An 8-year-old boy presents to the Emergency Department with altered mental status and weakness. The mother reports that her son had a fever and complained of a headache two days prior to presentation, along with upper extremity weakness. Earlier in the day, his headache worsened, he had vomiting, and appeared confused. The mother states that approximately one week ago, he had a viral illness but appeared to have fully recovered. Beyond this, he is neurologically normal at baseline. While performing the physical exam, he has a generalized tonic-clonic seizure, requiring benzodiazepine administration. Vital signs show that he is afebrile with a normal blood pressure. On physical exam, the patient has mild nuchal rigidity, a right relative afferent pupillary defect, right and left-sided weakness, and a bilateral Babinski reflex. Magnetic resonance imaging (MRI) showed diffuse white matter lesions. Which of the following is most likely the diagnosis?

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Question 1 of 5

An 8-year-old boy presents to the Emergency Department with altered mental status and weakness. The mother reports that her son had a fever and complained of a headache two days prior to presentation, along with upper extremity weakness. Earlier in the day, his headache worsened, he had vomiting, and appeared confused. The mother states that approximately one week ago, he had a viral illness but appeared to have fully recovered. Beyond this, he is neurologically normal at baseline. While performing the physical exam, he has a generalized tonic-clonic seizure, requiring benzodiazepine administration. Vital signs show that he is afebrile with a normal blood pressure. On physical exam, the patient has mild nuchal rigidity, a right relative afferent pupillary defect, right and left-sided weakness, and a bilateral Babinski reflex. Magnetic resonance imaging (MRI) showed diffuse white matter lesions. Which of the following is most likely the diagnosis?

Correct Answer: B

Rationale: Post-viral illness with acute encephalopathy, weakness, seizure, and diffuse white matter lesions in a child suggest ADEM, an immune-mediated demyelinating disorder.

Question 2 of 5

Which of the following statements about resting potential is true?

Correct Answer: D

Rationale: The sodium-potassium pump maintains the resting potential (-70 mV) by pumping 3 Na⁺ out and 2 K⁺ in, creating ion gradients across the membrane.

Question 3 of 5

Valium, a prescription drug used to treat depression, works by

Correct Answer: B

Rationale: Valium (a benzodiazepine) enhances GABA’s inhibitory effects by increasing chloride influx, reducing anxiety, not depression directly (likely a text error; it’s typically for anxiety).

Question 4 of 5

The enteric division of the autonomic nervous system consists of neurons in the digestive tract, the gallbladder, and the

Correct Answer: C

Rationale: The enteric nervous system governs the digestive tract, gallbladder, and pancreas, regulating gastrointestinal function.

Question 5 of 5

The network of neurons that extends through the core of the brainstem and selects information that reaches the cerebral cortex during sleep is the

Correct Answer: C

Rationale: The reticular formation regulates arousal and filters sensory input to the cortex, influencing sleep and attention.

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