To get accurate score, please answer the question once. Points will be subtracted if you get a correct answer on multiple attempts.
Which of the following process is unlikely to contribute to the possible mechanisms of antiepileptic drugs (AEDs)?
Blockade of voltage-gated sodium channels
Activation of GABA-A receptor
Depolarizing neurons
Blockade of T-calcium currents
Which of the following drugs does not exerts its anticonvulsant effect through altering GABAergic system?
Phenytoin
Barbiturates
Tiagabine
Benzodiazepines
Which of the following is the mechanism underlying the anticonvulsant effect of ethosuximide?
Blocking voltage-gated sodium channel.
Activating GABAA receptor and increases chloride influx.
Blocking transient (“T-type”) calcium currents.
Blocking glutamate-mediated currents.
Which of the following statements about antiepileptic drugs (AEDs) pharmacokinetcs is INCORRECT?
Calcium containing antacids may interfere with phenytoin absorption.
If valproic acid is added to a patient who is already taking phenytoin, the phenytoin is displaced from albumin binding sites, resulting in a higher free faction and toxicity.
Most AEDs are metabolized by the P450 enzyme system in the liver.
In general, enzyme-inducers increase the serum concentrations of drugs metabolized by the system and enzyme inhibitors have the opposite effect.
Which of the following statements about antiepileptic drugs (AEDs) is INCORRECT?
Gabapentin has no pharmacokinetic or pharmacodynamic interactions with other AEDs.
In the elderly, AEDs should usually be started at a lower dose and increased at a slower rate than in younger patients.
Drug metabolism and disposition in children can differ significantly from that in adults.
Pregancy increases the volume of distribution and the rate of drug metabolism, and decreases protein binding.
Which of the following statements about the adverse effects of antiepileptic drugs (AEDs) is INCORRECT?
The adverse effects of AEDs include dose-related, idiosyncratic and cumulative toxicities.
Most AEDs have a wide therapeutic window-a large range of serum concentrations within which seizure prevention is achievable without significant toxicity or side effects.
Valproate-related hepatotoxicity is more common in very young children receiving multiple AEDs.
Skin rashes are common, immunologically mediated, and usually minor and reversible.
Which of the following antiepileptic drugs (AEDs) does NOT belong to the four FDA approved anticonvulsants for Lennox-Gastaut syndrome?
Felbamate.
Lamotrigine.
Phenytoin.
Valproic acid.
WADA test refers to which of the following?
It utilizes injection of radio-labeled glucose (18FDG) to measure brain metabolism.
It utilizes injection of radio-labeled tracer of blood flow that can identify areas of increased blood flow during the seizure.
It utilizes intracarotid amobarbital injection to lateralize language and memory function.
Unlike EEG, which detects electrical activity of brain, it detects magnetic signals from the brain.
Which of the following statements regarding pre-surgical evaluation for epilepsy surgery is INCORRECT?
For temporal lobe epilepsy (TLE), the likelihood of seizure freedom after surgery is higher in those cases with MRI evidence of medial temporal sclerosis (MTS) than those without MTS on MRI.
Depth electrodes are used primarily in cases of suspected medial temporal lobe epilepsy.
The drawback of depth and subdural electrodes is limited EEG sampling.
Epidural electrodes require easier placement and provide EEG of better quality than subdural electrodes.
Which of the following statements regarding epilepsy surgery is INCORRECT?
The underlying rationale of multiple subpial transections (MST) is that disruption of horizontal connections that run within the cortex and which are vital for synchronizing neural activity can be accomplished without affecting the ascending and descending fibers that are critical for the normal functioning of the cortex.
Hemispherectomy can be used for patients with diffuse cortical dysplasia, pan-hemispheric Sturge-Weber syndrome, large perinatal infarcts, hemimegalencephaly, and Rasmussen’s encephalitis.
In patients with medial temporal lobe epilepsy, absence of mesial temporal sclerosis (MTS) on MRI predicts better seizure control after epilepsy surgery than if MTS is present on the MRI.
Callosotomy is most commonly performed for drop attacks.
Which of the following statements about traumatic brain injury (TBI)-induced seizures and epilepsy is INCORRECT?
The severity of injury is the primary risk factor for seizures after head injury.
Prophylactic antiepileptic drugs (AEDs) attempt to prevent early post-traumatic seizures, at least after severe head injury.
Short term prophylactic use of AEDs is recommended within the first week after severe head injury, but not for longer.
Prolonged use of AEDs can prevent late seizures following head injury.
Barbiturates facilitate GABA-A receptor-induced inhibition by which of the following mechanism?
Increase the duration of chloride channel openings.
Increase the frequency of chloride channel openings.