USMLE Forum Archives - USMLE Step 3 - phenytoin
phenytoin
bingousmle - 05-17-10 07:42
30 years female h/o siezure well conrolled with pills recently changed her contraceptives to OCP came in ER with acute attack of seizure. Where she was given phenytoin and seizure was well controlled.Next day on round the medical student saw that her phenytoin level 20(some unit) and eye exam shows horizental nystagmas. He rushed to the resident to do some thing for her.what do you wantto do next?
a)Stop phenytoin
b)Stop phenytoin and cheek blood level
c)Wait and see
D) Cheek LFT
e) Decrease the dose of phenytoin.
bingousmle - 05-17-10 07:42
30 years female h/o siezure well conrolled with pills recently changed her contraceptives to OCP came in ER with acute attack of seizure. Where she was given phenytoin and seizure was well controlled.Next day on round the medical student saw that her phenytoin level 20(some unit) and eye exam shows horizental nystagmas. He rushed to the resident to do some thing for her.what do you wantto do next?
a)Stop phenytoin
b)Stop phenytoin and cheek blood level
c)Wait and see
D) Cheek LFT
e) Decrease the dose of phenytoin.
The correct answer and explanation will be available after you answer.
Page 1
#1
Re: phenytoin mtniharika - 05-18-10 15:54 My answer is: b.
The side effects of phenytoin include nystagmus, ataxia, slurred speech, decreased coordination and mental confusion. Dizziness, insomnia, transient nervousness, motor twitchings, and headaches have also been observed.
#2
Re: phenytoin
bingousmle - 05-19-10 02:53 My answer is: c.
this patient has a horizontal nystagmus which isdue to effect of phenytoin... if it were vertical nystagmus it would be worrisome because it suggests phenytoin toxicity....
#4
Re: phenytoin babbu5508 - 05-25-10 02:35 My answer is: c.
At therapeutic doses, phenytoin produces horizontal gaze nystagmus. At toxic doses, patients experience sedation, cerebellar ataxia, and ophthalmoparesis, as well as paradoxical seizures.
#12
Re: phenytoin pth4usmle - 07-18-11 00:47 My answer is: b.
these are effect of phenytoin high concentration effect in the blood so need to discontinue the medication and check its level
Page 1