Bcacp Neurology Test Questions With 100% Verified Solutions

Bcacp Neurology Test Questions With 100% Verified Solutions What are the aromatic AEDs? (7) When should they be avoided? - ANSWER- Phenytoin Carbamazepine Oxcarbazepine Eslicarbazepine Phenobarbital Lamotrigine Perampanel Cross reactivity of rash is highest among aromatics. If patient has any type of rxn to one aromatic avoid all other aromatics Anticonvulsant hypersensitivity syndrome - ANSWER- Rare, severe, delayed, multiorgan, type IV reaction Can be life-threatening 2-8 weeks after initiation Triad: fever, rash, organ involvement What AEDs are considered first line for focal seizures? (9) - ANSWER- carbamazepine gabapentin lamotrigine oxcarbazepine phenobarbital topiramate valproate lacosamide eslicarbazepine What AEDs are considered first line for generalized seizures? (2) - ANSWER- Lamotrigine Topiramate Pregnant population considerations - ANSWER- monotherapy recommended. folate supplementation Minimize valproate (high birth defects) if possible Breastfeeding is ok Solid organ transplantation population considerations - ANSWER- avoid CYP3A4 enzyme inducers with cyclosporine check for DDI 2 MIGRAINE 11 PAGES - ANSWER- types of migraines - ANSWER- cluster tension migraine w/o aura migraine with aura cluster headaches - ANSWER- site of pain: Unilateral, fronto-temporal, periorbital character of pain: searing, excruciating may be accompanied by nasal sx more common in men tension HA - ANSWER- site of pain: bilateral, frontal, occipital character: aching, tight, squeezing migraine - ANSWER- site of pain: Usually unilateral at start; may become bilateral character: Pulsatile, throbbing accompanied by: photophobia, phonophobia, hyperosmia, N/V at least 5 attacks lasting 4-72 hrs first line acute tx of cluster HA - ANSWER- triptan - intranasal or injectable forms oxygen Preventive treatment of cluster HA - ANSWER- short term: corticosteroid burst 1x/year. ergotamines long term: verapamil (gold standard). lithium, gabapentin, topiramate, valproic acid non-pharm tx of migraines - ANSWER- avoid triggers acute tx of tension type HA - ANSWER- analgesics NSAIDs combination anagesics w/ and w/o caffeine preventive tx of tension-type HA - ANSWER- TCAs SSRIs if depression pharmacological acute treatment of migraines classes (4) - ANSWER- analgesics/NSAIDs triptans ergotamines anti-emetics What do you need to qualify as migraine w/ aura - ANSWER- at least 1 fully reversible aura sx. Usually visual sx. may include sensory sx, motor sx. Doesn't last longer than 60 min. Migraine HA follows aura within 60 min. Pharmacological tx of migraine abortive mild to moderate - ANSWER- NSAIDS, ASA, APAP - for mild to moderate NTE 3x/week Antiemetics Avoid opioids and butalbital except as last resort moderate to severe attacks Pharmacological tx of migraine abortive - ANSWER- Triptans, ergotamines, and combination therapy for moderate to severe attacks antiemetics Ergotamines/dihydroergotamines problems - ANSWER- Less specific to targeted receptor(s), thus causing more adverse effects Name the triptans - ANSWER- almotriptan naratriptan eletriptan zolmitriptan sumatriptan rizatriptan frovatriptan What triptans are renally excreted? - ANSWER- Almotriptan, Naratriptan Drug interactions (CYP3A4) - ANSWER- Eletriptan, Zolmitriptan Contraindication with MAOI - ANSWER- Sumatriptan, Rizatriptan, Zolmitriptan Propranolol DDI - ANSWER- Rizatriptan (5 mg dose/15 mg max total) Quickest onset - ANSWER- SQ: Sumatriptan Nasal spray: Sumatriptan and Zolmitriptan Quickest onset PO - ANSWER- Eletriptan, Sumatriptan, Almotriptan, Rizatriptan Longest duration - ANSWER- Frovatriptan, Naratriptan ODT formulation - ANSWER- Rizatriptan, Zolmitriptan Ergotamine DDI - ANSWER- No triptan within 24 hours Name the antiemetics for use in migraine tx - ANSWER- metoclopramide, promethazine, and prochlorperazine