Neurology – Set 7

What this deck covers

Neurology – Set 7 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. Raw leaking area on a newborn back
2. Deformational head shape from above
3. Cooled at term, now stiff in all limbs
4. Sorting microcephaly by its timing
5. Hair tuft on back and new wetting
6. Later change that questions the label
7. Blinks, jerks and sniffs for 2 years
8. Classifying spinal dysraphism
9. Delay, spasms and a shrinking head
10. Why most cerebral palsy happens
11. Long, narrow infant skull
12. Hips and knees move, ankles do not
13. Foot turns in as the day goes on
14. Second-trimester blood screening
15. Swelling behind a newborn head
16. Wetting and soiling return at five
17. Walker user now up on her toes
18. Neonatal scan behind stiff arms
19. Growing head after back closure
20. Shrugs and throat clearing at nine
21. Smooth thick cortex on imaging
22. Referral asking about a small skull
23. Wet voice and cough at mealtimes
24. Painful neck jerks and teasing
25. Sudden rituals and fidgety hands
26. Odds for the next pregnancy
27. Meaning of the plain film finding
28. Reading white matter at 9 months
29. Open back lesion in the delivery room
30. Where the spinal cord should end
31. Runs at dawn, drags a foot by dusk
32. Will she ever walk unaided
33. Helmet or new sleeping position?
34. Swollen kidneys and a tight bladder
35. Lasting answer for tight legs
36. Mapping a skull sac before surgery
37. Smooth cortex and the years ahead
38. Parents ask about surgery
39. Stridor and apnoeas at 8 weeks
40. How common each motor pattern is
41. Tics and inattention despite therapy
42. How this gait disorder is passed on
43. Unsafe swallow and falling weight
44. Scan to map a ridged forehead
45. Worsening legs and sphincters
46. Stiff hips in a frame walker
47. Neck twist after an antiemetic
48. Smooth cortex, worse at the back
49. Vitamin plan for the next pregnancy
50. Long-term outlook on treatment

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Open myelomeningocele, A head circumference already small at birth, Tourette syndrome, Infections of the brain after birth, Spastic diplegic cerebral palsy, MRI of the whole spine, Dandy-Walker malformation, Head circumference smaller than chest circumference, Lumbar puncture for oligoclonal bands, Fastest in year 1; adult-like on MRI by about age 2, Trial of oral baclofen, Antibiotic prophylaxis alone, with repeat scans, Severe disability with drug-resistant epilepsy, Dyskinetic types are the commonest overall.

Clinical pearls from this deck

• No skin, visible neural tissue and leaking fluid: that is open spina bifida until proved otherwise.
• Parallelogram is positional; trapezium is lambdoid synostosis.
• Arms as bad as the legs means quadriplegia, not diplegia.
• Timing is the key: small at birth is congenital, falling later is acquired.
• A child who loses continence and has a hairy back needs her spine imaged, not her bladder trained.
• The lesion never progresses; a child who loses skills does not have cerebral palsy until proved otherwise.

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.