WorksheetsP612 Exam 3
Total questions: 30
Worksheet time: 3600secs
What pathophysiologic pathway is involved in Parkinson’s symptoms?
Increased substance P
Aggregation of Aβ peptides
Loss of dopamine-producing neurons
Hyperexcitability of neurons
Increased dopamine production
SS has recently been having tremors and difficulty walking normally. He currently takes metformin and insulin for diabetes, as well as metoclopramide for gastroparesis, ibuprofen and Norco after hip replacement surgery, and diphenhydramine for sleep. What medications may contribute to his symptoms?
Metformin
Metoclopramide
Ibuprofen
Norco (acetaminophen/hydrocodone)
Diphenhydramine
What is a common side effect of amantadine?
Dry mouth
Amphetamine-like effects
Urinary discoloration
Compulsive behaviors
Urinary retention
What is the place in therapy for apomorphine in Parkinson’s disease?
Most effective symptomatic therapy
Add on medication for off-period dystonia
Rescue medication for off periods
First line for patients <65 yo
Add on medication to improve dopaminergic activity
BG is a 57 yo male with early onset Parkinson’s disease, manifested mostly by tremor. What initial therapy do you recommend?
Selegeline
Entacapone
Carbidopa/levodopa
Benztropine
Pramipexole and carbidopa/levodopa
BG was managed on the treatment you recommended in question 6 for 5 years. Now, he has progressed with more troublesome motor symptoms. What do you recommend now?
Add amantadine
Add bromocriptine
Stop current therapy and start Rytary (carbidopa/levodopa ER)
Add carbidopa/levodopa
Stop current therapy and add ropinirole
Which medication is associated with impulsive behaviors (such as gambling, online shopping, etc.)?
Tolcapone
Pramipexole
carbidopa/levodopa
amantadine
You notice BG stops in the middle of movements. What would you like to do?
Add apomorphine
Add selegiline
Increase frequency of carbidopa/levodopa dose
No pharmacologic changes are likely to help
Add baclofen
Which of the following is NOT a common trigger for seizures?
Sleep deprivation
Alcohol use
Flashing lights
Stress
Use of anticholinergic medications
LT was working in the grocery store when suddenly they had a stopped moving and stared at the same place for about 30 seconds. What kind of seizure did LT likely experience?
Dyscognitive focal
Atonic
Absence
Myoclonic
Clonic
Which medications are most likely to cause severe rash?
Carbamazepine
lamotrigine
Gabapentin
Levetiracetam
Topiramate
PR has seizures that affect her right arm and leg. She had been controlled on phenytoin but then developed severe liver dysfunction. Her physicians would like to try a new medication. What do you recommend? Her past medical history is significant for morbid obesity, hypothyroidism (managed on levothyroxine), and current infection treated with meropenem and anaphylaxis to sulfa drugs.
Zonisamide
Valproic acid
Phenobarbital
Topiramate
Fosphenytoin
What is phenytoin dosing adjusted for?
albumin concentrations
Kidney function
liver function
drug interactions
A 51 kg patient comes to the ED in status epilepticus (onset 15 minutes ago). What treatment is most appropriate?
Stabilize patient and try to get IV access
Administer IV diazepam 10 mg
Administer IM midazolam 10 mg
Administer IV phenobarbital 100 mg
Administer IV lorazepam 10 mg
Which of the following is true about phenytoin/fosphenytoin?
Fosphenytoin is takes at least 30 minutes to be converted to phenytoin in vivo
Neither can be administered IM
It can precipitate hypotension or arrhythmias because of the active drug component
An oral loading dose may be given in patients who are actively seizing
Phenytoin infusion is about 30 minutes long
If a patient is in status epilepticus refractory to phenytoin and valproic acid, what is another potential treatment?
Levetiracetam
Ethanol
Gabapentin
Lacosamide
Lorazepam PRN
For which patient should you stop giving Propofol continuous infusion?
BP 128/92
K+ 2.9 (hypokalemic)
K+ 5.8 (hyperkalemic)
Partial seizure remission
Dose given is 5 mg/kg/h
Which of the following is NOT a potential option for super-refractory status epilepticus cases?
Ketogenic diet
Hyperthermia induction
Pentobarbital
Topiramate
Ketamine
Which of the following antiepileptics is NOT correctly matched to its side effects?
Lacosamide and dizziness
Phenytoin and gingival hyperplasia
valproic acid and weight loss
carbamazepine and blood dyscrasias
topiramate and kidney stones
In super refractory cases for status epilepticus, which medication can be used for patients with cardiac instability?
ketamine
levetiracetam
lidocaine
propofol
Which of the following will NOT cross the placenta?
high molecular weight drug
unionized drug
lipophilic drug
low molecular weight drug
Which of the antipsychotics is best to use in a pregnant patient?
atypical antipsychotics
typical antipsychotics
lithium
mood stabilizers (valproic acid)
Which of the following agents would be okay to use weeks 6-12 of pregnancy?
LMWH
UFH
Warfarin
Direct thrombin inhibitors
NOACs
What is first line for nausea/vomiting in pregnant women?
ondansetron
pyridoxine +/- doxylamine
metoclopramide
prochlorperazine
Which of the following is contraindicated to use for constipation during pregnancy?
stool softeners
osmotic laxatives
stimulant laxatives
castor oil
Which of the following ABX is NOT correctly matched to it's contraindication reason during pregnancy?
sulfa-containing ABX - kernicterus, avoid during the last weeks of gestation
trimethoprim- hemolytic anemia
fluoroquinolones- impaired cartilage development
tetracyclines- teeth discoloration
When are NSAIDs NOT okay to use during pregnancy?
always okay to use
3rd trimester
1st trimester
2nd trimester
Which of the following is okay to use for HTN in pregnancy?
lisinopril
losartan
labetolol
aliskiren
spironolactone
what is the minimum duration of treatment for an acute thromboembolism?
3 months
12 months
6 weeks after delivery
1 month
Which is NOT a contraindication to breastfeeding?
illicit drug use
HIV +
Concurrent harmful medications
using category B drug
