Acute Weakness in Children — Board-Style Questions

What this deck covers

Acute Weakness in Children 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. Three weeks after the tummy bug
2. What the fluid should show
3. Counting to fifteen and no further
4. What the parents read about
5. The eyes went first
6. Twelve hours without passing water
7. Two children, one night
8. Pain for a week before the legs went
9. One arm stopped working
10. It happened over breakfast
11. Chickenpox in the spring
12. Two hours since he stopped speaking
13. A cousin who was affected
14. Five days of a worsening headache
15. Trouble only in the playground
16. Well for the first day and a half
17. An eye that aches when it moves
18. Back to normal by morning

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Juvenile dermatomyositis, A raised protein with a normal white cell count, Brainstem encephalitis, Guillain-Barre syndrome in its early phase, Weakness that is symmetrical rather than one-sided, Focal cerebral arteriopathy, in, Fibromuscular dysplasia of the carotid arteries, An arterial infarct is often invisible on cranial ultrasound, Neuromyelitis optica with aquaporin-4 antibodies, Postictal or Todd paresis.

Clinical pearls from this deck

• Tap the tendons on every weak child. Absent reflexes with a working bladder is the whole picture.
• Protein high, cells normal – and if it is normal on day three, that is normal too.
• A normal saturation in a weak child is not reassurance. Ask her to count out loud instead.
• The inflammatory disease that steroids do not touch. Give the immunoglobulin instead.
• Full power with no reflexes at all should stop you. Then look at the eyes.
• Ask about the bladder in every weak child. It decides between the cord and the nerve.

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.