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
A 2-year-old presents with fever, bulging fontanelle, and seizure. CSF gram stain shows gram-positive diplococci. The MOST appropriate antibiotic choice is:
Answer: Vancomycin and ceftriaxone
Vancomycin plus ceftriaxone is the empiric treatment for pneumococcal meningitis to cover possible penicillin-resistant strains.
A 10-year-old with a GCS of 9 after blunt head trauma has a BP of 140/90 mmHg and HR of 52 bpm. This combination MOST likely indicates:
Answer: Cushing's triad with impending herniation
Hypertension with bradycardia (Cushing's triad) is a late, ominous sign of severely elevated ICP and impending brainstem herniation.
Which position is MOST appropriate for a child with suspected increased ICP who is not in spinal precautions?
Answer: Head of bed elevated 30° with head midline
Head of bed at 30° with neutral head alignment promotes cerebral venous drainage and helps reduce ICP.
A 4-year-old with new-onset focal seizures and a fever of 39.5°C has CSF showing 120 WBC (lymphocytic), elevated protein, and normal glucose. Which pathogen is MOST likely?
Answer: Herpes simplex virus
Lymphocytic pleocytosis, elevated protein, normal glucose, focal seizures, and fever together are classic for HSV encephalitis, requiring urgent acyclovir.
What is the CORRECT pediatric dose of lorazepam for an actively seizing child?
Answer: 0.05–0.1 mg/kg IV, max 4 mg per dose
Lorazepam 0.05–0.1 mg/kg IV (max 4 mg per dose) is the first-line benzodiazepine for acute pediatric seizure management.
Which condition is characterized by episodic, severe, unilateral headache with ipsilateral lacrimation, nasal congestion, and ptosis in a 12-year-old?
Answer: Cluster headache
Cluster headaches present with severe unilateral periorbital pain plus ipsilateral autonomic features (lacrimation, rhinorrhea, ptosis) in episodic attacks.
A 6-year-old develops ascending weakness starting in the legs 3 weeks after a GI illness. Reflexes are absent. The MOST likely diagnosis is:
Answer: Guillain-Barré syndrome
Guillain-Barré syndrome presents with ascending flaccid paralysis and areflexia following a triggering infection, typically weeks prior.