Child health- neurology

Question 1

what is meningitis

Answer 1

serious infection of the meninges, the outer membranes covering the brain and spinal cord

Question 2

common causative agents of bacterial meningitis in neonates (0-3months)- think men-in-GEL-itis

Answer 2

group b strep
e.coli
listeria monocytogenes

Question 3

most common causative agent of bacterial meningitis in infants and young children

Answer 3

h.influenza

Question 4

what is more common viral meningitis/bacterial meningitis

Answer 4

viral meningitis

Question 5

common causative organisms of viral meningitis

Answer 5

enteroviruses
mumps
HIV
HSV
influenza
arboviruses

Question 6

red flag for meningitis

Answer 6

rash

Question 7

investigations for meningitis

Answer 7

bloods
urinalysis
lumbar puncture

Question 8

what is encephalitis

Answer 8

acute inflammation of the brain parenchyma

Question 9

most common causes of encephalitis

Answer 9

viral- usually HSV (most common), VZV, herpes group viruses, enteroviruses, adenoviruses

Question 10

clinical features of encephalitis

Answer 10

fever (90%)
meningism
personality and behaviour changes- progresses to reduced level of consciousness or even coma
seizures
Focal neurological deficits, such as speech disturbance

Question 11

management of encephalitis

Answer 11

IV acyclovir

Question 12

what are febrile convulsions

Answer 12

seizures in children triggered by a fever, usually without any underlying neurological cause

Question 13

what are reflex anoxic seizures

Answer 13

child gets fright and stops breathing- occurs when child is startled, most commonly when child bumps head

Question 14

what age range of children can febrile seizures occur in

Answer 14

6 months- 5 years

Question 15

what is the most common cause of syncope in children

Answer 15

vasovagal episode

Question 16

triggers of vasovagal episodes (fainting)

Answer 16

prolonged standing
emotional stress
pain
sight of blood

Question 17

what are breath holding attacks

Answer 17

involuntary episodes where a child holds their breath, usually triggered by something upsetting or scaring them

Question 18

how old are children who are more likely to have breath holding attacks

Answer 18

babies- between 6 and 18 months
most children outgrow by 4/5 years

Question 19

what happens in reflex anoxic seizures

Answer 19

Childs heart stops beating- child suddenly goes pale, loss consciousness, seizure like twitching
within 30 seconds heart restarts

Question 20

what are seizures

Answer 20

transient episodes of abnormal electrical activity in the brain

Question 21

what is epilepsy

Answer 21

umbrella term for a condition where there is a tendency to have seizures

Question 22

investigations for epilepsy

Answer 22

EEG
MRI brain

Question 23

once a child has had one febrile seizure, what is there risk of having a future febrile seizure

Answer 23

30-40%

Question 24

most common form of muscular dystrophy seen in children

Answer 24

Duchenne muscular dystrophy

Question 25

what is muscular dystrophy

Answer 25

refers to a group of nine genetic diseases that cause progressive weakness and degeneration of muscles used during voluntary movement

Question 26

what type of genetic disorders are muscular dystrophy disorders and who are affected

Answer 26

X-linked recessive- only boys affected

Question 27

muscular dystrophy diseases affect genes responsible for what

Answer 27

dystrophin

Question 28

in Duchenne muscular dystrophy there is an absence of dystrophy true/false?

Answer 28

true

Question 29

symptoms of muscular dystrophy

Answer 29

delay in motor development, some have more global delay

Question 30

when is onset of weakness in muscular dystrophy and where does the weakness usually affect

Answer 30

3-4 years pelvic and shoulder girdles

Question 31

what is gowers sign

Answer 31

arms used to compensate for weakness of pelvic girdle muscles getting up from the floor

Question 32

in Duchenne muscular dystrophy, severe disability is typical by what age

Answer 32

age 10

Question 33

bloods in Duchenne muscular dystrophy

Answer 33

raised serum creatine kinase

Question 34

signs of muscular dystrophy

Answer 34

gowers sign walking on toes exaggerated lumbar lordosis calf hypertrophy waddling gait

Question 35

diagnostic method for definitive diagnosis of muscular dystrophy

Answer 35

genetic testing

Question 36

when does death usually occur in those with Duchenne muscular dystrophy

Answer 36

20s- due to cardiac and respiratory failure

Question 37

what is cerebral palsy

Answer 37

cp is the name given to the permanent neurological problems resulting from damage to the brain around the time of birth (from prenatal to <1 month postnatal)

Question 38

prenatal causes of cerebral palsy

Answer 38

TORCH infections (80%) alcohol

Question 39

perinatal causes of cerebral palsy (10%)

Answer 39

Preterm birth asphyxia

Question 40

postnatal causes of cerebral palsy (10%)

Answer 40

meningitis severe neonatal jaundice head injury

Question 41

what is spastic cerebral palsy characterised by and what is a result of

Answer 41

hypertonia and < function (stiff, tight muscles) results from damage to upper motor neurons

Question 42

what is dyskinetic cerebral palsy characterised by and what is it a result of

Answer 42

hypertonia and hypotonia athetoid movements pro-motor problems results from damage to basal ganglia

Question 43

what is ataxic cerebral palsy characterised by and what is it a result of

Answer 43

problems with coordinated movements results from damage to cerebellum

Question 44

hemiplegic cerebral palsy =

Answer 44

one arm one leg

Question 45

paralegic cerebral palsy =

Answer 45

both legs

Question 46

diplegic cerebral palsy =

Answer 46

both legs, minimal involvement elsewhere

Question 47

quadriplegic cerebral palsy =

Answer 47

both arms both legs

Question 48

what is an intraventricular haemorrhage

Answer 48

bleeding into the ventricles inside the brain

Question 49

in neonates, who are more likely to have intraventricular haemorrhages

Answer 49

premature babies

Question 50

symptoms of intraventricular haemorrhages

Answer 50

apnoea decreased reflexes excessive sleep lethargy weak suck

Question 51

what is hydrocephalus

Answer 51

cerebrospinal fluid building up abnormally within the brain and spinal cord

Question 52

clinical features of hydrocephalus

Answer 52

enlarged and rapidly increasing head circumference bulging anterior fontanelle poor feeding and vomiting sleepiness poor tone

Question 53

management of hydrocephalus

Answer 53

ventriculoperitoneal shunt

Question 54

prenatal causes of cerebral palsy- TORCH

Answer 54

lots of kids with cerebral palsy cared olympic TORCH in 2012! toxoplasmosis rubella CMV herpes simplex

Question 55

main complication of Duchenne muscular dystrophy

Answer 55

dilated cardiomyopathy

Question 56

what causes a non-blanching rash in meningitis

Answer 56

meningococcal septicaemia= infection of the bloodstream

Question 57

most common causative organisms of meningitis in ages 10-21

Answer 57

neisseria meningitis streptococcus pneumonia

Question 58

listeria monoctogenes only affects:

Answer 58

very young (<3 months) very old immunocompromised