😡عصبيه
Whf
Ha
G
Hz
IB
What characterizes a seizure?
Decreased electrical activity in the brain
Abnormal and excessive electrical activity in the brain
Normal electrical impulses in neurons
Increased neurotransmitter production
Epilepsy is defined as:
A single seizure episode
A tendency to have recurrent seizures
Seizures only due to fever or head injury
Non-recurrent drug-induced seizures
How do children's seizures differ from adults'?
Only in drug response
No difference in EEG patterns
Only in clinical manifestations
In seizure manifestations, EEG patterns, and drug response
Which seizure type involves brief jerking movements?
Absence
Tonic
Myoclonic
Atonic
What is characteristic of a tonic-clonic seizure?
Loss of consciousness and motionlessness
Flexion, extension, tremor, clonic, and postictal phases
Only rhythmic jerking movements
Sudden loss of muscle tone
Lennox-Gastaut Syndrome is characterized by:
Single seizure type
Rapid cognitive development
Multiple seizure types and mental regression
Absence seizures only
Status epilepticus is defined as a seizure that:
Lasts less than 10 minutes
Involves only a brief loss of consciousness
Lasts more than 20 minutes
Is always non-epileptic
What is a prodrome in the context of epilepsy?
A type of seizure
A medication for seizures
A precursor indicating an impending seizure
An EEG patterns
An aura in epilepsy often includes:
Loss of muscle tone
Sensory or autonomic symptoms
Long-term memory loss
Complete loss of consciousness
What best describes generalized seizures?
Originating in one hemisphere
Involve bilaterally distributed neural networks
Always result in long-term harm
Only occur in adults
Which is not a major category of generalized seizures?
Clonic
Tonic
Absence
Reflexive
Infantile spasms are:
Common in adults
Age-specific to infancy and early childhood
Characterized by continuous muscle tone
A single, isolated event
What does an EEG in West syndrome typically show?
Normal activity
Hypsarrhythmia
Slow spike-and-wave discharges
Absence of electrical activity
Non-epileptic seizures can be:
Only psychogenic
Only organic
Either organic or psychogenic
Neither organic nor psychogenic
A key feature of absence seizures is:
Long-lasting muscle jerks
Continuous movement
Short loss of consciousness and staring
Loud vocalizations
Tonic seizures are characterized by:
Brief, lightning-like jerking movements
Flexion and/or extension phases
Loss of muscle tone
Staring and motionlessness
Atonic seizures involve:
Complex cognitive tasks
Loss of muscle tone
Continuous shaking
Sensory enhancement
What is a common feature of clonic seizures?
Rhythmic jerking movements
Complete immobility
Long-term memory enhancement
Increased muscle tone
What is unique about seizures in children compared to adults?
Children cannot have seizures
Only adults show EEG changes
Children's brains are more prone to seizures
Children always outgrow seizures
Which of the following is a blocker of repetitive activation of the Na channel?
Lac
Flb
CBZ
Ethosuximide
What is the primary mechanism of action for Lamotrigine?
GABA-A receptor enhancement
Blockade of AMPA receptors
Decreases glutamate and aspartate release
NMDA receptor blockade
Which drug is a T-calcium channel blocker?
Gabapentin
Ethosuximide
Lamotrigine
Oxcarbazepine
What is the primary concern with Lamotrigine use?
Hepatotoxicity
Rash
Weight loss
Cognitive impairment
Which medication requires dosage adjustment for renal dysfunction?
Phenytoin
Gabapentin
Carbamazepine
Ethosuximide
Eslicarbazepine is a prodrug for:
S(+)-licarbazepine
Gabapentin
Levetiracetam
Carbamazepine
Which medication is an enzyme inducer and nonlinear kinetic?
Levetiracetam
Primidone
Pregabalin
Phenytoin
Pregabalin is primarily used for:
Status epilepticus
Neuropathic pain
Absence seizures
Tonic-clonic seizures
Is the primary use of Ethosuximide?
Treatment of Lennox-Gastaut syndrome
Treatment of absence seizures
Adjunct therapy for anxiety
Management of bipolar disorder
Valproic acid decreases the metabolism of:
Lamotrigine
Gabapentin
Levetiracetam
Ethosuximide
Which medication is known for causing hyponatremia?
CBZ
Lac
Val
Gab
Which of these drugs can cause weight gain?
Topiramate
Valproic acid
Phenytoin
Rufinamide
Primidone is also used for:
Essential tremor
Anxiety disorders
Diabetic neuropathy
Bipolar disorder
Which drug is a neuronal potassium channel opener?
Ethosuximide
Ezogabine
Perampanel
Lacosamide
Fosphenytoin is used for:
Adjunctive therapy in anxiety
Status epilepticus
Treatment of neuropathic pain
Maintenance treatment of bipolar disorder
The usual maximal dose of Lacosamide is:
200 mg/day
400 mg/day
3600 mg/day
1600 mg/day
Which drug is associated with a risk of developing rash?
Valproic acid
Phenytoin
Ethosuximide
Gabapentin
Patient A, a 25-year-old female, experiences her first generalized tonic-clonic seizure. She has no prior history of seizures or known risk factors. The EEG and MRI results are normal, and no identifiable cause is found.
What is the most appropriate treatment decision for this patient?
Start antiepileptic drug (AED) therapy immediately
Observe without treatment and provide education
Perform a repeat EEG within 24 hours
Recommend lifestyle modifications only
Patient B, a 30-year-old female with epilepsy, is planning to become pregnant. She is currently taking carbamazepine as her antiepileptic drug (AED).
What is the most appropriate action regarding her AED treatment?
Continue carbamazepine during pregnancy
Switch to valproic acid during pregnancy
Discontinue AEDs before attempting pregnancy
Consider other AED options with a better safety profile during pregnancy
Patient C, an 80-year-old male, has been experiencing recurrent seizures despite optimal treatment with antiepileptic drugs (AEDs). The patient has multiple comorbidities and is at risk of drug interactions.
What is the most appropriate approach to manage his seizures?
Increase the dosage of the current AEDs
Add another AED to the current regimen
Evaluate for surgical options
Continue current treatment and monitor closely
Patient D, a 40-year-old male, presents to the emergency department with continuous seizures lasting for more than 30 minutes. Despite initial treatment with benzodiazepines, the seizures persist.
What is the next step in managing this patient's status epilepticus?
Administer a second dose of benzodiazepine
Begin long-term antiepileptic drug (AED) therapy
Initiate propofol infusion for anesthesia
Perform an urgent brain MRI
Patient E, a 10-year-old child, has been diagnosed with refractory epilepsy, and multiple antiepileptic drugs (AEDs) have failed to provide adequate seizure control. The child's parents are considering alternative treatments, including medical marijuana.
What should be discussed with the parents regarding this option?
Encourage the use of medical marijuana for seizure control
Advise against the use of medical marijuana due to limited evidence
Consider epilepsy surgery as the next step
Suggest trying additional AEDs before exploring alternatives
John, a 65-year-old male with a history of hypertension and smoking, is concerned about his risk of stroke. He has a family history of stroke in his parents.
Which of the following is not a modifiable risk factor for ischemic stroke in John's case?
Age
Smoking
Hypertension
Family history
Emily, a 50-year-old woman, suddenly experiences numbness in her right arm and leg, confusion, and trouble speaking.
What should be Emily's immediate course of action?
Wait and see if symptoms resolve in a few hours.
Immediately call emergency services for suspected stroke.
Take aspirin and rest.
Schedule an appointment with her doctor for the next day
A 70-year-old patient presents to the emergency department within 2 hours of onset of stroke symptoms.
Which of the following is the most appropriate initial treatment?
Immediate administration of tissue plasminogen activator (Alteplase)
Start oral anticoagulation therapy with warfarin
Immediate carotid endarterectomy
Administer aspirin and observe
Robert, a 55-year-old man, is brought to the hospital with acute stroke symptoms. He is currently taking warfarin for atrial fibrillation.
What is an important consideration in managing Robert's acute event?
Immediate cessation of warfarin.
Checking his International Normalized Ratio (INR) levels.
Administering tissue plasminogen activator without checking INR.
Starting aspirin therapy immediately.
Patient A, a 50-year-old male, arrives at the emergency department within the thrombolytic window after presenting with right-sided weakness and facial droop. Imaging confirms an acute ischemic stroke. However, the patient's medical history reveals recent major surgery within the past two weeks.
What should the healthcare team consider regarding thrombolytic therapy in this case?
Administer thrombolytic therapy immediately
Delay thrombolytic therapy until the surgical site is fully healed
Consult a neurologist for further evaluation
Administer a reduced dose of thrombolytic therapy
Patient B, a 75-year-old female, has a history of recurrent embolic ischemic strokes due to atrial fibrillation. The patient's CHA2DS2-VASc score is 4. The healthcare team is deciding on anticoagulation therapy.
Which of the following options should be considered for this patient?
Warfarin (oral vitamin K antagonist)
Apixaban (direct oral anticoagulant)
Clopidogrel (antiplatelet agent)
Low-dose aspirin
Patient C, a 60-year-old male, presents with an acute ischemic stroke. Imaging reveals a large infarct size. The healthcare team is considering thrombolytic therapy, but they are concerned about the risk of hemorrhagic transformation.
What factors should they consider when evaluating the risk-benefit ratio?
Age and gender
Smoking history and alcohol use
Infarct size and time since symptom onset
Family history of strokene
Patient D, a 45-year-old female, arrives at the hospital 8 hours after the onset of symptoms, including right- sided weakness and difficulty speaking. Imaging reveals a large vessel occlusion in a major cerebral artery. The healthcare team is considering endovascular
What factors should influence their decision regarding the extended time window for intervention?
Patient's age and comorbidities
Imaging evidence of salvageable brain tissue
Availability of the interventional radiology team
Patient's preference for treatment
Patient E, a 70-year-old male, on long-term anticoagulation therapy, presents with a large intracerebral hemorrhage. The healthcare team must rapidly reverse the anticoagulant effect to control bleeding.
Which reversal agent should be administered?
Protamine sulfate
Vitamin K
Fresh frozen plasma (FFP)
Idarucizumab (for dabigatran reversal)
Patient F, a 60-year-old male, is brought to the hospital with acute-onset left-sided weakness and slurred He woke up with these symptoms, and the exact time of symptom onset is unclear. Imaging shows a large-vessel occlusion.
What treatment options should be considered in this scenario?
Administer IV thrombolysis (IPA)
Perform endovascular thrombectomy
No acute reperfusion therapy
Initiate antiplatelet therapy
Patient G, a 55-year-old female, presents to the emergency department within 2 hours of symptom onset with right-sided weakness and aphasia. Imaging shows a proximal middle cerebral artery occlusion. The patient meets criteria for both IV thrombolysis and endovascular treatment.
What is the preferred sequence of these treatments?
Endovascular treatment followed by IV thrombolysis .
IV thrombolysis followed by endovascular treatment%
Administer only IV thrombolysis.
Administer only endovascular treatment
Patient H, a 70-year-old male, is found to have severe carotid artery stenosis after an ischemic stroke. He is on optimal medical therapy but remains at high risk for recurrent strokes.
What revascularization procedure should be considered in this patient?
Carotid endarterectomy (CEA)
Carotid artery stenting (CAS)
Coronary artery bypass grafting (CABG)
Aortic aneurysm repair
Patient I, a 40-year-old female, presents to the emergency department with severe right-sided weakness, aphasia, and a National Institutes of Health Stroke Scale (NIHSS) score of 20. Imaging confirms a large- vessel occlusion in the anterior circulation.
What is the recommended approach to thrombectomy in this hyperacute situation?
Perform thrombectomy as soon as possible
Administer IV thrombolysis before considering thrombectomy
Delay thrombectomy to assess collateral circulation
Administer antiplatelet therapy before thrombectomy
Patient J, a 65-year-old male, has completed thrombolysis and thrombectomy for an acute ischemic stroke. He is now in the rehabilitation phase. In addition to physical and occupational therapy
what medication management should be considered during this phase?
Discontinue all medications
Initiate statin therapy
Initiate anticoagulant therapy
Administer antiplatelet therapy
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