A 12-year-old presents with severe headache, grand mal seizure, and collapse into unresponsive flaccid coma. History includintermittent right-sided headachwithout aura. Exam shows afebrile state and nuchal rigidity. The most likely diagnosis is

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Question 1 of 5

A 12-year-old presents with severe headache, grand mal seizure, and collapse into unresponsive flaccid coma. History includintermittent right-sided headachwithout aura. Exam shows afebrile state and nuchal rigidity. The most likely diagnosis is

Correct Answer: D

Rationale: Arteriovenous malformation (AVM) fits severe headache, seizure, coma, and nuchal rigidity from subarachnoid hemorrhage (SAH). Prior right-sided headachsuggest vascular irritability; acute collapse indicatrupture. Afebrile state rulout bacterial or tuberculous meningitis , which present with fever. Brain tumor grows slowly, lacking sudden coma. Pott puffy tumor involvsinusitis, not coma. AVMs bleeding risk, per stroke literature, makes D the correct answer, aligning with acute vascular catastrophe.

Question 2 of 5

The most common cause of neonatal seizuris

Correct Answer: D

Rationale: Hypoxic-ischemic encephalopathy (HIE) is the most common neonatal seizure cause (~50-60%), per Volpe, from perinatal asphyxia disrupting brain metabolism. Febrile seizuroccur later (6 months-5 years). Pre-eclampsia affects mothers, indirectly fetuses. Hypocalcemia is less frequent (~10%). Aicardi syndrome is rare. HIprevalence in term infants makes D the correct answer.

Question 3 of 5

A 19-year-old female presents with headache, unsteadiness, and poor hearing progressed over 5 years. Her father had brain surgery and deafness since age 35. The most likely diagnosis is

Correct Answer: A

Rationale: Neurofibromatosis type II (NF2) fits progressive hearing loss, unsteadiness (vestibular schwannomas), and headache, with autosomal dominant inheritance (fathers deafness post-surgery). NF2 (chromosome 22) causbilateral vestibular schwannomas. Optic glioma and NF1 lack hearing loss prominence. Tuberous sclerosis featurseizures, not deafness. Congenital deafness isnt progressive. NF2s familial and auditory profile makes A the correct answer.

Question 4 of 5

Neurofibromatosis (NF type 1) has characteristic flat, light brown macules, called

Correct Answer: A

Rationale: Caféau lait maculare flat, light brown spots defining NF1, per NIH criteria, with ≥6 (prepubertal >5 mm) signaling diagnosis. Adenoma sebaceum are angiofibromas in tuberous sclerosis. Ash-leaf spots are hypopigmented in tuberous sclerosis. Shagreen patch is a connective tissue nevus in tuberous sclerosis. Nail fibromas are unrelated. NF1s autosomal dominant (chromosome 17) pattern and macule specificity make A the correct answer, distinguishing it from other neurocutaneous syndromes.

Question 5 of 5

A medical student during practical final exam was asked by the examiner to do a stroking of the skin along the edge of vertebrae to a 2-week-old neonate, which produccurvature of the spine with concavity on the side of the stroke, this maneuver is called

Correct Answer: D

Rationale: The Gallant reflex , or trunk incurvation, occurs in neonatwhen stroking paravertebrally causspinal curvature toward the stimulus, present at birth to 2-6 months, per pediatric texts. Asymmetrical tonic neck reflex involvhead-turning and limb extension. Parachute is protective arm extension. Placing is leg lifting when dorsum toucha surface. Moro is startle. Gallants spinal response makes D the correct answer.

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