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CAP PRITE Ninja > Clinical Neurology > Flashcards

Clinical Neurology Flashcards

1
Q

What to observe to assess toddlers gross motor ability? (2x)

A

Getting up from the prone position

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2
Q

Assess coordination in 7 yo?

A

Pretend to walk a tightrope

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3
Q

Aspect of neuro exam in young child that is most subjective and challenging

A

Sensory Exam

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4
Q

Ruling out what condition would make one choose a CT instead of an MRI in a patient with abnormal mental status?

A

Acute brain hemorrhage

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5
Q

7 yo child with new onset esotropia, 1st step in management?

A

Order MRI of brain

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6
Q

Modality of neuro imaging to demonstrate differences in gray and white matter in children w/ schizophrenia and ADHD compared to healthy children

A

MRI

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7
Q

Neuroimaging finding most common in non-accidental head trauma?

A

Subdural hematoma

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8
Q

14 yo falls off a house, brief loss of consciousness, then recovered, 3 hours later becomes unconscious and taken to ER with right dilated pupil. Head CT shows?

A

Epidural hematoma

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9
Q

What findings on CT would make you consider substance-induced neurocognitive disorder from inhalant abuse?

A

1) Global cerebral and cerebellar atrophy

2) Loss of brain mass in thalamus, basal ganglia, pons, and cerebellum

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10
Q

Diagnosing seizures in youth with intellectual disability is more challenging because? (2x)

A

More repetitive and stereotyped behaviors at baseline

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11
Q

Most common aura symptom preceding complex partial seizures? (2x)

A

Anxiety

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12
Q

Medication that may worsen juvenile myoclonic epilepsy?

A

Oxcarbazepine

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13
Q

Preliminary symptom in Landau-Kleffner syndrome?

A

Acquired aphasia

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14
Q

4 yo boy w/ previously normal development is losing responsiveness to parents verbal communication over the past year. He has had 2 tonic-clonic seizures and his EEG shows bilateral independent spike and wave discharges. Diagnosis?

A

Landau-Kleffner Syndrome

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15
Q

Diagnosis of a teenager who has several 2-3 minute episodes of being “in a daze,” smacking lips, fumbling with clothing followed by confusion and sleepiness?

A

Complex partial seizure

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16
Q

Psychotic 17 yo has seizures, most likely lesion location on MRI?

A

Left temporal lobe

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17
Q

What medication used for seizures can decrease IQ?

A

Phenobarbital

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18
Q

Repetitive transcranial stimulation can cause?

A

Induction of seizure

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19
Q

Type of EEG pattern seen in an adolescent with absence seizures and new onset myoclonic jerks, worse in morning after staying up late to work on book report?

A

Brief bursts of generalized 3.5 to 4.0-Hz spike-and-waves

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20
Q

Treatment for child with multiple staring spells and EEG with symmetrical 3-Hz spike and waves?

A

Ethosuximide

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21
Q

8 yo with ADHD well controlled on long acting stimulant with concern of episodes staring out the window during school. EEG shows diffuse alpha rhythm during hyperventilation. Diagnosis?

A

Normal behavior

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22
Q

Child with declining grades in school with staring spells for 8-10 seconds associated with eye blinking several times per day. Next step?

A

EEG

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23
Q

Increased risk of what medication side effect would you be concerned about in a HLA-B*1502 positive female adolescent patient with epilepsy, well controlled on antiepileptic, now presenting with poor concentration, trouble with memory, hair growth on chin, and hyperplasia of gingiva?

A

Stevens-Johnson syndrome

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24
Q

7 yo is conscious during 3 minute episode of mouth twitching and generalized jerking movements. Prognosis?

A

Spontaneous improvement without treatment

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25
Q

What area of the brain are you trying to approximate on an EEG by using nasopharyngeal electrodes inserted into the nostrils?

A

Basal temporal lobe

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26
Q

Most helpful in diagnosis of non-epileptic seizures? (3x)

A

Prolonged video EEG

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27
Q

What serum measurement helps to differentiate between organic and non-epileptic seizures? (2x)

A

Prolactin

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28
Q

In children with psychogenic non-epileptic seizures, most frequent environmental cause?

A

Parental conflict

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29
Q

16 yo patient with 2wk history of progressive left-sided weakness and paresthesias gets worse when promoted to varsity sports. Work-up is normal. What is the best initial approach?

A

Reinforce continuation of daily living and functional tasks

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30
Q

Child with non-epileptic seizures keeps getting sent to ER from school. Why should parents share the diagnosis with the school?

A

Potential risk of inappropriate and invasive medical treatment

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31
Q

Adolescent admitted to peds neuro service due to functional seizures. Best approach for talking with family and patient about conversion disorder diagnosis?

A

Emphasizing that the episodes are involuntary

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32
Q

Abnormal findings would be found on what diagnostic test of patient who needs to brace hands against the floor and walk his hands up his leg to stand?

A

Electromyography (EMG)

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33
Q

Area affected in spinal muscular atrophy?

A

Anterior horn cells

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34
Q

Area of brain affected in young child walking with a broad based lurching gait, moving side to side?

A

Cerebellum

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35
Q

Diagnostic test that would be abnormal in a young child who gets up from ground by walking his hands up his legs, has a waddling gait, and has weak leg and arm strength with normal muscle mass?

A

EMG

36
Q

3 yo with motor weakness, what would be a characteristic of an UMN lesion?

A

Increased deep tendon reflexes

37
Q

Preschool age child presents with hand biting, episodes last seconds to minutes, can be distracted from biting, history of rhythmic movement of hands at 2 yo. Diagnosis?

A

Developmental coordination disorder

38
Q

Deep brain stimulation is recommended in what condition in adolescence?

A

Dystonia

39
Q

Effective way to assess muscle strength in a 3 yo child?

A

Ask child to move from floor to chair

40
Q

Multiple motor tics in 13 year old over the course of six months?

A

Provisional tic disorder

41
Q

Findings from 2015 meta-analysis of placebo-controlled trials of stimulants and tic disorder association?

A

No association between worsening or new tic disorder

42
Q

Treatment for Tourette’s disorder when tics unresponsive to meds or HRT, continues into adulthood, and functionally debilitating?

A

Deep brain stimulation

43
Q

Child presents with headaches. Question to assess for frequency and severity?

A

Number of missed school days due to pain from headache

44
Q

Physician interviews child with possible migraines. What would make physician order a CT scan of head?

A

Abnormal motor exam

45
Q

First line medication for prophylaxis for migraine?

A

Propranolol

46
Q

Medication for migraine prophylaxis that can worsen depression?

A

Propranolol

47
Q

Child has normal neuro exam, but multiple episodes of dizziness, occipital headache, vertigo, hemiparesis, all spontaneously resolve in 24 hours. Diagnosis?

A

Basilar artery migraine

48
Q

Neuroimaging in peds pt w/ migraine is indicated?

A

When there’s no family history of migraine

49
Q

Most frequent comorbidity in patients with TBI?

A

Depression

50
Q

What is the medical condition associated with chronic aggressive behavior?

A

Traumatic brain injury

51
Q

12 yo falls, hits head, unconscious. Then has some difficulty following conversation. Likely course of cognitive function?

A

Complete recovery

52
Q

6 months after TBI, 15 yo with increased forgetfulness, testing shows deficient working memory. Affected cortical area?

A

Prefrontal cortex

53
Q

What request can be used to test the memory of a 15 year old regaining consciousness after MVA?

A

“Use your cell phone to call your parents”

54
Q

Child has Anti-NMDA-Receptor Encephalitis. Pt anxious, confused, waxy flexibility, minimal verbalization and staring episodes. What is initial treatment for motor symptoms? (2x)

A

Lorazepam

55
Q

17 yo has flu-like illness, then psychosis, paranoia, catatonia, and LLQ abdomen mass. Test to order? (2x)

A

Anti-NMDA receptor antibodies

56
Q

16 yo female with memory/confusion issues for three weeks, presents w/ new onset agitation, hallucinations, insomnia, inattention, brief seizure, elevated HR/BP, ovarian lesion on ultrasound, otherwise normal exam. Diagnosis?

A

Anti-N-methyl-d-aspartate receptor encephalitis

57
Q

Adolescent admitted for paranoia, hallucinations, mood lability, then develops facial tics, autonomic instability, obtunded. Adnexal mass on workup. Removal likely to normalize activity of receptor for which neurotransmitter?

A

Glutamate

58
Q

Child has multiple hyperpigmented, ovoid, and smooth macules on the arms, chest, and back with freckling in both axillae. Mother also has macules, freckling in axilla, and optic tumor. What psychiatric symptoms does the child likely have? (2x)

A

Attention-Deficit/Hyperactivity Disorder

59
Q

16 yo adolescent with newly diagnosed Schizophrenia has history of language delay. Pt has long narrow face, small mouth, hypernasal speech with history of cleft palate and ventricular septal defect. Syndrome? (2x)

A

DiGeorge syndrome

60
Q

Which developmental disorders are associated with same locus of chromosome 15, but with different phenotype expression? (2x)

A

Prader-Willi and Angelman

61
Q

Genetic abnormality of velocardiofacial syndrome? (2x)

A

Gene deletion

62
Q

Child w/tumors in brain, heart, and kidneys, seizures, intellectual disability. Likely presents with sx of? (2x)

A

Autism

63
Q

Psychotic adolescent with self-injurious behavior and chorea with elevated LFTs. Diagnosis? (2x)

A

Wilson Disease

64
Q

16 yo male with persistent irritability, depression, and impulsivity despite many medications and therapy. On exam, pt has tremor, drooling, speech problems, and brownish tinge of cornea. Screening tool?

A

24-hour urine copper test

65
Q

Diagnosis for a 14 year old adolescent with defiant behavior at home and school who presents with generalized dystonia, wing-beating action tremor in the arms and forced grin?

A

Wilson disease

66
Q

Highly comorbid with Fragile X?

A

ADHD

67
Q

Common finding in 7 yo with worsening vision in left eye, headaches, skin changes, father also had same skin changes, edema of optic disc seen on exam?

A

Cafe Au Lait spots

68
Q

How can you determine carrier status for Fragile X syndrome for pre-pregnancy planning?

A

Southern blot

S - D
N - R
O - O
W - P

69
Q

What is comorbid with syndrome of hypotonia, obesity, small hands, short stature, micro-orchidism, and paternal deletion of 15q11-15q13?

A

Compulsions

70
Q

Child with hyperphagia, obesity, intellectual disability, aggressive behavior, and obsessive-compulsive tendencies. Result of what genetic error?

A

Deletion

71
Q

15 yo male with intellectual disability, short, hypogonadism, low muscle tone. What other symptom may be present?

A

Hyperphagia

72
Q

What intellectual disability is most commonly associated with OCD?

A

Prader-Willi

73
Q

MRI shows symmetric basal ganglia lesions, child gets up from floor by pushing up with hands, grows progressively weaker. Diagnosis?

A

Mitochondrial disorder

74
Q

How do you rule out a particular condition associated with Down’s syndrome?

A

Echocardiogram

75
Q

What has contributed to the improved ability to identify the ideology for intellectual disability?

A

Genetic factors

76
Q

Young child with seizures, ID, port wine stain on half of face. Diagnosis?

A

Sturge-weber syndrome

77
Q

17 yo patient with malar distribution rash, macules on arms, bright lesions in cortex on MRI indicating tubers. What is the associated psych diagnosis?

A

Autism spectrum disorder

78
Q

Psychiatric disorders most frequently concurrent with Neurofibromatosis I?

A

Autism, Depression, ADHD

79
Q

Child with ADHD having more difficulty getting up from floor to chair over past 6 months. Diagnosis?

A

Duchenne muscular dystrophy

80
Q

Child who repeatedly trips and sprains ankles, climbs up his legs using hands in order to stand. Diagnosis?

A

Duchenne muscular dystrophy

81
Q

Four year old with limited social skills, facial angiomas, hypopigmented spot, absence seizures?

A

Tuberous sclerosis

82
Q

To reduce intellectual disability in patients with homocystinuria, give which vitamin?

A

Vitamin B6

83
Q

Karyotyping is still the preferred test in?

A

Prenatal trisomies

84
Q

Fragile X syndrome genetic abnormality

A

Trinucleotide expansion

85
Q

Genetic syndrome caused by MICROdeletion?

A

Williams syndrome

86
Q

In Rett and Fragile X syndromes, what is the function of Mecp2 (methyl-CpG-binding protein)?

A

Transcription

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