CH 20: Alterations of Neurologic Function in Children

The neural groove closes dorsally during which week of gestational life?
A. Second 
B. Eighth
C. Fourth
D. Twelfth

Which nutritional deficiency in a pregnant woman is associated with neural tube defect
(NTD)?
A. Folate
B. Vitamin C
C. Zinc
D. Iron 

Which defect of neural tube closure is most common?
A. Posterior
B. Midline
C. Lateral
D. Anterior 

What is the anomaly in which the soft bony component of the skull and much of the brain
is missing?
A. Anencephaly 
B. Cranial meningocele
C. Hydrocephaly
D. Myelodysplasia

The most common cause of obstructive hydrocephalus in infants is:
A. Stenosis of the aqueduct of Sylvius
B. Excessive production of cerebrospinal fluid
C. Obstructed arachnoid villi
D. Impaired cerebrospinal fluid circulation in the subarachnoid space

What is the term for a herniation or protrusion of brain and meninges through a defect in
the skull?
A. Encephalocele 
B. Arachnoidocele
C. Cephacephalocele
D. Meningocele

What is the result of a Chiari type II malformation associated with a myelomeningocele?
A. Generalized cerebral edema and hydrocephalus
B. Downward displacement of the cerebellum, brainstem, and fourth ventricle
C. Upward displacement of the cerebellum into the diencephalon
D. Motor and sensory lesions below the level of the myelomeningocele

Prompt surgical repair of a myelomeningocele is critical to best prevent:
A. Mental retardation
B. Infection 
C. Paralysis
D. Additional nervous system damage

An infant diagnosed with hydrocephalus is observed to demonstrate:
A. Decreased production of cerebrospinal fluid
B. Retarded head growth
C. Shrunken ventricles
D. Bulging fontanels

Gait disturbances and instability are characteristic of which form of cerebral palsy?
A. Biochemical
B. Spastic 
C. Ataxic
D. Dyskinetic

Children with phenylketonuria (PKU) are unable to synthesize:
A. Essential amino acid, phenylalanine, to tyrosine
B. Renin, erythropoietin, and antidiuretic hormone
C. Neurotransmitters gamma-aminobutyric acid (GABA) and acetylcholine
D. Aldosterone, cortisol, and androgens

Benign febrile seizures are characterized by:
A. Respiratory or ear infections
B. Onset after the fifth year of life
C. Episodes lasting 30 minutes or longer
D. A temperature lower than 39° C

What is the most common general symptom of a localized childhood brain tumor?
A. Increased intracranial pressure
B. Failure to thrive
C. Delayed extinction of newborn reflexes
D. Poor bonding

The tonic neck reflex observed in a newborn should no longer be obtainable by:
A. 2 years 
B. 10 months
C. 1 year
D. 5 months

What term is used to describe a hernial protrusion of a saclike cyst that contains meninges,
spinal fluid, and a portion of the spinal cord through a defect in a posterior arch of a
vertebra?
A. Meningocele
B. Myelomeningocele
C. Spina bifida occulta
D. Encephalocele 

What test is performed on amniotic fluid and maternal blood to test for neural tube defect?
A. Culture
B. Total protein 
C. Alpha-fetoprotein
D. C-reactive protein

The clinical manifestations of dyskinetic cerebral palsy include:
A. Exaggerated deep tendon reflexes, clonus, and rigidity of extremities
B. Increased muscle tone and prolonged primitive reflexes
C. Jerky uncontrolled and abrupt fine musculoskeletal movements
D. Scoliosis, contractures, and stiffness of trunk muscles

True microcephaly cannot be caused by:
A. X-linked gene alterations
B. Autosomal gene alterations
C. Toxic-induced chromosomal defects
D. Prenatal physical abuse of the mother

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