Peds0315 Seizures .pdf

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5. Which of the following laboratory tests is most
likely to be helpful in guiding management?
a. Serum chemistry in an otherwise healthy

and well appearing 10-year-old girl with

first-time self-resolved generalized seizure
b. Phenobarbital levels in a 3-month-old boy

on phenobarbital for a seizure disorder due

to hypoxic-ischemic encephalopathy
c. Cerebrospinal fluid studies in a smiling,

well appearing, otherwise healthy

18-month-old girl with a brief generalized

seizure associated with a fever of 40.5˚C
d. Serum chemistry in a well appearing

12-month-old girl with 1 day of mild cough

and runny nose, 2 hours of fever, and 3

minutes of generalized tonic-clonic seizure

8. Regarding neonatal seizures, which of the following is TRUE?
a. Neonates have a lower incidence of new-

onset seizures than other pediatric age
b. Most neonates with a single seizure can be

discharged home if an outpatient EEG can

be arranged.
c. Lip smacking, tongue thrusting, or bicycling

movements with the legs can represent

seizure activity in neonates.
d. Fosphenytoin has been clearly demonstrated

to be the most effective treatment for

neonatal status epilepticus.
9. In which of the following patients would intravenous pyridoxine be LEAST indicated?
a. A 1-week-old boy with status epilepticus

that is unresponsive to intravenous

lorazepam and phenobarbital
b. A 2-year-old girl with status epilepticus

after a witnessed single-agent ingestion of a
c. A 3-year-old girl with status epilepticus

whose only past medical history is a recent

diagnosis of latent tuberculosis
d. A 14-year-old boy with status epilepticus

whose sister states that “he tried to get high

by eating some mushrooms he picked”

6. Which of the following is TRUE?
a. Randomized controlled trials have

demonstrated that fosphenytoin and

phenytoin are the most effective second-

line agents for treatment of status
b. Fosphenytoin has a lower incidence of

cardiovascular side effects and local skin

irritation than phenytoin.
c. Phenobarbital is the preferred medication

for recurrent seizures in children because

it has a low incidence of detrimental

cognitive effects.
d. A bolus loading dose of carbamazepine

is indicated if carbamazepine levels are

10. Which of the following medications is most
highly associated with seizures in overdose?
a. Bupropion
b. Lorazepam
c. Levetiracetam
d. Acetaminophen

7. In which of the following patients would intravenous valproic acid be a reasonable third-line
a. A 2-week-old boy with status epilepticus

that is unresponsive to intravenous

lorazepam and phenobarbital
b. A 5-year-old boy with a known seizure

disorder and a mitochondrial disorder
c. An 8-year-old girl with a known seizure

disorder usually controlled with oral
d. A 15-year-old girl with known liver disease

who presents with new-onset status

March 2015 •



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