Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4: Paeds > Central nervous system > Flashcards

Central nervous system Flashcards

1
Q

When is asymmetry of motor skills (i.e. hand dominance) abnormal?

A

<1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What system classifies motor functional ability? e.g. in CP, and what are the levels?

A

Gross Motor Function Classification System (GMFCS)

1: walks without limitations
2: walks with limitations
3: walks using a handheld mobility device
4: self-mobility with limitations; may use powered mobility
5: transported in a manual wheelchair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of CP

A
  1. Spastic
    - unilateral (hemiplegia)
    - bilateral (quadriplegia)
    - bilateral (diplegia)
  2. Dyskinetic
  3. Ataxic (hypotonic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Features of spasticity in CP

A
  • velocity-dependent: the faster it’s stretched the greater the resistance
  • hallmark of spasticity: ‘dynamic catch’
  • clasp knife (increase tone may suddenly yield under pressure)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is unilateral (hemiplegia) spastic CP and the cause?

A
  • damage to UMN

- arm and leg on opposite side to lesion affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is bilateral (quadriplegia) spastic CP and the cause?

A
  • damage to UMN

- all 4 limbs affected, often severely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is bilateral (diplegia) spastic CP and the cause?

A
  • damage to UMN

- all 4 limbs but legs much more affected than arms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is dyskinetic CP and the cause?

A
  • damage/dysfunction in basal ganglia or associated pathways (extrapyramidal)
  • dyskinesia = involuntary, uncontrolled movements
  • chorea - irregular, sudden, brief, dance-like movements (non-repetitive)
  • athetosis - slow writhing movements distally
  • dystonia - simultaneous contraction of agonist and antagonist muscles of trunk and proximal muscles, causing twisting appearance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is ataxic (hypotonic) CP and the cause?

A
  • mostly genetic
  • if acquired: cerebellum or its connections
  • signs on same side as lesion
  • early trunk and limb hypotonia, poor balance, delayed motor movements
  • later incoordinate movements, intention tremor, ataxic gait
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What medications are used to relax muscles in CP?

A
  • diazepam
  • baclofen (can be given intrathecally)
  • botulinum injections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Features of febrile convulsions (consider another diagnosis if these are not present)

A
  • generalised tonic clonic
  • <15mins
  • without recurrence within next 24h or within same febrile illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Age range for febrile seizures

A

6 months - 6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What features suggest a focal frontal seizure?

A

motor phenomena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What features suggest a focal temporal seizure?

A

auditory or sensory (smell or taste) phenomena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What features suggest a focal occipital seizure?

A

positive or negative visual phenomena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What features suggest a focal parietal seizure?

A

contralateral altered sensation (dysaesthesia)

17
Q

What generalised seizures are there?

A
  • myoclonic
  • tonic
  • tonic-clonic
  • atonic
  • absence
18
Q

Investigations for ?epilepsy

A
  • ECG to rule out convulsive syncope due to arrythmia (if any diagnostic uncertainty)
  • EEG
  • MRI and CT (unless characteristic Hx of certain type)
  • metabolic Ix if related to feeds/fasting or developmental arrest/regression
  • genetic tests if indicated
19
Q

How to provoke absence seizure

A

hyperventilation e.g. blowing a toy windmill

20
Q

Long term management of absence seizures

A

sodium valproate, ethosuxamide or lamotrigine

21
Q

Which children with epilepsy are given rescue medication and what are they given?

A
  • children with prolonged epileptic seizures (convulsive with LOC >5min)
  • buccal midazolam (or rectal diazepam)
22
Q

Long term management of tonic clonic seizures

A

sodium valproate, carbamazepine, lamotrigine

23
Q

Long term management of myoclonic seizures

A

sodium valproate, levetiracetam, topiramate

24
Q

Long term management of focal seizures

A

sodium valproate, carbamazepine, levetiracetam, lamotrigine

25
Q

Non-pharmacological Mx options for epilepsy

A
  • ketogenic diet
  • vagal nerve stimulation
  • surgery
26
Q

Advice/things to discuss RE epilepsy

A
  • avoid situations where seizure would be dangerous
  • no driving until 1y seizure free
  • SUDEP very rare in childhood
  • self-help groups
  • liase with school RE managing seizures
27
Q

What is status epilepticus

A

epileptic seizure lasting 5 mins or repeated epileptic seizures for 5 mins without full recovery of consciousness

28
Q

Management of status epilepticus

A

0 mins: airway, high flow O2, glucose?

5 mins: IV/IO lorazepam, buccal midazolam or rectal diazepam

15 mins: IV/IO lorazepam, call for senior help, reconfirm it is an epileptic seizure

25 mins: senior help and anaesthetist needed, anaesthetist/ICU advice, consider rectal paraldehyde, phenytoin IV/IO over 20 min (or phenobarbitone over 5 min if already on phenytoin)

45 mins: RSI of anaesthesia with thiopental

29
Q

Who is at risk of developing rebound chronic daily headaches?

A

people who use analgesics or triptans on >2 days/week

30
Q

When to do Ix/imaging in children’s headaches

A

only if red flags present

31
Q

Prevention of headaches in children

A

for frequent, intrusive headaches

  • propranolol
  • topiramate (or valproate)
  • amitriptyline
32
Q

Management of headaches in children

A
  • lifestyle e.g. help with stressors; ensuring adequate rest, food, etc.
  • paracetamol + NSAIDs taken asap in an individual episode
  • antiemetics e.g. cyclizine
  • triptans e.g. sumitriptan - nasal preparation in EARLY migraine attack (with paracetamol and NSAID)
  • physical e.g. cold compress, warm pads, etc.

Y4: Paeds (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions