Neurology

Question 1

Infant with brief, frequent, “jackknifing” seizures especially in the morning

Answer 1

Infantile spasms

Question 2

What does sixth cranial nerve palsy indicate?

Answer 2

Elevated ICP
(if normal imaging, think pseudo tumor cerebri)

Question 3

Infant with poor feeding and constipation

Answer 3

Think botulism

Question 4

Evidence of a CNS infection and focal neurological findings. What imaging study is needed?

Answer 4

Head CT with contrast (brain abscess)

Question 5

Erratic behavior progressing to altered mental status with CSF pleocytosis

Answer 5

Anti-NDMA encephalitis
(in teen girls, think ovarian teratoma)

Question 6

Newborn with bounding pulses, widened pulse pressure, and pulsating fontanelle

Answer 6

Arteriovenous malformation

Question 7

Most accurate imaging study for stroke?

Answer 7

MRI with diffusion weighted imaging (DWI - if can be done ASAP)

Question 8

Patient with progressive weakness who had a diarrheal illness a month ago?

Answer 8

Guillain-Barré syndrome (triggered by Campylobacter jejuni infection)

Question 9

centrotemporal spike and waves

Answer 9

benign rolandic epilepsy

Question 10

4-6 Hz polyspike and wave pattern

Answer 10

juvenile myoclonic epilpesy

Mnemonic: juveniles 14-16 years of age

Question 11

3 Hz generalized spike and wave

Answer 11

Absence seizures

Mnemonic: Allen Iverson #3 “absent” from practice

Question 12

Irregular high-voltage spikes, slow waves and chaotic background

Answer 12

Hypsarrhythmia