Neuro

Question 1

Treatment of absence seizures

Answer 1

Ethosuximide

Question 2

Treatment of generalized tonic clonic seizures

Answer 2

Valproic Acid

Question 3

Side effect of IV phenytoin

Answer 3

skin necrosis (purple glove syndrome)

Question 4

Complex partial vs absence seizures

Answer 4

Complex partial: consciousness may not be completely impaired-may respond to simple commands, automatisms, postictal state, occur during the day (benign rolandic at night), MRI and EEG part of workup
Absence: abrupt, short, “snap out of it” and return to normal activity, 3/sec spike and wave on EEG

Question 5

Treatment of simple partial seizure

Answer 5

carbamazepine, if necessary

Question 6

treatment of benign rolandic seizures

Answer 6

carbamazepine, if needed.
These are self-limited seizures of the face at night while child sleeping, associated with migraines. Strong FHx, AD. age 3-13.EEG: right and left centrotemporal spikes

Question 7

how long must person be seizure free to drive?

Answer 7

12 months

Question 8

treatment of juvenile myoclonic epilepsy

Answer 8

valproic acid, patients stay on med into adulthood
Adolescent-onset, generalized tonic-clonic seizures occurring in the morning and with sleep deprivation.
–characteristic spike wave bursts present diffusely in all EEG leads

Question 9

difficulty concentrating, clumsy, adduction of contralateral leg with stimulation of patellar reflex

Answer 9

Neuro consult and MRI for adrenoleukodystrophy
-Prepubertal boy, MR, blindness, clumsiness, decreased school performance, hyperpigmentation of skin
Deposition of very long chain fatty acids in to adrenals and nervous system

Question 10

most common risk factors for premies developing CP

Answer 10

perinatal infections, although specific cause often not found

Question 11

cranial bruit, hydrocephalus, CHF

Answer 11

vein of galen malformation

Question 12

pendular nystagmus, intermittent head tilt, head bobbing

Answer 12

spasmus nutans, benign transient disorder

Question 13

repeat attacks of head tilting (lasting min), vomiting, pallor, irritability, a migraine variant in infants

Answer 13

paroxysmal torticollis

Question 14

teratogenic effects of phenytoin

Answer 14

broad low nasal bridge, epicanthal folds, hypertelorism, cardiac abnormalities, distal digital hypoplasia/finger stiffness

Question 15

teratogenic effects of Valproic acid

Answer 15

neural tube defects, cardiac, limb and renal anomalies

Question 16

teratogenic effects of warfarin

Answer 16

nasal hypoplasia, depressed nasal bridge, bone stippling, hypoplastic distal phalanges

Question 17

teratogenic effects of carbamazepine

Answer 17

spinal problems, facial deformities

Question 18

teratogenic effects of isoretinoin

Answer 18

small eyes/head/ears, truncus arteriosus, absent thymus

Question 19

levels of sedation

Answer 19

mild (anxiolysis): responds to normal commands, cardiorespiratory fxn unaffected
moderation (conscious): drug induced depression in which pt can still respond with stimulation, cardiorespiratory monitoring needed but fxn maintained
deep: partial or complete loss of protective airway maintenance
general anesthesia: LOC and loss of airway protection

Question 20

syndrome that develops in normal child with seizures and loss of previously acquired language skills

Answer 20

Landau Kleffner (acquired epileptic aphasia)