Home

Topic: Seizure
Subject: Medicine
A 75-year-old male is brought to your office 1 month after a stroke that involved the left anterior cerebral artery, manifested by leg weakness, initial incontinence, and slowness in mentation. He experienced seizure activity on the second day after his stroke, but this was controlled by phenytoin (Dilantin). He has improved significantly and is now ambulatory. His family states that he now has episodic confusion, sleepiness, and clumsiness, which is preceded by paresthesias and dizziness, although no tonicclonic activity has been noted. He remains very drowsy for several hours after these episodes. He was wearing a cardiac monitor during one episode, but it showed nothing remarkable. His phenytoin level is therapeutic, and a CBC, metabolic profile, and magnesium level are all normal.
Which one of the following would be the most appropriate next step?

A. Discontinue the phenytoin

B. Add phenobarbital to the phenytoin

C. Begin bupropion (Wellbutrin)

D. Begin lamotrigine (Lamictal)

Please do not use chat terms. Example: avoid using "grt" instead of "great".

You can do it
  1. Topic: Mini Mental Status Exam (or MMSE)Subject: MedicineWhile performing the Mini-Mental State Exam…
  2. Topic: Delirium TremensSubject: MedicineYou see a 49-year-old man in the emergency room with a 20-year-history…
  3. Topic: Normal Pressure HydrocephalusSubject: MedicineAn 81-year-old female is brought to your office…
  4. Topic: Trigeminal NeuralgiaSubject: MedicineA man complains that recently when he shaves he has a shooting…
  5. Topic: Organophosphate poisoningSubject: MedicineWhat is the mechanism of action in organophosphate…
  6. Topic: Temporal ArteritisSubject: MedicineA 75-year-old female presents with a 2-month history of bilateral…
  7. Topic: Alzheimer's DiseaseSubject: MedicineWhich one of the following has NOT been identified as a risk…
  8. Topic: Peripheral NeuropathySubject: MedicineA 68-year-old male presents to your department complaining…
  9. Topic: Temporal ArteritisSubject: MedicineA female patient complains of a severe headache and jaw pain…
  10. Topic: Temporal Lobe LesionSubject: MedicineA 40 year old man presents with sporadically occurring behaviour…
  11. Topic: Status EpilepticusSubject: MedicineWhich one of the following should be given intravenously in…
  12. Topic: DementiaSubject: MedicineAn 85 year old white male is brought to you for the first time by his…
  13. Topic: SeizureSubject: MedicineA 68-year-old man with a history of urolithiasis, suffered from a seizure…
  14. Topic: Neurologic painSubject: MedicineA 21-year-old man presented to the emergency hospital with severe…
  15. Topic: Guillain-Barr syndromeSubject: MedicineGuillain-Barr syndrome is not associated with which of the…
  16. Topic: Essential TremorSubject: MedicineWhich one of the following is most likely to be of benefit in…
  17. Topic: Glasgow Coma ScaleSubject: MedicineA 27 year old man is brought into the ER after a bicycling…
  18. Topic: Bell's PalsySubject: MedicineA 53-year-old male accountant comes to your office with progressive…
  19. Topic: Dementia Subject: MedicineAll of the following dementias can benefit from specific treatments,…
  20. Topic: Brain DeathSubject: MedicineA 35 year old man has been on life support systems for the past 48…
  21. Topic: Subarachnoid HemorrhageSubject: MedicineA 25-year-old male presents 5 hours after the onset of…
  22. Topic: Essential TremorSubject: MedicineA 75 year old white male complains of a tremor which has been…
  23. Topic: Subarachnoid HemorrhageSubject: MedicineA 36-year-old female presents with the sudden onset of…
  24. Topic: Mini Mental Status Exam (or MMSE)Subject: MedicineIn healthy adults, performance on the Folstein…
  25. Topic: Diagnostic InvestigationsSubject: MedicineA 52 year old male with a history of psychosis presents…
  26. Topic: Horner's SyndromeSubject: MedicineA 66-year-old diabetic man presents with constriction of the…
  27. Topic: SeizureSubject: MedicineA 75-year-old male is brought to your office 1 month after a stroke that…
  28. Topic: Tension headache.Subject: MedicineA woman presents with chief complaint of tightening, band-like…
  29. Topic: Status EpilepticusSubject: MedicineA 58-year-old male with a history of seizure attacks suffered…
  30. Topic: Brain DeathSubject: MedicineA 30 year old man has been on life support systems for the past 48…