Neurology – Set 8

What this deck covers

Neurology – Set 8 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. Floppy, bright-eyed infant
2. How he gets up from the floor
3. Girl losing hand use and words
4. New motor signs on levodopa
5. Unsteady boy with red-eye vessels
6. Before daily prednisolone starts
7. Floppy baby with gastroenteritis
8. Pigmented gums, slipping school marks
9. School decline, rigidity and seizures
10. Parents ask how severe it will be
11. Boy slow to release his grip
12. Weak, alert baby with no reflexes
13. Late walker with big firm calves
14. Parents fear sudden death
15. Cold in a weak 5-month-old
16. Long-term risk parents ask about
17. Fidgety girl, a sign to look for
18. School decline and tanned skin
19. Why her illness began so young
20. Third chest infection this year
21. Affected boy, affected uncle
22. Toe-walking girl with dystonia
23. Frog-leg posture, absent reflexes
24. Motor plateau at 6 years
25. Chance of it happening again
26. Girl who cannot let go of a handle
27. Low cortisol before sedation
28. Mother plans another pregnancy
29. Back pain after slipping off a step
30. Wobbly since her first steps
31. Long PR interval and a slow handshake
32. Grandmother asks about polio
33. Leaning to one side in her chair
34. Bright baby with a rippling tongue
35. Abnormal liver tests, frequent falls
36. Missing objects in the lower fields
37. Head lag after the diarrhoea settles
38. Cramps but still playing football
39. Transplant question from parents
40. Yearly review of a sleepy teenager
41. What else comes with her ataxia
42. A year after he stopped walking
43. A second white-matter disease
44. Well newborn with an affected sister
45. Flickering tongue, absent reflexes
46. Slow to run, with a very high CK
47. How juvenile Batten disease begins
48. Morning headaches at 14
49. Untreated natural history
50. Tripping from weak ankles

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Congenital muscular dystrophy, Rhythmic oscillation at a steady frequency, Discharge once drinking, with no further tone review, Degree of denervation on EMG, Myotonic dystrophy type 1, Cerebellar medulloblastoma, Two mutant copies, one from each parent, Caudate head atrophy with boxy ventricles, About 25%, as both parents are carriers, Any affected child will be milder than she is, CTG repeat sizing in the DMPK gene, Neurogenic pattern on electromyography, It is a normal variant; reassure and discharge him, Renal ultrasound to look for kidney stones.

Clinical pearls from this deck

• Floppy, areflexic, fasciculating but bright-eyed: think of spinal muscular atrophy.
• Hands on the thighs to stand means weak hips, whatever the cause.
• Lost hand use plus hand-wringing in a regressing girl is Rett syndrome until proved otherwise.
• Chorea flows, tremor oscillates, dystonia twists, and tics follow an urge.
• Ataxia first, telangiectasia a few years later, infections throughout.
• Before steroids, close the chickenpox gap.

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.