Neurology

Question 1

Obese young female with headaches + blurred vision + bilateral papilloedema without focal neurology and normal blood pressure

Answer 1

Idiopathic intracranial hypertension

Question 2

Management for idiopathic intracranial hypertension

Answer 2

1. Weight loss
2. Carbonic anhydrase inhibitors: acetazamide
3. Topiramate

Question 3

Mechanism of action of phenytoin

Answer 3

Binds to Na channels increasing refractory period

Question 4

Acute side effects of phenytoin

Answer 4

Dizziness, diplopia, nystagmus, slurred speech, ataxia

IV Phenytoin: Hypotension + bradyarrythmias

Later: confusion, seizures

Question 5

Chronic effects of phenytoin

Answer 5

Common: gingival hyperplasia, hirsutism, coarsening of facial features, drowsiness

Megaloblastic anaemia

Peripheral neuropathy

Osteomalacia

Lymphadenopathy

Dyskinesia

Question 6

Idiosyncratic effects of phenytoin

Answer 6

Fever
Rashes - TEN
Hepatitis
Dupuytrens contracture
Aplastic anaemia
Drug induced lupus

Question 7

Teratogenic effects of phenytoin

Answer 7

Cleft palate
Congenital heart disease