2. MTB Step 3 - Seizures Flashcards

Cards Complete:

1
Q

DIAGNOSIS

What are (4) Tests that should be done one all patients having a Seizure?

A
  1. Sodium, Calcium, Glucose, Oxygen, Creatinine, and Magnesium levels
  2. Head CT urgently; MRI later if the initial testing shows nothing
  3. Urine Toxicology screening
  4. Liver and Renal function
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2
Q

DIAGNOSIS

What should be performed if the initial set of diagnostic tests does not reveal the etiology of the Seizure?

A

Electroencephalogram (EEG)

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3
Q

TREATMENT

What is the ONLY thing that is clear when it comes to Status Epilepticus in Seizure Disorders?

A

The Management:

  • 1st Line: Benzodiazepines, such as Ativan (lorazepam).
  • 2nd Line: If the seizure persists after moving the clock forward 10–20 minutes, then add Fosphenytoin.
  • 3rd Line: If the seizure persists after moving the clock forward another 10–20 minutes, then add Phenobarbital.
  • 4th Line: If the seizure persists after moving the clock forward 10–20 minutes again, then add General Anesthesia, such as Pentobarbital, Thiopental, Midazolam, or Propofol.
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4
Q

TREATMENT

Chronic antiepileptic drug therapy is generally not indicated after a single Seizure. What are (4) Exceptions to this (when should you treat chronically after the first seizure)?

A
  1. Strong family history of seizures
  2. Abnormal EEG
  3. Status Epilepticus that required Benzodiazepines to stop the seizure
  4. Non-correctable precipitating cause, (i.e., brain tumor)
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5
Q

TREATMENT

What are (5) First-Line therapies for the Long-Term management of Seizures that are all equal in efficacy?

A
  1. Valproic Acid
  2. Carbamazepine
  3. Phenytoin
  4. Levetiracetam (Keppra)
  5. Lamotrigine (Lamictal) - has efficacy equal to those agents but is associated with the development of Stevens-Johnson syndrome and severe skin reactions.
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6
Q

TREATMENT

What are (4) Second-Line therapies for the Long-Term management of Seizures that are all equal in efficacy?

A
  1. Gabapentin
  2. Phenobarbital
  3. Lacosamide
  4. Zonisamide
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7
Q

TREATMENT

What is considered the Best Antiepileptic drug for Absence or Petit Mal Seizures?

A

Ethosuximide

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8
Q

TREATMENT

Which Antiepileptic drug is the Most Dangerous in Pregnancy?

A

Valproic Acid

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9
Q

TREATMENT

Which (2) Antiepileptic drugs are considered the Safest in Pregnancy?

A
  1. Levetiracetam (Keppra)
  2. Lamotrigine
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10
Q

TREATMENT

Which Antiepileptic drug has the Highest Risk of Hyponatremia?

A

Carbamazepine

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11
Q

TREATMENT

What increases the metabolism of Lamotrigine to ineffective levels?

A

ESTROGENS

This OCPs

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12
Q

TREATMENT

What Test will predict Stevens-Johnson syndrome induced by Carbamazepine and Phenytoin?

A

HLA B*1502 Testing

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13
Q

TREATMENT

What are (2) Disorders that many of the Antiepileptic drugs are associated with?

A
  1. Bone Loss
  2. Osteoporosis
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