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Adie Pupil – Pilocarpine — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardNeuro-ophthalmologyAdie Pupil – PilocarpineSCE Neurology

Cannabidiol is started in a patient with tuberous-sclerosis-associated seizures who also takes valproate and has normal baseline liver tests. Which monitoring plan reflects the higher-risk SmPC pathway?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — ALT, AST and bilirubin at 2 weeks, 1, 2, 3 and 6 months, then periodically

Explanation lettering: D = shown as A · A = shown as D

C is correct: concomitant valproate places the patient on intensified monitoring—transaminases and bilirubin at 2 weeks, 1, 2, 3 and 6 months, then periodically; the schedule restarts after relevant dose or interacting-drug changes. A and E under-monitor the highest-risk early period. B omits the principal injury markers and bilirubin. D targets a different valproate complication. Normal baseline results do not remove the valproate-associated cannabidiol risk.

Reference: Epidyolex 100 mg/mL oral solution SmPC: https://www.medicines.org.uk/emc/product/10781/smpc