Hydrocephalus, Raised Pressure and Brain Tumours — Board-Style Questions

What this deck covers

Hydrocephalus, Raised Pressure and Brain Tumours in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Crossing the centiles at four months
2. Three weeks after the big bleed
3. Mum has seen this before
4. Red along the tubing
5. Swaying when he sits
6. A cyst with a bright dot
7. Crossed signs and a swollen bridge
8. Not growing and bumping into doors
9. Freckled armpits and a bulging eye
10. The boy who tilts his head back
11. A bulging back of the head
12. Slow pulse and a blown pupil
13. Three big, one normal
14. Dad needs bigger hats
15. Where children grow them
16. Silent on the second day
17. An eye that will not turn out
18. A murmur over the soft spot

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Cerebellar hemisphere pilocytic astrocytoma, A metastasis, A demyelinating lesion, Optic nerve glioma with hypothalamic extension, Retinoblastoma, Pineoblastoma, Dandy-Walker malformation, A ventriculoperitoneal shunt, Most are meningiomas, A postoperative haematoma pressing on the brainstem, Myasthenia gravis, Congenital toxoplasmosis.

Clinical pearls from this deck

• An open fontanelle is a free window. Put the probe on it before anyone orders anything else.
• Tiny baby, bloody fluid: tap or reservoir now, shunt when he has earned it.
• A shunted child who vomits has a shunt problem until the scan says otherwise. Believe the mother.
• You cannot sterilise plastic from the outside. Infected shunt out, drain in, new shunt later.
• Trunk wobbles, hands steady: the tumour is in the midline. Midline in a five-year-old is medulloblastoma.
• Cyst with a nodule in a child’s cerebellum is the tumour you want. The knife is the cure.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Neurology case decks · pediatric reference values.