9 Flashcards
Common migraine in child
migraine without aura - any part of the head.
What type of HA sx should be concerning of ICP
HA after period of laying down (early morning/after a nap), wakes them up, associated vomiting
HA with photophobia and fever = rule out infectious like ______________
meningitis, encephalitis, intracranial abscess, sepsis
Can stress in children manifest as somatic symptoms like abdominal pain, chest pain, or headaches?
YES
What is Cushing’s triad?
Signs of + ICP = HTN, bradycardia, irregular respirations
What do you expect to see with Romberg when there is cerebellar pathology?
Romberg test is abnormal (+) with eyes opened and eyes closed.
What can ataxia be a reflection of?
Disease of cerebellum, the inner ear, and the dorsal columns (all involved in coordination)
Post infectious cerebellitis
Post viral onset of ataxia, vomiting, nystagmus, dysarthria; Self resolves in 3ish months
Fever, mental status change, ataxia
infectious cerebellitis - pathogens that cause bacterial meningitis
Opsoclonus-myoclonus- syndrome
- paraneoplastic syndrome (retinoblastoma)
- ataxia
- intermittent jerking movements (myoclonus) - erratic conjugate movements of eyes (opsoclonus)
Ataxia with neurodegenerative disease
Ataxia-telangiectasia and Friedreich ataxia
Ataxia, vomiting, emesis
Could be: MASS, MIGRAINE, MEDS
Basilar migraine
Bilateral transient blindness Vertigo Ataxia Incoordination of the limbs Dysarthria Bilateral limb and perioral paresthesias
Nystagmus
CEREBELLAR disease
ddx = tumors, toxins, cerebellitis, MS
*most prominent when looking to side of the lesion
Is an LP contraindicated in a patient with increased intracranial pressure?
YES, can lead to brain herniation
What would you expect with a supratentorial lesion?
focal motor and sensory abnormalities on the side opposite to the lesion
What is the most common childhood cancer?
Leukemia
What is the most common solid tumor in children?
Brain tumor
What are some genetic syndromes that predispose you to brain tumors?
Tuberous sclerosis, neurofibromatosis, Li-Fraumeni syndrome
What is the most common pediatric brain tumor?
Medulloblastoma
What is tx of medulloblastoma?
Surgical resection, radiation, and chemotherapy - *has tendency to metastasize
Partially cystic brain tumor, good prognosis,
Astrocytoma
Which domains do we address in development?
Gross motor Fine motor Communication Personal-social Problem-solving
What to worry about if a baby prefers standing over sitting?
Abnormally tight muscles, possibly due to a neuromuscular disorder, like CP
Sentence length = ?
years old
Will attach “mama/dada” to correct person.
Responds to one-step commands.
1 yr old
What are the minimum recommended ages to screen development?
9 and 18 months and at 24 or 30 months
When to screen for autism?
18 and 24 month visits; use the MCHAT
Neurodegenerative diseases causes _______ of milestones
regression
When does babinski (downgoing of toes) go away?
By 2, or when start walking
Apgars cannot be used to predict developmental outcome but continue to be useful predicting _______
Neonatal survival
Associated risk factors with CP
Perinatal asphyxia
Chorioamnionitis
Prematurity
Intrauterine growth retardation
You have a developmentally delayed child with lethargy, vomiting, coma. What is top of ddx?
Inborn errors of metabolism
Males with small testes and gynecomastia
XXY/Klinefelter
Macroorchidism
Fragile x
What syndromes are commonly associated with intellectual disability
Down syndrome
Fetal alcohol syndrome
Fragile X syndrome
A kid with Downs has _____ palpebral fissures
upslanting
What is the std diagnostic test for Downs?
Lymphocyte karyotype
Are most Downs babies born to women < 35?
YES
Conditions associated with Downs
Congenital hearing loss Congenital cataracts Congenital heart disease GI atresia (Duodenal atresia) Hip dysplasia
Do children with Downs have increased risk of hypothyroidism?
YES - need to routinely screen
What are two antenatal diagnostic tests for Downs?
Amniocentesis and CVS
Joint laxity, pectus excavatum, flat feet, large ears, large testes
Fragile X
Webbed neck Low ear placement Edema of the hands and feet Hyperconvex nails "Shield" chest Widely spaced nipples
Turner syndrome
Trisomy 13
Patau
Trisomy 18
Edwards
Microphthalmia Microcephaly Severe intellectual disability Polydactyly Cleft lip and palate Cardiac and renal defects Umbilical hernias Cutis aplasia
Trisomy 13/Patau
Rocker bottom feet
Trisomy 15
