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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 1-month-old presents with seizures, lethargy, and a sodium of 118 mEq/L after breastfeeding with excessive water supplementation. The SAFEST correction rate for hyponatremia is:

    Answer: Correct sodium by no more than 1–2 mEq/L per hour, max 10–12 mEq/L per day

    Overly rapid correction of hyponatremia risks osmotic demyelination; the safe rate is ≤1–2 mEq/L/hr, not exceeding 10–12 mEq/L in 24 hours (except for acute symptomatic seizures).

  2. Which antiepileptic drug is FIRST-LINE for infantile spasms (West syndrome)?

    Answer: ACTH (adrenocorticotropic hormone)

    ACTH is the first-line treatment for infantile spasms and has shown superior efficacy in reducing spasms and improving EEG in West syndrome.

  3. A 7-year-old presents 4 hours after last seizure with persistent confusion and no return to baseline. The MOST appropriate diagnosis to rule out immediately is:

    Answer: Nonconvulsive status epilepticus (NCSE)

    Persistent altered consciousness beyond the expected post-ictal period requires EEG to exclude nonconvulsive status epilepticus, which is treatable but easily missed.

  4. In a pediatric patient with suspected spinal cord injury without radiographic abnormality (SCIWORA), which imaging modality is MOST sensitive for diagnosis?

    Answer: MRI of the spine

    MRI is the gold standard for SCIWORA, as it visualizes cord edema, hemorrhage, and ligamentous injury not seen on CT or X-ray.

  5. A 10-year-old post-cardiac arrest is receiving targeted temperature management. The target core temperature range is:

    Answer: 36–37.5°C (normothermia) for 72 hours

    Current pediatric post-arrest guidelines support targeted temperature management at 36–37.5°C (normothermia prevention of fever) for at least 72 hours.

  6. A 5-year-old with meningococcal meningitis develops purpuric lesions spreading rapidly across the trunk and extremities. The MOST urgent intervention is:

    Answer: Administer IV ceftriaxone immediately without delay

    Rapidly spreading purpura indicates meningococcemia; IV ceftriaxone must be given immediately as delay worsens outcome even if LP has not yet been performed.

  7. Which clinical feature helps DIFFERENTIATE a complex febrile seizure from simple febrile seizure?

    Answer: Seizure lasting more than 15 minutes or focal features

    Complex febrile seizures are defined by duration >15 minutes, focal onset, or recurrence within 24 hours, distinguishing them from simple generalized febrile seizures.