Epilepsy

Description

Epilepsy given on 14th September 2018
Matthew Coulson
Quiz by Matthew Coulson, updated more than 1 year ago
Matthew Coulson
Created by Matthew Coulson about 6 years ago
22
1

Resource summary

Question 1

Question
A seizure whereby there is rapid contraction and relaxation of muscles causing an uncontrollable shaking of the body is called a [blank_start]convulsive[blank_end] seizure.
Answer
  • convulsive

Question 2

Question
[blank_start]Generalised seizures[blank_end] affect both brain hemispheres [blank_start]Focal seizures[blank_end] affect only one brain hemisphere
Answer
  • Generalised seizures
  • Focal seizures

Question 3

Question
Types of Generalised Seizure: [blank_start]Tonic-clonic[blank_end] - Contraction of limbs followed by their extension & arching of back lasting 10-30s, followed by a shaking of the limbs. [blank_start]Tonic[blank_end] - Constant contraction of the muscles. Person often turns blue as breathing is stopped. [blank_start]Clonic[blank_end] - Shaking of the limbs in unison. [blank_start]Myoclonic[blank_end] - Brief, shock-like jerks of a muscle or a group of muscles.
Answer
  • Myoclonic
  • Clonic
  • Tonic
  • Tonic-clonic

Question 4

Question
During tonic-clonic seizures, bites to which part of the tongue are more common?
Answer
  • Bites to tip of tongue
  • Bites to side of tongue

Question 5

Question
If a patient presents after a fall/seizure, it is mandatory to rule out a cardiovascular cause via which investigation?
Answer
  • ECG
  • Echocardiogram
  • Ultrasound
  • Blood Pressure Measurement

Question 6

Question
DVLA Rules Regarding Seizures - car: You’ve had a one-off seizure while awake and lost consciousness:
Answer
  • Licence suspended, can reapply after 6 months seizure free
  • Licence suspended, can reapply after 12 months seizure free
  • Licence only suspended after 2nd seizure

Question 7

Question
DVLA Rules Regarding Seizures - HGV: You’ve had a one-off seizure while awake and lost consciousness:
Answer
  • Licence suspended, can reapply after 12 months
  • Licence suspended, can reapply after 3 years
  • Licence suspended, can reapply after 5 years

Question 8

Question
DVLA Rules Regarding Seizures - car: Diagnosed with epilepsy:
Answer
  • Licence suspended, can reapply after 5 years seizure free
  • Licence suspended, can reapply after 1 year seizure free
  • Licence suspended, can reapply after 3 years seizure free

Question 9

Question
DVLA Rules Regarding Seizures - HGV: Diagnosed with epilepsy:
Answer
  • Licence suspended, can reapply after 5 years off medication & seizure free
  • Licence suspended, can reapply after 7 years off medication & seizure free
  • Licence suspended, can reapply after 10 years off medication & seizure free

Question 10

Question
Primary Generalised Epilepsy often presents ...
Answer
  • In childhood/teenage years
  • In late 20s/early 30s
  • In those over 50

Question 11

Question
The treatment of choice for primary generalised epilepsy is [blank_start]Sodium Valproate[blank_end]
Answer
  • Sodium Valproate

Question 12

Question
If a primary generalised epilepsy patient is unresponsive to Sodium Valproate, which of the following second line treatments is most common?
Answer
  • Lamotrigine
  • Clobazam
  • Gabapentin
  • Pregabalin

Question 13

Question
Due to the adverse side effects, sodium valproate is not recommended for focal onset epilepsy. Instead, what is the first line treatment for this condition?
Answer
  • Carbamazepine
  • Clobazam
  • Levetiracetam
  • Oxcarbazepine

Question 14

Question
Sodium Valproate is teratogenic and should not be prescribed to pregnant women
Answer
  • True
  • False

Question 15

Question
A 17 year old girl is taken to A&E after having had a generalized seizure. She had been out partying the night before. No past Hx of note, although her mother reported that she had been a bit clumsy and jerky in the mornings recently, e.g. dropping her hairbrush or coffee cup. Which of the following statements is correct?
Answer
  • The history is suggestive of a secondary generalized fit. The patient needs urgent brain scanning.
  • The history suggests a primary generalized epilepsy, and either Sodium Valproate or Lamotrigine would be treatment of choice.
  • Treatment of choice for this type of epilepsy is Carbamazepine
  • Juvenile myoclonic epilepsy is associated with hippocampal sclerosis
  • This is probably just an alcohol induced seizure. No further investigations or treatment required

Question 16

Question
What is status epilepticus?
Answer
  • Recurrent epileptic seizures without full recovery of consciousness. Continuous seizures lasting >30 minutes
  • Recurrent epileptic seizures without full recovery of consciousness. Continuous seizures lasting >60 minutes
  • A seizure that can only be halted by high loading with an acute anti-convulsant

Question 17

Question
Status Epilepticus is a clinical emergency. Whilst they tend to stop by themselves, to prevent further damage anticonvulsants should be given. Which of the following anticonvulsants should be given in an acute situation such as this?
Answer
  • Phenytoin
  • Lamotrigine
  • Sodium Valproate
  • Carbamazepine

Question 18

Question
A patient in status epilepticus is considered an emergency case. Therefore, urgent blood tests and CT to identify the cause are required.
Answer
  • True
  • False

Question 19

Question
What means of investigation is used to differentiate generalised from focal epilepsy?
Answer
  • Electroencephalogram (EEG)
  • Electrocardiogram (ECG)
  • Electroneurogram (ENG)
  • Electrical Seizure Test (EST)

Question 20

Question
Women on anti-convulsants seeking the contraceptive pill should not use the [blank_start]progesterone only pill[blank_end] and should instead be switched to the [blank_start]combined pill (estrogen + progesterone)[blank_end]
Answer
  • combined pill (estrogen + progesterone)
  • progesterone only pill

Question 21

Question
The morning after pill is more effective in women taking anti-convulsants and the dose should be titred down accordingly.
Answer
  • True
  • False

Question 22

Question
Which anti-convulsant can be given to patients who are obese/have sleep problems due to its weight reducing and sedative effects? [blank_start]Topiramate[blank_end]
Answer
  • Topiramate

Question 23

Question
Carbamazepine typically makes Primary Generalised Epilepsy worse
Answer
  • True
  • False

Question 24

Question
In the case of Status Epilepticus, patients are generally given benzodiazepines first line to attempt to halt the seizures. Such medications include IV [blank_start]Lorazepam[blank_end], Buccal [blank_start]Midazolam[blank_end] and Rectal [blank_start]Diazepam[blank_end]. If benzodiazepines fail to halt the seizures, then the anti-convulsant called [blank_start]Phenytoin[blank_end] should be given IV.
Answer
  • Phenytoin
  • Midazolam
  • Lorazepam
  • Diazepam

Question 25

Question
Which type of seizure typically causes the patient to experience odd smells? e.g. every time they drive they experience a "metallic smell"
Answer
  • Focal Seizure
  • Generalised Seizure

Question 26

Question
Is an absence feature focal or generalised?
Answer
  • Focal Seizure
  • Generalised Seizure

Question 27

Question
Following a seizure patients typically enter what is known as a [blank_start]postictal[blank_end] state where they feel drowsy and tired for around 15 minutes before they are back to feeling normal again.
Answer
  • postictal

Question 28

Question
Which of the following anticonvulsants is known to induce alopecia?
Answer
  • Sodium Valproate
  • Lamotrigine
  • Carbamazepine
  • Phenytoin

Question 29

Question
Which anticonvulsant medication is known to cause Stevens-Johnson Syndrome in some rare cases? [blank_start]Lamotrigine[blank_end]
Answer
  • Lamotrigine
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