PEDIATRIC NEUROLOGY
Question # 01:
A 12-year-old
female is brought to the ED because she has altered consciousness, headache and
fever of 1020F for 2 days. You examined her and you found no
meningeal signs, but she requires repeated tactile stimulation to maintain
arousal, she is not oriented except to person, makes frequent paraphasic
errors, and can recall just one of three objects after a distracting task. The
rest of the neurologic examination is unremarkable.
Lumbar
puncture was done and CSF analysis shows a red blood cell count of 25
cells/hpf; white blood cell count of 120 cells/hpf with a lymphocytic predominance;
glucose of 70 mg/dL; and protein of 95 mg/dL.
What is
the best treatment to be initiated at this time?
A.
Iduroxidine
B. Ceftriaxone
C.
Vidarabine
D.
Solumedrol
E.
Acyclovir
Question # 02:
A 2 days old full-term infant has been evaluated for irritability and microcephaly.
He is a product of uncomplicated pregnancy, labor and delivery for a healthy
mother. Head ultrasonography and CT scan showed enlarged posterior horns of the
lateral ventricles and punctuate calcifications which are both periventricular and
diffuse. On neurological examination, he has increased tone and hyperreflexia.
A dilated funduscopic exam shows a large area of absent retina with hyperpigmented
margins.
What is the most
likely diagnosis?
A. Congenital cytomegalovirus infection
B. Congenital toxoplasmosis
C. Congenital herpes simplex type 1
D. Congenital rubella
E. Congenital syphilis
Question # 03:
You have
been asked to see a 5-dayold baby girl in the NICU for possible seizures. She
was small for gestational age and born at 32 weeks gestation. On day 2 of life,
she has had feeding difficulties and has received phototherapy for jaundice. On
your exam, she is micro cephalic, has hepatosplenomegaly, and a purpuric rash.
You
ordered head ultrasound which shows ventriculomegaly. Her blood labs elevated
aminotransferases, direct and indirect hyperbilirubinemia, thrombocytopenia,
and hemolytic anemia.
Which
test is most likely to confirm this patient’s diagnosis?
A. Bone
marrow biopsy
B. Head
CT scan
C.
Ophthalmologic examination
D. Rapid
plasma reagin (RPR) test
E. Urine
CMV culture
Question # 04:
A 13-year-old female came to the
office with 2 days history of right facial weakness and she is unable to close
her right eye. She has trouble sucking from a straw and also, she has drooling
from her right side of the mouth. She denies paresthesias, ear pain or
hyperacusis. On skin examination you note the following:
The most likely infectious agent causing the
above symptoms is:
A. Herpes Simplex Virus Type 1
B. Borrelia burgdorferi
C. Rickettsia rickettsii
D. Mycoplasma pneumonia
E. Tuberculosis
Question # 05:
The best treatment option for the patient
in question # 04 is:
A.
Acyclovir
B.
Forscarnet
C.
Doxycycline
D.
Azithromycin
E.
Fluconazole
CHECK ANSWERS TOMORROW AT 10 AM PLEASE
