Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Neurologic Disorders--->Seizure Disorder
Page: 2

Question 6#Print Question

A 70-year-old man with a history of coronary artery disease, Alzheimer dementia, epilepsy, and chronic kidney disease is admitted to the ICU after presenting with respiratory failure. He started spiking high fevers on the third day and grew Staphylococcus aureus in his sputum. On the fourth day of admission, he starts to have rhythmic jerking of his left upper extremity with gaze deviation. With lorazepam treatment the episode resolves. An MRI of the brain after the event shows atrophy, prominent in the right temporoparietal regions, with some ex vacuo ventricular dilation.

Which of the following is the MOST likely explanation for this event? 

a. Staphylococcal meningitis in the setting of advanced age
b. Mycotic aneurysms in the cerebral vasculature as a result of hematogenous spread
c. Lowered seizure threshold in the setting of critical illness
d. Amyloid spells in advanced Alzheimer disease, in the setting of critical illness
e. Late manifestation of hypoxic injury in a patient with baseline brain atrophy

Question 7#Print Question

A 69-year-old woman with excessive alcohol intake (2 bottles of wine a day) suffers an out-of-hospital cardiac arrest. She receives several rounds of cardiopulmonary resuscitation, achieves return of spontaneous circulation, and is brought to the hospital. She undergoes 24 hours of therapeutic hypothermia. Her urine drug screen is positive for benzodiazepines. After rewarming, she is found to have rapid twitching movements of her face and extremities. An EEG is attached and it shows abnormal rhythmic activity.

Which of the following is MOST true about this condition?

a. Presence of EEG activity is an indicator of high chance of recovery at 6 months
b. Postanoxic myoclonic status epilepticus is an indicator of poor prognosis
c. Oxcarbazepine and topiramate are the only agents with proven efficacy in controlling these movements
d. Diagnostic lumbar puncture is essential to rule out meningitis in these cases
e. This is likely a manifestation of brain irritability secondary to benzodiazepine withdrawal

Category: Critical Care Medicine-Neurologic Disorders--->Seizure Disorder
Page: 2 of 2