Spinal Cord Injury – Board-Style Questions

What this deck covers

Spinal cord injury 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. Nothing broken on the pictures
2. One level, or all of it
3. Low pressure, slow pulse
4. A big head on a flat trolley
5. Forward on the film
6. Nothing to elicit yet
7. The last part of the check
8. Arms worse than legs
9. The chest that will not move
10. A drug from an older textbook
11. A pounding head, months later
12. Ahead of the tablet
13. Cold on a warm ward
14. The skin over the bones
15. What was missed on the chart
16. Sitting crooked two years on
17. Floppy at first, stiff later
18. What to say in the first week

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A fracture is present but hidden by the shoulders on the lateral view, The whole spine is imaged, because a second injury at another level is common, Bleeding into the abdomen that has not yet been found on the examination so far, An adult collar fastened tightly, which will hold the neck in the safest position, A normal variant of the growing neck, shown by the line along the posterior arches, The cord has been completely divided, and no recovery is possible from this moment on, Grip strength in both hands, repeated hourly through the first night on the ward, Injury to the nerve roots of the neck, from traction on the shoulder in the fall, The muscles between the ribs are paralysed while the diaphragm still works, They are given at once, since the eight-hour window has not yet closed for this boy, Raised pressure inside the skull from a missed injury at the time of the crash, Arrange an urgent scan of the head before anything else is done for her, He cannot shiver or sweat below the level, so he takes on the temperature around him, A daily inspection of the skin, with turning started as soon as redness appears.

Clinical pearls from this deck

• A child’s cord can tear while the bones stay whole.
• One spinal injury means looking for a second one.
• Low pressure with a slow pulse is not blood loss.
• A big head needs the shoulders raised, not the head.
• Step at the second on the third in a child is normal.
• Flaccid areflexia early hides the true final level.

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 emergency and critical care case decks · pediatric reference values.