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Pediatrics (Past Year) > CNS > Flashcards

CNS Flashcards

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1
Q

Definition of Mental retardation

A

Retardation in development of cognitive abilities,
adaptive behaviour,
and communication skills.

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2
Q

Causes of Mental retardation

A
  • Chromosome disorder
  • genetic syndrome
  • development brain abnormally
  • inborn error of metabolism
  • congenital infection
  • asphyxia, meningitis, PEM
  • unknown
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3
Q

Clinical picture of Mental retardation

A
  1. Newborn
    - major organ dysfunction
  2. Early infancy (2-6 month)
    - failure interaction w enviroment
    - vision, hearing impair
  3. Later infancy (6-18 month)
    - gross motor delay
  4. Toodlers (2-3 years)
    - language delay
  5. Preschool (3-5 years)
    - languange delay
    - behavior delay
    - delay motor skill
  6. School age (more 5 years)
    - academic underachievement
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4
Q

Complication of Mental retardation

A
  • increase hearing, vision defact
  • orthopedic disability
  • behavior, emotional disorder
  • seizure disorder
  • fragile x syndrome
  • down syndrome
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5
Q

Causes and clinical picture of Febrile Convulsion

A
  1. Causes
    - extra cranial infection
    - viral infection
  2. CP
    a) patient
    - 6month-6years
    - male than female
    - strong family history

b) type of seizure
- Preictal: onset on temperature more 39*c
- ictal: generalize tonic clonic
- short duration (5-15min)
- convulsion fit during same illness
- short postictal stupor

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6
Q

Definition of atypical febrile seizure

A

Seizure persisting more than 15 minute, same illness,

focal seizure

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7
Q

Investigation of Febrile Convulsion

A
  • CSF
  • lumbar puncture
  • EEG
  • neuro imaging
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8
Q

Factor effect later epilepsy

A
  • initial febrile seizure before 12 month
  • +ve family history
  • delay development
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9
Q

Treatment of Febrile Seizure

A
  1. Immediate 1st aid measure
    - posture
    - suction
    - mouth piece
    - oxygen
  2. Cold the temperature
    - cold formentation
    - antipyretic
  3. Ttt cause of fever: Ab
  4. Anticonvulsion
    - Diazepam 0.3mg/kg/dose IV
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10
Q

Definition of Cerebral Palsy

A 
Purely central motor disorder, 
non progressive,
non familial,
non fatal,
non curable
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11
Q

Causes of Cerebral Palsy

A
  1. Prenatal
    - fetal hypoxia
    - TORCH infection
    - drug
    - maternal disease, HTN
  2. Natal
    - birth asphyxia
    - birth trauma
    - prematurity
  3. Postnatal
    - hypoxia
    - infection
    - cerebro vascular accident
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12
Q

Clinical picture of Cerebral Palsy

A
  • spastic diplegia
  • spastic quadriplegia (most serious)
  • hemiplegia: hemiplegia + seizure
  • extrapyrimidal: hypotonia + poor head central
  • atonic cp:
    >severe hypotonia
    >deep reflex exaggerated
  • ataxia cp:
    >hypotonia
    >hyporeflexia
    >uncoordinate movement
  • mixed
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13
Q

Early warning sign of cerebral palsy

A
  • below 6 month
  • head lag
  • severe cry
  • difficult swallow
  • leg shift and cross
  • seizure
  • delay development
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14
Q

Investigation of Cerebral Palsy

A
  • MRI
  • Hearing and visual test
  • genetic evaluation
  • TORCH screen
  • EEG
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15
Q

Treatment of cerebral palsy

A
  • team of physician must contribute
  • parent taught how to work with their child
  • drug treat spasticity
    >benzodiazepam
    >baslofen
    >botulism toxin
  • physiotherapy
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16
Q

Clinical picture of grand mal epilepsy (generalized tonic clonic)

A
  1. Aura: unusual behavior
  2. Tonic:
    - powerful sustain contraction of all muscle
    - arm flex
    - leg extended
    - 5 minute
  3. Clonic
    - contract and relax of muscle limb& face
    - biting tongue
    - incontinence
  4. Post epileptic
    - fall deep sleep
    - confused
17
Q

Treatment of Grand mal epilepsy

A
  • Na valproate (20-40mg/kg)
  • Diazepam (0.3mg/kg)
  • Phenytoin (4-8mg/kg)
  • Carbamazepine (10-20mg/kg)
18
Q

Cause of 1ry inability to work with hypotonia

A
  1. Central
    - cerebral palsy
    - mental retard
    - down syndrome
    - hydrocephalus
    - cretinism
  2. Peripheral
    - traumatic birth injury
    - poliomyelitis
    - congenital peripheral neuropathy
    - congenital myopathy
  3. Ricket
  4. Osteogenesis imperfecta
    * 1ry cause: infang never walk up to 18 month
19
Q

DD of flaccid paralysis

A
  1. Cerebral hypotonia
    - down syndrome
    - cerebral palsy
  2. Spinal cord disorder
    - poliomyelitis
    - spinal muscular atrophy
    - spinal cord trauma
    - pressure of tumour
  3. Polyneuropathies
    - gullien barre syndrome
    - infection
    - DM
  4. Neuromuscular junction disorder
    - organophosphorus poisoning
  5. Muscle disease
    - congenital myopathies
    - muscular dystrophies
20
Q

Explain about Gullien Barre Syndrme. Predisposing factor, CP, investigation.

A
  1. Predisposing factor
    - above 3 years
    - has history of infection 1-2 weeks before
  2. Cp
    a) acute symmetrical paralysis
    - start LL to trunk
    - limb flaccid
    - lost tendon reflex
    - respiratory paralysis
    - bulbar paralysis

b) other
- peripheral sensory lost
- urinary retention

  • usually recover in weeks / month
  1. investigate
    - nerve conduction velocity
    - CSF examination
21
Q

Clinical picture of Petit Mal Epilepsy ( generalize absence)

A
  • sudden cessation of motor activity/ speech
  • blank facial expression
  • flicker of eyelid
  • common in 5-9 y.o girls
  • never associated with aura
  • frequent associated simple absence seizure
  • recurrence up to 100 time/ day
22
Q

Treatment Petit Mal Epilepsy

A
  • Ethosuximide 20-40mg/kg
  • Na valporate 10-20mg/kg
  • 1-2 years after lost convulsion
  • advice parent:
    > full information about dry therapy
    > allow normal activity
    > instruction about 1st Aid.
23
Q

Definition , DD of large head

A
  1. Definition
    - enlarged head more than 2sd above expected for age and sex
  2. DD
    a) cranial
    - family large head
    - rickets
    - chronic hemolysis anemia
    - cretinism
    - achondroplasia

b) intra cranial
- hydrocephalus
- hydran encephaly
- megalo encephaly
- cause of IC
> tumour
> mass
> chronic abscess
> hemorrhage

24
Q

Causes of floppy infant

A
  1. Cerebral palsy
  2. Cogenital
    - poliomyelitis
    - peripheral neuropathy
    - myopathy
    - myesthenia gravis
  3. Benign congenital hypotonia
  4. Down syndrome
  5. Severe PEM
25
Q

Explain about Brain tumour. Type amd cp

A
  1. Type
    - predominantly infratentorial involving cerebellum, midbrain, brain stem
    - astrocytoma
    - medulloblastoma
    - germ cell tumour
  2. CP
    - vomiting
    - morning headache
    - increase head circumference
    - ataxia

Pediatrics (Past Year) (10 decks)

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