Pathophysiology Chapter 20 – Alterations of Neurologic Function in Children

Pathophysiology

Chapter 20: Alterations of Neurologic Function in Children

MULTIPLE CHOICE

1. The neural groove closes dorsally during which week of gestational life?

a. Second

b. Fourth

c. Eighth

d. Twelfth

 

2. A healthcare professional advises a pregnant woman to add supplements of which nutrient to her diet to prevent birth defects?

a. Iron

b. Vitamin C

c. Zinc

d. Folate

 

3. Which defect of neural tube closure is most common?

a. Anterior

b. Posterior

c. Lateral

d. Midline

 

4. What is the anomaly in which the soft bony component of the skull and much of the brain is missing?

a. Anencephaly

 b. Myelodysplasia

c. Cranial meningocele

d. Hydrocephaly

 

5. What is the most common cause of obstructive hydrocephalus in infants?

a. Obstructed arachnoid villi

b. Stenosis of the aqueduct of Sylvius

c. Excessive production of cerebrospinal fluid

d. Impaired cerebrospinal fluid circulation in the subarachnoid space

 

6. A student reads in a chart that a baby was born with an encephalocele. The student asks the healthcare professional to explain this condition. What explanation by the healthcare professional is best?

a. A herniation or protrusion of brain and meninges through a defect in the skull

b. A protruding saclike cyst of meninges filled with spinal fluid and is a mild form of spina bifida

c. Protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord through a defect in the posterior arch of a vertebra

d. Premature closure of one or more of the cranial sutures during the first 18 to 20 months of an infant’s life

 

7. What is the result of a Chiari type II malformation associated with a myelomeningocele?

a. Upward displacement of the cerebellum into the diencephalon

b. Motor and sensory lesions below the level of the myelomeningocele

c. Downward displacement of the cerebellum, brainstem, and fourth ventricle

 d. Generalized cerebral edema and hydrocephalus

 

8. A baby is born with a myelomeningocele and needs urgent surgery to repair the defect. The parents want to take the baby home instead. What does the healthcare professional tell the parents about the purpose of this surgery?

a. “Surgery is much easier on a tiny infant than on a larger, older baby.”

b. “If your baby has surgery this young, he/she cannot feel pain.”

c. “Additional nervous system damage will occur the longer we wait.”

d. “Prompt surgery is needed to prevent total paralysis later on.”

 

9. A baby demonstrates asymmetric pathological reflexes and microcephaly at a 9-month checkup. The baby appeared normal at birth. What action by the healthcare professional is best?

a. Determine the baby’s risk for developing an HIV infection since birth.

b. Assess the baby for other signs of child abuse or neglect.

c. Ask the mother if she uses drugs or alcohol in excess.

d. Perform spinal cord imaging and other diagnostic studies.

 

10. An infant is brought to the emergency department by parents who report that the baby’s fontanels seem to be bulging outward. What action by the healthcare provider is most appropriate?

a. Assess the baby for recent trauma to the head.

b. Measure the head circumference and plot it on a growth chart.

c. Prepare the baby for a lumbar puncture and blood cultures.

d. Determine how much fluid the baby had in the last 24 hours.

 

11. Gait disturbances and instability are characteristic of which form of cerebral palsy?

a. Spastic

b. Dystonic

c. Ataxic

d. Biochemical

 

12. A child has phenylketonuria (PKU). The healthcare professional educates the parents on the special diet needed, telling them that children with PKU are unable to synthesize what?

a. Essential amino acid, phenylalanine, to tyrosine

b. Renin, erythropoietin, and antidiuretic hormone

c. Aldosterone, cortisol, and androgens

d. Neurotransmitters gamma-aminobutyric acid (GABA) and acetylcholine

 

13. A healthcare professional teaches a parenting class that benign febrile seizures are characterized by what?

a. A temperature higher than 38.5?C (101.3?F)

b. Concurrent respiratory or ear infections

c. Onset after the fifth year of life

d. Episodes lasting 30 min or longer

 

14. Parents bring their 1-year-old child to the emergency department, reporting that the child has been irritable and pounding on her head, has projectile vomiting, and seems very sleepy for most of the last 3 days. What diagnostic testing does the healthcare professional prepare the child and parents for as the priority?

a. Brain scanning with either CT or MRI

b. Lumbar puncture with CSF cultures

c. Developmental assessment

d. Ophthalmologic assessment

 

15. A 7 months old in the clinic displays an intact tonic neck reflex. What action by the healthcare professional is most appropriate?

a. Chart the finding as normal in the child’s chart.

b. Assess the baby for signs of malnutrition.

c. Educate the parents on how to improve mobility.

d. Assess the child’s development further.

 

16. A pregnant woman is seen for the first time at 6 months’ gestation and has not taken prenatal vitamins. The healthcare professional educates the woman on the need for a blood test specifically to assess what substance?

a. Total protein

b. Culture

c. ?-Fetoprotein

d. C-reactive protein

 

17. The clinical manifestations of dyskinetic cerebral palsy include what?

a. Increased muscle tone and prolonged primitive reflexes

b. Exaggerated deep tendon reflexes, clonus, and rigidity of extremities

c. Scoliosis, contractures, and stiffness of trunk muscles

d. Jerky uncontrolled and abrupt fine musculoskeletal movements

 

MULTIPLE RESPONSE

1. What can microcephaly be caused by? (Select all that apply.)

a. Autosomal gene alterations

b. Prenatal physical abuse of the mother

c. X-linked gene alterations

d. Toxic-induced chromosomal defects

e. Maternal anorexia

 

2. Which statements regarding the term myelodysplasia are true? (Select all that apply.)

a. Myelodysplasia is used to define a defect in the formation of the spinal cord.

b. It can be used to refer to brain anomalies involving missing brain tissue.

c. Myelodysplasia correctly includes encephaloceles.

d. It is used to describe a herniation of brain and meninges through a defect in theskull.

e. Myelodysplasia can be used to refer to a form of spina bifida.