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Epilepsy Flashcards

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1
Q

Efficacy of pharmacotherapy in the epilepsy population:
A) 30%
B) 40%
C) 70%
D) 99%
E) 15%

A

C) 70%

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2
Q

NOT a characteristic of psychogenic non-epileptic seizures:
A) closed eyes
B) variable seizure duration
C) lateral tongue biting
D) variable seizure symptoms
E) paroxysmal motor phenomena

A

C) lateral tongue biting

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3
Q

Oral and manual automatisms are characteristics for:
A) absence
B) complex partial seizures
C) generalized tonic-clonic seizures
D) sensomotor Jacksonian seizure
E) tetany

A

B) complex partial seizures

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4
Q

Epileptic aura is:
A) an antiepileptic side effect
B) a risk factor for status epilepticus
C) always accompanied by loss of consciousness
D) the first sign of a focal seizure
E) the first sign of an absence seizure

A

D) the first sign of a focal seizure

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5
Q

Antiepileptic drug with a specific indication:
A) TSH
B) L-dopa
C) acetylcholine
D) ACTH
E) digitalis

A

D) ACTH

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6
Q

NOT effective in focal epilepsy:
A) carbamazepine
B) diphenylhydantoin
C) vigabatrin
D) ethosuximide
E) oxcarbazepine

A

D) ethosuximide

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7
Q

First-choice drug in idiopathic generalized epilepsy:
A) valproate
B) dyphenylhydantoin
C) diazepam
D) Vitamin B6
E) carbamazepine

A

A) valproate

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8
Q

NOT a characteristic of convulsive syncope:
A) open eyes
B) jerking
C) sweating
D) pallor
E) lateral tongue biting

A

E) lateral tongue biting

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9
Q

In pregnant women taking antiepileptic drugs:
A) an abortion is recommended
B) 1000 mg/day Vitamin C is recommended
C) 1–5 mg/day folic acid is recommended
D) Vitamin K should be given during the whole pregnancy period
E) bed rest is recommended during the 3rd trimester

A

C) 1–5 mg/day folic acid is recommended

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10
Q

Major fetal (congenital) malformations caused by antiepileptic drugs can be detected by:
A) measuring CPK level
B) Ultrasound examination
C) antinuclear antibody test
D) measuring estrogen level
E) measuring progesterone level

A

B) Ultrasound examination

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11
Q

If a grand mal seizure appears during pregnancy:
A) cesarean section is indicated
B) antiepileptic drug dosage should be reduced
C) new antiepileptic drugs should be introduced in small dosage
D) measuring serum level of antiepileptic drugs is recommended the dosage should be modified accordingly
E) bed rest is recommended

A

D) measuring serum level of antiepileptic drugs is recommended the dosage should be modified accordingly

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12
Q

The most frequently used type of epilepsy surgery is:
A) parietal lobectomy
B) temporal lobectomy
C) callosotomy
D) hemispherectomy
E) multiple subpial transection

A

B) temporal lobectomy

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13
Q

Epileptic seizures are NOT characteristics of:
A) epilepsy
B) alcohol withdrawal
C) benzodiazepine withdrawal
D) sinus thrombosis
E) myasthenia gravis

A

E) myasthenia gravis

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14
Q

NOT an antiepileptic drug:
A) moclobemide
B) clobazam
C) lamotrigine
D) gabapentin
E) levetiracetam

A

A) moclobemide

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15
Q

NOT an antiepileptic drug:
A) carbamazepine
B) vigabatrin
C) valproate
D) levetiracetam
E) alprazolam

A

E) alprazolam

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16
Q

Interictal EEG sign suggesting epilepsy:
A) vertex potential in sleep
B) 3 Hz spike-and-wave complex
C) 6–14 Hz positive discharges
D) none of them
E) all of them

A

B) 3 Hz spike-and-wave complex

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17
Q

Side effect of valproate:
A) hair loss
B) weight gain
C) tremor
D) all of them
E) none of them

A

D) all of them

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18
Q

An epileptic patient taking antiepileptic drugs:
A) is permitted to drive a car if he/she is long-term seizure free
B) is permitted to drive a car but only after withdrawal of antiepileptic drugs
C) is not permitted to drive a car
D) is permitted to drive a car but only under supervision

A

A) is permitted to drive a car if he/she is long-term seizure free

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19
Q

Which seizure type can NOT appear after a traumatic brain injury?
A) generalized tonic-clonic seizure
B) absence
C) complex partial seizure
D) focal motor seizure
E) Jacksonian seizure

A

B) absence

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20
Q

Which is NOT true for epilepsy?
A) diagnosis of epilepsy does not exclusively based on the EEG
B) focal EEG abnormality is an indication for a CT or MRI examination
C) after cessation of seizures, the antiepileptic drugs can be stopped immediately
D) the underlying etiology should also be treated in cases of symptomatic epilepsy
E) most antiepileptic drugs require a slow titration

A

C) after cessation of seizures, the antiepileptic drugs can be stopped immediately

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21
Q

A 55 year-old man was admitted to the emergency department due to the first epileptic seizure in his life. Neurological examination revealed a mild left-sided (central) facial paresis and left-sided hemiparesis. MRI showed a space-occupying lesion in the right frontal lobe. What is the most probable diagnosis?
A) occlusion of the right-sided internal carotid artery
B) medulloblastoma
C) cerebellar astrocytoma
D) provoked seizure due to alcohol withdrawal
E) glioma

A

E) glioma

22
Q

Epilepsy can be established if the patient has:
A) 1 proven epileptic seizure
B) 2 epileptic seizures 1 hour after a severe brain injury
C) 1 epileptic seizure and a family history of epilepsy
D) recurrent non-provoked epileptic seizures
E) all of the above
F) only A and B is true
G) only C and D is true

A

D) recurrent non-provoked epileptic seizures

23
Q

Prevalence of epilepsy in industrialized countries:
A) 0.04-0.05%
B) 0.02%
C) 0.5–1%
D) 5–6%
E) 10–12%
F) 8–10%

A

C) 0.5–1%

24
Q

The following statement is NOT true for epilepsy:
A) carbamazepine is one of the first drugs of choice in epilepsy
B) monotherapy is preferred
C) surgery is one of the options in drug-resistant focal epilepsy
D) measuring serum level of antiepileptic drugs can be useful
E) epilepsy treatment is based on the EEG
F) some antiepileptic drugs in combination can reduce each other’s effects

A

E) epilepsy treatment is based on the EEG

25
Q

Oral contraceptive drugs:
A) frequently provoke epileptic seizures
B) are not recommended in epilepsy
C) are recommended only in seizure-free epilepsy patients
D) enhance the effect of antiepileptic drugs
E) some antiepileptic drugs can reduce the effect of oral contraceptives

A

E) some antiepileptic drugs can reduce the effect of oral contraceptives

26
Q

Disorder(s) which can mimic epilepsy:
A) psychogenic seizures
B) convulsive syncope
C) parasomnia
D) none of them
E) all of them

A

E) all of them

27
Q

Seizures with „jamais vu” usually occur in:
A) frontal lobe epilepsy
B) temporal lobe epilepsy
C) parietal lobe epilepsy
D) occipital lobe epilepsy

A

B) temporal lobe epilepsy

28
Q

Postictal exhaustion of the brain can manifest in:
1) tenebrosity
2) Todd-paresis
3) terminal sleep
4) aphasia

A) 1., 2. and 3. answers are correct
B) 1. and 3. answers are correct
C) 2. and 4. answers are correct
D) only answer 4 is correct
E) all of the answers are correct

A

E) all of the answers are correct

29
Q

An option in epilepsy treatment:
1) vagus nerve stimulation
2) ketogenic diet
3) benzodiazepines
4) deep brain stimulation

A) 1., 2. and 3. answers are correct
B) 1. and 3. answers are correct
C) a 2. and 4. answers are correct
D) only answer 4 is correct
E) all 4 answers are correct

A

E) all 4 answers are correct

30
Q

Hepatic enzyme inducers:
1) carbamazepine
2) levetiracetam
3) diphenylhydantoin
4) gabapentin

A) 1., 2. and 3. answers are correct
B) 1. and 3. answers are correct
C) 2. and 4. answers are correct
D) only 4. answer is correct
E) all of the answers are correct

A

B) 1. and 3. answers are correct

31
Q

Psychopathological symptoms in epilepsy can be caused by:
1) chronic epileptic dysfunction
2) underlying etiology
3) brain injuries caused by seizures
4) long-term antiepileptic treatment

A) 1., 2. and 3. answers are correct
B) 1. and 3. answers are correct
C) 2. and 4. answers are correct
D) only 4. answer is correct
E) all of the answers are correct

A

E) all of the answers are correct

32
Q

Life-threatening complication of epilepsy:
1) Adrenal insufficiency
2) ictal injury
3) hypoglycemic coma
4) status epilepticus

A) 1., 2. and 3. answers are correct
B) 1. and 3. answers are correct
C) a 2. and 4. answers are correct
D) only answer 4 is correct
E) all 4 answers are correct

A

C) a 2. and 4. answers are correct

33
Q

Effective in status epilepticus:
1) diazepam iv.
2) clonazepam iv.
3) propofol iv.
4) diphenylhydantoin iv.

A) 1., 2. and 3. answers are correct
B) 1. and 3. answers are correct
C) 2. and 4. answers are correct
D) only answer 4 is correct
E) all 4 answers are correct

A

E) all 4 answers are correct

34
Q

Effective in status epilepticus:
1) phenytoin iv.
2) diazepam iv.
3) clonazepam iv.
4) disulfiram iv.

A) 1., 2. and 3. answers are correct
B) 1. and 3. answers are correct
C) a 2. and 4. answers are correct
D) only answer 4 is correct
E) all 4 answers are correct

A

A) 1., 2. and 3. answers are correct

35
Q

Characteristics of temporal lobe epilepsy:
1) psychopathological symptoms
2) good response to antiepileptic drugs in comparison with other epilepsy types
3) epileptic aura
4) 3 Hz spike-and-wave discharge on the EEG

A) 1., 2. and 3. answers are correct
B) 1. and 3. answers are correct
C) a 2. and 4. answers are correct
D) only answer 4 is correct
E) all 4 answers are correct

A

B) 1. and 3. answers are correct

36
Q

Epileptic seizure can be provoked by:
1) some psychotropic drugs
2) sleep deprivation
3) cocoa consumption
4) alcohol withdrawal
5) infection with fever

A) All of them are correct
B) Answers 2, 4, 5 are correct
C) Answers 2, 3, 4, 5 are correct
D) Answers 1, 2, 4 are correct
E) Answers 1, 2, 4, 5 are correct

A

E) Answers 1, 2, 4, 5 are correct

37
Q

Mechanism of action of antiepileptic drugs:
1) GABA-receptor-antagonism
2) GABA-receptor-agonism
3) NMDA-receptor-antagonism
4) NMDA-receptor-agonism
5) serotonin-reuptake inhibition
6) serotonin-reuptake enhancement

A) Answers 1, 3 and 5 are true
B) Answers 2, 4 and 5 are true
C) Answers 2, 3 and 6 are true
D) Answers 2, 4 and 6 are true
E) Answers 2 and 3 are true

A

E) Answers 2 and 3 are true

38
Q

Generalized tonic-clonic seizures:
1) tetany
2) provoked epileptic seizures
3) cataplexy
4) seizures of eclampsia in pregnancy

A) Answers 1, 2, 3 are true
B) Answers 2, 3, 4 are true
C) Answers 2 and 4 are true
D) Answers 1 and 4 are true
E) all of them are true

A

C) Answers 2 and 4 are true

39
Q

Indication for measuring serum level of antiepileptic drug:
1) suspicion on lack of compliance/adherence
2) suspicion on drug-to-drug interaction
3) evaluation of the individual drug metabolism
4) evaluating the therapeutic effect

A) Answers 1, 2, 3 are true
B) Answers 2 and 4 are true
C) Answers 1 and 2 are true
D) Answers 1 and 4 are true
E) all of them are true

A

A) Answers 1, 2, 3 are true

40
Q

Pair the matching items!
A) epilepsia partialis continua
B) Jacksonian seizure (Jacksonian march)
C) absence
D) tonic seizure
E) sleep attack

NEU - 4.41 - Lennox–Gastaut syndrome
NEU - 4.42 - 3-Hz spike-and-wave complex on the EEG
NEU - 4.43 - focal status epilepticus
NEU - 4.44 - focal seizure
NEU - 4.45 - narcolepsy

A

41- D
42- C
43- A
44- B
45- E

41
Q

Every patient with epilepsy had at least 1 epileptic seizure, therefore all patients with epileptic seizures have an epilepsy.
A) both parts are correct, causative relation exists
B) both parts are correct, causative relation does not exist
C) first part is correct, the second is incorrect
D) first part is incorrect, second part is correct
E) both parts are incorrect

A

C) first part is correct, the second is incorrect

42
Q

Multiple antiepileptic drugs should be administrated if various seizure types are present, therefore a dose reduction is recommended.
A) both parts are correct, causative relation exists
B) both parts are correct, causative relation does not exist
C) first part is correct, the second is incorrect
D) first part is incorrect, second part is correct
E) both parts are incorrect

A

E) both parts are incorrect

43
Q

Alcohol withdrawal can provoke epileptic seizures, therefore these patients had an epilepsy.
A) both parts are correct, causative relation exists
B) both parts are correct, causative relation does not exist
C) first part is correct, the second is incorrect
D) first part is incorrect, second part is correct
E) both parts are incorrect

A

C) first part is correct, the second is incorrect

44
Q

Ethosuxumide is the first drug of choice in absence epilepsy, because the EEG shows a 3-Hz spike-and-wave activity during absence seizures.
A) both parts are correct, causative relation exists
B) both parts are correct, causative relation does not exist
C) first part is correct, the second is incorrect
D) first part is incorrect, second part is correct
E) both parts are incorrect

A

B) both parts are correct, causative relation does not exist

45
Q

Grand mal seizure is always accompanied by enuresis, because grand mal is always accompanied by loss of consciousness.
A) both parts are correct, causative relation exists
B) both parts are correct, causative relation does not exist
C) first part is correct, the second is incorrect
D) first part is incorrect, second part is correct
E) both parts are incorrect

A

D) first part is incorrect, second part is correct

46
Q

Pathological EEG is always a proof of epilepsy, because every epileptic patient has a pathological EEG.
A) both parts are correct, causative relation exists
B) both parts are correct, causative relation does not exist
C) first part is correct, the second is incorrect
D) first part is incorrect, second part is correct
E) both parts are incorrect

A

E) both parts are incorrect

47
Q

Some of the antiepileptic drugs can be teratogenic, therefore an abortion is indicated in pregnant women with epilepsy.
A) both parts are correct, causative relation exists
B) both parts are correct, causative relation does not exist
C) first part is correct, the second is incorrect
D) first part is incorrect, second part is correct
E) both parts are incorrect

A

C) first part is correct, the second is incorrect

48
Q

Some of the antiepileptic drugs can be teratogenic, therefore folic acid substitution is recommended during and before pregnancy.
A) both parts are correct, causative relation exists
B) both parts are correct, causative relation does not exist
C) first part is correct, the second is incorrect
D) first part is incorrect, second part is correct
E) both parts are incorrect

A

A) both parts are correct, causative relation exists

49
Q

Diagnosis:
A 18-year-old young man had grand mal seizures since age 14. No provoking factors were revealed. The patient reported that he also had involuntary jerking in the mornings.
A) focal epilepsy
B) juvenile myoclonic epilepsy
C) chorea major
D) psychogenic epilepsy

A

B) juvenile myoclonic epilepsy

50
Q

Frist drug of choice:
A 18-year-old young man had grand mal seizures since age 14. No provoking factors were revealed. The patient reported that he also had involuntary jerking in the mornings.
A) phenobarbital
B) valproate
C) clobazam
D) ethosuximide
E) carbamazepine

A

B) valproate

51
Q

Follow-up and prognosis:
A 18-year-old young man had grand mal seizures since age 14. No provoking factors were revealed. The patient reported that he also had involuntary jerking in the mornings.
A) Lobectomy will never be a therapeutic option.
B) The patient should probably take antiepileptic drugs for > 10 years.
C) Taking appropriate antiepileptic drugs will probably result in complete seizure freedom.
D) in case of a long-term seizure freedom, the patient is permitted to drive a car.
E) all of them

A

E) all of them

Neuro states (6 decks)

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