Neurological Disease

Question 1

Epilepsy & seizure disorders

Answer 1

Spontaneous, uncontrolled electrical activity among cerebral neurons.

Question 2

What AED drug causes intestinal malabsorption of dietary folate?

Answer 2

Phenytoin. Inhibits enzyme that converts poly-glutamte form to the mono- form of folate. Phenytoin is dependent on folate as a cofactor for drug metabolism

Question 3

How do AED affect Calcium and Vit D status?

Answer 3

Inhibit intestinal Ca transport. ↑ turnover of Ca & Mg in the bone. Interfere w/ vit D activation.

Question 4

What vitamins/minerals need supplemented in epilepsy?

Answer 4

Vitamin D, folate. Ca

Question 5

Carnitine

Answer 5

The shuttle protein for fatty acid oxidation

Question 6

What AED causes carnitine deficiency? Why?

Answer 6

Valproic acid uses carnitine for metabolism & can induce carnitine deficiency.

Question 7

What is the urinary ketone goal for the ketogenic diet?

Answer 7

80-160mg/dL

Question 8

How does the ketogenic diet work?

Answer 8

Alters neurotransmitter synthesis & action. Some investigators suggest that increased synthesis of GABA, the primary inhibitory neurotransmitter, may explain dietary efficacy. Reduced availability of glucose.

Question 9

Classic ketogenic diet

Answer 9

Macronutrient ratio of 4:1, or 3:1. Fluids encourages. Sugar-free multivitamin, calcium, Vit D

Question 10

MCT ketogenic diet

Answer 10

CHO = 18%, pro = 10%, dietary fat = 12% of total energy for essential fats. MCT = 60%. Supplements - multi, Vit D, Ca

Question 11

beta-hydroxybutyrate

Answer 11

ketone measured in the blood. >4.0 mmol/L

Question 12

Nomogram for energy 0-12mo

Answer 12

90-100 kcal/kg

Question 13

Nomogram for energy 13-24mo

Answer 13

80-90 kcal/kg

Question 14

Nomogram for energy 25-36mo

Answer 14

70-75 kcal/kg

Question 15

Nomogram for energy 4-6 years

Answer 15

65-68 kcal/kg

Question 16

Nomogram for energy 7-10 years

Answer 16

55-69 kcal/kg

Question 17

Nomogram for energy ≥ 11 years

Answer 17

30-40 kcal/kg

Question 18

Signs/symptoms of stroke

Answer 18

Loss of vision or speech, paralysis, muscle, weakness, change in mental status

Question 19

Tissue plasminogen activator (tPA)

Answer 19

thrombolytic drug

Question 20

Parkinson’s disease

Answer 20

Neuromuscular, neuro-degeneratve disease caused by loss of dopamine producing cells. Imbalance between inhibitory and excitatory communication w/ GABA

Question 21

Signs and symptoms of Parkinson’s

Answer 21

Resting tremor, rigidity, bradykinesia, stooped posture, shuffling gait, cognitive dysfunction

Question 22

Treatment of Parkinson’s

Answer 22

Primarily w/ L-dopa, other meds, and surgery. Manage GI symptoms; gastroparesis

Question 23

B6 supplementation should be limited to ? in Parkinson’s

Answer 23

15mg

Question 24

Food-drup interactions of Levodopa

Answer 24

N/V, loss of appetite, change in taste, fatigue

Question 25

Why should B6 be supplemented in Parkinson's

Answer 25

B6 is required as a cofactor for dopa decarboxylase (DDC), an enzyme needed for the conversation of L-dopa to dopamine.