NEUROLOGY Flashcards
ADHD patients can best be managed with one of the following:
a. Stimulants
b. Clonidine
c. Methylphenidate
d. structured routine response consistency
Which of the following findings is alarming and should prompt the physician to do further investigation?
a. Moro & parachute reflexes in a 6-month old
b. An infant who feeds from a spoon by 18 months old
c. Retinal hemorrhages in a full-term
neonate delivered via vaginal delivery
d. Soft cranial bruit over the anterior fontanel in a 40-month old with febrile illness
d. Soft cranial bruit over the anterior fontanel in a 40-month old with febrile illness
The following are risk factors for recurrence of febrile seizures EXCEPT:
a. Fever is > 38C
b. less than 1 year old
c. duration of fever < 24 hrs
d. family history of febrile seizure
d. family history of febrile seizure
Which of the following statements is true regarding tuberous sclerosis complex (TSC)?
a. The hallmark of TSC is a cortical tuber best demonstrated in brain MRI
b. To count as a major feature, at least 3 hypermelanotic macules must be present
c. Spontaneous genetic mutations occur in majority of cases resulting to loss of tumor suppression
d. Brain MRI is recommended every 1-3 years for those with symptomatic subependymal giant cell astrocytomas (SEGA)
a. The hallmark of TSC is a cortical tuber best demonstrated in brain MRI
Epilepsy is a paroxysmal brain disorder characterized by the following, except
a. Has a lifetime predisposition to generate seizures
b. Etiology may be structural, metabolic, infectious, or unknown
c. Considered when there is at least 1 unprovoked seizure plus an associated neurodevelopmental abnormality
d. Can lead to intellectual disability if left unrecognized or untreated
c. Considered when there is at least 1 unprovoked seizure plus an associated neurodevelopmental abnormality
The prevalence of cerebral palsy increases in the following conditions, except
a. Antenatal infection
b. Death of a twin in utero
c. Magnesium sulfate in preterm labor
d. Enhanced survival of very premature infants
d. Enhanced survival of very premature infants??
or c?
The neurodevelopmental function (cognition) is dependent mainly on the development of the following functions EXCEPT
a. sensory and motor
b. Language
c. Visual–spatial
d. Intellectual
e. cerebeller
e. cerebeller
Diagnosis of autistic spectrum disorder (ASD) depends partly but importantly on assessment of language. All the following may raise your concern regarding language development and may indicate ASD EXCEPT
a. absent babbling by 6 months
b. absent gestures by 12 month
c. absent single words by 16 month
d. absent 2-word purposeful phrases by 24
month
a. absent babbling by 6 months
One of the following neurologic signs and/or symptoms is most useful in the localization of a CNS lesion?
a. Unsteadiness while sitting in a 6-year old
b. Extension of the great toe & fanning of the remaining toes on stimulation of the lateral aspect of the sole of the foot in a
neonate
c. Seizures with lethargy & nuchal rigidity in any age
d. Incomplete abduction of the eyes on lateral gaze
d. Incomplete abduction of the eyes on lateral gaze??
.Juvenile myoclonic epilepsy is also known as:
a. Janz syndrome
b. West syndrome
c. Dravet syndrome
d. Lennox-Gastaut syndroe
a. Janz syndrome
All the following should raise the suspicion of autistic spectrum disorders (ASD) EXCEPT
a. sibling with ASD
b. playmate concern
c. parental concern
d. caregiver concern
e. Epediatrician concern
b. playmate concern
Benign Rolandic Epilepsy or Benigh Childhood Epilepsy shows the following characteristics EXCEPT:
a. seizures resolve y 16 years
b. it is a single nocturnal seizure
c. altered consciousness is common
d. postictal confusion and aura are rare
c. altered consciousness is common
??
The following are indications for neuroimaging in a child with a headache EXCEPT
a. frontal headache
b. brief cough headache
c. abnormal neurologic examination
d. headache worst on first awakening
e. migrainous headache in the child with no family history of migraine
a. frontal headache
occipital dapat
In the evaluation of the first seizure, magnetic resonance imaging (MRI) should be seriously considered in all of the following conditions, except
a. Children < 1 -year old
b. Benign partial epilepsy of childhood
c. Unexplained acute psychosis
d. Electroencephalography showing
secondary generalized epilepsy
b. Benign partial epilepsy of childhood
The following are TRUE about Absence seizures EXCEPT:
a. last for > 30 secs
b. common in >6 yrs old
c. not associated with postictal state
d. patients resume activity after a seizure
a. last for > 30 secs
All the following are red flags in the history of children with specific learning disorders (SLD) EXCEPT
a. parents concern about academic performance
b. inconsistency in marks report from grade to grade
c. struggling with home work activities
d. positive vision or hearing test
e. positive standard screening test
b. inconsistency in marks report from grade to grade
?
Of the following, the MOST common presenting behavior in girls with attention-deficit hyperactivity disorder is:
a. inattentive
b. hyperactive
c. impulsive
d. disruptive
e. combined
a. inattentive
The initial management of a febrile seizure in an emergency room setting is:
a. start IV fluids
b. securing the airway
c. give diazepam per rectum
d. give paracetamol per rectum
b. securing the airway
A 4-month old girl presenting with status epilepticus at the emergency room was noted to have an occipital cephalhematoma on palpation of the head. What is the imaging modality of choice to evaluate for intracranial hemorrhage and to rule out a skull fracture?
a. Skull x-ray
b. Cranial ultrasound
c. Plain cranial CT scan
d. Cranial MRI
c. Plain cranial CT scan
Which is a red flag for an 8 month old child?
a. not saying “dada”
b. not interested in “peek-a-boo”
c. not able to hold a rattle on both hands
d. does not stand while holding on
b. not interested in “peek-a-boo”
The following is a gross motor red flags EXCEPT
a. @ 4 years old, does not hop
b. @ 5 mos, does not roll over
c. @ 7 mos, does not sit with support
d. @ 10 mos, does not stand while holding on
c. @ 7 mos, does not sit with support
dapat without support
Guillain Barre Syndrome is an autoimmune disorder of postinfectious polyneuropathy involving mainly motor but also sensory and sometimes autonomic nerves.All the following are required in diagnosis EXCEPT
a. CSF study
b. muscle biopsy
c. electromyography
d. sural nerve biopsy
e. motor nerve conduction study
Matching type: Summary of neurocutaneous syndromes.
NEUROFIBROMATOSIS // TUBEROUS SCLEROSIS// BOTH
S. Lisch nodules
NEUROFIBROMATOSIS
Matching type: Summary of neurocutaneous syndromes.
NEUROFIBROMATOSIS // TUBEROUS SCLEROSIS// BOTH
mental retardation
BOTH
Matching type: Summary of neurocutaneous syndromes.
NEUROFIBROMATOSIS // TUBEROUS SCLEROSIS// BOTH
Cafe au lait macules
NEUROFIBROMATOSIS
Matching type: Summary of neurocutaneous syndromes.
NEUROFIBROMATOSIS // TUBEROUS SCLEROSIS// BOTH
ash leaf, shagreen patch
TUBEROUS SCLEROSIS
Matching type: Summary of neurocutaneous syndromes.
NEUROFIBROMATOSIS // TUBEROUS SCLEROSIS// BOTH
axillary or inguinal freckling
NEUROFIBROMATOSIS
Of thefollowing, the MOST recognized sign of impending respiratory failure in Guillain Barre Syndrome is:
a. dysphagia
b. tachypnea
c. tachycardia
d. altered sensorium
e. vasomotor instability
a. dysphagia
??
The main difference between simple febrile and complex febrile seizures is:]
a. the gender of the patient
b. the temperature during the seizure
c. the length of time of the seizure episode
d. the number of seizure episodes in a 24 hour period
d. the number of seizure episodes in a 24 hour period
the following are characteristics of West syndrome EXCEPT:
a. begins @ 4-8 mos
b. ECG shows hypsarrythmia
c. brief symmetric contractions of neck, trunk, extremities
d. loss of body tone and falling and slumping forward
d. loss of body tone and falling and slumping forward
hich of the following statements is true regarding neurofibromatosis?
a. Neurofibromas typically involving the skin are the hallmark of neurofibromatosis
b. Iris hamartomas are characteristically absent in NF-2
c. Brain MRIs should be done to detect “unidentified bright objects”
d. ≥6 café-au-lait macules > 5mm in prepubertal patients are specific for NF-1
d. ≥6 café-au-lait macules > 5mm in prepubertal patients are specific for NF-1
Benign myoclonic epilepsies are often best treated with
a. clonazepam
b. lamotrigine
c. topiramate
d. valproate
e. benzodiazepines
d. valproate
A 9-month old male child was in active seizure at the ER. He was febrile. Laboratory work-up in this patient includes EXCEPT:
a. CBC
b. EEG
c. Urinalysis
d. Lumbar tap
c. Urinalysis
Which is not a red flag for a 2 year old?
a. screams easily
b. not able to stack 5 blocks
c. no repetition of words
d. does not categorize similarities
e. Stiffens when approached
e. Stiffens when approached
One of the following statements are true for generalized-tonic seizures:
a. usually starts with sudden cry
b. post-ictal state is sudden drowsiness
c. tonic phase shows generalized
contractions
d. clonic phase shows snapping of jaw with
cyanosis
a. usually starts with sudden cry
Cranial CT is a valuable diagnostic tool in the evaluation of the following conditions EXCEPT
a. acute infarcts
b. skull fractures
c. intracranial hemorrhages
d. impending herniation
a. acute infarcts
Severe myoclonic epilepsy of infancy is also known as:
a. West syndrome
b. Dravet syndrome
c. Ohtahara syndrome
d. Janz syndrome
b. Dravet syndrome
Which statement is FALSE regarding specific learning disorders (SLD)?
a. it focuses on academic skill development
b. it is a type of neurodevelopmental dysfunctions
c. the overall estimates of the prevalence of SLD range from 3-10%
d. includes students did well in academic testing but not in intelligence testing
d. includes students did well in academic testing but not in intelligence testing
Which is a contraindication to performing a lumbar tap?
a. Loss of brainstem reflexes
b. Thrombocytopenia of < 50 x 109/L
c. Seizures and nuchal rigidity suggestive of CNS infection
d. Lack of a cranial CT scan to rule out a mass lesion of the brain prior to a lumbar tap
a. Loss of brainstem reflexes
absence seizures are MOST often initially treated with
a. ethosuximide
b. valproate
c. lamotrigine
d. acetazolamide
e. clonazepam
a. ethosuximide
Electroencephalogram (EEG) in febrile seizure is characterized by the following EXCEPT
a. an EEG need not norrmally be performed in first simple febrile seizure
b. an abnormal EEG could predict the future recurrence of febrile seizures or epilepsy
c. spikes during drowsiness are often seen in children with febrile seizures
d. an EEG performed within 2 wk of a febrile seizure often have nonspecific slowing
e. an EEG should be used to delineate the type of epilepsy
b. an abnormal EEG could predict the future recurrence of febrile seizures or epilepsy
High-voltage, slow, chaotic background with multifocal spikes is a typical electroencephalographic finding in:
a. Lennox-Gastaut syndrome
b. West syndrome
c. Dravet syndrome
d. Landau-Kleffner syndrome
b. West syndrome
All the following are characteristic features of autistic spectrum disorder (ASD) EXCEPT
a. defective social communication
b. highly restricted fixated interests
c. scarce of gesture use
d. stereotyped motor movements
e. absence of routines
e. absence of routines
The behavioral changes in attention-deficit/hyperactivity disorder (ADHD) should met all the following criteria EXCEPT
a. developmentally inappropriately far comparing with other children of the same age
b. must begin before age 6 yr
c. must be present for at least for 6 mo
d. must be present in 2 or more settings
e. must not be secondary to another
disorder
b. must begin before age 6 yr
True regarding treatment of migraine headaches, except
a. IV prochlorperazine plus ketorolac has a better response rate of 93%
b. The most commonly used preventive therapy for migraine is amitriptyline
c. The most effective abortive treatment is to use NSAIDs first, limited to < 2-3 attacks per month then adding triptan if nonresponsive to NSAIDs
d. IV prochlorperazine is very effective in aborting an attack in the emergency room with 75% improvement at 1 hou
c. The most effective abortive treatment is to use NSAIDs first, limited to < 2-3 attacks per month then adding triptan if nonresponsive to NSAIDs
Ideally all children should be subjected to routine screening for autistic spectrum disorders at ageof
a. 06and12mo
b. 12and18mo
c. 18and 24mo
d. 24and30mo
e. 30and18mo
c. 18 and 24mo
Case
A 13-year old female with mental retardation was brought in for consult due to headache. The mother reported that when it happens the patient would hit her forehead several times as if indicating pain in the frontal area and she would not stop shouting and crying. This has happened 3 times already in the past 2 months. In all three occasions, the patient would gradually become clumsy and drowsy followed, within an hour, by head slapping and the incessant crying often lasting for several hours. There was no family history of migraine, tumors, or epilepsy. There were no lateralizing signs noted on physical examination.
Headache management plan should include which of the following?
a. Acute treatment + biobehavioral therapy
b. Acute & preventive strategy + biobehavioral therapy
c. Acute & preventive strategy + biobehavioral therapy + neuroimaging
d. Acute & preventive strategy +
biobehavioral therapy + EEG & neuroimaging
c. Acute & preventive strategy + biobehavioral therapy + neuroimaging