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Flashcards in Neurological Disorders Deck (52)
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1

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 1 yo with otitis media and a fever of 104

2

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

d) protect the child from injury

3

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

d) first aid management during a seizure

4

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

c) routinely giving immunizations such as Hib and PCV7

5

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

b) infantile spasm

6

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) focal motor signs

7

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) complaints of pain on one side of the head only

8

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

c) diazepam may be indicated for children

9

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) learning disabilities

10

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

d) more severe in the morning followed by vomiting

11

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

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

12

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

c) language delays/disorders

(Hearing deficits are almost equally as common.)

13

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) bulging fontanel

14

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) must have both motor and vocal tics

15

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

d) symptoms decrease after puberty

16

A prominent feature in a simple partial seizure is:
a) very short postictal drowsiness
b) microcephaly
c) bilateral tremors
d) no loss of consciousness

d) no loss of consciousness

17

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

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

18

The differential diagnosis for seizures includes which of the following:
a) poliomyelitis without paralysis
b) schizophrenia
c) complicated migraine headaches
d) multiple sclerosis

c) complicated migraine headaches

19

The most useful diagnostic tool for diagnosing epilepsy is:
a) MRI
b) EMG
c) EEG
d) CT scan

c) EEG

20

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

b) valproic acid

21

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

b) nausea and vomiting, positive family history, aura

22

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

b) epidural hematoma

23

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

b) skin abnormalities, seizures, cognitive deficits

24

Inheritance of tuberous sclerosis is by:
a) autosomal dominant mutant gene
b) fragile x chromosome
c) autosomal recessive mutant gene
d) trisomy 23

a) autosomal dominant mutant gene

25

The most important diagnostic measure for identifying tuberous sclerosis is:
a) EEG
b) thorough neurological physical exam
c) MRI
d) skin biopsy

c) MRI

26

For children 1-4 yo the most common cause of head injury is:
a) MVA
b) falls
c) child abuse
d) tricycle accidents

b) falls

27

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) brief loss of consciousness and/or amnesia

28

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) contusion

29

The most common type of skull fracture in children with an excellent prognosis is:
a) depressed
b) basilar
c) linear
d) simple

c) linear

30

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

b) Escherichia coli