BCACP NEUROLOGY ACTUAL TEST EXAM 2024|VERIFIED EXAM QUESTIONS AND CORRRECT ANSWERS |ALL GRADED A+|GUARANTEED SUCCESS|LATEST UPDATES 2024

BCACP NEUROLOGY ACTUAL TEST EXAM 2024|VERIFIED EXAM QUESTIONS AND CORRRECT ANSWERS |ALL GRADED A+|GUARANTEED SUCCESS|LATEST UPDATES 2024 Clinical definition of epilepsy - ANSWER- propensity to have unprovoked seizures repeatedly 2 unprovoked seizures >24 hrs apart OR one unprovoked seizure for high risk populations (older adult, pts post CVA) What can a seizure be provoked by? (5) - ANSWER- 1. withdrawal of illicit drugs or EtOH 2. drugs that can lower the seizure threshold or precipitate a seizure 3. metabolic disturbances such as hypoglycemia or severe hyponatremia 4. CNS infections 5. febrile illness How are epilepsies classified? (3) - ANSWER- focal Generalized Unknown focal seizures - ANSWER- begin focally in one hemisphere of the brain focal seizures are (5) - ANSWER- a. Focal aware b. Focal impaired awareness c. Focal motor (e.g., atonic, clonic) d. Focal nonmotor (i.e., sensory) e. Focal to bilateral tonic-clonic Generalized seizures (bilateral hemispheres involvement) (7) - ANSWER- a. Absence (blanking/spacing out) b. Atonic (lack of muscle tone) c. Clonic (sustained jerking movements) d. Myoclonic (brief, shocklike jerks) e. Tonic (increased muscle tone/stiffening) f. Tonic-clonic (jerking followed by stiffening) g. Infantile spasms Non-pharm tx of epilepsy - ANSWER- 1. Surgical intervention (usually for intractable): Vagus nerve stimulation (VNS) Deep brain stimulation (DBS) Responsive neurostimulator system (RNS/Neuropace) 2. Ketogenic diet Broad spectrum AEDs can treat - ANSWER- both focal and generalized Broad spectrum AEDs (9) - ANSWER- Clobazam Lamotrigine Levetiracetam Perampanel Phenobarbital Rufinamide Topiramate Zonisamide Valproate Narrow spectrum AEDs for focal (8) - ANSWER- Brivaracetam Carbamazepine Eslicarbazepine Oxcarbazepine Gabapentin Pregabalin Lacosamide Phenytoin Narrow spectrum AEDs for generalized (1) - ANSWER- Ethosuximide (absence) Treatment considerations for selecting AED therapy - ANSWER- cost side effects comorbidities type of epilepsy AEs Age/sex Drug interactions Strong inducers of CYP - ANSWER- phenytoin phenobarbital primidone carbamazepine AEDs that do not inhibit/induce CYP at any dose - ANSWER- levetiracetam lamotrigine gabapentin pregabalin Strong inhibitors of CYP - ANSWER- valproate Lamotrigine can be decreased by other AEDs (4) - ANSWER- phenytoin phenobarbital carbamazepine estrogen Lamotrigine can be increased by other AEDs (1) - ANSWER- valproate The following AEDs decrease oral contraceptive effectiveness (10) - ANSWERCarbamazepine Clobazam Eslicarbazepine Felbamate Oxcarbazepine (>1200 mg) Perampanel Primidone/Phenobarbital Phenytoin Rufinamide Topiramate (>200 mg) What AEDs are metabolized by the liver? - ANSWER- carbamazepine clobazam ethosuximide felbamate fosphenytoin oxcarbazepine phenobarbital phenytoin primidone tiagabine topiramate valproic acid What AEDs are renally eliminated? - ANSWER- Eslicarbazepine Felbamate Gabapentin Lacosamide Levetiracetam Pregabalin Vigabatrin *topiramate (not renally eliminated but can cause kidney stones) Monitoring considerations for AEDs (8) - ANSWER- bone disorders serum concentrations driving restrictions depression life-threatening rash potential cross-sensitivity between agents with an aromatic ring discontinuing AEDs in the seizure free patient What AED drugs should be avoided in a patient with Obesity - ANSWER- valproate What AED drugs should be avoided in a patient with osteoporosis/osteopenia - ANSWER- Phenytoin Phenobarbital Carbamazepine Oxcarbazepine Valproate