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Paediatrics > 2: Neurology + Development - Squint, Autism > Flashcards

2: Neurology + Development - Squint, Autism Flashcards

1
Q

What is strabismus

A

misalignment of the visual axis

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2
Q

what are the two main types of squint

A
  • Non- paralytic (Concomitant)

- Paralytic (Non-concomitant)

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3
Q

what is non-paralytic squint also known as

A

Concomitant

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4
Q

what causes a non-paralytic squint commonly

A

Most commonly due to refractive errors

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5
Q

what are other causes of a concomitant squint

A

Cataracts
Retinoblastoma
Intraoccular occlusion

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6
Q

what typically causes a paralytic squint

A

Often due to weakness of intra-occur muscles caused by denervation of cranial nerves. Therefore, check for intra-cranial lesion.

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7
Q

is a concomitant squint usually divergent or convergent

A

Convergent

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8
Q

When does a concomitant squint occur

A

Occurs in childhood

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9
Q

what is a convergent squint also called

A

Esotropia

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10
Q

what eye abnormality can lead to convergent squint

A

Hypermetropia

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11
Q

what is the risk of squints

A

The brain will not process the abnormal image. This affects development of the visual pathway causing visual amblyopia.

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12
Q

what is divergent squint also referred to as

A

Exotropia

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13
Q

what is exotropia

A

Bad-eye is turned outwards

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14
Q

what is a latent squint

A

When normally squint does not manifest as it is controlled by subconscious methods. However, when the individual is tired and subconscious control is lost, it may manifest.

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15
Q

what is a pseudo squint

A

Where an individual has wide epicanthic folds making it appear that they have a squint.

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16
Q

What are three indications for an ophthalmology review

A
  • Divergent squint
  • Suspect paralytic squint
  • Squint does not resolve in 2 months
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17
Q

What are two tests for a squint

A
  • Corneal Reflection Test

- Cover Test

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18
Q

Explain the corneal light reflection test

A

Light is shone on the cornea. If no squint is present, it should be reflected back equally on both sides.

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19
Q

What is the cover test

A

Each eye is covered up in turn. Movement is looked for in the uncovered eye

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20
Q

Explain the cover test in a convergent squint

A

When the good eye is covered the ‘bad’ eye will move temporally to assume its position

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21
Q

Explain the cover test in a divergent squint

A

When to good eye is covered the ‘bad’ eye will more nasally to take up its position

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22
Q

What are the three ‘O’s of managing a squint

A

Optics
Orthoptics
Operation

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23
Q

What is the ‘Optic’ of managing squint

A

Use cyclopentolate to relax the ciliary bodies and check the eye for refractive errors

24
Q

What is used to correct refractive errors

A

Glasses

25
Q

What is the orthoptics ‘O’ of managing squints

A

Use an eye patch to cover the good eye - this will encourage use of the eye with the squint

26
Q

What operations may correct squint

A

Botox - may be used

Surgical resection to re-align rectus muscle

27
Q

When should squint be treated by and why

A

If not treated within 7-years it can cause strabismus ambylopia

28
Q

Explain strabismus amblyopia

A

In strabismus, there is discrepancy in two images projecting to the brain from the different eyes. This causes the brain to ignore input from one or both eyes. Lack of visual stimuli during plastic period (7-years) leads to cortical blindness

29
Q

What are 4 common causes fo squint

A

Refractive Error
Congenital Cataracts
Browns syndrome
Duane’s retraction syndrome

30
Q

What refractive error mostvcommonly causes squint

A

Hypermetropia

31
Q

What is Brown’s syndrome

A

Eyes cannot move upwards

32
Q

What is Duane’s retraction syndrome

A

Eyes cannot turn to the side

33
Q

How did the DSM4 describe autism

A

autism was one of the pervasive developmental disorders (PDD). That also included Aspergers, childhood disintegrative disorder and not other specified

34
Q

In the DSM4 what was asperger’s syndrome

A

Some features of autism but with no delay in cognition or language

35
Q

what is child disintergration disorder

A

Child develops normally - then regresses in terms of social or language development from 2-10 years

36
Q

what was not other specified in DSM4

A

Meet some features of autism

37
Q

Describe autism in the DSM5

A

Autism spectrum disorder encompasses all of the above disorders of varying severity - it is scale on social communication and interaction deficits

38
Q

What is the prevalence of autism

A

1:200

39
Q

What gender are impacted more by autism

A

Males

40
Q

What chromosome is associated with autism

A

11p12

41
Q

What environmental factors contribute to autism

A
  • Teratogens

- Peri-natal infection

42
Q

When are children with autism often identified

A

2-4 years. As this is when language develops the most

43
Q

What are the three features of autism

A
  1. Impaired reciprocal social interaction
  2. Poor range of activities + interests
  3. Impaired imagination
44
Q

Explain impaired reciprocal social interaction

A
  • Does not wave bye-bye
  • Unaware to feelings of others
  • Abnormal response to being hurt
  • Repetitive play
45
Q

Explain poor range of activities and interests

A
  • Sterotyped movements
  • Upset over trial things
  • Follows routine
  • Narrow fixation eg. lines toys up
46
Q

Explain impaired imagination (language + communication)

A
  • Poor babbling and facial expression
  • Avoids eye contact
  • Odd speech
  • Difficultly reciprocating conversation
47
Q

What are 5 associations with ASD

A
  1. Learning difficulties
  2. Intellectual impairment
  3. Epilepsy
  4. ADHD
  5. Rett Syndrome
48
Q

What is Rett syndrome

A

Condition in girls 6-18. Present with hand wringing, odd facial expressions, sudden bouts of laughter, hand licking or hair grasping and chorea.

49
Q

Explain how ASD is diagnosed

A
  • Parents keep behaviour diary
  • Modified checklist for autism in toddlers (M-CHAT) can be used as a screening tool
  • Diagnosis is made by MDT assessment based on symptoms on ICD10
50
Q

What is implemented to treat ASD

A
  • Early intensive behavioural therapy including parent training, SALT, social skills training
51
Q

What is early intensive behavioural therapy

A

special schooling before 3-years to improve communication and motor skills.

52
Q

What is the benefit of parent training

A

improves parent-child interaction Reduces maternal depression

53
Q

What medical treatment may be given in ASD for aggression

A

Risperidone

54
Q

What medical treatment may be given in ASD for poor sleep

A

Melatonin

55
Q

What medication may be given in ASD for repetitive behaviour

A

SSRIs

Paediatrics (61 decks)

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