# data[].attributes.body
Status epilepticus - It is a type of seizure which continues for a prolonged period (longer than 5 minutes)

Yes, the patient corresponds to the disease.

Treatment: IV Diazepam 10mg at a rate of 1mL(5mg) per miniute, repeat once after 10 minutes if necessary.

# data[].attributes.body
1) drug counselling for patient

2) Readjust the dose according to BNF and monitoring is needed. If the situation is uncontrollable, adjunctive therapy might be needed.

Lamotrigine - Initially 50mg OD for 14 days then increase to 50 mg twice daily. (maintenance dose: 200mg-400mg daily in 2 divided doses)

# data[].attributes.body
1) Inappropriate dose of Carbamazepine - underdose

According to BNF, the maintenance dose should be 0.8g-1.2g daily in divided dose but not 200mg TDS. (0.6g)

2) Inappropriate dose of Naproxen- overdose

According to BNF, the dose should be given 0.5g-1g daily in 1 to 2 divided dose but not 550mg PO BID in rheumatic disease as shown in the patient's case.

3) Poor patient's compliance

# data[].attributes.body
ait re-education, improvement of balance and flexibility

enhancement of aerobic capacity

improvement of movement initiation

improvement of functional independence, including mobility and activities of daily living

provision of advice regarding safety in the home environment.

# data[].attributes.headline
Question 10 How should AB's hematological status be monitored to prevent ADR of CBZ?

# data[].attributes.subject
Question 10 How should AB's hematological status be monitored to prevent ADR of CBZ?

# data[].attributes.body
A. Baseline FBC and if pretreatments are normal then periodically

Patients should have blood and platelet count before treatment. Patients with low white cell and neutrophil counts were at risk of developing leucopenia and should be monitored every 2 weeks for the first 1 to 3 months. If counts fell further the dose should be reduced or treatment stopped. Source: Martindale

# data[].attributes.headline
Question 9 how would you initiate CBZ once the patient is able to take oral medication

# data[].attributes.subject
Question 9 how would you initiate CBZ once the patient is able to take oral medication

# data[].attributes.body
CBZ suspension 200mg PO BID

CBZ initial oral dose 100-200mg 1-2 times daily, increased to 0.8 to 1.2g daily in divided dose (100-200mg increments every two weeks) Source:BNF

# data[].attributes.body
High SrCr: may indicate renal impairment, dehydration, muscle fiber breakdown

Low Hct: volume of blood is much more greater than the volume of RBC. Low RBC concentration in blood may indicate anaemia

Low Hgb: within range but required monitoring, may indicate hemolytic anaemia/sickle cell anaemia, abnormalities in the red blood cell membrane or G6PD deficiency.

Low PLT: may indicate abnormalities in bone marrow or destruction of bone marrow

High ESR: detect presence of inflammation caused by infections, tumor, autoimmune disease with symptoms such as temporal arteritis, systemic vasculatis is and rheumatoid arthritis

ANA: Detect autoimmune disease, such as SLE

High amylase- to diagnose and monitor pancreatitis

High RBC- due to cigarette smoking, congenital heart disease, dehydration, kidney tumor and some medications such as gentamicin and methyldopa

BP168/98: stage 2 hypertesion

HR110: Tachycardia (normal: 100)

RR 20 - normal is 12-16 bpm

Temperature 37.5 (slightly elevated) normal: 37 degree Celsius

# data[].attributes.body
A. IV Phenytoin 100mg q8h

This is because:

B. Incorrect. Carbamazepine is not available in IV form.

C. Incorrect. Ethosuximide is for the treatment of absence seizure.

D. Incorrect. The side effects of Phenobarbital are diminish in memory function and lead to over-dosage of medication.

# data[].attributes.body
Loss of consciousness

Tongue bitting

Jerking movement

Muscle rigidity

# data[].attributes.body
Partial seizure begins at a focal site in the cortex. There are three types of partial seizure: Simple, Complex and Partial Seizure 2nd generalised.

AB is having a complex partial seizure, because she is loss of consciousness and associated with purposeless movement.

# data[].attributes.body
LOA- lose of appetite.

LOW-loss of weight.

ESR-Erythrocytes sedimentation rate

Arthralgias-Joint pain

DRNM-Dual Rhythm No Murmur

NKDA-No Known Drug Allergies

ANA- Antinuclear antibody

SLE- systemic lupus erythematosus

HEENT-head, eyes, ears, nose and throat

GTC- Generalised tonic-clonic