Development and Psychiatry Flashcards
Myopia and sports: if a child’s corrected vision is worse than __, they are considered functionally __. Anticipatory guidance?
Corrected worse than 20/40 in any eye = functionally 1-eyed, and needs protective eyewear or sports goggles for participation in sports (especially those with a fast-moving ball, baseball, basketball) + avoid wrestling/boxing.
Same for those with previous eye surgery/trauma - weakened eye tissue more susceptible to injury.
Persistently irritable mood with severe temper outbursts occurring 3 or more times per week
Disruptive mood dysregulation disorder
Fluctuating mood + elevated or irritable mood and energy or goal-directed activity for at least 7 days, causing severe impairment or warranting hospitalization + excessive silliness, decreased sleep, inappropriate sexual behaviors
Type I bipolar disorder. Description of mania.
Major depression + elevated or irritable mood and energy or goal-directed activity for at least 4 days, not enough to cause severe impairment or to warrant hospitalization
Consider bipolar II if meeting other criteria
Syndrome: parental over concern for minor issues and excessive use of health services
Vulnerable child syndrome
___ levels of dopamine, ___ levels of serotonin, and ___ levels of GABA (γ-aminobutyric acid) are associated with aggression
high, low and low. Hormones such as steroids and cortisol levels (rapid high release or low chronic) can be associated with aggression as well.
Progressive headache, cognitive impairment, TIAs and CSF with elevated protein, lymphs + no infection or malignancy noted = ?
Treatment?
Medium-vessel vasculitis called primary angiitis of the CNS (PACNS) treated with high dose steroids + cyclophosphamide
Vertigo, nystagmus + high risk factors - consider __. Evaluate with __.
Vertebrobasilar stroke; MRI.
Central Vertigo Sx?
nystagmus, dysphagia, dysarthria, diplopia, ataxia, postural instability, hemiparesis, or mental status changes
Parkinsonism + cerebellar ataxia, dysautonomia, and early postural instability
Multiple system atrophy - trial with levodopa. Often no MRI findings.
Markedly asymmetric parkinsonism and frequently is associated with dystonia, myoclonus, cortical sensory deficits, prominent cognitive dysfunction, and apraxia (impaired motor planning) = ?
Corticobasilar degeneration - MRI typically shows asymmetric posterior parietal and frontal cortical atrophy.
Parkinsonism + early prominent postural instability + vertical extra ocular saccades = ?
progressive supranuclear palsy
Parkinsonism that occurs in step-wise onset, and disproportionately involves the lower extremities = ?
Vascular Parkinsonism
Treatment for cervical radiculopathy?
When to obtain imaging?
neck exercises - should resolve in 2-3 months. Then consider epidural glucocorticoid injects, re-evaluation.
If progressive motor deficit, suspect neoplasm, myelopathy (difficulty writing, gait, hypertonia or hyperreflexia, problems with fine manipulation), epidural abscess, or bilateral symptoms get an MRI/CT; or on re-evaluation.
