Clinical Perspective - Pediatric Neurology

Question 1

What is the most common reason for seizures in children?

Answer 1

Febrile seizures due to rapid rise in temperature

Question 2

Presentation of these actions indicates an intact brainstem.

Answer 2

Rolling from tummy-back and sitting up independently

Question 3

What is sun-setting?

Answer 3

Downward eyes in a baby that may indicate hydrocephalus

Question 4

What is the suck-swallow reflex?

Answer 4

Instinctual reflex to suck anything that stimulates the roof of the mouth

Question 5

What gross motor action appears around 9mo?

Answer 5

Crawling, pulling to stand

Question 6

What food is most associated with infantile botulinum poisoning?

Answer 6

Honey

Question 7

What is the Rooting reflex?

Answer 7

Opening of the mouth when the cheek is rubbed

Question 8

What action corresponds with the development of the higher cortex?

Answer 8

Pull to stand and equilibrium

Question 9

What social milestone is associated with 8mo?

Answer 9

Child will look in the same direction as the caregiver - looks at what the caregiver is looking at

Question 10

What social milestone is usually achieved by 5mo?

Answer 10

Recognizing caregiver

Question 11

What fine motor movement presents around 5mo?

Answer 11

The involuntary grasp reflex disappears and infants begin to explore their environment with their hands and place objects in their mouth

Question 12

What is proto-imperative pointing and when does it develop?

Answer 12

Pointing at a desired object - develops 12-14mo

Question 13

What is Chusing’s Triad?

Answer 13

A possible sign of hydrocephalus in children, includes hypertension, bradycardia, and respiratory depression

Question 14

What figure can be drawn by a child at age 4?

Answer 14

Cross

Question 15

What figure can be drawn by a child at age 3?

Answer 15

Circle

Question 16

By this age, a baby can “manipulate” their environment by crying, etc.

Answer 16

4mo

Question 17

True/False. Swimming is a primitive reflex.

Answer 17

True

Question 18

Port-wine stains involving the V1 & V2 branches of CN V are characteristic of this pediatric neurocutaneous disorder.

Answer 18

Sturge-Weber Syndrome

Question 19

At what age can a child draw a triangle?

Answer 19

5yo

Question 20

By what age does a child know the difference between real and imaginary?

Answer 20

4yo

Question 21

Werdnig-Hoffman disease is a form of muscular atrophy with onset in the first few months of life. Changes are reversible with early intervention. What symptoms are associated with the disease?

Answer 21

Weak cry, hypotonia, respiratory distress, head lag, tongue fasciculations, “frog legs”

Question 22

Around what age do infants understand object permanence?

Answer 22

9-10mo

Question 23

What is the primary reason for speech delay?

Answer 23

Hearing issues

Question 24

Around what age does chest support with arms in a prone manner present?

Answer 24

3 months

Question 25

What is the most common cause of bacterial meningitis in newborns?

Answer 25

Strep agalactiae

Question 26

What gross motor action appears around 6mo?

Answer 26

Sitting with truncal support

Question 27

This principle is believed to allow an infant to achieve their social milestones in a predictable manner.

Answer 27

Attachment theory

Question 28

At what age will a child understand its name?

Answer 28

6mo

Question 29

By what age does a baby develop the concept of "stranger danger?"

Answer 29

6mo

Question 30

When does a child develop simple play, bringing objects to their caregiver?

Answer 30

18mo

Question 31

By what age should a child know 150-200 words?

Answer 31

15mo

Question 32

By what age will a baby respond to their name by turning their head?

Answer 32

10mo

Question 33

When can a child draw a square?

Answer 33

4.5yo

Question 34

What should be the response of the Babinski test in a newborn?

Answer 34

Up going toes - this response disappears between 12-18mo with toes going down in older children and adults

Question 35

At what age can a child draw a diamond?

Answer 35

6yo

Question 36

What are potential causes of abnormal head shape in a baby?

Answer 36

Craniosynostosis or plagiocephaly

Question 37

What is the atonic-neck reflex?

Answer 37

Turning of a newborn's head causes arm motion

Question 38

What is the most common cause of febrile seizures in children?

Answer 38

HSV-6

Question 39

You are reviewing the chart of a child at your clinic. The chart describes ash leaf spots, Shagreen patches, and adenoma sebaceum. What disease does this child have?

Answer 39

Tuberous Sclerosis

Question 40

What is craniosynostosis?

Answer 40

Premature closing of cranial sutures. Closure of one suture results in abnormal head shape, but closure of multiple sutures causes cognitive impairment

Question 41

What action coincides with midbrain development in a newborn?

Answer 41

Postural righting response

Question 42

Children develop the ability to walk up/down stairs in various stages. What are they and when do they generally present?

Answer 42

2 years - Ascend/descend with both feet on each step 3 years - Ascend with alternating feet, but descend with both feed on each step 4 years - Ascend/descend with alternating feet

Question 43

What is the most common cause of meningitis in babies >6mo and older children?

Answer 43

Strep pneumoniae

Question 44

What language can a child express by 15mo?

Answer 44

Mama, dada, and one other word

Question 45

When does the parachute reflex present?

Answer 45

Generally between 8-10mo

Question 46

Which develops first? Receptive or expressive language?

Answer 46

Receptive language - expressive language follows

Question 47

When does the development of the higher cortex begin?

Answer 47

9-12mo

Question 48

"Cooing" presents around what age?

Answer 48

2mo

Question 49

What is the most common cause of headaches in children?

Answer 49

Tension headaches

Question 50

A what age will a baby smile in response to a stranger's smile?

Answer 50

2mo - social smile

Question 51

Parallel play, playing alongside another child but not with the child, develops when?

Answer 51

2yo

Question 52

Grasping of the fingers and toes in response to stimulation is called...?

Answer 52

Palmer & Planter Grasps

Question 53

When does complex play develop?

Answer 53

30mo

Question 54

A child may begin putting words together by what age?

Answer 54

2 years

Question 55

Failure of the Moro Test/Startle Reflex (abduction and extension of the arm) may indicate what type of injury in a newborn?

Answer 55

Brachial plexus injury

Question 56

What reaction should a newborn have in response to light?

Answer 56

Involuntary closing of the eyes - Blinking Reflex

Question 57

True/False. By 5yo the head is approximately adult size and shape.

Answer 57

False. The head is adult size and shape by approximately 2yo

Question 58

In the Galant test, an infant's back is stroked on one side. What is the normal response?

Answer 58

The baby will bend to the stimulated side

Question 59

What are the most common pediatric neurocutaneous disorders?

Answer 59

Neurofibromatosis, tuberous sclerosis, Sturge-Weber, von Hippel-Lindau, ataxia-telangiectsia

Question 60

What is the primary difference between Neurofibromatosis Types 1 & 2?

Answer 60

Type 1 is more severe and has pediatric onset, whereas Type 2 does not have onset until after 18yo

Question 61

What social milestones develop around 3yo?

Answer 61

Aggression, fantasy, fear, sharing, playing with some other children

Question 62

A child develops adult skills and can play "dress up" by this age.

Answer 62

5yo

Question 63

What expressive language milestone presents at 6mo?

Answer 63

Babbling

Question 64

True/False. Walking/Stepping is a primitive reflex that presents around 8mo.

Answer 64

False. Involuntary walking/stepping is present at birth and later returns as a voluntary behavior.

Question 65

What causes Neurofibromatosis Type 1?

Answer 65

Mutation in NF1 gene

Question 66

A child can begin to recognize common words and extract words when?

Answer 66

8-10mo

Question 67

What is proto-declarative pointing and when does it develop?

Answer 67

Pointing to share an experience - develops around 16mo

Question 68

What are the most common causes of communicating hydrocephalus in babies?

Answer 68

Meningitis, subarachnoid hemorrhage

Question 69

What figure can be drawn by a child at age 2?

Answer 69

Straight line

Question 70

This reflex disappears around 4mo and indicates an intact brainstem in a newborn.

Answer 70

Atonic neck reflex - prevents the baby from rolling onto its stomach

Question 71

By what age should a stranger be able to fully understand what a child is saying?

Answer 71

4 years old

Question 72

What are potential complications of Sturge-Weber Syndrome?

Answer 72

Glaucoma, Blindness

Question 73

What are the clinical features of Neurofibromatosis Type 1?

Answer 73

Cafe au lait spots, axillary freckling, cutaneous neurofibromas, iris hamartomas (Lisch nodules)

Question 74

Around what age does an infant develop the ability to walk?

Answer 74

12months