Matthew Coulson
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Epilepsy given on 14th September 2018

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Matthew Coulson
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Epilepsy

Epilepsy

Questão 1 de 29

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Preencha o espaço em branco para completar o texto.

A seizure whereby there is rapid contraction and relaxation of muscles causing an uncontrollable shaking of the body is called a seizure.

Explicação

Questão 2 de 29

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affect both brain hemispheres
affect only one brain hemisphere

Arraste e solte para completar o texto.

    Generalised seizures
    Focal seizures

Explicação

Questão 3 de 29

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

Arraste e solte para completar o texto.

    Myoclonic
    Clonic
    Tonic
    Tonic-clonic

Explicação

Questão 4 de 29

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During tonic-clonic seizures, bites to which part of the tongue are more common?

Selecione uma das seguintes:

  • Bites to tip of tongue

  • Bites to side of tongue

Explicação

Questão 5 de 29

1

If a patient presents after a fall/seizure, it is mandatory to rule out a cardiovascular cause via which investigation?

Selecione uma das seguintes:

  • ECG

  • Echocardiogram

  • Ultrasound

  • Blood Pressure Measurement

Explicação

Questão 6 de 29

1

DVLA Rules Regarding Seizures - car:

You’ve had a one-off seizure while awake and lost consciousness:

Selecione uma das seguintes:

  • Licence suspended, can reapply after 6 months seizure free

  • Licence suspended, can reapply after 12 months seizure free

  • Licence only suspended after 2nd seizure

Explicação

Questão 7 de 29

1

DVLA Rules Regarding Seizures - HGV:

You’ve had a one-off seizure while awake and lost consciousness:

Selecione uma das seguintes:

  • Licence suspended, can reapply after 12 months

  • Licence suspended, can reapply after 3 years

  • Licence suspended, can reapply after 5 years

Explicação

Questão 8 de 29

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DVLA Rules Regarding Seizures - car:

Diagnosed with epilepsy:

Selecione uma das seguintes:

  • 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

Explicação

Questão 9 de 29

1

DVLA Rules Regarding Seizures - HGV:

Diagnosed with epilepsy:

Selecione uma das seguintes:

  • 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

Explicação

Questão 10 de 29

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Primary Generalised Epilepsy often presents ...

Selecione uma das seguintes:

  • In childhood/teenage years

  • In late 20s/early 30s

  • In those over 50

Explicação

Questão 11 de 29

1

Preencha o espaço em branco para completar o texto.

The treatment of choice for primary generalised epilepsy is

Explicação

Questão 12 de 29

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If a primary generalised epilepsy patient is unresponsive to Sodium Valproate, which of the following second line treatments is most common?

Selecione uma das seguintes:

  • Lamotrigine

  • Clobazam

  • Gabapentin

  • Pregabalin

Explicação

Questão 13 de 29

1

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?

Selecione uma das seguintes:

  • Carbamazepine

  • Clobazam

  • Levetiracetam

  • Oxcarbazepine

Explicação

Questão 14 de 29

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Sodium Valproate is teratogenic and should not be prescribed to pregnant women

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 15 de 29

1

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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 16 de 29

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What is status epilepticus?

Selecione uma das seguintes:

  • 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

Explicação

Questão 17 de 29

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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?

Selecione uma das seguintes:

  • Phenytoin

  • Lamotrigine

  • Sodium Valproate

  • Carbamazepine

Explicação

Questão 18 de 29

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 19 de 29

1

What means of investigation is used to differentiate generalised from focal epilepsy?

Selecione uma das seguintes:

  • Electroencephalogram (EEG)

  • Electrocardiogram (ECG)

  • Electroneurogram (ENG)

  • Electrical Seizure Test (EST)

Explicação

Questão 20 de 29

1

Women on anti-convulsants seeking the contraceptive pill should not use the and should instead be switched to the

Arraste e solte para completar o texto.

    combined pill (estrogen + progesterone)
    progesterone only pill

Explicação

Questão 21 de 29

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 22 de 29

1

Preencha o espaço em branco para completar o texto.

Which anti-convulsant can be given to patients who are obese/have sleep problems due to its weight reducing and sedative effects?

Explicação

Questão 23 de 29

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Carbamazepine typically makes Primary Generalised Epilepsy worse

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 24 de 29

1

Preencha os espaços em branco para completar o texto.

In the case of Status Epilepticus, patients are generally given benzodiazepines first line to attempt to halt the seizures. Such medications include IV , Buccal and Rectal .
If benzodiazepines fail to halt the seizures, then the anti-convulsant called should be given IV.

Explicação

Questão 25 de 29

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

Selecione uma das seguintes:

  • Focal Seizure

  • Generalised Seizure

Explicação

Questão 26 de 29

1

Is an absence feature focal or generalised?

Selecione uma das seguintes:

  • Focal Seizure

  • Generalised Seizure

Explicação

Questão 27 de 29

1

Preencha o espaço em branco para completar o texto.

Following a seizure patients typically enter what is known as a state where they feel drowsy and tired for around 15 minutes before they are back to feeling normal again.

Explicação

Questão 28 de 29

1

Which of the following anticonvulsants is known to induce alopecia?

Selecione uma das seguintes:

  • Sodium Valproate

  • Lamotrigine

  • Carbamazepine

  • Phenytoin

Explicação

Questão 29 de 29

1

Preencha o espaço em branco para completar o texto.

Which anticonvulsant medication is known to cause Stevens-Johnson Syndrome in some rare cases?

Explicação

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