Neuro and developmental

Question 1

Genetic abnormality in Turners syndrome

Answer 1

• 45X

Question 2

What cardiac abnormalities are common in children with turners syndrome

Answer 2

• bicuspid valve (aortic stenosis)
• coarctation of aorta

Question 3

What renal malformation is commonly seen in girls with turners syndrome

Answer 3

• horseshoe kidney

Question 4

Most common cause of meningitis in ages < 1 month

Answer 4

• Group B strep = strep agalactiae (70%)
• Listeria monocytogenes

Question 5

Tx for meningitis in children < 1 month

Answer 5

• Ampicillin (for listeria) + cefotaxime or aminoglycoside

Question 6

Most common pathogens causing meningitis in 1 month - 18 y.o.

Answer 6

• N. meningitidis (associated with a petechial rash)
• S. Pneumo

Question 7

Tx for meningitis for 1 mo-18 y.o.

Answer 7

• Ceftriaxone + vancomycin

Question 8

Most common cause of meningitis in 18 y.o. To 50 y.o.

Answer 8

• strep pneumo (50%) MC
• N. Meningitidis (assoc with petechial rash)

Question 9

Tx for bacterial meningitis in 18 y.o. To 50 y.o.

Answer 9

• ceftriaxone + vancomycin

Question 10

Most common cause of bacterial meningitis in adults > 50 y.o.

Answer 10

• Step pneumo
• listeria monocytogenes

Question 11

Tx for bacterial meningitis in adults > 50 y.o.

Answer 11

• Ampicillin + ceftriaxone +/- vancomycin

Question 12

What is Kernig sign

Answer 12

• Thigh is flexed at hip and knee is at 90 degrees
• subsequent extension of knee is painful

Question 13

Brudzinski’s sign

Answer 13

• neck flexion produces knee/hip flexion

Question 14

What you expect CSF analysis to be for bacterial meningitis in terms of

• neutrophils
• glucose
• total protein
• CSF pressure

Answer 14

• neutrophils: increased (100-10,000)
• glucose: decreased ( < 45)
• total protein: high (> 200)
• CSF pressure: increased

** if glucose is normal, then viral meningitis is most likely. IF WBC are predominantly neutrophils, then it is likely bacterial

Question 15

Post exposure prophylaxis medication for exposure to meningitis

Answer 15

• ciprofloxacin

Question 16

MC cause of viral meningitis

Answer 16

• enterovirus family (echovirus, coxsackie) MC
• arboviruses second

Question 17

Meningeal sx associated with normal cerebral function is more consistent with viral or bacterial meningitis

Answer 17

Viral

Question 18

Febrile seizures are most common in what age group

Answer 18

• 3 months to 5 y.o.

Question 19

What two imaging studies must be performed after a seizure

Answer 19

• neuroimaging: CT or MRI
• EEG

Question 20

Which vaccination is given at birth

Answer 20

Hepatitis B

Question 21

Which vaccines are given at 2 months, 4 months, and 6 months

Answer 21

• Hep B #2-4
• HIB #1-3
• DTAP/IPV #1-3
• Prevnar #1-3

Question 22

Which vaccines are given at 12 months

Answer 22

• MMR #1
• Varivax #1
• Prevnar #4

Question 23

Which vaccines are given at 15 months

Answer 23

• Hep A #1
• Dtap #4
• HIB #4

Question 24

Which vaccine is given at 2 years

Answer 24

• hep A #2

Question 25

Which vaccines are given between 4-6 yrs of age

Answer 25

* Varivax #2 * MMR #2 * DTAP #5 * IPV #4

Question 26

Which vaccines are given at ages 10-12 y.o.

Answer 26

* Tdap * meningococcal vaccine