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NCA 623 Exam 2 Latest Update
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NCA 623 Exam 2 Latest UpdateAll of the following are potential causes for seizures or increased seizure risk potential
from baseline EXCEPT:
Hypoglycemia
Alcohol and drug use
Brain tumor
adherence with current epileptic regimen - Answer adherence with current epileptic
regimen
Abscence nonmotor seizures is a form of a generalized seizure and has no post-ictal
state: True or False - Answer true
A 20 year old male presents for an epilepsy follow-up after being diagnosed about 10
years ago. He averages about 3 seizurs per month. His seizures are preceded by a
warning of deja-vu and queasiness of the abdomen, followed by lip smacking and
speech arrest for 1-2 minitures, then postictal disorientation and amnesia occur. As an
advanced provider you understand that his most likey diagnosis is:
Lennox-Gaustatu Syndrome
Aytpical abscence seizures
Complex-partial seizures
Simple partial seizures - Answer Complex-partial seizures
True or False: Tonic-Clonic seizures are a generalized onset motor seizure with NO loss
of consciousness and NO pos-ictal state. - Answer false
true or false: Petit-Mal abscence seizures have a sudden arrest of motor activity with a
blank starte and is someitmes assiciated with other types of sieures. - Answer true
True or False: Tonic Clonic Grand-Mal seizures is a form of generalized seizures with
tonic contractions then clonic contractions with development of rigid muscles, a loss of
conciousness, and post-ictal state that may be preceded by an aura prior to the seizure.
- Answer true
True or False: Focal onset seizures involve both cerebral hemispheres and can occur as
a Jacksonian March (previously kown as simple partial sieizures) - Answer False,
involves one cerebral hemisphere
What type of seizure is the most common type of those with epilepsy and is a simple
,partial seizure followed by loss of conciousness with a preced aura, loss of
consciousness, and post-ictal state and have the potential to turn into secondary
generalized seizures:
Generalized tonic-clonic seizure
Focal Complex Partial Seizures
Abscence seizures
Todd's Paralysis - Answer Focal Complex Partial Seizures
A 30 y/o female with PMH of epilepsy diagnosed as a child presents to the ED after
having a seizure. This seizure was unlike her prior seizures. Exam reveals right upper
and lower extremity weakness with normal strength on the left side. She is alert,
oriented, and following commands. Physical exam is normal. Seizure occurred about
four hours ago and involved clonic spasms of her entire right side that rapidly spread to
overtake her entire body. Which one of the following is the most likely diagnosis?
Psychogenic seizures
Todd's Paralysis
Post-Ictal State
Abscence seizures - Answer Todd's Paralysis
Which of the following type of generailzed epileptic siezure presents with alternating
stiffening and movement?
Simple-partial
Complex partial
Generalized tonic-clonic
Focal - Answer Generalized tonic-clonic
What is the most important initial medicaiton treatment in status epilepticus? - Answer
Benzodiazepines like Versed or Ativan.
The most important FIRST step in seizure diagnosis is:
A thorough physical exam.
Conducting a thorough medical history.
Order LTEEG monitoring
Obtian CT of Head - Answer Conducting a thorough medical history.
True or False: The most important test in determining seizure classifications and for
,determining the best seizure management is long term EEG monitoring. - Answer true
True or False: As an advanced provider, you are starting a patient on treatment for new
onset seizures with Phenytoin (Dilantin) and understand that gingival hyperplasia,
drowsiness n/v, and constipation are all potential side effects of this medicaiton -
Answer true
A 70 y/o male presents wo thte ED with a head injury after being in a motor vehicle
accident. He is having generalilzed tonic-clonic seizures. What is the INITIAL FIRST
LINE therapy of choice to treat this specfic type of seizure?
Answer Valproic Acid was Correct. Feedback provided:
radio_button_checked
Valproic Acid
Topimax
Tegretol
Gabapentin
Ethosuximide - Answer Valproic Acid
A 28 y/o female with PMH Of epilepsy and HTN is considering having children. She has
been on Keppra for her seizure control for the past five years. She has been siezure free
for three years. As the advance provider, you consider the following when disscussing
what her next steps are:
-Refer to neurology for further counseling and rpeat LTEEG monitoring and MRI of Brain
first before further discussion in determining rather to wean off of AED therapy versus
continued use of Keppra during pregnancy.
-Continue Keppra therapy alone.
-Stop all seizure medications today.
-Advise her to not proceed with pregnancy as the risk are too high.
-Add a secaond AED therapy, sinc ethe pregnancy may affect seizure control. - Answer
-Refer to neurology for further counseling and rpeat LTEEG monitoring and MRI of Brain
first before further discussion in determining rather to wean off of AED therapy versus
continued use of Keppra during pregnancy.
when a patient is in status epilepticus, which one of the following agents is your initial
therapy and most important management of of this condition?
midazolam or lorazepam
trileptal
, phenytoin
keppra - Answer
As an advanced provider, you understand that the most common type of MS is:
Primary progressive
Progressive-Relpasing
Relapsing-Remitting
Secondary progressive - Answer Relapsing-Remitting
True or False: Vitamin D deficiency is a risk factor for the development of MS - Answer
true
True or False: Pregnancy is contraindicated in those with MS> - Answer false
As an advance provider, you are evaluating a patient with MS. She describes episodes
of not feeling well, but states only last a period of time, before she feels normal again.
She kows this cycle will repeat itself with time. She is describing which type of MS?
Primary Progressive
Secondary Progresive
Clinically isolated type
Relapsing-Remitting - Answer Relapsing-Remitting
A 40 y/o female presentss to the ED with a several day history of weakness, diziness,
lack of coordination, and difficulty with gain. MRI of Brain and spine revelas spinal
lesions. An LP is performed after a CT is done (no cerebral edema or space occupying
lesions are found) and reveals oligoclonal bands and elevated IgG levels. As an
advanced provider you know that the most likely diagnosis is:
Multiple Sclerosis
Guillian Barre Syndrome
Meningitis
Myasthenia gravis - Answer Multiple Sclerosis
True or False: Steroids are indicated for short term management in those with an MS
flare. - Answer true
As an advanced provider caring for a patient who presents to your neurology clinic with
an MS flare. You understand that the best management is to admit her to the hospital
and that all of the following treatment option should be given/considered along with a
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