Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Part 2 exam > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What kind of anti-epileptic is carbamazapine?

A

Hepatic enzyme inducer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What kind of anti-epileptic is phenytoin?

A

Hepatic enzyme inducer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kind of anti-epileptic is phenobarbitol?

A

Hepatic enzyme inducer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What kind of anti-epileptic is topiramate?

A

Hepatic enzyme inducer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What kind of anti-epileptic is sodium valproate?

A

Non hepatic enzyme inducing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What kind of anti-epileptic is lamotrigine?

A

Non hepatic enzyme inducing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What kind of anti-epileptic is Levetiracepam?

A

Non hepatic enzyme inducing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which AED has the highest risk of major congenital abnormality?

A

sodium valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the risk of major congenital abnormality with polytherapy of AED?

A

6-8% (up to 10% if valproate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the risk of major congenital abnormality with sodium valproate?

A

6-10% (dose dependent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the risk of major congenital abnormality with lamotrigine?

A

2-5% (dose dependent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the risk of major congenital abnormality with carbamazipine?

A

2-5% (dose dependent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the risk of major congenital abnormality in a non-epileptic pregnancy?

A

2-2.3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which congenital abnormalities are associated with sodium valproate?

A

Neural tube defects, cleft palate, cardiac abnormalities, neurodevelopmental delay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which congenital abnormalities are associated with AEDs?

A

Cardiac abnormalities, neural tube defects, cleft palate,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the advice regarding folic acid and pregnancy for women with epilepsy?

A

5mg OD for 3 months pre-conception to end of 1st trimester (Neural tube is formed on day 26 so no benefit starting after day 30)

17
Q

What is the incidence of AED use in pregnancy?

A

1 in 200 pregnancies

18
Q

How much does epilepsy increase risk of maternal mortality?

A

Increases risk 10 fold

19
Q

What are the risk factors for SUDEP?

A

Changing, stopping, poor compliance, inadequate dose of AED
Nocturnal seizures or tonic clonic seizures
Poor seizure control pre-conception
Triggers/risk factors: Poor sleep, stress, Living alone, Learning difficulties, Infrequent neurology input

20
Q

What are the risks of lamotrigine use in pregnancy?

A

Lamotrigine excretion increases in pregnancy and therefore doses may become inadequate (can fall by 70%) and need increasing to avoid seizure precipitation

21
Q

What proportion of women with epilepsy have seizures in pregnancy?

A

60% have no change in seizure activity, approximately 30% have increasing frequency of seizures, 10% have reduced frequency of seizures

22
Q

When is risk of seizure highest in pregnancy?

A

Peripartum - 1-2% risk of seizure

23
Q

Which pain relief is unsafe in labour?

A

pethidine (increases seizure threshold)

24
Q

What are the risks to baby with AEDs?

A

Congenital malformation
SGA
Hypoxia if mother has seizure
Risk of toxicity/withdrawal after delivery
Risk of haemorrhagic disease of the newborn

25
Q

What is the rate of SGA with epilepsy?

A

3.5 x higher than no epilepsy pregnancy

26
Q

Which medication might be used to avoid seizures in labour for a woman who has previously had seizure in labour or has had a recent seizure in pregnancy?

A

clobazam (benzodiazepam)

27
Q

What are the signs of AED toxicity e.g. in a postnatal woman?

A

Diplopia
Drowsiness
Unsteadiness walking

28
Q

Which contraception should be avoided in patients taking hepatic enzyme inducing anti-epileptics?

A 
oral contraceptives (3 x higher risk of contraceptive failure)
Implant
29
Q

Which contraceptives should be offered to women with hepatic enzyme inducing AEDs?

A

Depo, IUS or IUCD

30
Q

Which contraceptive should be avoided with lamotrigine?

A

COCP - oestrogen lowers serum lamotrigine levels increasing risk of seizure

31
Q

Which emergency contraceptive should be offered to women with hepatic enzyme inducing AEDs?

A

Offer IUCD
Evidence for doubling levenogestrel dose weak
Avoid ullipristal

32
Q

What are the risks of sodium valproate and pregnancy?

A

10 in 100 risk of congenital malformations e.g. neural tube defect, cleft palate, hypospadius
High risk of neurodevelopmental delay and autism

33
Q

What was the mortality rate from epilepsy in last MMBRACE report 2020

A

0.92 in 100000 pregnancies

34
Q

Risk of developmental disorders with sodium valproate in pregnancy

A

4 in 10

35
Q

Risk of congenital abnormalities with sodium valproate in pregnancy

A

1 in 10

Part 2 exam (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions