Neurology

1.    Seizure Disorders.

???) Concerning neonatal convulsions, all the following are true except:

The usual tonic-clonic are not common, but tonic convulsions are the commonest in pre-matures

Subtle type is the commonest form and hypoxic ischemia encephalopathy is the most common cause

Differential diagnosis includes Jitteriness

Phenobarbitone is considered to be the drug of choice for neonatal seizure

Etiology: hypoglycemia, hypocalcemia, and hypermagnesemia

Answer: 5* Etiology: hypoglycemia, hypocalcemia, and hypermagnesemia

???) Commonest type of neonatal seizures is:

Generalized tonic clonic

Subtle type

Tonic type

Clonic type

Myoclonic type

Answer: 2* Subtle type

???) Possible causes of convulsions in neonate include all of the following, except:

Hypocalcemia

Hypoglycemia

Febril convulsions

Pyridoxine deficiency

Intracranial hemorrhage

Answer: 3* Febril convulsions

???) Convulsions in a premature newborn could be caused by all of the following, except:

Brain anoxia

Hypokalemia

Hypoglycemia

Hypocalcemia

Kernicterus

Answer: 2* Hypokalemia

???) Neonatal convulsions can be caused by all except:

Hypoglycemia

Hypoxic-ischemic encephalopathy

Pyridoxin deficiency (Vit B6)

High fever

Hypocalcemia

Answer: C* Pyridoxin deficiency (High levels of Vit B6 may lead to convulsions)

???) The differential diagnosis of "staring" in a child includes all of the following, except:

Absence seizure

Partial complex seizure

Day dreaming

Clonic seizure

Drug intoxication

Answer: 4* Clonic seizure

2.    Febrile Seizures.

???) Criteria for diagnosis of febrile convulsions include all the following except :

Age 6 months to 5 years

Presence of fever

Absence of CNS infection

Abnormal electroencephalography EEG

Positive family history of febrile convulsions

Answer: 4* Abnormal electroencephalography EEG

???) Concerning febrile seizures one of the following is true:

Do no harm to most healthy children

Are associated with low grade meningitis

Never occur after 3 years

Produce permanent EEG changes

Require therapy with rnysoline

Answer: 1* Do no harm to most healthy children

???) All of the following are risk factors for increase recurrence of febrile convulsions, except:

Older age of onset (more than 4 years)

Prior neurological abnormality

Family history of febrile convulsions

Family history of non-febrile convulsions

Complex febrile seizures

Answer: 4* Family history of non-febrile convulsions

???) All of the following statements are correct about simple febrile convulsions (SFC), except:

Age range is 6 months - 6 years

Incidence of subsequent epilepsy is double the general populations

Risk of recurrence for a 4 year old child presenting with first attack of SFC is 10%

The younger the age of onset of SFC the higher is the recurrence rate

IQ in late onset of SFC is usually decreased by 15 points below the mean of the general population

Answer: 5* IQ in late onset of SFC is usually decreased by 15 points below the mean of the general population

3.    Hypotonia.

???) Treatable causes of hypotonic infant include all of the following, except:

Myastenia gravis

Rickets

Malnutrition

Chronic demyelinating polyneuropathy

Dystrophies

Answer: 5* Dystrophies

***) One of the following statements is correct about floppy infant:

Suprasegmental (central) causes are commoner than segmental (peripheral) ones

Muscle disease is the commenest segmental (peripheral) cause of floppy infants

There are no treatable causes for floppy infant

Anterior horn cell disorder is considered to be supra segmental cause

Tongue fibrillation are caused only by suprasegmental causes (central)

Answer: 1* Suprasegmental (central) causes are commoner than segmental (peripheral) ones

4.    Cerebral Palsy (CP).

***) In kernicterus infants staining of the brain is more intense in the:

A.    Basal ganglion

B.     Cerebellar vermis

C.     Cerebral cortex, motor areas

D.    Spinal cord

E.     Corpus callosum

Answer: A* Basal ganglion

***) Patients with severe cerebral palsy usually die because of:

Urinary tract infections

Chest infections

Meningitis

Heart failure

Hepatic failure

Answer: 2* Chest infections

***) All of the following are clinical features of basal ganglia disorders, except:

Chorea

Athetosis

Dystonia

Myotonia

Hypertonia

Answer: 4* Myotonia

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***) Methylphenidate (Ritalin) is a drug used in the treatment of one of the following disorders:

A.    Migraine

B.     Tension headaches

C.     Hyperkinetic behavior

D.    Vertigo

E.     Epilepsy

Answer: C* Hyperkinetic behavior