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Pediatric Board Prep > Neurology > Flashcards

Neurology Flashcards

1
Q

What is the most likely diagnosis for pt who hit head and complaining of headache, confusion and finding of biconvex shape on head CT?

A

Epidural hematoma

due to middle meningeal artery

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2
Q

what is the most likely diagnosis for infant (less than 1 year old) presenting with progressively poor feeding, lethargy, drooling, bilateral ptosis, and hypotonia?

A

Infantile botulism

(associated with honey)

(tx: botulism antitoxin & respiratory support)

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3
Q

What is the most likely diagnosis of pt presenting with morning jerks (mistaken for tics) and generalized tonic clonic seizures starting in early to mid adolescence?

A

Juvenile myoclonic epilepsy

(EEG: 4-6 Hz polyspike and slow waves triggered by photic stimulation)

(tx: Valproic acid followed by Keppra or Lamictal)

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4
Q

What is the EEG finding associated with Infantile Spams (sudden flexion of neck/trunk/arms followed by abrupt extension of neck and trick with ab/adduction of arms and legs)?

A

hypsarrhythmia

very high voltage, random, slow waves and spikes in all cortical areas

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5
Q

What is the most common cause of cerebral palsy?

A

low birth weight/ prematurity

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6
Q

What is the most likely diagnosis for pt presenting with inability to raise arms fully, shortened and broad neck, low hairline, fusion and hypoplasia of more than 2 cervical vertebrae and hypoplastic, high riding scapula?

A

Klippel-Feil syndrome

monitor for brainstem compression

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7
Q

What cause of poor feeding, lethargy and hypotonia has a known potential to worsen after antibiotic therapy?

A

Infant bolutism (due to Clostridium botulinum)

death of organism causes release of more toxin

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8
Q

what is the most likely diagnosis for pt presenting with ataxia, lower extremity weakness, cardiomyopathy, eye difficulties, ear difficulties, hypoactive/ absent deep tendon reflexes and scoliosis/ pes cavus?

A

Friedreich ataxia

(autosomal recessive)

(associated with diabetes)

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9
Q

What is the most likely diagnosis for pt presenting with progressive ascending distal weakness, muscle atrophy, stork legs, and lost deep tendon reflexes?

A

Charcot-Marie-Tooth disease

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10
Q

What is the treatment for Infantile Spasm?

A

Adrenocorticotropic hormone (ACTH)

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11
Q

What is the most likely diagnosis for pt presenting with localized lower back pain, sudden paresthesias (burning, pricking, tingling) in legs, loss of sensation, partial/ full paralysis of legs and incontinence after preceding infection?

A

Transverse myelitis

CSF shows mild lymphocyte pleocytosis

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12
Q

What neurologic disorder is associated with myelomeningocele (herniation of meninges, spinal fluid and spinal cord thru a defect in vertebral column)?

A

Chiari II malformation

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13
Q

What electrolyte abnormality is associated with oxcarbazepine (triletpal) especially in first 3 months of starting therapy?

A

Hyponatremia

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14
Q

what is the most likely diagnosis for pt (1-4 years old) presenting with sudden attacks of vertigo lasting a few minutes while maintaining alertness?

A

Benign paroxysmal vertigo of childhood

associated with migraine development

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15
Q

What is the most likely diagnosis for pt presenting with focal seizure with impaired consciousness , motor symptoms involving face and EEG showing centrotemporal sharp spike and wave discharges?

A

Benign Rolandic Epilepsy

(majority of seizures occur during sleep or upon awakening)

(resolves over years)

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16
Q

What is the most likely diagnosis for Asian pt presenting with altered mental status, recurrent headaches, chorea, transient ischemic attacks, hemorrhage stroke, focal neuro deficits, seizures, imaging showing dilated collateral vessels in basal ganglia and thalamus and stenotic lesion in distal carotid arteries and circle of Willis?

A

Moyamoya disease

dx: MR angiography

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17
Q

What is the most common cause of subdural hematomas in infants?

A

child abuse

18
Q

what antiseizure medication can result in acute-angle glaucoma (sudden onset eye pain, swelling and reddness)?

A

Topiramate (Topamax)

also can result in nephrolithiasis

19
Q

What is the most likely diagnosis for newbown (days 4-6 of life) presenting with brief focal tonic seizures with otherwise normal birth history, normal Apgars, and normal work-up?

A

Benign neonatal seizures

no sequelae or long term antiseizure therapy needed

20
Q

What antiseizure medication can result in hyperammmonemic encephalopathy?

A

Valproic acid (during intiation or dose increase)

21
Q

What is the most likely diagnosis for pt with hydrocephalus, club feet and myelomeningocele?

A

Spina Bifida

22
Q

what is the best initial preventative therapy for cluster headaches (severe, unilateral pain in and around eye and temporal area peaking in minutes and resolving in hours and associated with ipsilateral autonomic symptoms)?

A

Verapamil

alternative are lithium, glucocorticoids, topiramate

23
Q

what nutritional supplement can be used for neonatal seizure when they are resistant to conventional seizure therapy?

A

Pyridoxine (vitamin B6)

24
Q

… is characterized by multiple motor and vocal tics (although not necessarily present concurrently) for more than 1 year

A

Tourette syndrome

peaks at 10-12 years old

25
Q

What is the most likely diagnosis for pt presenting with simultaneous eyelid blinking during sucking-jaw movements?

A

Marcus Gunn (jaw winking) phenomenon

due to abnormal innervation of trigeminal and oculomotor nerve

26
Q

What is the most likely cause of a pt who is unable to wrinkle his forehea unilaterally, unable to close ipsilateral eye, and unable to raise ipsilateral mouth?

A

Lower motor neuron dysfuction of 7th cranial nerve on ipsilateral side

27
Q

What is the most likely diagnosis for pt presenting with infantile hypotonia that has progressed to progressive weakness with tongue fasiculations by 2 years of age, but has normal cognitive development?

A

Werdnig-Hoffman disease (Spinal muscular atrophy type 1)

28
Q

What antiseziure medication is associated with elevated maternal alpha fetoprotein and prenatal ultrasound concerning for meneingomyelocele?

A

Valproic acid

29
Q

What extraocular muscle is responsible for abduction of the eye and what nerve innervates the muscle?

A

Lateral rectus muscle

Cranial 6

(So4-LR6- all the rest 3)

30
Q

What is the characteristic EEg finding for absence seizures?

A

3Hz generalized spike and wave

tx: Ethosuximide

31
Q

What is the most likely diagnosis for pt presenting with expressionless face, inability to blink or grimace, clubfeet, absent finger/toes, unilateral absence of pec muscle (Poland syndrome), and cranial nerve 6 paralysis?

A

Mobius syndrome

dysinnervation syndrome from hypoplasia/ agenesis of brainstem nuclei

32
Q

What are red flags for headaches?

A
  1. systemic symptoms (fever, weight loss, chills)
  2. secondary risk factors (hx of cancer or HIV)
  3. neuro deficits (confusion, impaired consciousness, focal neuro deficits)
  4. Older ( older than 50 years old with new onset or progressive headache)
  5. onset (sudden, thunderclap)
  6. previous headache character change
33
Q

What is the most likely diagnosis for pt presenting with ascending flaccid paralysis, severe pain, areflexia, and CSF showing elevated protein with normal glucose and WBC after a preceding URI or GI illness?

A

Guillian Barre syndrome

34
Q

What is the risk of subsequent sibling would have spina bifida if other child is affected?

A

2-3%

35
Q

What is the most likely diagnosis for pt presenting with dysconjugate gaze, difficulty swallowing, dysphagia, blurred vision/ diplopia and descending paralysis after eating canned food?

A

Botulism

36
Q

What is the most likely diagnosis for pt (1-3 years old) presenting with sudden truncal ataxia, horizontal nystagmus, tremors, dysarthria, fine motor dysfunction associated with normal MRI, normal UDS, normal CSF except mild pleocytosis following viral infection (varicella, coxsackie)?

A

Acute cerebellar ataxia

37
Q

What cranial nerve abnormality is often seen in patients with idiopathic increased intracranial pressure?

A

6th nerve palsy

38
Q

What GI infection is associated with Guillain Barre syndrome?

A

Campylobacter jejuni

39
Q

What is the most likely diagnosis for pt presenting with difficulty speaking, facial droop, crossed eyes and ataxia?

A

Brainstem glioma

40
Q

What is the first line treatment for cluster headaches?

A

oxygen and triptans

41
Q

What is the medication treatment for kids aged 6-12 years old with migraine without aura?

A

rizatriptan

other triptans once 12 or older

Pediatric Board Prep (26 decks)

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