Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PNP Boards > Neurological Disorders > Flashcards

Neurological Disorders Flashcards

1
Q

A typical febrile seizure is most likely to be the problem of which of the following children?

a) a 1 yo with otitis media and a fever of 104
b) a 3 mo with unequal pupils and bulging fontanels
c) an 11 yo with a fever of 101 who is on valproic acid for a seizure disorder
d) a 5 yo with bacterial meningitis

A

a) a 1 yo with otitis media and a fever of 104

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which of the following responses during a tonic-clonic seizure is most important to teach family members of a child who has these seizures?

a) restrain the child
b) insert an airway into the mouth to prevent tongue biting
c) note the time, duration, and activity of the seizure
d) protect the child from injury

A

d) protect the child from injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which of the following is an appropriate strategy to instruct the parents of an 18 mo child who has just been diagnosed with a febrile seizure and who has a fever of 104?

a) give aspirin every 4 hours for temp over 101
b) bathe with tepid water
c) dress warmly to avoid chills
d) first aid management during a seizure

A

d) first aid management during a seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the primary public health measure to decrease the incidence of bacterial meningitis in infants and children?

a) keeping infants and young children away from crowded places
b) set up screening measures in schools
c) routinely giving immunizations such as Hib and PCV7
d) provide written information about meningitis to high school students

A

c) routinely giving immunizations such as Hib and PCV7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The type of seizure that first presents during infancy in which the infant goes into a “jack-knife” posture is:

a) febrile seizure
b) infantile spasm
c) absence seizure
d) atonic “drop” attacks

A

b) infantile spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which of the following would not be associated with an uncomplicated concussion?

a) focal motor signs
b) brief loss of consciousness
c) headache
d) confusion or amnesia for the event

A

a) focal motor signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which of the following factors is not usually present in a 4 yo with migraine headaches?

a) complaints of pain on one side of the head only
b) positive family history in immediate relatives
c) pain relieved by brief sleep
d) recurrent abdominal pain

A

a) complaints of pain on one side of the head only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The parents of a 13 mo are very concerned after she experienced a second simple febrile seizure. At today’s visit, they ask you about the use of medications to prevent any further seizures. Which of the following statements is true about febrile seizure prophylaxis?

a) short-term anticonvulsant prophylaxis with valproic acid is indicated after 3 febrile seizures
b) prolonged anticonvulsant prophylaxis with phenobarbital for preventing recurrent febrile convulsions is now recommended
c) diazepam may be indicated for children

A

c) diazepam may be indicated for children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Problems associated with NF1 most likely to require medical treatment include which of the following?

a) learning disabilities
b) transient tics
c) obsessive-compulsive behavior
d) progressive mental retardation

A

a) learning disabilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

An 11 yo girl is brought into the clinic complaining of severe headaches associated with nausea and vomiting. Which of the following signs and symptoms would lead you to consider brain tumor as part of your differential?

a) throbbing pain accompanied by severe light sensitivity
b) bilateral throbbing pain
c) preceded by a visual aura
d) more severe in the morning followed by vomiting

A

d) more severe in the morning followed by vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The NIH Consesus conference on NF describes guidelines for diagnosis of NF. Which of the following is not among the diagnostic criteria?

a) family history of first degree relative with NF1
b) 6 or more cafe au lait spots > 15 mm in prepubertal child
c) freckling in armpits and groin
d) optic glioma

A

b) 6 or more cafe au lait spots > 15 mm in prepubertal child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Although meningitis related mortality decreases dramatically after the neonatal period, as many as 50% of survivors experience some sequelae. Which of the following is the most frequent post-meningitis sequela in older infants and children?

a) motor deficits
b) seizures
c) language delays/disorders
d) visual impairments

A

c) language delays/disorders

Hearing deficits are almost equally as common.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A neonate is being worked up for meningitis after experiencing a seizure preceded by fever, irritability, and poor feeding for one day. On PE which of the following findings would be most consistent with a diagnosis of meningitis?

a) bulging fontanel
b) positive brudzinski’s sign
c) nuchal rigidity
d) positive Kernig’s sign

A

a) bulging fontanel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnostic criteria for Tourette syndrome include which of the following?

a) must have both motor and vocal tics
b) steadily increasing pattern of motor tics
c) presence of any tic for 6 months
d) multiple motor tics with significant voluntary control

A

a) must have both motor and vocal tics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which of the following statements about Tourette syndrome is not true?

a) it is the most severe type of tic disorder
b) it is more common among males than females
c) mean age at onset is between 6 & 7 years
d) symptoms decrease after puberty

A

d) symptoms decrease after puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A prominent feature in a simple partial seizure is:

a) very short postictal drowsiness
b) microcephaly
c) bilateral tremors
d) no loss of consciousness

A

d) no loss of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Absence seizures:

a) often begin between 1 & 2 years of age
b) appear as altered awareness and blank stare for a brief period
c) more commonly occur in first-born children
d) usually progress to a more severe seizure disorder

A

b) appear as altered awareness and blank stare for a brief period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The differential diagnosis for seizures includes which of the following:

a) poliomyelitis without paralysis
b) schizophrenia
c) complicated migraine headaches
d) multiple sclerosis

A

c) complicated migraine headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The most useful diagnostic tool for diagnosing epilepsy is:

a) MRI
b) EMG
c) EEG
d) CT scan

A

c) EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which of the following is a primary drug used for treatment of generalized tonic-clonic seizures?

a) ethosuximide
b) valproic acid
c) clonazepam
d) corticosteroids

A

b) valproic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which of the following is included in the diagnostic criteria for migraine headache in postpubertal children?

a) recurrent abdominal pain, throbbing head pain not relieved by sleep
b) nausea and vomiting, positive family history, aura
c) positive family history, vomiting without nausea, pain not relieved by sleep
d) aura, positive family history, pain in both hemispheres of the brain, relieved by sleep

A

b) nausea and vomiting, positive family history, aura

22
Q

The type of head injury that is easily treatable but potentially the most lethal is:

a) concussion
b) epidural hematoma
c) acute subdural hematoma
d) linear skull fracture

A

b) epidural hematoma

23
Q

Tuberous sclerosis is a progressive, neurocutaneous syndrome in which there is a combination of:

a) skin abnormalities, blindness, and cognitive deficits
b) skin abnormalities, seizures, cognitive deficits
c) cerebral palsy, cognitive deficits, and skin problems
d) skin abnormalities, blindness, and cognitive deficit

A

b) skin abnormalities, seizures, cognitive deficits

24
Q

Inheritance of tuberous sclerosis is by:

a) autosomal dominant mutant gene
b) fragile x chromosome
c) autosomal recessive mutant gene
d) trisomy 23

A

a) autosomal dominant mutant gene

25
Q

The most important diagnostic measure for identifying tuberous sclerosis is:

a) EEG
b) thorough neurological physical exam
c) MRI
d) skin biopsy

A

c) MRI

26
Q

For children 1-4 yo the most common cause of head injury is:

a) MVA
b) falls
c) child abuse
d) tricycle accidents

A

b) falls

27
Q

A senior in high school suffers a concussion playing football. Immediately following the event a typical clinical picture would include:

a) brief loss of consciousness and/or amnesia
b) confusion and lethargy lasting about 2 hours
c) slowed and sometimes unequal pupil response
d) associated Battle sign

A

a) brief loss of consciousness and/or amnesia

28
Q

A head injury in which bruising or tearing of the cerebral structures occurs is a:

a) contusion
b) concussion
c) hematoma
d) diffuse axonal injury

A

a) contusion

29
Q

The most common type of skull fracture in children with an excellent prognosis is:

a) depressed
b) basilar
c) linear
d) simple

A

c) linear

30
Q

Which of the following is most likely to be the etiologic cause of meningitis in the newborn?

a) Neisseria meningitidis
b) Escherichia coli
c) Streptococcus pneumoniae
d) Haemophilus influenzae B

A

b) Escherichia coli

31
Q

Drug therapy commonly used to treat absence seizures, in addition to valproic acid, includes:

a) phenytoin
b) phenobarbital
c) carbamazpine
d) benzodiazepines

A

c) carbamazpine

32
Q

A 5 mo boy born at 28 weeks gestation is being evaluated due to concern about delayed motor development. In formulating the differential diagnosis, you keep in mind that spastic CP is characterized by:

a) increased DTRs and sustained clonus
b) dystonic posturing
c) abnormal involuntary movements
d) nystagmus

A

a) increased DTRs and sustained clonus

In spastic CP, a lowered reflex threshold results in incrased DTRs and sustained clonus.

33
Q

A 4 yo child with a history of myelomeningocele and a ventriculoperitoneal shunt presents to the clinic with a headache, nausea, vomiting, and lethargy. The most probable diagnosis is:

a) viral gastroenteritis
b) shunt malfunction
c) meningitis
d) shunt infection

A

b) shunt malfunction

Headache, nausea, vomiting, and lethargy are frequently associated with malfunctioning shunt systems.

34
Q

A healthy child enrolled in Head Start is suspected of having developmental delays based on Denver II results at 2 separate clinic visits. The most appropriate next step would be:

a) request developmental evaluation from the Head Start program
b) repeat the Denver II in 6 months
c) refer the child for a more definitive evaluation
d) discuss ways in which parents can foster the child’s development

A

c) refer the child for a more definitive evaluation

If a developmental lag is suspected based on repeated performances on the Denver II, a more definitive assessment should be obtained.

35
Q

A 6 mo is recovering from a viral illness. At the peak of her illness (2 days ago) she spiked a temp of 104 and experienced a febrile seizure. Her mother wants to know if the seizure will “do anything” to her daughter. While teaching this mother about febrile seizures, it would be accurate to say that the patient:

a) is at increased risk for epilepsy as an adult
b) would benefit from phenytoin prophylaxis
c) may experience repeated seizures
d) would benefit from phenobarbital prophylaxis

A

c) may experience repeated seizures

Children with simple febrile seizures may experience repeated febrile seizures, particularly if the first seizure occurred before 1 year of age.

36
Q

Which of the following signs is not characteristic of generalized seizures?

a) unilateral motor manifestations
b) disturbance of consciousness
c) tonic stiffening of the trunk
d) simultaneous and symmetric cerebral hemisphere discharge

A

a) unilateral motor manifestations

In generalized seizures, motor manifestations, if any, are bilateral.

37
Q

Which of the following is the primary diagnostic tool used in the evaluation of seizure disorder?

a) EEG
b) cerebral blood flow studies
c) CT scan
d) MRI

A

a) EEG

In the study of seizure disorders, the EEG has the greatest clinical applicability. The other imaging techniques are considered supplemental.

38
Q

Upon PE of a 4 yo boy you notice 7 cafe au lait spots greater than 5 mm in diameter. This finding may be indicative of:

a) Tuberous sclerosis
b) Sturge-Weber disease
c) Duchenne’s dystrophy
d) Neurofibromatosis

A

d) Neurofibromatosis

More than 6 cafe au lait spots greater than 5 mm in diameter in prepubertal children is an essential part of the diagnosis of neurofibromatosis

39
Q

A 15 yo boy is being seen for a sports physical. He appears to be in good health but is concerned about a bad headache he had a few weeks ago, because his mother’s friend died of a brain tumor. You tell him that the most common type of headache with onset in adolescence is:

a) sinus headache
b) vascular headache
c) tension headache
d) migraine headache

A

c) tension headache

The most common headache in adolescents is the tension, or psychogenic headache.

40
Q

An 18 yo college freshman is seen in the student clinic with a complaint of migraine headaches. In collecting the history, you would expect him to say he experiences pain:

a) throughout his head without any localization
b) restricted to one side of his head during an episode
c) mostly in the occipital area
d) across his head from one temporal side to another

A

b) restricted to one side of his head during an episode

After puberty, migraine headache pain is restricted to one side of the head but may switch sides from one headache episode to the next.

41
Q

Which of the following historic points would not alert the practitioner to the possibility of brain tumor?

a) headache in the morning associated with vomiting
b) FTT and developmental delay in young children
c) school failure and personality changes in older children
d) sleep apnea

A

d) sleep apnea

Brain tumors can be associated with morning headaches, vomiting, and behavioral changes.

42
Q

Which of the following signs is not scored on the Glasgow Coma Scale?

a) eye opening
b) verbal response
c) upper limb response
d) fine motor response

A

d) fine motor response

43
Q

A 2 yo boy tripped on the sidewalk and hit his head on concrete. Which of the following symptoms reported by his father would require a visit to the ED?

a) uncontrollable crying
b) loss of consciousness
c) scalp laceration
d) history of febrile seizure

A

b) loss of consciousness

Emergency care should be sought following head trauma if the child is unresponsive.

44
Q

A 2 yo is evaluated in the ED for a closed head injury following a 10 foot fall from an open window. When interpreting diagnostic imaging results you are aware that the most common and generally the least serious type of skull fracture is:

a) basilar fracture
b) compound fracture
c) depressed fracture
d) linear fracture

A

d) linear fracture

The linear fracture is the most common and has little serious clinical implication, unless it overlies a vascular channel or penetrates an air sinus.

45
Q

A 12 mo child whose parents have a history of noncompliance for routine care presents to the clinic with fever, irritability, and nuchal rigidity. The most critical diagnostic step in the child with suspected meningitis is:

a) the history
b) the PE
c) evaluation of the CSF
d) blood culture

A

c) evaluation of the CSF

Collection of the CSF is the most critical diagnostic step in the child with suspected meningitis, based on the history and physical exam.

46
Q

In a child with suspected meningitis, the LP should be delayed and a CT scan obtained first in which of the following circumstances?

a) signs of increased ICP
b) tachycardia
c) negative Brudzinski sign
d) the WBC count is greater than 10,000

A

a) signs of increased ICP

If elevated ICP is suspected, a CT scan should be obtained first to avoid the compliation of cerebellar or uncal herniation.

47
Q

Primary immunization is of paramount importance for preventing menengitis in young children that is caused by:

a) Haemophilus influenzae type b
b) Neisseria meningitidis
c) Escherichia coli
d) Klebsiella pneumonia

A

a) Haemophilus influenzae type b

HIB is part of the recommended primary immunization schedule.

48
Q

the most common type of brain tumor in children is:

a) ependymoma
b) brain stem tumor
c) craniopharyngioma
d) medulloblastoma

A

d) medulloblastoma

Medulloblastomas are the most common brain tumors of childhood.

49
Q

In most states, a learning disability is defined based on:

a) the child’s IQ as determined by a psychological evaluation
b) a discrepancy between the child’s actual and expected achievement
c) a diagnosis of attention deficits
d) achievement test scores

A

b) a discrepancy between the child’s actual and expected achievement

In most states a learning disability means a discrepancy between the child’s actual and expected achievement.

50
Q

Which of the following is a measure of childhood intelligence?

a) Wechsler scales
b) Denver II
c) Bayley scales
d) Vineland scales

A

a) Wechsler scales

The Wechsler scales measure intelligence, the other scales measure development and adaptive behavior.

51
Q

In working with a child with Tourette syndrome the NP should be aware that:

a) symptoms become more unpredictable during adolescence
b) boys are more likely than girls to exhibit behavioral problems such as OCD
c) sleep disturbance from tics increases with age
b) there are several medications now available to control the tics without interfering with daily functioning

A

a) symptoms become more unpredictable during adolescence

Changing hormones make the symptoms more unpredictable.

52
Q

There are several skin features seen with tuberous sclerosis. Which of the following is most characteristic?

a) cafe au lait spots
b) blue or purple striae
c) papules in a “christmas tree” pattern
d) hypopigmented macules in an “ash leaf” shape

A

d) hypopigmented macules in an “ash leaf” shape

Hypopigmented macules in an elliptical shape are characteristic and are often described as “ash leaf” spots.

PNP Boards (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions