Neurology Case Study: 14-Year-Old Boy
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Questions and Answers

Which of the following is the most likely diagnosis?

  • Multiple sclerosis
  • Guillain-barre syndrome (correct)
  • Polymyositis
  • Acute poliomyelitis
  • Which of the following is the most appropriate treatment?

  • Phenytoin
  • Paracetamol (correct)
  • Amoxicillin
  • Diazepam
  • Which of the following measures would decrease the incidence of Sudden Infant Death Syndrome?

  • Soft sleeping mattress
  • Sleep position support device
  • Sleep in prone position
  • Pacifier at bedtime (correct)
  • In which conditions should circumcision be avoided?

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    Study Notes

    Case 1: 14-Year-Old Boy with Lower Limb Weakness

    • Progressive weakness and tingling in lower limbs, no upper limb or trunk involvement.
    • Recent history of fever and runny nose, indicating possible viral infection.
    • Physical exam reveals muscle strength of 3/5 in lower limbs, absent reflexes.
    • Vital signs: Blood pressure 120/80 mmHg, heart rate 85/min, respiratory rate 18/min, temperature 37.4°C.
    • Most likely diagnosis: Guillain-Barré syndrome. Characterized by acute, progressive weakness and sensory changes.

    Case 2: 5-Year-Old Boy with Convulsions

    • Presented with generalized convulsion involving all limbs, lasted for 3 minutes, accompanied by drooling and loss of consciousness.
    • Exhibited symptoms of upper respiratory infection: runny nose, mild cough, fever for 3 days.
    • Physical examination shows child is fully active with mild throat congestion.
    • Vital signs: Blood pressure 120/80 mmHg, heart rate 98/min, respiratory rate 22/min, temperature 37.9°C.
    • Most appropriate treatment for the convulsion: Paracetamol. Suggests fever management rather than anticonvulsant therapy due to mild illness.

    Sudden Infant Death Syndrome (SIDS)

    • Pacifier use at bedtime is associated with a decreased incidence of SIDS.
    • Recommendations focus on safe sleeping practices to reduce risk factors.

    Circumcision Conditions

    • Circumcision should be avoided in cases of hypospadias.
    • Other conditions like phimosis, unilateral cryptorchidism, and posterior urethral valve are not contraindications for the procedure.

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    Description

    Explore a clinical scenario involving a 14-year-old boy with a history of epilepsy who presents with progressive weakness and tingling in his lower limbs. This quiz will test your understanding of neurology, differential diagnoses, and clinical assessments related to his symptoms. Join to enhance your diagnostic skills in pediatric neurology.

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