Quiz 06/01/2022 (1)

An 18-year-old male presents to the ED after having his first generalized tonic-clonic seizure. MRI was unremarkable but a routine EEG showed 4-6 Hz polyspike and wave discharges in sleep. Which of the following antiepileptic drugs are most appropriate to start based on the available information?

A 28-year-old woman with a history of intractable epilepsy presents to you for outpatient follow-up. She has been seizure-free on valproic acid and levetiracetam for the last 18 months. She reports a desire to become pregnant and asks if she has an increased risk of in-utero defects with her medications. Which of the following is the most appropriate answer to this question?

A 6-year-old girl presents to the clinic with frequent episodes of awakening from sleep in extreme fear. Sometimes she has a brief twitching of the limbs with this. She has these events in clusters on some nights, lasting seconds to minutes. On further questioning, you discover the mother had a similar problem when she was around this age, which slowly got better over time. Both patient and mother are otherwise healthy with no intellectual deficits or symptomatic features. Which of the following gene mutations do they both likely share?

Hyperammonemia is a side effect seen with which of the following antiepileptic drugs?

A 30-year-old woman with well-controlled epilepsy with lamotrigine monotherapy comes to the clinic today stating that she and her husband are planning to start a family. Which of the following statements is most correct regarding her clinical situation?

A 26-year-old physics teacher and mother on valproic acid (VPA) for epilepsy presents to your clinic with her husband stating she wishes to try to become pregnant soon. She asks how anti-seizure medications (ASMs) used during pregnancy may impact the intelligence and school performance of her child. Which is the most accurate response?

Which of the following antiepileptic drugs can induce myoclonic seizures?

Stevens-Johnson syndrome associated with carbamazepine use is more likely in patients with which of the following HLA alleles?

Which of the anti-seizure medications (ASMs) listed operates under zero-order kinetics at high doses?

A 4-year-old male with no significant past medical history presents to the emergency room after experiencing a first-time seizure. An EEG is obtained and captures a seizure arising from the left hemisphere and polymorphic delta slowing on the same side. Over the next several months the child continues to experience focal-onset seizures despite being on 2 maximally-dosed seizure medications. His brain MRI, below, shows asymmetric left-hemispheric atrophy. His clinic presentation and imaging are most consistent with which of the following diseases?

A 24-year-old male with no known past medical history experienced a first-time generalized tonic-clonic seizure while at work. She is now in the emergency room and back to her neurological baseline. Bloodwork was unremarkable. A routine EEG and MRI of the brain were normal. Which is the most appropriate next step in management?

A 68-year-old woman presents to the emergency room with a 3-month history of worsening cognition, ataxia, dysphagia, and periodic episodes of brachial dystonia, and facial grimacing. A continuous EEG was performed but no EEG correlate was seen with the abnormal movements. An autoimmune process is suspected. Which of the following serum autoantibodies is most likely present?

Which of the following is the most common cause of focal clonic seizures in full-term neonates?

An 8-year-old patient with new-onset seizures has an MRI performed after seeing you in the clinic. Based on the lesion appreciated in the image, what seizure type does this patient most likely experience?

A 7-year-old male with a history of multiple febrile seizures has recently presented repeatedly with new recurrent non-febrile clonic seizures. Which of the following gene mutations is associated with this epilepsy syndrome?