Neuro-imaging is warranted in a child with headache in the following conditions EXCEPT

Correct Answer: B

Rationale: Neuroimaging is indicated for headachwith red flags: abnormal neurologic exam , age <6 , or brief cough headache suggesting raised intracranial pressure, and migrainwithout family history . Afternoon headache is not a specific alarm sign; timing alone lacks diagnostic weight unless tied to other symptoms. Guidelin(e.g., AAP) prioritize objective or high-risk featurover temporal patterns, making B the exception and correct answer, as it donot independently warrant imaging.

Correct Answer: B

Rationale: Pseudotumor cerebri (idiopathic intracranial hypertension) featurheadache , papilledema , fatigue , and normal CSF (E is false). Stiff neck suggests meningitis or hemorrhage, not pseudotumor, which mimics tumor pressure without infection. This clinical differentiation pressure versus inflammation make B the exception and correct answer.

Correct Answer: B

Rationale: Benign familial megalencephaly is the most common anatomic megalencephaly cause, a non-syndromic, inherited large head size without neurologic deficits. Sotos , Simpson-Golabi-Behmel , fragile X , and Weaver are rarer syndromic causwith additional features. Bs frequency and benign nature make it the correct answer.

Correct Answer: D

Rationale: Prolonged febrile seizurpost-vaccination with encephalopathy often reveal Dravet syndrome , a severe SCN1A-related epilepsy misdiagnosed as vaccine injury. GEFS+ , temporal lobe epilepsy , and myoclonic-astatic seizurare less common in this context. Dravets early onset and severity make D the correct answer.

Correct Answer: B

Rationale: Valproic acid causweight gain and alopecia via metabolic and hormonal effects (e.g., insulin resistance, hair follicle disruption). Primidone , oxcarbazepine , lamotrigine , and acetazolamide lack this profile rash or sedation dominate instead. Valproatunique side effects make B the correct answer.