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Neurological Emergencies Flashcards

7 cards from real CPEN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Neurological Emergencies flashcards as text

  1. A 3-year-old presents with sudden onset of left-sided hemiplegia and facial droop. Which condition should be highest on the differential?

    Answer: Arterial ischemic stroke

    Arterial ischemic stroke in children presents with acute focal neurological deficits and requires immediate neuroimaging to guide treatment.

  2. Which finding on CT head is MOST concerning for non-accidental trauma in a 6-month-old with altered mental status?

    Answer: Bilateral subdural hematomas in different stages

    Bilateral subdural hematomas in varying stages of evolution are a classic and highly concerning finding for non-accidental trauma (abusive head trauma).

  3. A 7-year-old with known VP shunt presents with headache and vomiting for 24 hours. His temperature is 38.8°C. What is the priority intervention?

    Answer: Obtain immediate neurosurgical consultation for shunt evaluation

    Fever with VP shunt malfunction symptoms requires urgent neurosurgical evaluation because shunt infection or obstruction can be life-threatening.

  4. During lumbar puncture in a child with suspected bacterial meningitis, CSF opening pressure is 38 cmH2O. Which action is MOST appropriate?

    Answer: Collect minimal CSF, remove needle promptly, and initiate ICP management

    Elevated opening pressure signals increased ICP; collect minimal CSF and remove the needle quickly to reduce herniation risk, then manage ICP.

  5. An 8-year-old is brought in after a diving accident with complaints of neck pain and inability to move his arms. Which initial action takes highest priority?

    Answer: Maintain spinal immobilization and secure the airway

    Airway and spinal immobilization are the immediate priorities in suspected cervical spinal cord injury to prevent secondary injury.

  6. A 5-year-old presents with acute onset ataxia, nystagmus, and dysarthria 2 weeks after a varicella infection. The MOST likely diagnosis is:

    Answer: Acute cerebellar ataxia

    Acute cerebellar ataxia is a post-infectious complication most commonly seen 1–3 weeks after varicella, presenting with sudden gait unsteadiness.

  7. Which pupillary finding is the EARLIEST sign of uncal herniation?

    Answer: Unilateral dilated and non-reactive pupil ipsilateral to the lesion

    Uncal herniation compresses CN III, causing ipsilateral pupillary dilation that is non-reactive — this is an early and critical sign.