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Questions and Answers

A patient with hypokalemic periodic paralysis should avoid which of the following triggers?

  • Beta-blockers
  • Low sodium intake
  • Physical rest after exercise
  • High carbohydrate meals (correct)

    • Which of the following best describes the "second wind" phenomenon seen in McArdle disease?

  • Improved exercise tolerance after a brief rest during activity (correct)
  • Sudden onset of muscle weakness after meals
  • Immediate fatigue with minimal exertion
  • Muscle cramps that worsen with continued activity

    • Regarding a trauma patient with right-sided cerebellar signs and cranial nerve palsy, which area is likely affected?

  • Left pons
  • Right medulla
  • Right midbrain (correct)
  • Left cerebellar hemisphere

    • In a patient with Horner syndrome, which of the following is a correct statement?

    <p>Anhidrosis occurs in lesions of first and second-order neurons</p> Signup and view all the answers

    Which antiepileptic drug is excreted in breast milk?

    <p>Ethosuximide</p> Signup and view all the answers

    Regarding treatment for a child with Juvenile Myoclonic Epilepsy (JME), which of the following is correct?

    <p>Treatment is usually lifelong</p> Signup and view all the answers

    Which of the following increases the risk to develop another febrile seizure in a child with febrile seizures?

    <p>All of the above</p> Signup and view all the answers

    Regarding NF1, a child with Café au lait spots, what should be done next?

    <p>Ophthalmology examination to assess for optic pathway gliomas</p> Signup and view all the answers

    What is the best management for a patient with an arachnoid cyst causing intractable seizures?

    <p>Surgical removal or fenestration of the cyst without VP shunt</p> Signup and view all the answers

    In the case of a child post-RTA with a CT brain showing a skull fracture, what should be done next?

    <p>Neurosurgery consultation</p> Signup and view all the answers

    What is the most probable diagnosis for a child who developed headache and photophobia after being hit on the head with a ball?

    <p>Concussion</p> Signup and view all the answers

    A patient with a history of worsening verbal development and EEG showing epileptiform discharges during sleep is most likely diagnosed with?

    <p>Landau-Kleffner syndrome</p> Signup and view all the answers

    A patient presenting with frequent headaches that are relieved by rest and exacerbated by lack of sleep should be advised to?

    <p>Improve sleep hygiene practices</p> Signup and view all the answers

    What is the most likely diagnosis for a child who presents with an inability to abduct the left eye and retraction of the globe upon attempted adduction?

    <p>Duane syndrome</p> Signup and view all the answers

    In a patient undergoing chemotherapy for leukemia who develops seizures and visual symptoms, the most probable cause of PRES is?

    <p>Methotrexate toxicity</p> Signup and view all the answers

    A patient with unexplained behavioral changes shows improvement with steroids. Which investigation is most appropriate?

    <p>Anti-thyroid antibodies (TPO, thyroglobulin) and TSH levels</p> Signup and view all the answers

    Which antiepileptic medication should be avoided in a patient with Dravet syndrome (SCN1A mutation)?

    <p>Carbamazepine</p> Signup and view all the answers

    If a patient with anti-NMDA receptor encephalitis did not improve with high-dose steroids, what is the next best step?

    <p>Start plasma exchange</p> Signup and view all the answers

    A child with esotropia and impaired vertical gaze after trauma is most likely diagnosed with?

    <p>Basal skull fracture</p> Signup and view all the answers

    What is the EEG pattern seen in a patient with Ohtahara syndrome?

    <p>Burst suppression pattern during both sleep and wakefulness</p> Signup and view all the answers

    A neonate has episodes of apnea and sudden jerky movements with touch. What is the most likely diagnosis?

    <p>Hyperekplexia</p> Signup and view all the answers

    In the context of Tuberous Sclerosis, which of the following statements about everolimus is correct?

    <p>It is an mTOR inhibitor used for treating subependymal giant cell astrocytomas (SEGAs)</p> Signup and view all the answers

    Which of the following syndromes can be treated with cannabidiol (marijuana)?

    <p>Dravet syndrome</p> Signup and view all the answers

    A trauma patient with right-sided cerebellar signs and cranial nerve palsy shows which area is likely affected?

    <p>Right midbrain</p> Signup and view all the answers

    Regarding patient identification in the hospital, which method is correct?

    <p>Use both name and MRN</p> Signup and view all the answers

    An 8-year-old girl had two attacks of abnormal movements after minor trauma. What is the likely diagnosis?

    <p>Reflex anoxic seizures</p> Signup and view all the answers

    If an infant presents with seizures and an EEG showing burst-suppression patterns, what is the most likely diagnosis?

    <p>Ohtahara syndrome (Early Infantile Epileptic Encephalopathy)</p> Signup and view all the answers

    In the case of a previously normal 18-month-old girl with developmental regression, what is the most likely diagnosis?

    <p>Rett syndrome</p> Signup and view all the answers

    A patient with a large brain abscess on MRI had a negative lumbar puncture. What should be done next?

    <p>Aspiration and culture/sensitivity</p> Signup and view all the answers

    What is the treatment for a child diagnosed with dopa-responsive dystonia?

    <p>Levodopa-carbidopa (Sinemet)</p> Signup and view all the answers

    Which of the following is associated with dopa-responsive dystonia (DYT5)?

    <p>GTP cyclohydrolase 1 gene mutation</p> Signup and view all the answers

    After a minor head injury during sports, when can a patient return to playing football?

    <p>After being symptom-free for at least 5 days and following a gradual return-to-play protocol</p> Signup and view all the answers

    What should be done for a child post-RTA with a CT brain showing a skull fracture?

    <p>Neurosurgery consultation</p> Signup and view all the answers

    In a child diagnosed with metachromatic leukodystrophy (MLD), what is the deficient enzyme?

    <p>Arylsulfatase A</p> Signup and view all the answers

    When a child presents with seizures and neuroimaging shows holoprosencephaly, what investigation should be ordered?

    <p>Endocrine evaluation including pituitary hormones and electrolytes</p> Signup and view all the answers

    A junior resident talks about a senior who humiliates her in rounds. What is the correct course of action?

    <p>Take the issue seriously and address it with appropriate supervisory staff or department leadership</p> Signup and view all the answers

    If a colleague asks you to prescribe an antipsychotic medication he is using, what should you do?

    <p>Refuse and advise him to seek appropriate medical care</p> Signup and view all the answers

    For a patient with tension-type headaches, which of the following treatments is correct?

    <p>Preventive therapy includes amitriptyline</p> Signup and view all the answers

    What is the next step for a patient reporting frequent headaches worsening with lack of sleep?

    <p>Advise to improve sleep hygiene</p> Signup and view all the answers

    What is the most appropriate step for a patient with medication overuse headache?

    <p>Abruptly discontinue the overused medication</p> Signup and view all the answers

    What affects cognitive function prognosis for a child diagnosed with medulloblastoma?

    <p>It depends on several factors including age, treatment modalities, and postoperative complications</p> Signup and view all the answers

    For a child in the PICU post-neurosurgery who is extubated but not talking, what is correct regarding this condition?

    <p>It is a transient condition known as cerebellar mutism</p> Signup and view all the answers

    What is the risk of recurrence for future pregnancies in a child born with myelomeningocele?

    <p>2-5%</p> Signup and view all the answers

    If the mother of a neonate born with myelomeningocele indicates that her husband hit her during the 34th week of gestation, what should you tell her?

    <p>An injury at that gestational age has nothing to do with the presentation</p> Signup and view all the answers

    A child presenting with headaches and MRI shows cerebellar tonsillar herniation 6 mm below the foramen magnum, what type of Chiari malformation is this?

    <p>Chiari I malformation</p> Signup and view all the answers

    MRI spine shows an extensive lesion involving the cervicothoracic area. What would you expect to find on examination?

    <p>Weakness in upper limbs and muscle atrophy in hands</p> Signup and view all the answers

    The treatment for a patient with Guillain-Barré Syndrome (GBS) is?

    <p>Intravenous immunoglobulin (IVIG)</p> Signup and view all the answers

    For a 15-year-old patient with cognitive decline, myoclonic jerks, and an EEG shows periodic complexes, what investigation will help confirm the diagnosis?

    <p>Elevated anti-measles IgG antibodies in CSF</p> Signup and view all the answers

    A 15-year-old patient has been having academic difficulties accompanied by quick jerking movements. The EEG shows background slowing and generalized periodic epileptiform discharges every 4 seconds. Which of the following is least likely to be found in this condition?

    <p>Cowdry B bodies</p> Signup and view all the answers

    In Duchenne muscular dystrophy (DMD), which statement regarding the genetic mutation is correct?

    <p>DMD is caused by an out-of-frame mutation in the dystrophin gene</p> Signup and view all the answers

    In Horner syndrome, anhidrosis occurs in lesions involving which neurons?

    <p>First and second-order neurons</p> Signup and view all the answers

    In a neonate with episodes of apnea and sudden jerky movement with touch, what is the most likely diagnosis?

    <p>Hyperekplexia</p> Signup and view all the answers

    Which of the following syndromes can be treated with cannabidiol (CBD)?

    <p>Dravet syndrome</p> Signup and view all the answers

    What are you going to do for a child with multiple types of seizures including myoclonic, difficult to control on levetiracetam and lamotrigine with high LFT?

    <p>Add carbamazepine</p> Signup and view all the answers

    What to give to a patient who deteriorated after tonsillectomy under anesthesia due to Central Core Disease?

    <p>IV Dantrolene</p> Signup and view all the answers

    What to do next for a 10-year-old girl diagnosed with MS who did not improve after high dose steroids?

    <p>Plasma exchange</p> Signup and view all the answers

    What to do for a patient with opsoclonus myoclonus diagnosed with Neuroblastoma who presented again with the same symptoms?

    <p>IV Ig</p> Signup and view all the answers

    What to do next for a patient with recurrent Staphylococcus aureus meningitis who also has rhinorrhea?

    <p>MRI brain</p> Signup and view all the answers

    What to do for a patient with a sore throat and high ASO titer who developed chorea?

    <p>Infectious Disease</p> Signup and view all the answers

    When to start treatment for a 6-year-old child diagnosed with BECTs?

    <p>Older age group</p> Signup and view all the answers

    What is the most probable cause for a patient with leukemia who develops bilateral leg pain even with touch?

    <p>Side effect of chemotherapy</p> Signup and view all the answers

    What to do next for a child with macrocephaly and normal development?

    <p>Measure parents' head circumference</p> Signup and view all the answers

    Where is the localization of the aura of palpitation and sweating?

    <p>Insular cortex</p> Signup and view all the answers

    What are you going to do for a patient with ADHD on methylphenidate who developed tics?

    <p>Discontinue methylphenidate</p> Signup and view all the answers

    Which AED to start for a patient post renal transplant who developed focal seizures with automatism?

    <p>Phenytoin</p> Signup and view all the answers

    What to do next for a neonate found to have Café au lait spots?

    <p>Echocardiogram</p> Signup and view all the answers

    What is the correct answer for a neonate with myoclonus, not in clusters?

    <p>KCNQ2 channel mutation (Benign familial neonatal seizures)</p> Signup and view all the answers

    What is the most probable diagnosis for a patient with episodes of one-sided headache with lacrimation that improves after indomethacin?

    <p>Paroxysmal hemicrania</p> Signup and view all the answers

    Which of the following is most likely the cause of leg paresthesias in a patient with inflammatory bowel disease?

    <p>Selenium deficiency</p> Signup and view all the answers

    What is the diagnosis for a child who developed febrile and afebrile seizures on the right and left sides?

    <p>Dravet syndrome (SCN1A mutation)</p> Signup and view all the answers

    What is the most likely diagnosis for a neonate with apnea and sudden jerky movement upon touch?

    <p>Hyperekplexia</p> Signup and view all the answers

    Which antiepileptic drug is excreted in breast milk?

    <p>Ethosuximide</p> Signup and view all the answers

    What is the treatment for dopa-responsive dystonia?

    <p>Levodopa-carbidopa (Sinemet)</p> Signup and view all the answers

    What is the diagnosis for a patient with episodes of alternating weakness aggravated by crying?

    <p>Moyamoya disease</p> Signup and view all the answers

    Which of the following is a major criterion for Tuberous Sclerosis?

    <p>Hypomelanotic macules (≥3), Angiofibromas (≥3), Shagreen patch, etc.</p> Signup and view all the answers

    In which condition is the 'second wind' phenomenon seen?

    <p>McArdle disease (Glycogen storage disease type V)</p> Signup and view all the answers

    Myokymia is seen in which conditions?

    <p>Episodic ataxia type I</p> Signup and view all the answers

    What to do next for a patient with Guillain-Barré syndrome who started to improve without treatment?

    <p>No need for treatment currently</p> Signup and view all the answers

    What to do for a colleague who asks you to prescribe an antipsychotic medication he is using?

    <p>Advise him to seek appropriate medical care and refrain from prescribing.</p> Signup and view all the answers

    What should you do if a junior resident talks to you about a senior humiliating her in rounds?

    <p>Take the issue seriously and address it with appropriate supervisory staff or department leadership.</p> Signup and view all the answers

    What is the next step for a patient with a headache related to lack of sleep?

    <p>Advise to improve sleep hygiene</p> Signup and view all the answers

    What is the next step for a patient with medication overuse headache?

    <p>Abruptly discontinue the overused medication</p> Signup and view all the answers

    What is the most probable diagnosis for a child with a history of febrile seizures who developed afebrile seizures occasionally on different sides?

    <p>Dravet syndrome (SCN1A mutation)</p> Signup and view all the answers

    What is the most likely diagnosis for a neonate with myoclonus and a sibling with similar history but now normal?

    <p>KCNQ2 channel mutation (Benign familial neonatal seizures)</p> Signup and view all the answers

    What is the most probable cause of transient cerebral arteriopathy?

    <p>Varicella zoster virus</p> Signup and view all the answers

    What should be ordered for a patient with visual symptoms following an URTI who requires MRI brain?

    <p>R/O demyelinating disease</p> Signup and view all the answers

    What is the deficient enzyme in metachromatic leukodystrophy (MLD)?

    <p>Arylsulfatase A</p> Signup and view all the answers

    What is the treatment for a patient with Guillain-Barré syndrome?

    <p>Intravenous immunoglobulin (IVIG)</p> Signup and view all the answers

    What test to order for a patient with behavior changes responsive to steroids?

    <p>TSH and antithyroid antibodies (TPO, thyroglobulin)</p> Signup and view all the answers

    What is the most probable diagnosis for a patient with anemia, hepatosplenomegaly, and vertical gaze palsy?

    <p>Niemann-Pick disease type C</p> Signup and view all the answers

    Which syndrome can be treated with marijuana (cannabidiol)?

    <p>Dravet syndrome</p> Signup and view all the answers

    What is the diagnosis for an 8-year-old girl with two attacks of loss of consciousness triggered by minor injury?

    <p>Reflex anoxic seizures</p> Signup and view all the answers

    What is the recurrence risk for future pregnancies for a child born with myelomeningocele?

    <p>2-5%</p> Signup and view all the answers

    What do you tell a mother of a neonate born with myelomeningocele whose husband hit her during pregnancy?

    <p>An injury at that gestational age has nothing to do with the presentation</p> Signup and view all the answers

    What is the correct inheritance pattern for Neurofibromatosis type 1 (NF1)?

    <p>It is autosomal dominant with high penetrance and variable expression</p> Signup and view all the answers

    What is the correct answer regarding Wilson disease and its serum levels?

    <p>Low serum ceruloplasmin levels and decreased serum copper concentration</p> Signup and view all the answers

    What is the most common cause of transient cerebral arteriopathy?

    <p>Varicella zoster virus</p> Signup and view all the answers

    Which patient requires PICU admission for spinal injury post RTA?

    <p>Injury above T10</p> Signup and view all the answers

    What is the diagnosis for an 11-year-old girl presenting with unsteadiness, seizures, and impaired upward gaze?

    <p>Cataplexy</p> Signup and view all the answers

    What causes a patient with anemia, hepatosplenomegaly, and vertical gaze palsy?

    <p>Niemann-Pick disease type C</p> Signup and view all the answers

    What is the diagnosis for a child with two attacks of abnormal movements following minor injuries?

    <p>Reflex anoxic seizures</p> Signup and view all the answers

    What is the correct approach for a patient with medication overuse headache?

    <p>Abruptly discontinue the overused medication</p> Signup and view all the answers

    Which of the following conditions is associated with loss of previously acquired language skills in children?

    <p>Landau-Kleffner syndrome</p> Signup and view all the answers

    What are the features of anti-NMDA receptor encephalitis?

    <p>Orofacial dyskinesias</p> Signup and view all the answers

    What is a major criterion for Tuberous Sclerosis?

    <p>Cardiac rhabdomyoma</p> Signup and view all the answers

    What differentiates Duchenne from Becker muscular dystrophy?

    <p>Duchenne is caused by an out-of-frame mutation, Becker by an in-frame mutation</p> Signup and view all the answers

    In Horner syndrome, anhidrosis occurs in lesions of which neurons?

    <p>First and second-order neurons</p> Signup and view all the answers

    What is correct regarding treatment for a patient with tension-type headache?

    <p>Abortive therapy includes acetaminophen or NSAIDs</p> Signup and view all the answers

    What is correct regarding a mute postoperative patient with cerebellar tumor?

    <p>It is transient and typically improves over weeks to months</p> Signup and view all the answers

    What to tell a mother of a neonate with myelomeningocele after a traumatic event in pregnancy?

    <p>An injury at that gestational age has nothing to do with the presentation</p> Signup and view all the answers

    What is the inheritance pattern of Neurofibromatosis type 1?

    <p>It is autosomal dominant with high penetrance and variable expression</p> Signup and view all the answers

    What is the serum concentration characteristic of Wilson disease?

    <p>Low serum ceruloplasmin levels and decreased serum copper concentration</p> Signup and view all the answers

    What is the most common cause of transient cerebral arteriopathy?

    <p>Varicella zoster virus</p> Signup and view all the answers

    What is required for a patient with spinal injury post RTA who has an injury above T10?

    <p>Injury above T10</p> Signup and view all the answers

    What is associated with Niemann-Pick disease type C?

    <p>Anemia, hepatosplenomegaly, and vertical gaze palsy</p> Signup and view all the answers

    What is the diagnosis for a child with two attacks of abnormal movements triggered by minor injury?

    <p>Reflex anoxic seizures</p> Signup and view all the answers

    What should be done for a patient with medication overuse headache?

    <p>Abruptly discontinue the overused medication</p> Signup and view all the answers

    Which syndrome is known for loss of previously acquired language skills in children?

    <p>Landau-Kleffner syndrome</p> Signup and view all the answers

    Which features indicate anti-NMDA receptor encephalitis?

    <p>Orofacial dyskinesias</p> Signup and view all the answers

    What is a major criterion for Tuberous Sclerosis?

    <p>Cardiac rhabdomyoma</p> Signup and view all the answers

    What informs the distinction between Duchenne and Becker muscular dystrophy?

    <p>Duchenne is caused by an out-of-frame mutation, Becker by an in-frame mutation</p> Signup and view all the answers

    Anhidrosis in Horner syndrome is identified in which neurons?

    <p>First and second-order neurons</p> Signup and view all the answers

    In treating tension-type headache, what statement is accurate?

    <p>Abortive therapy includes acetaminophen or NSAIDs</p> Signup and view all the answers

    What is accurate about a mute patient following cerebellar tumor surgery?

    <p>It is transient and typically improves over weeks to months</p> Signup and view all the answers

    Study Notes

    Seizure Management and Investigation

    • Difficult-to-control seizures in a child with myoclonic types require maximizing levetiracetam therapy.
    • Post-anesthesia complications in Central Core Disease are managed with IV Dantrolene.
    • In multiple sclerosis diagnosed cases presenting with extensive MRI lesions, plasma exchange is preferred when high-dose steroids are ineffective.
    • Recurrent opsoclonus myoclonus in neuroblastoma patients should be treated with IV immunoglobulin.

    Infection and Consultation Protocols

    • In patients with recurrent Staphylococcus aureus meningitis presenting rhinorrhea, a thin cuts CT brain is indicated for investigation.
    • Following sore throat and high ASO titer with resultant chorea, initial consultation should be directed to cardiology.

    Pediatric Seizure Disorders

    • In cases of benign epilepsy with centrotemporal spikes (BECTs), treatment is indicated if seizures are frequent.
    • Development of chorea post-streptococcal infection warrants consideration for autoimmune etiology and potential rheumatology involvement.

    Asymptomatic Conditions and Diagnostics

    • In a child with macrocephaly and normal development, measuring parental head circumference can provide valuable context.
    • Café au lait spots in a neonate necessitate checking parents for similar manifestations to assess genetic implications.

    Neurological Symptoms and Treatments

    • Hyperekplexia is characterized by neonatal myoclonus without clusters and normal prior development.
    • Paroxysmal hemicrania diagnosis is likely when headaches improve after indomethacin administration.
    • Vitamin B12 deficiency is indicated by leg paresthesias and other neurological signs in patients with inflammatory bowel disease.

    Pediatric Disorders and Their Assessments

    • Reflex anoxic seizures should be diagnosed in a child with unintentional injury causing loss of consciousness and drowsiness.
    • Investigating holoprosencephaly requires an endocrine evaluation to assess associated hormonal disturbances.
    • Patients with metachromatic leukodystrophy show deficiency in arylsulfatase A enzyme.

    Management and Treatment Protocols

    • Abrupt discontinuation of overused medications is critical in medication overuse headache cases.
    • Intravenous immunoglobulin is the recommended treatment for Guillain-Barré Syndrome, while steroids are not indicated unless severe.
    • In Neiman-Pick disease type C, diagnosis involves identifying anemia and hepatosplenomegaly alongside neurological signs.

    Genetic and Inheritance Considerations

    • Neurofibromatosis type 1 follows an autosomal dominant inheritance pattern with high penetrance and variable expression.
    • Duchenne muscular dystrophy results from an out-of-frame mutation; Becker muscular dystrophy involves in-frame mutations.

    Other Significant Findings

    • The second wind phenomenon in McArdle disease is associated with improved exercise tolerance after brief pauses, illustrating a unique body response during physical activity.
    • Anhidrosis in Horner syndrome is indicative of first and second-order neuron lesions, affecting sympathetic pathways.

    Prognosis and Risk Assessment

    • Myelomeningocele recurrence risk is approximately 2-5% in subsequent pregnancies.
    • Cognitive function prognosis post-medulloblastoma treatment relies on various factors including age, treatment modalities, and complications.

    Emotional and Behavioral Concerns

    • Behavioral changes responsive to steroid therapy may require TSH and antithyroid antibody tests to rule out underlying thyroid disorders.
    • Junior residents facing bullying must report the incidents to supervisory staff for proper intervention.

    Epilepsy and Antiepileptic Drugs

    • Long-term treatment is usually necessary for Juvenile Myoclonic Epilepsy, as seizures typically do not resolve without ongoing management.
    • Ethosuximide is notably excreted in breast milk, requiring caution in breastfeeding mothers with epilepsy.

    This condensed view emphasizes critical information regarding clinical conditions, treatments, neurologic assessments, and familial contexts, ensuring a comprehensive understanding for medical students and professionals.### Febrile Seizures and NF1

    • First febrile seizure occurs before 12 months of age, may indicate risk of epilepsy.
    • Complex febrile seizures exhibit features that increase risk.
    • Family history of epilepsy is a significant risk factor.

    Neurofibromatosis Type 1 (NF1)

    • In children with Café au lait spots, the next step is an ophthalmology examination to check for optic pathway gliomas.

    Arachnoid Cyst and Seizures

    • Best management for an arachnoid cyst causing seizures is surgical removal or fenestration, rather than VP shunt placement.

    Head Trauma and Imaging

    • Post-RTA children with skull fractures and no neurological deficits should receive a neurosurgery consultation.
    • Symptoms following minor head trauma, such as headache and photophobia, suggest a concussion.

    Seizure Disorders

    • EEG showing epileptiform discharges during sleep and language regression indicates Landau-Kleffner syndrome.
    • Burst suppression pattern on EEG is characteristic of Ohtahara syndrome (Early Infantile Epileptic Encephalopathy).

    Medications and Treatment

    • Carbamazepine is contraindicated in Dravet syndrome (SCN1A mutation).
    • Everolimus, an mTOR inhibitor, is used for treating subependymal giant cell astrocytomas (SEGAs) in Tuberous Sclerosis.
    • CBD (cannabidiol) is effective for treating Dravet syndrome.

    Behavioral and Psychological Issues

    • In cases of unexplained behavioral changes with steroid response, testing anti-thyroid antibodies is appropriate.

    Neurological Assessment

    • Cerebellar signs and cranial nerve palsy post-trauma likely indicate right midbrain injury.
    • Persistent speech loss in a PICU patient post-neurosurgery is often transient, known as cerebellar mutism.

    Chiari Malformation and Myelomeningocele

    • Cerebellar tonsillar herniation of 6 mm below the foramen magnum indicates Chiari I malformation.
    • Myelomeningocele has a recurrence risk of 2-5% in future pregnancies.

    Treatment for Conditions

    • Intravenous immunoglobulin (IVIG) is the treatment for Guillain-Barré syndrome.
    • Levodopa-carbidopa (Sinemet) is indicated for dopa-responsive dystonia.
    • Abrupt discontinuation of overused headache medications is necessary for medication overuse headache.

    Genetic and Infectious Disease Insights

    • Duchenne muscular dystrophy results from an out-of-frame mutation in the dystrophin gene.
    • Elevation of anti-measles IgG antibodies in CSF helps confirm diagnosis in patients with cognitive decline and myoclonic jerks.

    Eye and Neurological Conditions

    • Symptoms of esotropia paired with vertical gaze abnormalities suggest a basal skull fracture.
    • Apnea and sudden jerky movements in newborns are indicative of hyperekplexia.

    Psychiatric Considerations

    • In situations of workplace bullying, it is advised to escalate the issue to supervisory staff rather than ignoring it.

    Laboratory and Imaging Protocols

    • When faced with a brain abscess, aspiration and culture/sensitivity testing follow a negative lumbar puncture.
    • Initial endocrine evaluation is appropriate for children with seizures and holoprosencephaly.

    Miscellaneous

    • Chiari malformation types vary, and clarity on the correct type is essential for appropriate management.
    • Understanding of symptom patterns and the body’s response to injury is crucial for accurate diagnosis and treatment pathways.

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    Description

    Test your knowledge on the management of pediatric seizure disorders and related investigations. This quiz covers treatment protocols for conditions like myoclonic seizures, post-anesthesia complications, and the role of consultations in related infections. Ensure you understand the nuances in treatment and diagnosis for these cases.

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