Answers
On your patient schedule see a diagnosis of plagiocephaly on your patient schedule.
You vaguely recall learning something about this in Nurs 612 so you check UpToDate
and are able to explain the etiology of this head growth disturbance is to the parents
of this 4-month-old :
A. Your child's head appears small. His head size is 2 SD below the mean, this can
result abnormal brain development from a genetic or teratogenic exposure
B. Your child's head appears flat. This form of craniostenosis can result from
premature fusion of lambdoidal or coronal skull sutures and often results in brain
injury.
C. Your child's head appears large. His head size is 2 SD above the mean, this can
result from hydrocephalus while skull sutures are open.
D. Your child's head appears flat. This form of craniostenosis can result from
premature fusion of lambdoidal or coronal skull sutures and is often only cosmetic and
can be treated with a s Ans: D. Your child's head appears flat. This form of
craniostenosis can result from premature fusion of lambdoidal or coronal skull sutures
and is often only cosmetic and can be treated with a special helmet.
During a 1-week-old male well child check the head circumference is 3 S.D. (standard
deviations) below the predicted mean. What risk factors increases the risk of this
finding?
A. Positioning infant on their back
B. Prenatal Zika virus exposure
C. Hydrocephaly
,D. Subdural hematoma or tumor Ans: B. Prenatal Zika virus exposure
You are seeing a 6-month-old today for follow-up after a febrile seizure yesterday. On
exam you expect to find:
A. the anterior fontanel closed.
B. the posterior fontanel closed
C. sleepiness from a post-ictal state
D. nuchal rigidity Ans: B. the posterior fontanel closed
You are examining a 22-month-old today for follow-up after a with a new sudden
onset of jerking movements while febrile earlier today. Which of the following is not
typical of this type seizure?
A. Positive family history
B. Age onset between 3 months and 5 years
C. Seizure lasting more than 15 minutes
D. Most likely to occur with a rapid rise in body temperature Ans: C. Seizure lasting
more than 15 minutes
A 15-year-old with a diagnosis of epilepsy had a seizure in your office lasting 12
minutes requiring rectal diazepam (Valium). He is stable in a postictal state. His parents
express concern as his last seizure was 2 years ago and he wanted to be weaned off his
phenytoin (Dilantin).Which of the following may have contributed to this seizure?
A. Experimentation with alcohol consumption which lowers seizure threshold.
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, B. Recent growth spurt resulting in decreased kg/mg dosage
C. Adolescent may be challenging diagnosis and non-compliant with phenytoin regimen
D. All choices are correct Ans: D. All choices are correct
What question in an adolescent's history is the MOST important to ask concerning
new onset of headaches?
A. Alcohol use
B. Caffeine use
C. History of headache most severe when arising from sleep
D. Positive family history for headaches Ans: C. History of headache most severe
when arising from sleep
A 17-year-old arrives for evaluation of a headache. He states it is worse in the morning
and does not respond to ibuprofen. His caffeine intake has not changed, he has no
known head trauma. On exam you note he is slow to respond to questions and your
fundoscopic exam the optic disc borders are blurred (papilledema). You explain your
next action
A. He exhibits a focal neurological sign, order a CT
B. He exhibits a focal neurological sign, discharge the patient home prescribing bedrest,
acetaminophen and recommend sunglasses
C. He exhibits no focal neurological signs, discharge the patient home on bedrest,
teaching family members signs warning signs of increased ICP
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