EBCOG Part 1-Maternal Medicine-Day 1(SBA)

1.You review a 26 year old epileptic woman on the postnatal ward following a ventousedelivery.She is taking lamotrigine & is keen to breast feed.Her last fit was 2 mths prior to delivery.What advise would you give her?

2. A 32 year old woman planning a pregnancy comes to the preconceptional clinic.She is a known epileptic since age of 10.The following is true about AEDs in pregnancy,except known epileptic since age of 10.The following is true about AEDs in pregnancy,except

3.Which of the following conditions results from failure of the anterior neuropore to close?

4. The choroid plexus of the fourth ventricle is derived from the

5.Stroke is the second leading cause of death and third leading cause of adult disability, with —— people at risk of experiencing a stroke in their lifetime.

6.CVT can be variable in its clinical presentation, with only —-% of patients presenting with typical stroke symptoms and signs .

7. FAST campaign for stroke is

8..This campaign is for

9.Epilepsy is one of the most common neurological conditions in pregnancy, with a prevalence of

10. which is the strongest risk factor for SUDEP ?

11.An Epileptic drug whose efficacy is reduced if used concomitantly with combined oral contraceptive pills

12. Mrs. Sara, 34year old is known Epileptic , para1Living1 , just delivered by forceps .she was on carbamazepine , dose and frequency was increased during pregnancy ,To avoid postpartum toxicity, of antiepileptics, when she should be reviewed ?

13. Mr. Sara , is now14 weeks pregnant in her second pregnancy .She is a known case ofepilepsy .her first delivery was normal Vaginal delivery , first child is 8year old and diagnosed tohave epilepsy .what is risk of this baby having epilepsy

14. Mr. Sara , is now14 weeks pregnant in her second pregnancy .She is a known case of epilepsy and on tab. Levatricetam. ,her first delivery was normal Vaginal delivery , first child is 8year old and diagnosed to have epilepsy .What’s her risk of not having seizure deterioration in pregnancy ?

15. Mrs. Roma , is here for preconceptional counselling .She is a known case of epilepsy and on tab. Lamotrigine. ,her first delivery was normal Vaginal delivery , first child is 8year old and diagnosed to have epilepsy .You explain to the changes in the pharmacokinetics of absorption, metabolism for these AED &fall of drug level leading to seizures .she ask u upto what —-% lamotrigine are known to fall in pregnancy.?

16.  Mr. Shamna, is now 34 weeks pregnant in her second pregnancy .She is a known case of epilepsy and on antiepileptics . Her first delivery was normal Vaginal delivery , the first child is 8year old and diagnosed to have epilepsy .you explain that the baby has to receive vitamin K, as it increases the risk of haemorrhagic disease of the newborn. All of the drugs can have this effect except

17.Mr. Shamna, delivered 24hrs before he is a known case of epilepsy and on phenobarbitone Her first delivery was normal Vaginal delivery , the first child is 8year old and diagnosed to have epilepsy .She is requesting for postpartum contraception .which one of these are safest ?

18. An 18-year-old woman with epilepsy booked at 14 weeks of gestation in her second pregnancy. Three years previously she had had a termination of pregnancy. Her current pregnancy was unplanned, but she was happy to continue it. She is certain of her menstrual dates. She has not taken folic acid. She has had one fit since she conceived. She was taking phenytoin and sodium valproate. She has an epileptic seizure approximately once a year, mostly when she forgets her tablets or drinks too much alcohol. She smokes 20 cigarettes daily. She had no other medical problems. She lives with her mother, has a supportive partner and works in a local shop. She does not have a driving licence.whch of the following statement is true?

19. A 26-year-old obese white women at 34 weeks of gestation presented to triage with history of waking up with headache that has been gradually worsening. The headache is associated with nausea, one episode of vomiting, intermittent tingling in her left arm and blurring of vision in left eye. She has past history of headaches; however, they have not been so intense.

Body mass index = 40

Blood pressure = 130/80 mmHg

Pulse rate = 78 per minute

Respiratory rate = 13 per minute

Temperature = 37.2°C.

There is no neurological deficit and neck stiffness, normal fundoscopy and no pedal oedema.

Haematology: WBC = 9.0 x109/l, Hb = 134 g/l, platelets = 325, ESR = 5

Biochemistry: CRP = 2, liver function tests and U&Es are within normal limits

Urinalysis: protein negative, glucose negative, pus cells positive, WBC negative, nitrite negative.

What would be the most likely cause of her headache?

20.A 25-year-old nulliparous woman requests contraception. She has epilepsy, which is wellcontrolled with carbamazepine.Which contraceptive option is most suitable for her?