Neurology – Set 6

What this deck covers

Neurology – Set 6 in 50 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 50 cases, in order

1. Weak legs, lost jerks after a cold
2. Girl waking with a drooping mouth
3. Numb below the navel, arms strong
4. Floppy baby with weak suck and ptosis
5. A fizzy feeling at bedtime
6. Where the climbing weakness arises
7. Drooping lids worse by afternoon
8. Wiring that empties the bladder
9. Dragged leg after an ankle twist
10. Febrile boy, one limp leg
11. What a palsied face can still do
12. Nerve studies in areflexic weakness
13. Cannot walk or pass urine at 7
14. Proving the cause of crawly calves
15. A bedside check for a tiring eyelid
16. Cannot stand, still getting weaker
17. A sweet remedy for colic
18. Evidence that counts in a weak leg
19. Side-by-side double vision at 6
20. What to send for a floppy limb
21. Quieter voice and a weak cough
22. Inflammation or compression on MRI
23. First blood test for tiring muscles
24. Evening leg urge, still sleeping badly
25. Site of damage in one floppy leg
26. An eye that will not close
27. Floppy legs with a full bladder
28. An older name for a climbing illness
29. Words for a family wanting more scans
30. Baby who cannot swallow his saliva
31. Newly diagnosed and on no medicines
32. Double vision and an unsteady walk
33. A girl who kicks in her sleep
34. Inflamed cord with nothing pressing
35. Spinal fluid in a febrile, limp child
36. Findings that change the diagnosis
37. Swinging pulse and pressure, day 4
38. Dragging leg, diagnosis accepted
39. Proving the cause in a floppy baby
40. Chest infection on pyridostigmine
41. Clue to a collection near the cord
42. Lumbar puncture on day 9 of weakness
43. Drooping eyelid for two days
44. Unsteady after a camping holiday
45. Asleep in class despite 10 hours
46. Stay at home until she walks?
47. Eight weeks on from a paralysed leg
48. Strength returning in week 3
49. Still weak after 6 months of steroids
50. Collapses with eyes shut tight

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Acute transverse myelitis, Spinal muscular atrophy type 1, Miller Fisher syndrome, Guillain-Barré syndrome, Lumbar puncture for CSF protein before imaging, IV immunoglobulin 2 g/kg over 2 to 5 days, Left lateral rectus; seek raised pressure, An epidural collection displacing the cord, Anterior horn cells of the spinal cord, Landry ascending paralysis, Oral pyridostigmine, Oral prednisolone 1 mg/kg once daily for 5 days, Autonomic nerve dysfunction, Aminoglycosides such as gentamicin.

Clinical pearls from this deck

• Ascending symmetrical weakness plus lost reflexes after an infection is Guillain-Barré syndrome until proved otherwise.
• Forehead weak: the nerve; forehead spared: the brain.
• Umbilicus is T10: legs weak, arms normal, the cord is thoracic.
• Constipated, then floppy from the top down, with big sluggish pupils: think infant botulism.
• Urge, rest, relief, evening: the four features of restless legs.
• Lost reflexes with no sensory level point to roots and nerves, not to the cord.

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.