Epilepsy and Status Epilepticus 2021 Quiz Survey

Question Title

* 1. Which statement below best describes what a seizure is ?

Abnormal firing of neurons in a synchronised manner

Normal firing of neurons in an unsynchronized manrer

Abnormal disinhibition of neurons firing in an unsynchronized manner

Abnormal disinhibition in normal firing neurons

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* 2. What proportion of all children will have at least one seizure?

10%

25%

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* 3. When would one usually initiate anti-epileptic treatment ?

After the second febrile seizure

After the second unprovoked seizure

After the first status epilepticus episode

After four seizure whether provoked or unprovoked

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* 4. When would one treat a seizure as though it is a status epilepticus ?

Immediately

After 5 minutes of a seizure not stopping

After 15 minutes of a seizure not stopping

After 30 minutes of a seizure not stopping

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* 5. The first line therapy for managing an acute seizure beyond the neonatal period would include which of the following ?

Phenobarbitone

Phenytoin

Lorazepam

Lamotrigine

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* 6. What does DEFG in the resuscitation of a child with a seizure prompt one to do ?

Remember to check serum Calcium levels

Remember to check serum Sodium levels

Remember to check Phosphate levels

Remember to check blood glucose

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* 7. Which one of these seizure types would best be treated by Carbamazepine (Tegretol)

Focal seizures (partial seizures)

Generalized tonic clonic seizures

Myoclonic seizures

Absence seizures (Petit Mal)

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* 8. Which one of the following would NOT usually be first line therapy for generalised tonic clonic seizures ?

Ethosuximide

Sodium valproate

Levetiracetam

Lamotrigine

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* 9. Which of the following can be subtle signs of ongoing seizure activity in a child ?

Speaking in a confused manner

Shouting

Lip smacking

Coughing

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* 10. The 2017 seizure classification guideline primarily divides seizures into

Simple or complex

Focal onset or generalized onset

Stable or unstable

Congenital or acquired

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* 11. Conditions to consider in the differential diagnosis of an apparent epileptic seizure include syncope and psychogenic non-epileptic seizure

True

False

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* 12. Treatment of an actively seizing patient should include

Ensuring the patient is in a safe location and position

Expectant management of the airway

Administration of a benzodiazepine as the seizure approaches five minutes duration

All of the above

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* 13. You are working an ER shift in your pediatric rotation. A 4 year old male is brought into the Emergency Department being carried by his father. He started seizing approximately 30 minutes ago. You observe and see that the patient is seizing in a generalized tonic-clonic fashion.What is this presentation called? Choose one

Complex febrile seizure

Grand mal seizure

Status epilepticus

Myoclonus

Atypical febrile seizure

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* 14. In such a situation , it is very difficult to determine the height and weight of the child to determine doses of medications. What is a tool that you can utilize to assist. Choose one

Duke tape

Broselow tape

Johnson tape

Littman device

PAWPER tape

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* 15. The patient is placed in a bed and vitals are taken:HR 160, RR 28, BP 88/50, T 38.5, Oxygen saturation 90% on room air. What is the first line of treatment? Choose all that apply

Position patient on side

Start IV access

Check airway

Give 100% oxygen

Check blood glucose

Give anti-seizure medication

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* 16. Once you stabilize the patient in the appropriate position and supply supplemental oxygen, what is the next step to perform immediately? Choose one

Get IV access

Check blood glucose

Give anti-seizure medication

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* 17. What is the first line of treatment? Choose one

Dilantin

Lorazepam

Phenobarbitol

Valproic acid

Naloxone

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* 18. You are fortunate to have a PICU nurse present and the nurse is able to get IV access. The rapid glucose test is normal. A dose of Lorazepam is administered IV. The patient is still seizing after 5 minutes. What is the next step? Choose one

Repeat lorazepam dose IV

Start phenytoin IV

Start phenobarbitol IV

Start propofol IV

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* 19. You administer the second dose of lorazepam. What pertinent initial information on history do you want to gather from the parents while you are monitoring the child and waiting to determine if the lorazepam works? Choose all that apply

History of previous seizures

Recent head trauma

Medication use

History of ingestion

Any chronic medical conditions

Birth history

Developmental history

Family history of seizures

Current illnesses

Any other symptoms

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* 20. The patient stops seizing after the third dose of lorazepam. After the seizure, you attempt to assess the patient’s responsiveness to determine the GCS status during the post-ictal period. The patient is not moving their eyes spontaneously. He does not look at you when you call his name but looks at you when you give him a sternal rub and moves his arm towards the pain. You ask him what’s his name but he simply moans and makes sounds. What is the patients GCS status. Choose one

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* 21. After 2 hours, the patient has a GCS of 14 and is alert and oriented. What is your next step in management of the patient? Choose one

Discharge the patient

Discharge the patient with outpatient follow-up arranged with Pediatric neurology

Observe and monitor in ER for 6 hours

Admit patient for further work-up

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* 22. Did you listen to the podcasts?

Yes

Only 1 of them (specify which below)

Other (please specify)

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* 23. Where are you working?

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* 24. What is your designation?

Nurse

Intern

Community Service

Medical officer

Registrar

Specialist

Other (please specify)

Epilepsy and Status Epilepticus 2021 Quiz

Question Title

* 1. Which statement below best describes what a seizure is ?

Question Title

* 2. What proportion of all children will have at least one seizure?

Question Title

* 3. When would one usually initiate anti-epileptic treatment ?

Question Title

* 4. When would one treat a seizure as though it is a status epilepticus ?

Question Title

* 5. The first line therapy for managing an acute seizure beyond the neonatal period would include which of the following ?

Question Title

* 6. What does DEFG in the resuscitation of a child with a seizure prompt one to do ?

Question Title

* 7. Which one of these seizure types would best be treated by Carbamazepine (Tegretol)

Question Title

* 8. Which one of the following would NOT usually be first line therapy for generalised tonic clonic seizures ?

Question Title

* 9. Which of the following can be subtle signs of ongoing seizure activity in a child ?

Question Title

* 10. The 2017 seizure classification guideline primarily divides seizures into

Question Title

* 11. Conditions to consider in the differential diagnosis of an apparent epileptic seizure include syncope and psychogenic non-epileptic seizure

Question Title

* 12. Treatment of an actively seizing patient should include

Question Title

Question Title

* 14. In such a situation , it is very difficult to determine the height and weight of the child to determine doses of medications. What is a tool that you can utilize to assist. Choose one

Question Title

* 15. The patient is placed in a bed and vitals are taken:HR 160, RR 28, BP 88/50, T 38.5, Oxygen saturation 90% on room air. What is the first line of treatment? Choose all that apply

Question Title

* 16. Once you stabilize the patient in the appropriate position and supply supplemental oxygen, what is the next step to perform immediately? Choose one

Question Title

* 17. What is the first line of treatment? Choose one

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* 18. You are fortunate to have a PICU nurse present and the nurse is able to get IV access. The rapid glucose test is normal. A dose of Lorazepam is administered IV. The patient is still seizing after 5 minutes. What is the next step? Choose one

Question Title

* 19. You administer the second dose of lorazepam. What pertinent initial information on history do you want to gather from the parents while you are monitoring the child and waiting to determine if the lorazepam works? Choose all that apply

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* 21. After 2 hours, the patient has a GCS of 14 and is alert and oriented. What is your next step in management of the patient? Choose one

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* 22. Did you listen to the podcasts?

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* 23. Where are you working?

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* 24. What is your designation?

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* 25. How useful did you find the podcasts?

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* 26. What are the key take aways messages you have following this activity?

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* 27. What would you like to ask or have clarified during the online session with Prof Coovadia?