAL OTHERS EEG AED ARE INEFFECTIVE < 1M BURST SUPPRESSION PATTERN POOR

94 OHTAHARA SYNDROME BURST SUPPRESSION PATTERN BURST SUPPRESSION BURST

95 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

96 18. OHTAHARA SYNDROME IS A BENIGN CONDITION. A. TRUE B. FALSE

97 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

98 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

99 SEIZURE TYPE: EEG: SEARCH FOR ETIOLOGY: WOODS LAMP, METABOLIC DISORDERS (BIOTINIDASE), TRIALS OF B6 & FOLINIC ACID; ANTIEPILEPTIC DRUGS NOT EFFECTIVE, BUT TRY OHTAHARA SYNDROME (EARLY INFANTILE EPILEPTIC ENCEPHALOPATHY WITH BURST SUPPRESSION) TONIC AND OTHERS BURST SUPPRESSION (ESTABLISHES DIAGNOSIS) VARIETIES: IDIOPATHIC (RARE) SYMPTOMATIC CRYPTOGENIC EXAMCAUSE NEGATIVENONE ABNORMALNONE PRESENTEITHER PROGNOSIS: POOR

100 18. OHTAHARA SYNDROME IS A BENIGN CONDITION. A. TRUE B. FALSE

101 19. GIGGLING IN A NEONATE CAN BE A SIGN OF A. MENINGITIS B. HYPOTHALAMIC HAMARTOMA C. TEMPORAL LOBE SCLEROSIS

102 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

103 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

104 SEIZURE TYPE: EEG: TREATMENT: GELASTIC SEIZURES BRIEF EPISODES OF PLEASANT LAUGHTER AND GIGGLING, FACIAL FLUSHING AND MYDRIASIS NORMAL, EVEN DURING EPISODES SURGERY, PHENOBARBITAL ETIOLOGY: HYPOTHALAMIC HAMARTOMA

105 19. GIGGLING IN A NEONATE CAN BE A SIGN OF A. MENINGITIS B. HYPOTHALAMIC HAMARTOMA C. TEMPORAL LOBE SCLEROSIS

106 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

107 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

108 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

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

110 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

111 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

112 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

113 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

114 SIMPLE FEBRILE SEIZURES FEBRILE SEIZURES SEIZURE THAT OCCURS BETWEEN 3 MONTHS AND 5 YEARS OF AGE (PEAK M), ASSOCIATED WITH FEVER, WITHOUT INTRACRANIAL DEMONSTRABLE PATHOLOGY LESS THAN 15 MINUTES GENERALIZED NO RECURRENCE IN 48 HOURS NORMAL NEUROLOGICAL EXAMINATION COMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROL DIAZEPAM (PO): 0.33 MG/KG Q 8 HOURS DIASTAT 2.5;5;10 MG (RECTAL): < 10 MG PHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG > DIASTAT

115 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

116 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

117 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

118 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

119 SIMPLE FEBRILE SEIZURES FEBRILE SEIZURES SEIZURE THAT OCCURS BETWEEN 3 MONTHS AND 5 YEARS OF AGE (PEAK M), ASSOCIATED WITH FEVER, WITHOUT INTRACRANIAL DEMONSTRABLE PATHOLOGY LESS THAN 15 MINUTES GENERALIZED NO RECURRENCE IN 48 HOURS NORMAL NEUROLOGICAL EXAMINATION COMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROL DIAZEPAM (PO): 0.33 MG/KG Q 8 HOURS DIASTAT 2.5;5;10 MG (RECTAL): < 10 MG PHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG > DIASTAT

120 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

121 23. THE FEBRILE SEIZURE GENE HAS BEEN MAPPED TO CHROMOSOME 19p AND 8q IN SOME FAMILIES. A. TRUE B. FALSE

122 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

123 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

124 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 HOURS NORMAL NEUROLOGICAL EXAMINATION COMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROL DIAZEPAM (PO): 0.33 MG/KG Q 8 HOURS DIASTAT 2.5;5;10 MG (RECTAL): < 10 MG PHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG > DIASTAT THINK, CNS PROBLEMS

125 23. THE FEBRILE SEIZURE GENE HAS BEEN MAPPED TO CHROMOSOME 19p AND 8q IN SOME FAMILIES. A. TRUE B. FALSE

126 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

127 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

128 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

129 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 HOURS NORMAL NEUROLOGICAL EXAMINATION COMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROL DIAZEPAM (PO): 0.33 MG/KG Q 8 HOURS DIASTAT 2.5;5;10 MG (RECTAL): < 10 MG PHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG > DIASTAT THINK, CNS PROBLEMS

130 24. ORGANIC CNS PATHOLOGY SUCH AS INFECTIONS OR TOXIC PROCESS IS MORE LIKELY IN PATIENTS WITH: A. BENIGN ROLANDIC EPILEPSY B. SIMPLE FEBRILE SEIZURE C. EPILEPSY OF JANZ D. COMPLEX FEBRILE SEIZURES

131 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

132 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

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134 NO RISK FACTORS FEBRILE SEIZURES DURATION: MORE THAN 15 MINUTES FOCAL RECURRENCE IN 48 HOURS ABNORMAL NEUROLOGICAL EXAMINATION EPILEPSY: 1% RISK FACTORS FAMILY HISTORY OF EPILEPSY DEVELOPMENTAL DELAY THE PRESENCE OF SEVERAL OF THIS FACTORS MAKES THE RISK OF EPILEPSY: 9%

135 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

136 26. AN EEG IS INDICATED IN PATIENTS WITH THE FIRST SIMPLE FEBRILE SEIZURE. A. TRUE B. FALSE

137 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

138 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

139

140 26. AN EEG IS INDICATED IN PATIENTS WITH THE FIRST SIMPLE FEBRILE SEIZURE. A. TRUE B. FALSE

141 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

142 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

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144 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 HOURS NORMAL NEUROLOGICAL EXAMINATION COMPLEX FEBRILE SEIZURES IF NOT SIMPLE TREATMENT: TEMPERATURE CONTROL DIAZEPAM (PO): 0.33 MG/KG Q 8 HOURS FROM FEVER ONSET TO FINISH DIASTAT 2.5;5;10 MG (RECTAL): < 10 MG PHENOBARBITAL (PO): 3-5 MG/KG/D AGE/Y MG/KG > DIASTAT THINK, CNS PROBLEMS

145 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

146 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

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149 TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOOD NORMAL EEG BACKGROUND FAST SPIKE WAVES COMPLEX > 2.5 Hz 50 % ARE SEIZURE FREE AFTER FEW YEARS 33 % POSITIVE FAMILY HISTORY OFTEN DEVELOP PROBLEMS WITH: LEARNING AND LANGUAGE EMOTIONS AND BEHAVIOR MENTAL RETARDATION IS RARE

150 SEIZURE TYPE: EEG: TREATMENT: TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOOD UPPER LIMB MYOCLONUS, AWAKE AND SLEEP GB: NORMAL, ICTAL GENERALIZED SPIKE & WAVE DIAGNOSIS: EXCLUDE SLEEP MYOCLONUS (NO ICTAL ONSET OF SEIZURES: 6 MONTHS TO 3 YEARS OF AGE NORMAL NEUROLOGICAL EXAMINATION NO ETIOLOGY VALPROIC ACID ? FAMILY HISTORY OF SEIZURES (SOMETIMES) EEG CHANGES)

151 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

152 29. ALL THE SPASMS IN INFANTS WITH INFANTILE SPASM LOOK THE SAME. A. TRUE B. FALSE

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155 WEST SYNDROME (INFANTILE SPASM) GENERALIZED FLEXOR SPASM PARTIAL LEFT ARM SPASM HIP FLEXION SPASMHEAD DROP

156 29. ALL THE SPASMS IN INFANTS WITH INFANTILE SPASM LOOK THE SAME. A. TRUE B. FALSE

157 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

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160 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 SYNDROME WEST SYNDROME (INFANTILE SPASM) FLEXOR SPASM, EXTENSION SPASM, OTHERS (SOMETIMES PRECEDED BY CRY) VARIETIES: IDIOPATHIC (RARE) SYMPTOMATIC CRYPTOGENIC EXAMCAUSE NEGATIVENONE ABNORMALNONE PRESENTEITHER HYPSARHYTHMIA (ESTABLISHES DIAGNOSIS) PROGNOSIS: POOR NOT PRODUCED BY IMMUNIZATIONS! *

161 SEIZURE TYPE: EEG: WEST SYNDROME (INFANTILE SPASM) FLEXOR SPASM, EXTENSION SPASM, OTHERS (SOMETIMES PRECEDED BY CRY) VARIETIES AS PER NELSON SYMPTOMATICCRYPTOGENIC NEURO EXAM NORMAL IF NOT CRYPTOGENIC PREGNANCY BAD HYPSARHYTHMIA (ESTABLISHES DIAGNOSIS) PROGNOSIS * NORMAL BIRTH HISTORY DEVELOPMENT BRAIN CT & MRI RISK FACTORS NORMAL NONE GOOD

162 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

163 31. ALL OF THE FOLLOWING ARE POSSIBLE CAUSES OF WEST SYNDROME, EXCEPT: A. PYRIDOXINE DEPENDENCY B. LISSENCEPHALY C. CONGENITAL INFECTIONS D. IMMUNIZATIONS

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166 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 SYNDROME WEST SYNDROME (INFANTILE SPASM) FLEXOR SPASM, EXTENSION SPASM, OTHERS (SOMETIMES PRECEDED BY CRY) VARIETIES: IDIOPATHIC (RARE) SYMPTOMATIC CRYPTOGENIC EXAMCAUSE NEGATIVENONE ABNORMALNONE PRESENTEITHER HYPSARHYTHMIA (ESTABLISHES DIAGNOSIS) PROGNOSIS: POOR NOT PRODUCED BY IMMUNIZATIONS! *

167 31. ALL OF THE FOLLOWING ARE POSSIBLE CAUSES OF WEST SYNDROME, EXCEPT: A. PYRIDOXINE DEPENDENCY B. LISSENCEPHALY C. CONGENITAL INFECTIONS D. IMMUNIZATIONS

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

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171 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 SYNDROME WEST SYNDROME (INFANTILE SPASM) FLEXOR SPASM, EXTENSION SPASM, OTHERS (SOMETIMES PRECEDED BY CRY) VARIETIES: IDIOPATHIC (RARE) SYMPTOMATIC CRYPTOGENIC EXAMCAUSE NEGATIVENONE ABNORMALNONE PRESENTEITHER HYPSARHYTHMIA (ESTABLISHES DIAGNOSIS) PROGNOSIS: POOR NOT PRODUCED BY IMMUNIZATIONS! *

172 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)

173 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

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176 SEIZURE TYPE: EEG: TREATMENT: TYPICAL MYOCLONIC EPILEPSY OF EARLY CHILDHOOD UPPER LIMB MYOCLONUS, AWAKE AND SLEEP GB: NORMAL, ICTAL GENERALIZED SPIKE & WAVE DIAGNOSIS: EXCLUDE SLEEP MYOCLONUS (NO ICTAL ONSET OF SEIZURES: 6 MONTHS TO 3 YEARS OF AGE NORMAL NEUROLOGICAL EXAMINATION NO ETIOLOGY VALPROIC ACID ? FAMILY HISTORY OF SEIZURES (SOMETIMES) EEG CHANGES)

177 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

178 34. WHAT EEG PATTERN IS CHARACTERISTIC OF WEST SYNDROME? A. BURST SUPPRESSION PATTERN B. GENERALIZED 3-PER-SECOND SPIKE AND WAVE C. HYPSARHYTHMIA D. FOCAL SHARP WAVES IN THE CENTROTEMPORAL REGION

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181 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 SYNDROME WEST SYNDROME (INFANTILE SPASM) FLEXOR SPASM, EXTENSION SPASM, OTHERS (SOMETIMES PRECEDED BY CRY) VARIETIES: IDIOPATHIC (RARE) SYMPTOMATIC CRYPTOGENIC EXAMCAUSE NEGATIVENONE ABNORMALNONE PRESENTEITHER HYPSARHYTHMIA (ESTABLISHES DIAGNOSIS) PROGNOSIS: POOR NOT PRODUCED BY IMMUNIZATIONS! *

182 34. WHAT EEG PATTERN IS CHARACTERISTIC OF WEST SYNDROME? A. BURST SUPPRESSION PATTERN B. GENERALIZED 3 PER SECOND SPIKE AND WAVE C. HYPSARHYTHMIA D. FOCAL SHARP WAVES IN THE CENTROTEMPORAL REGION

183 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

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186 EPILEPSY SYNDROMES OF ONSET - DURING EARLY CHILDHOOD LENNOX-GASTAUT SYNDROME LANDAU-KLEFFNER SYNDROME SLOW SLEEP STATUS SYNDROME TYPICAL MYOCLONIC EPILEPSY OF EARLY INFANCY

187 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

188 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

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191 LENNOX-GASTAUT SYNDROME PARTIAL SEIZURE HEAD DROPDROP ATTACK

192 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

193 37. MOST CHILDREN WITH LENNOX GASTAUT SYNDROME ARE: A. MENTALLY RETARDED B. AUTISTIC C. HEMIPLEGIC D. ALL OF THE ABOVE

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196 LENNOX-GASTAUT SYNDROME PARTIAL SEIZURE HEAD DROPDROP ATTACK

197 37. MOST CHILDREN WITH LENNOX GASTAUT SYNDROME ARE: A. MENTALLY RETARDED B. AUTISTIC C. HEMIPLEGIC D. ALL OF THE ABOVE

198 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

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201 EEG: SEARCH FOR ETIOLOGY: WOODS LAMP, METABOLIC DISORDERS, TRIAL OF B6; ANTIEPILEPTIC DRUGS INEFFECTIVE, BUT TRY! FREQUENTLY HISTORY OF WEST SYNDROME LENNOX-GASTAUT SYNDROME SEIZURE TYPE: ABSENCE, ATONIC & MYOCLONIC FITS VARIETIES: IDIOPATHIC (RARE) SYMPTOMATIC CRYPTOGENIC EXAMCAUSE NEGATIVENONE ABNORMALNONE PRESENTEITHER SPIKE OR POLYSPIKE AND WAVES (1 TO 2.5 Hz) FREQUENT STATUS EPILEPTICUS GENERALIZED (MAXIMALLY FRONTAL) PROGNOSIS: POOR

202 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

203 39. AN IV TRIAL OF PYRIDOXINE SHOULD BE PREFORMED WHILE CONDUCTING AN EEG AND WHILE THE PATIENT IS BEING MONITORED. A. TRUE B. FALSE

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206 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

207 39. AN IV TRIAL OF PYRIDOXINE SHOULD BE PREFORMED WHILE CONDUCTING AN EEG AND WHILE THE PATIENT IS BEING MONITORED. A. TRUE B. FALSE

208 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

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

212 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

213 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

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

217 SEIZURE TYPE: EEG: SEARCH FOR ETIOLOGY: WOODS LAMP, METABOLIC DISORDERS (BIOTINIDASE), TRIALS OF B6 & FOLINIC ACID; ANTIEPILEPTIC DRUGS NOT EFFECTIVE, BUT TRY OHTAHARA SYNDROME (EARLY INFANTILE EPILEPTIC ENCEPHALOPATHY WITH BURST SUPPRESSION) TONIC AND OTHERS BURST SUPPRESSION (ESTABLISHES DIAGNOSIS) VARIETIES: IDIOPATHIC (RARE) SYMPTOMATIC CRYPTOGENIC EXAMCAUSE NEGATIVENONE ABNORMALNONE PRESENTEITHER PROGNOSIS: POOR

218 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

219 42. ALL THE FOLLOWING EPILEPTIC SYNDROMES FREQUENTLY OCCUR IN LATE CHILDHOOD, EXCEPT: A. BENIGN ROLANDIC EPILEPSY B. PYKNOLEPSIES C. WEST SYNDROME D. BENIGN OCCIPITAL EPILEPSY

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222 EPILEPSY SYNDROMES OF ONSET - DURING LATE CHILDHOOD BENIGN ROLANDIC SEIZURES PETIT MAL, PYKNOLEPSY BENIGN OCCIPITAL EPILEPSY

223 42. ALL THE FOLLOWING EPILEPTIC SYNDROMES FREQUENTLY OCCUR IN LATE CHILDHOOD, EXCEPT: A. BENIGN ROLANDIC EPILEPSY B. PYKNOLEPSIES C. WEST SYNDROME D. BENIGN OCCIPITAL EPILEPSY

224 43. IN CHILDREN WITH BENIGN ROLANDIC EPILEPSY, SPEECH ARREST IS USUALLY FOLLOWED BY: A. LEFT ARM SEIZURES B. RIGHT ARM SEIZURES C. GENERALIZED SEIZURES

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227 SEIZURE TYPE: EEG: TREATMENT: BENIGN ROLANDIC EPILEPSY FACIAL-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 SIDE TEGRETOL, 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 EXAMINATION SEIZURES STOP BY 16 YEARS OF AGE

228 43. IN CHILDREN WITH BENIGN ROLANDIC EPILEPSY, SPEECH ARREST IS USUALLY FOLLOWED BY: A. LEFT ARM SEIZURES B. RIGHT ARM SEIZURES (LANGUAGE IS ON THE LEFT) C. GENERALIZED SEIZURES

229 44. BENIGN OCCIPITAL EPILEPSY MAY BE ASSOCIATED WITH: A. CELIAC DISEASE B. MAPLE SYRUP URINE DISEASE D. DIABETES MELLITUS

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232 SEIZURE TYPE: EEG: TREATMENT: BENIGN OCCIPITAL EPILEPSY OCCIPITAL LOBE SEIZURES REPETITIVE OCCIPITAL DISCHARGES ON EYE CLOSURE TEGRETOL, TRILEPTAL SIMPLE OR COMPLEX HALLUCINATIONS, VISUAL DISTORTIONS, HEMIANOPSIA, AND AMAUROSIS WITH PRESERVATION OF CONSCIOUSNESS DO NOT MISDIAGNOSE AS MIGRAINE MAYBE ASSOCIATED WITH CELIAC DISEASE AND - OCCIPITAL LOBE CALCIFICATION NORMAL NEUROLOGICAL EXAMINATION

233 44. BENIGN OCCIPITAL EPILEPSY MAY BE ASSOCIATED WITH: A. CELIAC DISEASE B. MAPLE SYRUP URINE DISEASE D. DIABETES MELLITUS

234 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

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237 SEIZURE TYPE: EEG: TREATMENT: PETIT MAL, PYKNOLEPSY ABSENCE, AUTOMATISMS, SMALL JERKS 3 Hz SPIKES AND WAVES, TRIGGER BY HV 30 TO 40 % DEVELOP GENERALIZED CONVULSIONS LATER NORMAL NEUROLOGICAL EXAMINATION GENETIC PREDISPOSITION ETHOSUXIMIDE, VALPROATE NO AURA NO POST-ICTAL CONFUSION

238 PETIT MAL, PYKNOLEPSY F F F F O O O

239 SEIZURE TYPE: EEG: TREATMENT: PSYCHOMOTOR SEIZURES ABSENCE, CONVULSIONS FOCAL TEMPORAL OR FRONTAL SPIKES TEMPORAL LOBE SCLEROSIS (FEBRILES SEIZURES ?) ABNORMAL NEUROLOGICAL EXAMINATION FRONTAL LOBE TUMORS TEGRETOL OR VALPROIC ACID AURA: TEMPORAL LOBE: METALLIC SMELL FRONTAL LOBE : ABNORMAL BEHAVIOR POST-ICTAL CONFUSION

240 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

241 46. COMPLEX PARTIAL SEIZURES ALWAYS COINCIDE WITH THE ONSET OF AN ALTERED STATE OF CONSCIOUSNESS. A. TRUE B. FALSE

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

245 46. COMPLEX PARTIAL SEIZURES ALWAYS COINCIDE WITH THE ONSET OF AN ALTERED STATE OF CONSCIOUSNESS. A. TRUE B. FALSE SOME NEUROLOGIST DO NOT AGREE WITH THIS ANSWER!

246 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

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249 INFANT ONSET EPILEPSIES SYNDROMES OTHERS COMPLEX PARTIAL SEIZURES SIMPLE PARTIAL SEIZURES EPILEPSY SYNDROMES OF ONSET DURING INFANCY WEST SYNDROME (INFANTILE SPASM) FEBRILE SEIZURES BENIGN MYOCLONIC EPILEPSY OF INFANCY OTHER EPILEPSY ALIMENTARY AUTOMATISM

250 SEIZURE TYPE: EEG: TREATMENT: PSYCHOMOTOR SEIZURES ABSENCE, CONVULSIONS FOCAL TEMPORAL OR FRONTAL SPIKES TEMPORAL LOBE SCLEROSIS (FEBRILES SEIZURES ?) ABNORMAL NEUROLOGICAL EXAMINATION FRONTAL LOBE TUMORS TEGRETOL OR VALPROIC ACID AURA: TEMPORAL LOBE: METALLIC SMELL FRONTAL LOBE : ABNORMAL BEHAVIOR POST-ICTAL CONFUSION

251 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

252 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

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255 TEMPORAL LOBE SEIZURES RIGHT ARM TONIC THEN CONFUSION ABNORMAL BEHAVIOR

256 FEAR RAGE SECONDARY GENERALIZED TONIC POSTURE HEAD TURNING FRONTAL (PREMOTOR) LOBE SEIZURES

257 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

258 49. A NORMAL INTERICTAL ROUTINE EEG EXCLUDES THE POSSIBILITY OF COMPLEX PARTIAL SEIZURES. A. TRUE B. FALSE

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261 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

262 49. A NORMAL INTERICTAL ROUTINE EEG EXCLUDES THE POSSIBILITY OF COMPLEX PARTIAL SEIZURES. A. TRUE B. FALSE

263 50. RASMUSSEN ENCEPHALITIS IS A FREQUENT CAUSE OF: A. BENIGN ROLANDIC EPILEPSY B. EPILEPSY OF JANZ C. EPILEPSIA PARTIALIS CONTINUA D. OHTAHARA SYNDROME

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266 RASMUSSEN ENCEPHALITIS NO CAUSE KNOWN EPILEPSIA PARTIALIS CONTINUA POOR PROGNOSIS

267 50. RASMUSSEN ENCEPHALITIS IS A FREQUENT CAUSE OF: A. BENIGN ROLANDIC EPILEPSY B. JANZ SYNDROME C. EPILEPSIA PARTIALIS CONTINUA D. OHTAHARA SYNDROME

268 51. THE HALLMARK OF JANZ SYNDROME IS: A. SPEECH ARREST B. MYOCLONIC JERKS WITHIN 30 MINUTES OF AWAKENING C. ROLANDIC SEIZURES D. MENTAL RETARDATION

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271 EPILEPSY SYNDROMES OF ONSET - DURING ADOLESCENCE JANZ’S SYNDROME (JUVENILE MYOCLONIC EPILEPSY)

272 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 ARMS DO NOT STOP MEDICATION LINKED TO CHROMOSOME 6 NORMAL NEUROLOGICAL EXAMINATION JANZ’S SYNDROME

273 (JUVENILE MYOCLONIC EPILEPSY) JANZ’S SYNDROME MYOCLONIC JERK TRIGGER BY PHOTIC STIMULATION

274 51. THE HALLMARK OF JANZ SYNDROME IS: A. SPEECH ARREST B. MYOCLONIC JERKS WITHIN 30 MINUTES OF AWAKENING C. ROLANDIC SEIZURES D. MENTAL RETARDATION

275 52. JUVENILE MYOCLONIC EPILEPSY IS LINKED TO: A. 20q B. 8q C. 6p D. 21q

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278 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 ARMS DO NOT STOP MEDICATION LINKED TO CHROMOSOME 6 NORMAL NEUROLOGICAL EXAMINATION JANZ’S SYNDROME

279 52. JUVENILE MYOCLONIC EPILEPSY IS LINKED TO: A. 20q B. 8q C. 6p D. 21q

280 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

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283 GLOBUS PALLIDUS RED NUCLEUS SUBSTANTIA NIGRA PUTAMEN CLAUSTRUM CAUDATE NUCLEUS

284 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

285 54. THE MINIMUM WORK-UP FOR THE FIRST AFEBRILE SEIZURE, IN AN OTHERWISE HEALTHY CHILD, SHOULD INCLUDE ALL OF THE FOLLOWING, EXCEPT: A. FASTING GLUCOSE B. MAGNESIUM C. EEG D. AMMONIA

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288 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.

289 54. THE MINIMUM WORK-UP FOR THE FIRST AFEBRILE SEIZURE, IN AN OTHERWISE HEALTHY CHILD, SHOULD INCLUDE ALL OF THE FOLLOWING, EXCEPT: A. FASTING GLUCOSE B. MAGNESIUM C. EEG D. AMMONIA

290 55. INTERICTAL EEG RECORDINGS ARE NORMAL IN APPROXIMATELY ___ PERCENT OF PATIENTS WITH FIRST AFEBRILE SEIZURE. A. 20 B. 40 C. 60 D. 80

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293 40% NORMAL

294 55. INTERICTAL EEG RECORDINGS ARE NORMAL IN APPROXIMATELY ___ PERCENT OF PATIENTS WITH FIRST AFEBRILE SEIZURE. A. 20 B. 40 C. 60 D. 80

295 56. BEFORE SCHEDULING A ROUTINE EEG, THE SEIZURE MEDICATION SHOULD BE STOPPED. A. TRUE B. FALSE

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298

299 56. BEFORE SCHEDULING A ROUTINE EEG, THE SEIZURE MEDICATION SHOULD BE STOPPED. A. TRUE B. FALSE

300 57. MRI OF THE BRAIN SHOULD BE DONE IN ALL PATIENTS WITH AFEBRILE SEIZURES. A. TRUE B. FALSE

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

304 57. MRI OF THE BRAIN SHOULD BE DONE IN ALL PATIENTS WITH AFEBRILE SEIZURES. A. TRUE B. FALSE

305 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

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308 A POSITIVE FAMILY HISTORY OF SEIZURES IS AN INDICATION TO TREAT

309 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

310 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

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313 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

314 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

315 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

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318 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

319 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

320 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

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323 WEANING PROCESS OF ANTIEPILEPTIC DRUGS SHOULD OCCUR FOR: MONTH

324 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

325 62. BENZODIAZEPINES EXERT ANTICONVULSANT ACTIVITY BY: A. OPENING CHLORIDE CHANNELS B. BLOCKING SODIUM-DEPENDENT CHANNELS C. DECREASING THE POLARIZATION- DEPENDENT CALCIUM UPTAKE D. INCREASING GABA TURNOVER

326 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

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328 MUST SEIZURE MEDICATION WORK EITHER BY “CLOSING” Na CHANNELS OR “OPENING” Cl CHANNELS Cl CHANNELS Cl BARBITURATES BENZODIAZEPINES GABA BY OPENING Cl CHANNELS THE MEMBRANE POTENTIAL IS FIXED AT THE NERNST POINT FOR Cl (-60  V)

329 = 10  V + NEURONAL MEMBRANE AT REST 60  V DEPOLARIZATION ACTION POTENTIAL: Na CHANNELS ARE OPEN HYPER POLARIZATION NERNST POINT = 73  V K = 60  V Cl Na = + 57  V Na CHANNELS ARE CLOSED + 50  V MUST SEIZURE MEDICATION WORK EITHER BY “CLOSING” Na CHANNELS OR “OPENING” Cl CHANNELS

330 62. BENZODIAZEPINES EXERT ANTICONVULSANT ACTIVITY BY: A. OPENING CHLORIDE CHANNELS B. BLOCKING SODIUM-DEPENDENT CHANNELS C. DECREASING THE POLARIZATION- DEPENDENT CALCIUM UPTAKE D. INCREASING GABA TURNOVER

331 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

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334 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)

335 CARBAMAZEPINE (CBZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D LEVEL: 4-12 MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LOW SODIUM, LUPUS LIKE, ARRHYTHMIA INTERACTION CBZ LOWERS ANTICOAGULANT AND “PILL” CBZ INCREASED BY ERYTHROMYCIN STOP IF ABSOLUTE NEUTROPHILIC COUNT IS < 1000 CBC & LFT: ONSET, 6 WEEKS, & Q 3-6 MONTHS

336 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

337 64. WHICH OF THE FOLLOWING DRUGS RAISES THE LEVEL OF CARBAMAZEPINE? A. ERYTHROMYCIN B. PHENYTOIN C. PHENOBARBITAL D. VALPROIC ACID

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340 CARBAMAZEPINE (CBZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D LEVEL: 4-12 MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LOW SODIUM, LUPUS LIKE, ARRHYTHMIA INTERACTION CBZ LOWERS ANTICOAGULANT AND “PILL” CBZ INCREASED BY ERYTHROMYCIN STOP IF ABSOLUTE NEUTROPHILIC COUNT IS < 1000 CBC & LFT: ONSET, 6 WEEKS, & Q 3-6 MONTHS

341 PHENOBARBITAL PHENYTOIN VALPROIC ACID CARBAMAZEPINE LEVEL

342 ERYTHROMYCIN CARBAMAZEPINE LEVEL

343 64. WHICH OF THE FOLLOWING DRUGS RAISES THE LEVEL OF CARBAMAZEPINE? A. ERYTHROMYCIN B. PHENYTOIN C. PHENOBARBITAL D. VALPROIC ACID

344 65. TOXICITY DESPITE THERAPEUTIC CARBAMAZEPINE LEVELS IS LIKELY TO OCCUR WHEN ______ IS ADDED. A. ERYTHROMYCIN B. PHENYTOIN C. PHENOBARBITAL D. VALPROIC ACID

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347 PHENOBARBITAL PHENYTOIN VALPROIC ACID CARBAMAZEPINE LEVEL EPOXIDE (TOXICITY)

348 65. TOXICITY DESPITE THERAPEUTIC CARBAMAZEPINE LEVELS IS LIKELY TO OCCUR WHEN ______ IS ADDED. A. ERYTHROMYCIN B. PHENYTOIN C. PHENOBARBITAL D. VALPROIC ACID

349 66. CARBAMAZEPINE EXERTS ANTICONVULSANT ACTIVITY BY: A. OPENING CHLORIDE CHANNELS B. BLOCKING SODIUM-DEPENDENT CHANNELS C. BLOCKING CALCIUM CHANNELS ASSOCIATED WITH THALAMOCORTICAL CIRCUITRY D. INCREASING GABA TURNOVER

350 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

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352 MUST SEIZURE MEDICATION WORK EITHER BY “CLOSING” Na CHANNELS OR “OPENING” Cl CHANNELS Na CHANNELS Na BY CLOSING Na CHANNELS THE MEMBRANE POTENTIAL DOES NOT MOVES TO THE NERNST POINT FOR Na (+57  V) CARBAMAZEPINE

353 = 10  V + NEURONAL MEMBRANE AT REST 60  V DEPOLARIZATION ACTION POTENTIAL: Na CHANNELS ARE OPEN HYPER POLARIZATION NERNST POINT = 73  V K = 60  V Cl Na = + 57  V Na CHANNELS ARE CLOSED + 50  V MUST SEIZURE MEDICATION WORK EITHER BY “CLOSING” Na CHANNELS OR “OPENING” Cl CHANNELS

354 66. CARBAMAZEPINE EXERTS ANTICONVULSANT ACTIVITY BY: A. OPENING CHLORIDE CHANNELS B. BLOCKING SODIUM-DEPENDENT CHANNELS C. BLOCKING CALCIUM CHANNELS ASSOCIATED WITH THALAMOCORTICAL CIRCUITRY D. INCREASING GABA TURNOVER

355 67. ETHOSUXIMIDE EXERTS ANTICONVULSANT ACTIVITY BY: A. OPENING CHLORIDE CHANNELS B. BLOCKING SODIUM-DEPENDENT CHANNELS C. BLOCKING CALCIUM CHANNELS ASSOCIATED WITH THALAMOCORTICAL CIRCUITRY D. INCREASING GABA TURNOVER

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

359 67. ETHOSUXIMIDE EXERTS ANTICONVULSANT ACTIVITY BY: A. OPENING CHLORIDE CHANNELS B. BLOCKING SODIUM-DEPENDENT CHANNELS C. BLOCKING CALCIUM CHANNELS ASSOCIATED WITH THALAMOCORTICAL CIRCUITRY D. INCREASING GABA TURNOVER

360 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

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363 STOP

364 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

365 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

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368 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

369 VALPROIC ACID PHENOBARBITAL LEVEL

370 MUST SEIZURE MEDICATION WORK EITHER BY “CLOSING” Na CHANNELS OR “OPENING” Cl CHANNELS Cl CHANNELS Cl BARBITURATES BENZODIAZEPINES GABA BY OPENING Cl CHANNELS THE MEMBRANE POTENTIAL IS FIXED AT THE NERNST POINT FOR Cl (-60  V)

371 = 10  V + NEURONAL MEMBRANE AT REST 60  V DEPOLARIZATION ACTION POTENTIAL: Na CHANNELS ARE OPEN HYPER POLARIZATION NERNST POINT = 73  V K = 60  V Cl Na = + 57  V Na CHANNELS ARE CLOSED + 50  V MUST SEIZURE MEDICATION WORK EITHER BY “CLOSING” Na CHANNELS OR “OPENING” Cl CHANNELS

372 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

373 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

374 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

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376 MUST SEIZURE MEDICATION WORK EITHER BY “CLOSING” Na CHANNELS OR “OPENING” Cl CHANNELS, BUT A FEW WORK BY INCREASING PERMEABILITY TO POTASSIUM Na CHANNELS BY CLOSING Na CHANNELS THE MEMBRANE POTENTIAL DOES NOT MOVES TO THE K NERNST POINT (-73  V) VALPROIC ACID K CHANNELS BY OPENING K CHANNELS THE MEMBRANE POTENTIAL MOVES TOWARD THE Na NERNST POINT (+57  V)

377 = 10  V + NEURONAL MEMBRANE AT REST 60  V DEPOLARIZATION ACTION POTENTIAL: Na CHANNELS ARE OPEN HYPER POLARIZATION NERNST POINT = 73  V K = 60  V Cl Na = + 57  V Na CHANNELS ARE CLOSED + 50  V MUST SEIZURE MEDICATION WORK EITHER BY “CLOSING” Na CHANNELS OR “OPENING” Cl CHANNELS

378 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVES DISEASE GIRL > 10 Y: FOLIC ACID

379 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

380 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

381 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

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383 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

384 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

385 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

386 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

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388 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.

389 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

390 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

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392 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

393

394 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

395 74. ACTH AND PREDNISONE ARE EQUALLY AFFECTIVE IN THE TREATMENT OF INFANTILE SPASMS: A. TRUE B. FALSE

396 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

397 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

398 PREDNISONEACTH SUCCESS FOR CRYPTOGENIC AND SYMPTOMATIC WEST SYNDROME 70 % I DO NOT THINK SO, BUT …

399 74. ACTH AND PREDNISONE ARE EQUALLY AFFECTIVE IN THE TREATMENT OF INFANTILE SPASMS: A. TRUE B. FALSE

400 75. ALL OF THE FOLLOWING DRUGS LOWER THEOPHYLLINE LEVELS, EXCEPT: A. PHENOBARBITAL B. PHENYTOIN C. PRIMIDONE D. VALPROIC ACID

401 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

402 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

403 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

404 PRIMIDONE (PRM) TR: PB: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: AGRANULOCYTOSIS, MEGALOBLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” TIDQID CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES DOSE/PO START UP/W BY USUAL MAX MG/D

405 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

406 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

407 75. ALL OF THE FOLLOWING DRUGS LOWER THEOPHYLLINE LEVELS, EXCEPT: A. PHENOBARBITAL B. PHENYTOIN C. PRIMIDONE D. VALPROIC ACID

408 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

409 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

410 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

411 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

412 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

413 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

414 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

415 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

416 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

417 PRIMIDONE (PRM) TR: PB: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: AGRANULOCYTOSIS, MEGALOBLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” TIDQID CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES DOSE/PO START UP/W BY USUAL MAX MG/D

418 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

419 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

420 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

421 78. LARYNGOSPASM AND BRONCHOSPASM ARE COMPLICATIONS OF: A. PHENOBARBITAL B. PHENYTOIN C. CARBAMAZEPINE D. VALPROIC ACID

422 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

423 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

424 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

425 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

426 CARBAMAZEPINE (CBZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D LEVEL: 4-12 MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LOW SODIUM, LUPUS LIKE, ARRHYTHMIA INTERACTION CBZ LOWERS ANTICOAGULANT AND “PILL” CBZ INCREASED BY ERYTHROMYCIN STOP IF ABSOLUTE NEUTROPHILIC COUNT IS < 1000 CBC & LFT: ONSET, 6 WEEKS, & Q 3-6 MONTHS

427 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

428 78. LARYNGOSPASM AND BRONCHOSPASM ARE COMPLICATIONS OF: A. PHENOBARBITAL B. PHENYTOIN C. CARBAMAZEPINE D. VALPROIC ACID

429 79. WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS SHOULD BE AVOIDED IN PATIENT WITH CARDIAC DISEASE? A. PHENOBARBITAL B. PHENYTOIN C. CARBAMAZEPINE D. VALPROIC ACID

430 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

431 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

432 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

433 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

434 CARBAMAZEPINE (CBZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D LEVEL: 4-12 MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LOW SODIUM, LUPUS LIKE, ARRHYTHMIA INTERACTION CBZ LOWERS ANTICOAGULANT AND “PILL” CBZ INCREASED BY ERYTHROMYCIN STOP IF ABSOLUTE NEUTROPHILIC COUNT IS < 1000 CBC & LFT: ONSET, 6 WEEKS, & Q 3-6 MONTHS

435 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

436 79. WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS SHOULD BE AVOIDED IN PATIENT WITH CARDIAC DISEASE? A. PHENOBARBITAL B. PHENYTOIN C. CARBAMAZEPINE D. VALPROIC ACID

437 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

438 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

439 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

440 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

441 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

442 OXCARBAMAZEPINE (OXC) DOSE/PO START UP IN USUAL WEIGHT (KG) G/D MG/KG/D W 20-29:.9;29-39:1.2;>39:1.8 TR: MG/L* SIDE EFFECTS CNS: HEADACHE, DIZZINESS, ATAXIA, DIPLOPIA GI: NAUSEA, VOMITING OTHERS: LOW SODIUM INTERACTION OXC: LOWERS “PILL” BIDTID SERUM SODIUM * 10-MONOHYDROXYL METABOLITE (MHD)

443 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

444 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

445 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

446 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

447 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

448 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

449 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

450 PRIMIDONE (PRM) TR: PB: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: AGRANULOCYTOSIS, MEGALOBLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” TIDQID CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES DOSE/PO START UP/W BY USUAL MAX MG/D

451 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

452 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

453 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

454 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

455 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

456 CARBAMAZEPINE (CBZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D LEVEL: 4-12 MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LOW SODIUM, LUPUS LIKE, ARRHYTHMIA INTERACTION CBZ LOWERS ANTICOAGULANT AND “PILL” CBZ INCREASED BY ERYTHROMYCIN STOP IF ABSOLUTE NEUTROPHILIC COUNT IS < 1000 CBC & LFT: ONSET, 6 WEEKS, & Q 3-6 MONTHS

457 OXCARBAMAZEPINE (OXC) DOSE/PO START UP IN USUAL WEIGHT (KG) G/D MG/KG/D W 20-29:.9;29-39:1.2;>39:1.8 TR: MG/L* SIDE EFFECTS CNS: HEADACHE, DIZZINESS, ATAXIA, DIPLOPIA GI: NAUSEA, VOMITING OTHERS: LOW SODIUM INTERACTION OXC: LOWERS “PILL” BIDTID SERUM SODIUM * 10-MONOHYDROXYL METABOLITE (MHD)

458 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

459 83. WHICH ANTIBIOTIC CAN PRODUCE DIPLOPIA AND ATAXIA IN A CHILD TAKING CARBAMAZEPINE? A. PENICILLIN B. AUGMENTIN C. SULFA D. ERYTHROMYCIN

460 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

461 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

462 CARBAMAZEPINE (CBZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D LEVEL: 4-12 MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LOW SODIUM, LUPUS LIKE, ARRHYTHMIA INTERACTION CBZ LOWERS ANTICOAGULANT AND “PILL” CBZ INCREASED BY ERYTHROMYCIN STOP IF ABSOLUTE NEUTROPHILIC COUNT IS < 1000 CBC & LFT: ONSET, 6 WEEKS, & Q 3-6 MONTHS

463 83. WHICH ANTIBIOTIC CAN PRODUCE DIPLOPIA AND ATAXIA IN A CHILD TAKING CARBAMAZEPINE? A. PENICILLIN B. AUGMENTIN C. SULFA D. ERYTHROMYCIN

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

465 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

466 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

467 OXCARBAMAZEPINE (OXC) DOSE/PO START UP IN USUAL WEIGHT (KG) G/D MG/KG/D W 20-29:.9;29-39:1.2;>39:1.8 TR: MG/L* SIDE EFFECTS CNS: HEADACHE, DIZZINESS, ATAXIA, DIPLOPIA GI: NAUSEA, VOMITING OTHERS: LOW SODIUM INTERACTION OXC: LOWERS “PILL” BIDTID SERUM SODIUM * 10-MONOHYDROXYL METABOLITE (MHD)

468 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

469 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

470 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

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

472 85. GUM HYPERTROPHY IS AN UNAVOIDABLE COMPLICATION OF PHENYTOIN THERAPY? A. TRUE B. FALSE

473 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

474 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

475 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

476 85. GUM HYPERTROPHY IS AN UNAVOIDABLE COMPLICATION OF PHENYTOIN THERAPY? A. TRUE B. FALSE

477 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

478 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

479 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

480 PRIMIDONE (PRM) TR: PB: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: AGRANULOCYTOSIS, MEGALOBLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” TIDQID CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES DOSE/PO START UP/W BY USUAL MAX MG/D

481 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

482 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

483 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

484 86. FOLIC ACID SHOULD BE USE IN ALL FEMALE OVER 14 YEARS OF AGE WHO IS TAKING WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS? A. PRIMIDONE B. PHENOBARBITAL C. VALPROIC ACID D. PHENYTOIN

485 87. HIRSUTISM, GUM HYPERTROPHY, AND COARSE FACIES ARE SIDE EFFECTS OF: A. PRIMIDONE B. PHENOBARBITAL C. VALPROIC ACID D. PHENYTOIN

486 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

487 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

488 PRIMIDONE (PRM) TR: PB: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: AGRANULOCYTOSIS, MEGALOBLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” TIDQID CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES DOSE/PO START UP/W BY USUAL MAX MG/D

489 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

490 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

491 PHENYTOIN (PHT) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, NYSTAGMUS, DYSTONIA GI: LIVER FAILURE BLOOD: LYMPHOCYTIC REACTION, PANCYTOPENIA, OTHERS: HIRSUTISM, COARSE FACE, BIG GUM (HYGIENE) INTERACTION PHT: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDTID CONTRAINDICATIONS: CONDUCTION HEART PROBLEMS.5-3 MG/L (FREE) LYMPHADENOPATHY, LEARNING PROBLEMS MEGALOBLASTIC ANEMIA

492 87. HIRSUTISM, GUM HYPERTROPHY, AND COARSE FACIES ARE SIDE EFFECTS OF: A. PRIMIDONE B. PHENOBARBITAL C. VALPROIC ACID D. PHENYTOIN

493 88. SALICYLATES INCREASED THE LEVELS OF A. PHENOBARBITAL B. VALPROIC ACID C. CARBAMAZEPINE D. OXCARBAMAZEPINE

494 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

495 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

496 VALPROIC ACID (VPA) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: TREMOR, HYPERACTIVITY, BRAIN ATROPHY GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW PLATELETS, APLASTIC ANEMIA OTHERS: POLYCYSTIC OVARIAN SYNDROME INTERACTION VPA LEVEL ARE INCREASED BY SALICYLATES TIDQID CBC, AMMONIA, AMYLASE & LFT: ONSET CBC, & LFT: IN 6 WEEKS, & Q 3-6 MONTHS LOW FACTOR VII, LOW CARNITINE CONTRAINDICATIONS: PORPHYRIA, LIVER DISEASE GIRL > 10 Y: FOLIC ACID

497 ASPIRIN VALPROIC LEVEL

498 88. SALICYLATES INCREASED THE LEVELS OF: A. PHENOBARBITAL B. VALPROIC ACID C. CARBAMAZEPINE D. OXCARBAMAZEPINE

499 89. WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS DO NOT AFFECT THE EFFICACY OF CONTRACEPTIVE DRUGS? A. PHENOBARBITAL B. CARBAMAZEPINE C. CLONAZEPAM D. ETHOSUXIMIDE

500 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

501 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

502 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

503 CARBAMAZEPINE (CBZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D LEVEL: 4-12 MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA GI: NAUSEA, WEIGHT GAIN, PANCREATITIS, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LOW SODIUM, LUPUS LIKE, ARRHYTHMIA INTERACTION CBZ LOWERS ANTICOAGULANT AND “PILL” CBZ INCREASED BY ERYTHROMYCIN STOP IF ABSOLUTE NEUTROPHILIC COUNT IS < 1000 CBC & LFT: ONSET, 6 WEEKS, & Q 3-6 MONTHS

504 CLONAZEPAM (CLN) -DOSE START UP BY/W USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, HYPERACTIVITY, PSYCHOSIS GI: INCREASED SALIVATION, HEPATITIS BLOOD: EOSINOPHILIA OTHERS: INCREASED BRONCHIAL SECRETION INTERACTION CLONAZEPAM IS DECREASED BY OTHER AED TID URINARY RETENTION

505 ETHOSUXIMIDE (ETZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: SEDATION, HEADACHES, PSYCHOSIS GI: NAUSEA, VOMITING, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LUPUS-LIKE SYNDROME INTERACTION ETHOSUXIMIDE: LOWER VALPROIC AND “PILL” ETHOSUXIMIDE LEVEL INCREASED BY VALPROIC BIDTID CBC & LFT: ONSET, 3 WEEKS, & Q 3-6 MONTHS CONTRAINDICATION: PORPHYRIA, allergy: SUCCINIMIDE

506 89. WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS DO NOT AFFECT THE EFFICACY OF CONTRACEPTIVE DRUGS? A. PHENOBARBITAL B. CARBAMAZEPINE C. CLONAZEPAM D. ETHOSUXIMIDE

507 90. RENAL STONES ARE A FREQUENT COMPLICATION OF WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS? A. PHENOBARBITAL B. CLONAZEPAM C. TOPIRAMATE D. ETHOSUXIMIDE

508 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

509 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

510 PHENOBARBITAL (PB) DOSE/PO USUAL MAX MG/D MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, HYPERACTIVITY, COGNITIVE CHANGES GI: LIVER FAILURE BLOOD: APLASTIC ANEMIA OTHERS: LARYNGO- & BRONCO-SPASM, HYPOTENSION INTERACTION PB: LOWERS THEOPHYLLINE, ANTICOAGULANT & “PILL” BIDQD CONTRAINDICATIONS: OBSTRUCTIVE LUNG, PORPHYRIA RICKETS PERSONALITY CHANGES

511 CLONAZEPAM (CLN) -DOSE START UP BY/W USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, HYPERACTIVITY, PSYCHOSIS GI: INCREASED SALIVATION, HEPATITIS BLOOD: EOSINOPHILIA OTHERS: INCREASED BRONCHIAL SECRETION INTERACTION CLONAZEPAM IS DECREASED BY OTHER AED TID URINARY RETENTION

512 TOPIRAMATE (TPM) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: 4-10 MG/L SIDE EFFECTS CNS: LETHARGY, ATAXIA, DIPLOPIA, AGGRESSIVITY GI: INCREASE SALIVATION, PANCREATITIS, ANOREXIA BLOOD: ACIDOSIS, BONE MARROW DEPRESSION OTHERS: RENAL STONES, ARRHYTHMIA INTERACTION TPM LOWERS DIGOXIN AND “PILL” BID CBC & LFT: ONSET, 3 WEEKS, & Q 3-6 MONTHS POOR CONCENTRATION, VISUAL FIELD DEFECT

513 ETHOSUXIMIDE (ETZ) DOSE/PO START UP/W BY USUAL MAX MG/KG/D TR: MG/L SIDE EFFECTS CNS: SEDATION, HEADACHES, PSYCHOSIS GI: NAUSEA, VOMITING, HEPATITIS BLOOD: LOW WHITE & RED CELLS &/OR PLATELETS OTHERS: LUPUS-LIKE SYNDROME INTERACTION ETHOSUXIMIDE: LOWER VALPROIC AND “PILL” ETHOSUXIMIDE LEVEL INCREASED BY VALPROIC BIDTID CBC & LFT: ONSET, 3 WEEKS, & Q 3-6 MONTHS CONTRAINDICATION: PORPHYRIA, allergy: SUCCINIMIDE

514 90. RENAL STONES ARE A FREQUENT COMPLICATION OF WHICH OF THE FOLLOWING ANTIEPILEPTIC DRUGS? A. PHENOBARBITAL B. CLONAZEPAM C. TOPIRAMATE D. ETHOSUXIMIDE

515 91. TO DEFINE ANY CONTINUOUS SEIZURES OR INTERMITTENT SEIZURES WITHOUT REGAINING CONSCIOUSNESS AS STATUS EPILEPTICUS, THE EVENT MUST LAST FOR: A. 10 MINUTES B. 20 MINUTES C. 30 MINUTES D. 60 MINUTES

516 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

517 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

518 CONVULSIVE STATUS EPILEPTICUS ABC, 100% OXYGEN MASK OR TUBE, VITAL SIGNS, BRIEF EXAM; VENOUS BLOOD: DEXTROSTIX, GLUCOSE, CALCIUM, ELECTROLYTES, AED LEVELS, (TOXICOLOGY AND METABOLIC SCREENING IF APPROPRIATE); ARTERIAL BLOOD GASES. > 30 MIN OF CONTINUOS CONVULSION > 30 MIN OF INTERMITTENT CONVULSIONS WITHOUT RECOVERY OF CONSCIOUSNESS DEXTROSTIX < 60: D 25 PUSH, 2-4 ML/KG (MAX: 100 ML) ON PHENOBARBITAL: FOSPHENYTOIN (FOS) NOT ON PHENOBARBITAL: LORAZEPAM & FOS LORAZEPAM MAY BE REPEATED IN 10 MINUTES, MAXIMUM OF 3 DOSES IF CONVULSION PERSISTS IN INFANTS: PYRIDOXINE MG IV IF SEIZURES PERSISTS: EEG; INTUBATE, DIAZEPAM, PENTOTHAL;

519

520 91. TO DEFINE ANY CONTINUOUS SEIZURES OR INTERMITTENT SEIZURES WITHOUT REGAINING CONSCIOUSNESS AS STATUS EPILEPTICUS, THE EVENT MUST LAST FOR: A. 10 MINUTES B. 20 MINUTES C. 30 MINUTES D. 60 MINUTES

521 92. WHICH OF THE FOLLOWING IS NOT A MAJOR SUBTYPE OF STATUS EPILEPTICUS IN CHILDREN: A. PROLONGED FEBRILE SEIZURES B. IDIOPATHIC STATUS EPILEPTICUS C. SYMPTOMATIC STATUS EPILEPTICUS D. CRYPTIC STATUS EPILEPTICUS

522 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

523 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

524 MAJOR SUBTYPE OF STATUS EPILEPTICUS IN CHILDREN ARE PROLONGED FEBRILE SEIZURES, IDIOPATHIC STATUS EPILEPTICUS AND SYMPTOMATIC STATUS EPILEPTICUS

525 92. WHICH OF THE FOLLOWING IS NOT A MAJOR SUBTYPE OF STATUS EPILEPTICUS IN CHILDREN: A. PROLONGED FEBRILE SEIZURES B. IDIOPATHIC STATUS EPILEPTICUS C. SYMPTOMATIC STATUS EPILEPTICUS D. CRYPTIC STATUS EPILEPTICUS

526 93. WHICH OF THE FOLLOWING IS NOT A CAUSE OF STATUS EPILEPTICUS IN CHILDREN WITH SEIZURES: A. IRREGULAR USE OF ANTICONVULSANTS B. SLEEP DEPRIVATION C. COLD WEATHER D. INTERCURRENT INFECTION

527 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

528 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

529 COLD WEATHER IS NOT A CAUSE OF STATUS EPILEPTICUS IN CHILDREN WITH SEIZURES

530 93. WHICH OF THE FOLLOWING IS NOT A CAUSE OF STATUS EPILEPTICUS IN CHILDREN WITH SEIZURES: A. IRREGULAR USE OF ANTICONVULSANTS B. SLEEP DEPRIVATION C. COLD WEATHER D. INTERCURRENT INFECTION

531 94. WHICH OF THE FOLLOWING IS NOT AN INITIAL STEP IN THE TREATMENT OF STATUS EPILEPTICUS: A. NASOGASTRIC TUBE PLACEMENT B. INTRAVENOUS CATHETER PLACEMENT C. BLOOD PRESSURE MONITORING D. ENDOTRACHEAL INTUBATION

532 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

533 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

534 CONVULSIVE STATUS EPILEPTICUS ABC, 100% OXYGEN MASK OR TUBE, VITAL SIGNS, BRIEF EXAM; VENOUS BLOOD: DEXTROSTIX, GLUCOSE, CALCIUM, ELECTROLYTES, AED LEVELS, (TOXICOLOGY AND METABOLIC SCREENING IF APPROPRIATE); ARTERIAL BLOOD GASES. > 30 MIN OF CONTINUOS CONVULSION > 30 MIN OF INTERMITTENT CONVULSIONS WITHOUT RECOVERY OF CONSCIOUSNESS DEXTROSTIX < 60: D 25 PUSH, 2-4 ML/KG (MAX: 100 ML) ON PHENOBARBITAL: FOSPHENYTOIN (FOS) NOT ON PHENOBARBITAL: LORAZEPAM & FOS LORAZEPAM MAY BE REPEATED IN 10 MINUTES, MAXIMUM OF 3 DOSES IF CONVULSION PERSISTS IN INFANTS: PYRIDOXINE MG IV IF SEIZURES PERSISTS: EEG; INTUBATE, DIAZEPAM, PENTOTHAL;

535 ENDOTRACHEAL INTUBATION IS NOT AN INITIAL STEP IN THE TREATMENT OF STATUS EPILEPTICUS ENDOTRACHEAL INTUBATION IS DONE ONLY IF RESPIRATORY DEPRESSION IS LIKELY

536 94. WHICH OF THE FOLLOWING IS NOT AN INITIAL STEP IN THE TREATMENT OF STATUS EPILEPTICUS: A. NASOGASTRIC TUBE PLACEMENT B. INTRAVENOUS CATHETER PLACEMENT C. BLOOD PRESSURE MONITORING D. ENDOTRACHEAL INTUBATION

537 95. ALL OF THE FOLLOWING DRUGS CAN POTENTIATE OR PRECIPITATE STATUS EPILEPTICUS, EXCEPT: A. AMPHETAMINES B. TRICYCLIC ANTIDEPRESSANTS C. PHENYLTHIAZINES D. GENTAMICIN

538 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

539 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

540 DRUGS THAT CAN POTENTIATE OR PRECIPITATE STATUS EPILEPTICUS ARE: (1) AMPHETAMINES, (2) TRICYCLIC ANTIDEPRESSANTS, (3) PHENYLTHIAZINES, (4) TOXIC LEVEL OF THEOPHYLLINE, (5) TRICYCLIC ANTIDEPRESSANTS, AND (6) COCAINE

541 95. ALL OF THE FOLLOWING DRUGS CAN POTENTIATE OR PRECIPITATE STATUS EPILEPTICUS, EXCEPT: A. AMPHETAMINES B. TRICYCLIC ANTIDEPRESSANTS C. PHENYLTHIAZINES D. GENTAMICIN

542 96. ALL OF THE FOLLOWING DRUGS CAN POTENTIATE OR PRECIPITATE STATUS EPILEPTICUS, EXCEPT: A. TOXIC LEVEL OF THEOPHYLLINE B. TRICYCLIC ANTIDEPRESSANTS C. SULFA D. COCAINE

543 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

544 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

545 DRUGS THAT CAN POTENTIATE OR PRECIPITATE STATUS EPILEPTICUS ARE: (1) AMPHETAMINES, (2) TRICYCLIC ANTIDEPRESSANTS, (3) PHENYLTHIAZINES, (4) TOXIC LEVEL OF THEOPHYLLINE, (5) TRICYCLIC ANTIDEPRESSANTS, AND (6) COCAINE

546 96. ALL OF THE FOLLOWING DRUGS CAN POTENTIATE OR PRECIPITATE STATUS EPILEPTICUS, EXCEPT: A. TOXIC LEVEL OF THEOPHYLLINE B. TRICYCLIC ANTIDEPRESSANTS C. SULFA D. COCAINE

547 97. WHICH OF THE FOLLOWING SHOULD BE USED TO TREAT STATUS EPILEPTICUS: A. INTRAMUSCULAR FOSPHENYTOIN B. PHENYTOIN MIXED WITH GLUCOSE SOLUTION C. INTRAVENOUS DIAZEPAM AT A DOSE OF 1 MG PER KILO D. INTRAVENOUS LORAZEPAM AT A DOSE 0.05 – 0.1 PER KILO

548 SHOW ME THE QUESTION AGAIN GO TO THE NEXT QUESTION I WANT TO SEE THE CLUE, ANYWAY

549 I WANT TO TRY AGAIN JUST GIVE ME THE ANSWER GIVE ME A CLUE

550 DIAZEPAM 1 MG/KG GLU RIP LORAZEPAM 0.05 – 0.1 MG/KG, MAXIMUM OF 5 MG PER DOSE, MAXIMUM OF 3 DOSES PER EVENT PHE

551 97. WHICH OF THE FOLLOWING SHOULD BE USED TO TREAT STATUS EPILEPTICUS: A. INTRAMUSCULAR FOSPHENYTOIN B. PHENYTOIN MIXED WITH GLUCOSE SOLUTION C. INTRAVENOUS DIAZEPAM AT A DOSE OF 1 MG PER KILO D. INTRAVENOUS LORAZEPAM AT A DOSE 0.05 – 0.1 PER KILO

552 98. DIAZEPAM RATE OF INFUSION SHOULD BE NO GREATER THAN: A. 2 MG PER MINUTE B. 3 MG PER MINUTE C. 4 MG PER MINUTE D. 5 MG PER MINUTE

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555 DIAZEPAM (DZP) DOSE IV=.1-.3 MG/KG/DOSE MAY REPEAT 15 MIN TR: MG/L SIDE EFFECTS CNS: SEDATION, IRRITABILITY, HEADACHE GI: NAUSEA OTHERS: THROMBOPHLEBITIS, INTERSTITIAL NEPHRITIS CONTRAINDICATIONS: GLAUCOMA, SEVERE PAIN HYPOTENSION, RESPIRATORY DEPRESSION DIZZINESS, DEPRESSION DRIP (50 MG IN 250 ML.9% NaCl OR D5W) AT A RATE OF MG/KG/HR. NEW INFUSION Q 12 H WEAN OVER 8-12 H IF NO SEIZURE IN H FLUMAZENIL (ANTIDOTES) RELATIVE: HYPERBILIRUBINEMIA (BENZOATE) INFUSE AT A RATE NOT FASTER THAN 2 MG/MIN

556 98. DIAZEPAM RATE OF INFUSION SHOULD BE NO GREATER THAN: A. 2 MG PER MINUTE B. 3 MG PER MINUTE C. 4 MG PER MINUTE D. 5 MG PER MINUTE

557 99. WHICH OF THE FOLLOWING STATEMENTS IS NOT TRUE REGARDING THE USE OF PHENYTOIN DURING STATUS EPILEPTICUS: A. THE RATE OF INFUSION SHOULD BE 1 MG PER KILO PER MINUTE (UP TO 50 MG /MIN) B. PHENYTOIN SHOULD BE MIXED WITH NORMAL SALINE C. EKG TRACING IS RECOMMENDED DURING INFUSION D. SYSTEMIC HYPERTENSION MAY COMPLICATE INTRAVENOUS PHENYTOIN