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Pediatrics I - OSCE > AFP > Flashcards

AFP Flashcards

1
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A
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2
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Etiology of Acute Flaccid Paralysis

A
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3
Q

Etiology of Acute Flaccid Paralysis

  • Spinal Cord
A
  • Acute transverse myelitis
  • Trauma
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4
Q

Etiology of Acute Flaccid Paralysis

  • AHCs
A
  • Poliovirus & polio vaccination
  • Other neurotropic viruses e.g. CMV, EBV, HSV
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5
Q

Etiology of Acute Flaccid Paralysis

  • Peripheral Nerves
A
  • Guillain Barré syndrome
  • Critical illness neuropathy
  • Toxic neuropathy (arsenic, lead)
  • Diphtheritic neuropathy
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6
Q

Etiology of Acute Flaccid Paralysis

  • NMJ
A
  • Myasthenia gravis
  • Botulism
  • Organophosphate poisoning
  • Snakebite
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7
Q

Etiology of Acute Flaccid Paralysis

  • Muscles
A
  • Inflammatory myopathies
  • Critical illness myopathy
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8
Q

Etiology of Acute Flaccid Paralysis

  • Muscle Membrane
A
  • Familial periodic paralysis
  • 2ry hypokalemic paralysis
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9
Q

Introduction to Guillian Barré Syndrome

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10
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Etiology of Guillian Barré Syndrome

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11
Q

Etiology of Guillian Barré Syndrome

  • Causative agents
A

It occurs 2 - 4 weeks after a benign febrile illness:

  • 2/3 of cases follow a respiratory or gastrointestinal infection
  • Campylobacter infection 20 - 30%
  • Others e.g. CMV, EBV, HSV

GBS has been reported to follow:

  • Vaccinations
  • Epidural anesthesia
  • Thrombolytic Agents
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12
Q

Subtypes of Guillian Barré Syndrome

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13
Q

CP of Guillian Barré Syndrome

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14
Q

CP of Guillian Barré Syndrome

  • Motor
A
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15
Q

CP of Guillian Barré Syndrome

  • Sensory
A
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16
Q

CP of Guillian Barré Syndrome

  • Autonomic
A
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17
Q

CP of Guillian Barré Syndrome

  • CNs
A
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18
Q

INVx for Guillian Barré Syndrome

A
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19
Q

INVx for Guillian Barré Syndrome

  • CSF Analysis
A
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20
Q

INVx for Guillian Barré Syndrome

  • Electrophysiological Studies
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21
Q

Management of Guillian Barré Syndrome

22
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Management of Guillian Barré Syndrome

  • Indication of PICU Admission
23
Q

Management of Guillian Barré Syndrome

  • Specific TTT
24
Q

Management of Guillian Barré Syndrome

  • IVIG
25
Q

Management of Guillian Barré Syndrome

  • Advantages of IVIG
A

IVIG is the preferred immunomodulatory treatment as it is

  • easier to give
  • few side effects
  • the treatment can be implemented more quickly
  • good outcome as plasmapheresis
26
Q

Management of Guillian Barré Syndrome

  • regimens of IVIG
27
Q

Management of Guillian Barré Syndrome

  • Plasmapheresis
28
Q

Prognosis of Guillian Barré Syndrome

29
Q

INVx for Myasthenia Gravis

30
Q

INVx for Myasthenia Gravis

  • Labs
A

Acetylcholine receptor antibody assays: +ve in 85 % of cases

  • the most helpful diagnostic investigation
31
Q

INVx for Myasthenia Gravis

  • Electrophysiological Studies
A
  • Repetitive nerve stimulation is abnormal with characteristic findings in 60%
32
Q

INVx for Myasthenia Gravis

  • Chest CT
A

Assessment of thymoma or thymic hyperplasia

33
Q

TTT for Myasthenia Gravis

34
Q

Def of Transverse Myelitis

A

Acute demyelinating disorder of the spinal cord (other parts of CNS can affected)

35
Q

CP of Transverse Myelitis

36
Q

CP of Transverse Myelitis

  • Motor
37
Q

CP of Transverse Myelitis

  • Sensory
A
  • Back pain is common at the onset Els Neese
  • Sensory level of loss of sensation which is usually thoraci
38
Q

CP of Transverse Myelitis

  • Autonomic
A
  • Bladder and/or bowel incontinence
39
Q

TTT of Transverse Myelitis

40
Q

TTT of Transverse Myelitis

  • Acute Management
41
Q

Acute Management of Transverse Myelitis

  • 1st Line
42
Q

Acute Management of Transverse Myelitis
- 2nd Line

43
Q

Acute Management of Transverse Myelitis

  • Supportive Care
A

Management of bowl & bladder dysfunction

44
Q

Management of Transverse Myelitis

  • Long Term
A
  • Physical & occupational therapy to prevent contracture
  • Treatment of underlying cause
45
Q

CP of Botulism Toxicity

46
Q

CP of Botulism Toxicity

  • Non-Specific
47
Q

CP of Botulism Toxicity

  • CN
48
Q

CP of Botulism Toxicity

  • Autonomic
A
  • Paralytic ileus advancing to severe constipation
  • Bladder distention advancing to urinary retention
  • Orthostatic hypotension
49
Q

CP of Botulism Toxicity

  • Additional Symptoms
A
  • Deep tendon reflexes are absent.
  • There is NO sensory loss.
  • There is NO fever
  • Consciousness is NOT impaired
50
Q

INVx for Botulism Toxicity

A
  • Toxin detection, serology
  • Electromyography (EMG), Nerve conduction study (NCS)
  • CSF examination is normal
51
Q

TTT of Botulism Toxicity

A
  • Antitoxin (Human botulism Ig)
  • Complete recovery takes weeks to months

Pediatrics I - OSCE (20 decks)

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