ATI RN
Pediatric Neurology Question Bank Questions
Question 1 of 5
The MOST common neurologic sequelae of bacterial meningitis is
Correct Answer: C
Rationale: Hearing loss is the most common sequela of bacterial meningitis (~10-30%), per CDC, from cochlear damage (e.g., pneumococcus). Seizur, language delay , cognition , and vision are less frequent. Hearings vulnerability makes C the correct answer.
Question 2 of 5
The MOST common involved segments in transverse myelitis (TM) are in the
Correct Answer: B
Rationale: Transverse myelitis (TM) most commonly affects the thoracic region , accounting for approximately 50-60% of cases, according to data from the National Multiple Sclerosis Society and clinical studies. This predominance is due to the thoracic spinal cords greater length and vulnerability to inflammatory or demyelinating processes, such as those seen in neuromyelitis optica (NMO) or idiopathic TM. The cervical region is involved in about 20-30% of cases, often with more severe motor deficits, but it is less frequent. The lumbar and lumbosacral regions are even rarer, typically linked to specific etiologilike viral infections or trauma, and represent a minority of cases. The thoracic regions anatomical exposure to ascending or descending inflammatory insults, combined with its extensive vascular supply, makes itthe most susceptible segment. Clinical presentations often include bilateral sensory loss, weakness, and bladder dysfunction, which align with thoracic involvement. Thus, B is the correct answer, reflecting the epidemiological and pathophysiological patterns of TM.
Question 3 of 5
Elevated maternal serum α-fetoprotein
Correct Answer: B
Rationale: Elevated maternal serum α-fetoprotein (MSAFP) strongly indicatspina bifida , an open NTD where AFP leaks into amniotic fluid and maternal blood, per screening protocols (e.g., ACOG). Levels rise significantly by 16-18 weeks. Hydrocephalus alone donot typically elevate MSAFP unless paired with an open defect, which is rare. Both A and B overgeneralizes, as hydrocephaluss link is indirect. Neither dismissspina bifidas established marker. Spina bifidas direct AFP correlation, rooted in its pathophysiology, make B the correct answer, distinguishing it from hydrocephaluss imaging-based diagnosis.
Question 4 of 5
A 7-year-old with poor dentition has persistent frontal headaches, fever, and irritability for 5 weeks. Lumbar puncture shows opening pressure 250 mm Hg, WBC 120 (75% leukocytes), glucose 80 mg/dL, protein 95 mg/dL, negative Gram stain and culture. The next appropriate step is
Correct Answer: A
Rationale: CSF culture for tuberculosis is the next step for subacute frontal headaches, fever, and irritability with elevated CSF pressure (250 mm Hg), pleocytosis (120 WBC, 75% leukocytes), normal glucose (80 mg/dL), and elevated protein (95 mg/dL), negative for bacteria. This suggests tuberculous meningitis, common with chronic symptoms and dental/sinus spread. Cryptococcal antigen fits immunocompromised patients, less likely here. EEG assessseizures, not present. CT or dental consult may follow but miss CSF-specific diagnosis. TB culturspecificity, per IDSA guidelines, makes A the correct answer.
Question 5 of 5
The Gowers sign demonstrates
Correct Answer: D
Rationale: Gowers sign indicatproximal motor weakness, seen in muscular dystrophi(e.g., Duchenne), where patients use hands to walk up their legs to stand due to hip and thigh weakness. Poor reflexare nonspecific, not Gowers-specific. Spinal dysraphism and tethered cord affect lower limbs or sphincters, not proximal strength. Hysterical paralysis lacks organic basis. Gowerss biomechanical pattern, per neuromuscular literature, makes D the correct answer.