The teacher of a 6-year-old girl noticed that she had frequent attacks of a brief loss of environmental awareness accompanied by eye fluttering and lip smacking. Of the following, the first-choice therapy in this condition is

Correct Answer: D

Rationale: Ethosuximide is first-choice for absence seizures, per NICE, targeting T-type calcium channels for brief awareness loss with eye fluttering/lip smacking. Fosphenytoin and phenobarbital treat tonic-clonic; valproate broader-spectrum; midazolam acute. Ethosuximidspecificity makes D the correct answer.

Correct Answer: B

Rationale: IVIG is first-line for Guillain-Barré, per AAN, hastening recovery by neutralizing antibodies. Physiotherapy supports; plasma exchange alternative; drugs and steroids less effective. IVIGs evidence base make B the correct answer.

Correct Answer: D

Rationale: Slow muscle relaxation distinguishmyotonic dystrophy, per neurology, from Duchenne, due to myotonia (delayed relaxation post-contraction). Ptosis , cardiac issu, leg weakness , and facial weakness overlap. Myotonias specificity makes D the correct answer.

Correct Answer: C

Rationale: Benign congenital hypotonia featurpoor manipulative skills , per pediatrics, with delayed fine motor due to low tone but eventual normalcy. Presentation is at birth (A wrong); sitting delayed; arm kicking possible; verbal skills intact. Motor lag makes C the correct answer.

Correct Answer: D

Rationale: Cerebral palsy is the most common cause of pediatric dystonia, per neurology, from perinatal brain injury affecting basal ganglia (~1-4/1,000). Tourette tics; electrolytacute; Wilson rare; tardive drug-related. CPs prevalence makes D the correct answer.