Brainscape's Knowledge GenomeTM

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


See full index

Primary > Musculoskeletal Disorders > Flashcards

Musculoskeletal Disorders Flashcards

1
Q

Musculoskeletal disorders

Infammatory DIsorders: Two types

A

1) Osgood- Schlatter disease

2) Toxic synovitis

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

Inflammation of the tibial tubercle as a result of repetitive stressors (e.g.g, avulsion injury) in a patient with immature skeletal development

  1. Peak ages: 11 to 14 years
    2) Associated with a rapid growth spurt
A

Osgood- Schlatter Disease

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

Signs and symptoms include of ________:

a) Pain and tenderness at tibial tubercle
b) Point tenderness
c) Enlargement compared to the unaffected side

A

Osgood- Schlatter Disease

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

Laboratory/ Diagnostics for Osgood- Schlatter disease:

1) ______; typically, this is a diagnosis that is made clinically.
2) Radiographs to rule out more serious causes of pain

A

1) none

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

Self-limiting inflammation of the hip, most likely due to a viral or immune cause

1) Occurs most often in children between the ages for two and six, but can occur for age 1 to 15 years
2) Affects males more than females

A

Toxic Synovitis

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

Signs and symptoms of Toxic Synovitis include:

1) _____ limp
2) Unilateral involvement
3) Insidious onset
4) Internal rotation of hip causes spasm
5) No obvious signs of infection on inspection /palpation

A

1) Painful

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

Laboratory/ Diagnostics of Toxic Synovitis include:

a) Normal radiographs
b) Normal joint fluid _______

A

b) aspiration

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

Management of Toxic Synovitis include:

a) _______
b) bed rest as needed
c) typically benign and self-limiting
d) hospitalization should be considered if the patient has a high fever or septic arthritis is suspected

A

a) analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Noninflammatory disorders include:

a) Legg- Calce- Perthes Disease
b) Slipped capital femoral epiphysis (SCFE)
c) ___ _____
d) Septic arthritis

A

Juvenile arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

_____ ___ ___ _____ (____):

Aseptic or avascular necrosis of the femoral head

A

Legg-Calve-Perthes Disease (LCPD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Etiology/Incidence of Legg-Calve-Perthes Disease (LCPD):
1. Unknown etiology, possibly due to vascular disruption
2. Slightly shorter stature or delayed bone age
compared to peers
3. Most common in ____ ____, ages four to nine

A

Caucasian boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Signs/Symptoms of this include:

  1. Insidious onset of limp with knee pain; pain may also migrate to groin/lateral hip
  2. Painless acute and severe than transient synovitis or septic arthritis
  3. Afebrile
A

Legg-Calve-Perthes Disease (LCPD)

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

Physical Findings of Legg-Calve-Perthes Disease (LCPD):

  1. Limited passive internal rotation (PIR) and abduction of the hip joint
  2. Maybe resisted by ____ ___ or guarding
  3. Hip flexion contracture and leg muscle atrophy occur in long-standing cases
A
  1. mild spasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Laboratory/Diagnostics of Legg-Calve-Perthes Disease (LCPD):

  1. Radiograph studies
  2. ___ ____ necessary
A
  1. No labs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management/Treatment of Legg-Calve-Perthes Disease (LCPD):
1. Goal: To restore range of motion (ROM) while maintaining femoral head within the acetabulum

  1. Observation only if:
    a. The full range of motion (FROM) is preserved
    b. Less than ___ years of age
    c. Involvement of less than one-half of the femoral head
  2. Aggressive treatment
    a. Indicated when more than the __-___ femoral head is involved and in children older than six years
    b. Refer to orthopedics
A
  1. six

3. one-half

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

Spontaneous dislocation of the femoral head (capital epiphysis) both downward and backward
relative to the femoral neck and secondary to disruption of the epiphyseal plate

A

Slipped Capital Femoral Epiphysis (SCFE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Etiology, /Incidence of Slipped Capital Femoral Epiphysis (SCFE):
1. Etiology: Unknown; perhaps precipitated by puberty-related hormone changes

  1. Generally occurs without severe, sudden force or trauma
  2. Typical during a growth spurt and prior to menarche in girls
  3. Rare: 1-8: 100,000
  4. More common in males and ___ ____ adolescents
  5. Incidence is greater among obese adolescents with sedentary lifestyles
A
  1. African American
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Signs/Symptoms of Slipped Capital Femoral Epiphysis (SCFE):

  1. Pain in the ____ and often referred to the thigh and/or knee
  2. When acute onset, the pain will be severe with the inability to ambulate or move the hip
  3. Physical findings
    a. Unable to properly flex __ as femur abducts/rotate
    externally
    b. May observe limb shortening, resulting from the
    proximal displacement of the metaphysis
A
  1. groin

3. a. hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Laboratory/Diagnostics of Slipped Capital Femoral Epiphysis (SCFE):
1. ___ _____combined with knowledge of etiological factors

  1. Radiographs
  2. Laboratory studies - typically none
A
  1. Accurate history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management/Treatment of Slipped Capital Femoral Epiphysis (SCFE):

  1. Immediate referral to an _______
  2. No ambulation permitted
  3. Monitor other hips for the same problem
A
  1. orthopedist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

All these are structural ______?

  1. Genu varum
  2. Genu valgum
  3. Scoliosis
  4. Hip dysplasia
A

Disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lateral bowing of the tibia, often due to joint laxity; considered a normal variant until age two
(toddler most common)

A

Genu Varum (Bowleg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Signs/Symptoms

  1. It is acceptable for bowing that does not increase after walking
  2. Retains full range of motion
A

Genu Varum (Bowleg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Laboratory/Diagnostics of Genu Varum (Bowleg):

1. ___ ____

A

None indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Management of Genu Varum (Bowleg):
1. None necessary under age two if appears as a normal
variant
2. Refer to orthopedics
a. Continues after age ____
b. Unilateral
c. Becomes progressively worse after the first year

A
  1. a. two
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q 
\_\_\_\_ \_\_\_\_\_ (\_\_\_-\_\_\_):
Knees are abnom~ally close and ankle space is increased; typically evolves to normal alignment by seven years of age (preschool most common)
A

Genu Valgum (Knock-Knee)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Signs/Symptoms of ____ ___?

  1. Knees close together
  2. Distance between medial malleoli (ankles) is more than three inches.
  3. No pain
  4. Full range of motion
  5. Walk or nm may be awkward
A

Genu Valgum (Knock-Knee)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Laboratory/Diagnostics for Genu Valgum (Knock-Knee):

  1. ______ necessary
  2. Radiographs if over age seven or if unilateral involvement is present.
A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Management for Genu Valgum (Knock-Knee):

  1. ___ _____
  2. Older children need a referral to orthopedics.
A
  1. None necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q
  1. Lateral curvature of the spine that is idiopathic and most common in adolescence
  2. Other types are congenital (e.g., infancy) or neuromuscular (associated with conditions)
  3. Occurs more often in females with an 8:1 ratio; familial in 70% of cases
A

Scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Signs/Symptoms of Scoliosis:

  1. May occur any age
  2. Rarely painful
  3. _____ of shoulder, ribs, hips, and waistline (Adam’s Forward Bend Test
A
  1. Asymmetry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Laboratory/Diagnostics for Scoliosis:

1. _____ for further evaluation

A
  1. Radiographs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Management for Scoliosis:
1. Further evaluation in any degree if pain occurs

  1. Observe if no pain exists and if less than ___ degrees curvature
  2. Refer if painful or greater than ___ degrees curvature
A
  1. 25 degrees

3. 25 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q 
\_\_\_ \_\_\_ \_\_\_ \_\_\_ \_\_\_ (\_\_ )
Abnormal dislocation (luxation or subluxation) of the hip in which the femoral head is partially or completely displaced from the acetabulum
A

Developmental Dysplasia of the Hip (DDH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Signs/Symptoms of Developmental Dysplasia of the Hip (DDH):

Physical examination
a. ______ sign,
i. Compare knee height with infant supine, hips mad
knees flexed
ii. Asymmetry suggests DDH
iii. Not helpful if DDH is bilateral

b. Barlow until six months of age and Ortolani until one-year-old

c. Painless
May not be detected in the newborn/infant period
May present as a limp when the child begins to walk
Decreased hip abduction in older children

A

a. Galeazzi’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Laboratory/Diagnostics for Dysplasia of the Hip (DDH):

1. Radiographs and/or _____

A

ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Management for Dysplasia of the Hip (DDH):

1. Referral to ______

A

orthopedics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Chronic Progressive Disorder is known as what?

A

Muscular Dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

_____ ______
Progressive genetic disorder beginning in the lower extremities and progressing to the upper extremities and torso

  1. The most common inherited neuromuscular disease in children
  2. Affects 1:3, 500 males
  3. The average age of diagnosis is three to five years.
A

Muscular Dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Signs/Symptoms Muscular Dystrophy:
1. Abnormalities of gait and posture

  1. Developmental clumsiness
  2. Cannot keep up with developing peers
  3. ______ maneuver
    a. Child “walks” hands up legs to attain standing
    position when getting up
    b. Suggests pelvic girdle weakness
  4. Firm, large, woody calves (healthy muscle replaced by degenerative tissue)
  5. Decreased proximal muscle strength
  6. Wheelchair dependent by age ___ years
  7. Eventual death from cardiopulmonary failure
A
  1. Gower’s

7. 12 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Laboratory/Diagnostics for Muscular Dystrophy:

  1. Creatine kinase: Markedly ____ in affected males (15,000 to 35,000 IU/L)
  2. Electromyography (EMG): _____
  3. Electrocardiogram (ECG): ______
  4. Muscle biopsy: ______degenerating fibers
  5. The DNA analysis of gene
A
  1. elevated
  2. Myopathy
  3. Abnormal
  4. Necrotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Management for Muscular Dystrophy:

  1. Symptomatic care to ___ progression and maintain strength and mobility
  2. Genetic testing
A
  1. delay
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Stretching and/or tearing of the ligaments around the ankle, typically involving the lateral ligament complex

  1. Most common sports injury
  2. Most common musculoskeletal injury
  3. Usually a forced inversion (lateral ankle) or eversion (medial ankle)
A

Ankle Sprain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Signs/Symptoms of Ankle Sprain:

  1. Grade ___: Stretching but no tearing of ligament; no joint instability
    a. Local tenderness

b. Minimal edema
c. Ecchymoses typically insignificant or absent

d. Full range of motion remains although maybe
uncomfortable

e. The patient retains the weight-bearing ability

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Signs/Symptoms of Ankle Sprain:

  1. Grade ___: Partial (incomplete) tearing of ligament; some joint instability but definite endpoint to laxity
    a. Pain immediately upon injury

b. Localized edema and ecchymosis
c. Significant pain with weight-bearing
d. The range of motion is limited.

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Signs/Symptoms of Ankle Sprain:
3. Grade ___: Complete ligamentous tearing; joint unstable with no definite endpoint to ligamentous stressing
a. Severe pain immediately upon injury
b. Significant edema along the foot and ankle
c. Profound ecchymoses due to hemorrhage; worsens
over several days
d. Patient cannot weight bear
e. No range of motion to the ankle

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Laboratory/Diagnostic of Ankle Sprain:
1. The radiograph is indicated according to ____ ___ ___ if:
a. There is pain near the malleoli and
b. Bone tenderness is present at the posterior edge of
the distal six cm or the tip of either malleolus or
c. The patient is unable to bear weight for at least four
steps at the time of injury and evaluation.
2. Otherwise, diagnostic studies are not indicated.

A
  1. Ottawa Ankle Rule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Management of Ankle Sprain:
1. RICE: All grades including 3 (unless severe grade 3) respond well to rest, ice, compression, and elevation (RICE)

a. ___: Weight beming should be avoided for the first several days.
b. ____: Should be applied on top of the compression dressing as quickly as possible following injury, 30 minutes on and off alternately
c. _______: Immediate secure compression will minimize edema and support stability of the ankled.
d. _______: For several days following injury reduces pain and swelling and promotes recovery
2. Nonsteroidal anti-inflammatory drugs (NSAIDs) for pharmacologic relief

A

a. Rest
b. Ice
c. Compression
d. Elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Often associated with injuries resulting from straight, outstretched arm falls

A

Elbow Fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Signs/Symptoms
1. ___ ___signs: Elbow Fracture
a. No fracture is visible on X-ray.
b. The lateral view demonstrates the elevation of the
anterior and posterior fat pads.
c. Even if fracture cannot be visualized on a radiograph,
the fat-pad sign suggests the presence of an occult
fracture.

A

Fat pad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Laboratory/Diagnostics: Elbow Fracture

1. Follow up radiographs with an ____ view

A

oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Management: Elbow Fracture

1. Refer to ______ to be treated as a fracture

A

orthopedics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

____ ______

A common injury in a young child resulting from swinging or pulling child’s arm; radial head subluxation

A

Nursemaid Elbow

54
Q

Signs/Symptoms: Nursemaid Elbow

  1. Inability/refusal to use affected arm
  2. Pain with ______
  3. Holds arm across the body with thumb up
  4. Significant swelling and bruising justifies X-Ray
A

supination

55
Q

Laboratory/Diagnostics: Nursemaid Elbow

1. X-ray will be read as ____ and are usually not done

A

normal

56
Q

Management: Nursemaid Elbow

1. Supportive care at home with _____

A

NSAIDs

57
Q

a) CN 1 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Olfactory
b) Smell
c) Sensory

58
Q

a) CN 2 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Optic
b) Vision
c) Sensory

59
Q

a) CN 3 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Oculomotor
b) Most EOMs, opening eyelids, papillary constriction
c) Motor

60
Q

a) CN 4 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Trochlear
b) Down and inward eye movement
c) Motor

61
Q

a) CN 5 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Trigeminal
b) Muscle and mastication, the sensation of the face, scalp, cornea, mucus membranes, and nose
c) Both

62
Q

a) CN 6 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Abducens
b) Lateral eye movements
c) Motor

63
Q

a) CN 7 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Facial
b) Move face, close moth andy eyes, taste (anterior 2/3), saliva and test secretion
c) both

64
Q

a) CN 8 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Acoustic
b) Hearing and equilibrium
c) sensory

65
Q

a) CN 9 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Glossopharyngeal
b) Phonation, ( one-third), gag reflex, carotid reflex swallowing, taste (posterior)
c) both

66
Q

a) CN 10 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Vagus
b) Talking, swallowing, the general sensation from the carotid body, carotid reflex
c) both

67
Q

a) CN 11 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Spinal accessory
b) Movement of the trapezius and sternomastoid muscle (shrug shoulders)
c) motor

68
Q

a) CN 12 is what?
b) The major function is?
c) Is this a sensory or motor neuron?

A

a) Hypoglossal
b) Move the tongue
c) motor

69
Q

Eye movement by what nerves?

A

3, 4, 6

70
Q

Facial (Bell’s Palsy) by what nerve is this affected?

A

7

71
Q

Tongue by what nerve is affected?

A

12

72
Q

_____ may present for a multitude of reasons and can be difficult to evaluate. Proper evaluation of the history of the headache, and associated symptoms, are essential to making an accurate diagnosis.

A

Headache

73
Q

____ _____: cranial artery distension (e.g. migraine, fever, vasodilator drugs, metabolic disturbance, systemic infection)

A

Vascular dilation:

74
Q

____ _____: head and neck muscle contraction (e.g. tension or psychogenic headache)

A

Muscular contraction

75
Q

____: space-occupying lesion (e.g. brain tumors, mass lesions, abscess, hematoma, increased intracranial pressure (ICP))

A

Traction

76
Q

____: infection (e.g. meninges, sinuses, and teeth)

A

Inflammation

77
Q

Febrile Patient
1) ______: bacterial, bacterial, viral, tuberculous, aseptic
2) A brain abscess or other intracranial infection
3) Encephalitis
4) Sinusitis
5) Associated infection: Strep throat, influenza, mono,
rubeola

•

A

1) Meningitis

78
Q

Viral meningitis is more common in ______

A

infants

79
Q

Bacterial meningitis occurs only in up to 2%
a. Temperatures higher than ___ °F (38.8 °C)
b. Causative agents include: Group B. streptococcus’, S.
pneumoniae, H. influenzae, Salmonella, N. meningitis,
protozoa, and E. coli
c. Infants between six to ___ months are at the highest
risk.
d. 90% of cases occur in children ages one month to five
years

A

a. 101.8 °F

c. 12 months

80
Q 
Signs/Symptoms of meningitis: 
Most are behavioral responses 
1. Newborns and young infants 
     a. Mimics septicemia 
     b. Temperature instability 
     c. Irritability, lethargy 
     d. Poor \_\_\_\_\_ 
     e. Volniting 
     f. Bulging fontanel 
    g. No stiff neck
A

d. feeding

81
Q

Older infants and children of meningitis:

a) Nausea and vomiting
b) Irritability, confusion
c) Headaches, back pain, nuchal rigidity
d) Hyperesthesia, cranial nerve palsy, ataxia
e) __________
f) Positive Kernig’s sign
i. Flexion of the hip at 90 degrees
ii. Pain on the extension of the leg
g. Positive Bmdzinski’s sign
i. Involuntary flexion of legs when the neck is flexed.

A

Photophobia

82
Q

Diagnostic Tests

  1. Cerebrospinal fluid (CSF) analysis via lumbar puncture
    a. Cloudy
    b. _____ present
    c. Increased protein
    d. Decreased glucose
A

b. WBCs

83
Q

_____ Patient

  1. Subarachnoid hemorrhage
  2. Intraparenchymal hemorrhage
  3. Postictal headache
  4. Cerebral ischemia
  5. Severe hypertension
  6. Space-occupying condition (examples: a brain tumor,
    hydrocephalies) Acute dental disease
  7. Acute glaucoma, inflammatory disease of the eye/orbit
A

Afebrile

84
Q

___ Tumors

  1. Etiology is unknown.
  2. Infratentorial, brainstem tumors predominate: Most common ages 4 to 11 years
A

Brain

85
Q

Signs/Symptoms: Brain tumor
1. Infants
a. Increased head circumference, tense bulging
fontanel
b. _______
c. Head tilt
d. Loss of developmental milestones

A

b. Irritability

86
Q

Signs/ symptoms: Brain tumor
Older Children
a. Headache
1. Worst in the morning followed by ____
2. Usually increases in frequency
b. Abnormal neurologic or ocular findings
1. Ataxia, hemiparesis, cranial nerve palsies
2. Somnolence
3. _______
4. Head tilt, failure to thrive (FTT), diabetes insipidus
5. Papilledema
6. Loss of fine motor control
7. Positive Babinski’s sign
8. Behavioral changes

A

a) 1) vomiting

b) 3) Seizures

87
Q

Diagnostic Tests: Brain Tumor

  1. Computed axial tomography (CT scan)
  2. ___ ____ ___ (__)
  3. Lumbar puncture (LP): Approach with caution
A
  1. Magnetic resonance imaging (MRI)
88
Q

Causes/Incidence: Brain Tumor

  1. Common migraine (no aura) ____years of age at onset
  2. Classic migraine onset (with aura) ___years of age
  3. Often, there is a family history.
  4. _______more often affected
  5. A variety of “triggers” are associated with migraine
A
  1. < 10
  2. > 10
  3. Females
89
Q

A variety of “triggers” are associated with migraine (e.g. emotional or physical stress, lack or excess ____, missed meals, nitrate-containing foods, alcoholic beverages, menstruation, use of oral contraceptives).

A

sleep

90
Q

Symptoms: Migraine

  1. Unilateral, lateralized dull or throbbing headache that occurs episodically
  2. ______ onset
  3. Focal neurologic disturbances may precede or accompany classic migraines (e.g. field defects, luminous visual hallucinations
  4. Aphasia, numbness, tingling, clumsiness or weakness may occur
  5. Nausea and vomiting
  6. Photophobia and phonophobia
A
  1. Insidious onset
91
Q

Variant Migraine Syndromes:

1) _______migraine
2) Abdominal migraine

A

1) Confusional

92
Q

_______migraine: More common in younger children; period of confusion and disorientation followed by vomiting and deep sleep, waking feeling well; a headache may not be described

A

Confusional

93
Q

_______ migraine: Episodic abdominal pain with nausea, vomiting followed or accompanied by headache

A

Abdominal

94
Q

Laboratory/Diagnostics: Migraine
1. Baseline studies
a. Blood chemistries, basic metabolic panel (CMP)
b. ___ ____ ____ ____ (____)
c. Venereal Disease Research Laboratory test (VDRL)
d. Erythrocyte sedimentation rate (ESR)
e. CT scan of the head
f. Other studies as indicated by the history and physical
exam

A

b. Complete blood count test (CBC)

95
Q

Management of Migraines:
1. Avoidance of trigger factors is very important; have the patient keep a headache diary
2. Improve general health: Balanced diet, aerobic exercise, regular sleep
3. Relaxation/stress management techniques (e.g., counseling, biofeedback)
4. Eliminate monosodium glutamate (MSG) and nitrates or nitrites from the diet
5. Stabilize or wean caffeine intake
6. Prophylactic therapy if attacks occur more than three to four times per month, or if migraines interfere with daily functioning or school; for example
a. Non-steroidal anti-inflammatory drugs (NSAIDs) in chronic, low doses daily b. Other agents:
i. _______ (Inderal):
ii. Amitriptyline (Elavil):
iii. Topiramate (Topamax):
iv. Imipramine (Tofranil): Ten to 150 mg daily
v. Verapamil (Calan): Fifteen to 30 mg/kg/24 hour by
mouth twice a day

A

i. Propanolol

v. Verapamil

96
Q

Management of an acute attack/ Migraine
a. Rest in a ____, quiet room
b. A simple analgesic such as Tylenol or ibuprofen (preferred) taken right away may provide some relief
i. Ibuprofen _____ mg/kg dose in younger children
ii. May use up to 800 mg/dose in older teens
c. Antiemetics
d. When OTC analgesics, not enough use triptans
i. Almotriptan (Axert) 6.25 mg (approved for children 12
years and older)
ii. Rizatriptan (Maxalt) 5 mg
iii. Sumatriptan (Imitrex):
1. Nasal 5 mg
2. Tablets - (less expensive; may not work as well
due to slower absorption)
iv. Zolmitriptan (Zomig) nasal 5 mg
v. Most evidence in adolescence - all triptans noted
above
vi. Most evidence for ages 6 to 11 years: Maxalt 5 mg or
Imitrex nasal 5 mg vii.
vii. May take at first sign of a headache, then repeat in
two hours if needed viii.
viii. Avoid in children at risk for heart disease

A

a. dark

b. i. 7.5 - 10

97
Q

A transient disturbance of cerebral function due to an abnormal paroxysmal neuronal discharge in the brain

A

Seizure Disorder

98
Q

Causes/Incidence: Seizure Disorder

1. ______ abnormalities and perinatal injuries may result in seizures presenting in infancy and early childhood

A

Congenital

99
Q

Causes/Incidence: Seizure Disorder

2. _______ disorders: hypocalcemia, hypoglycemia, pyridoxine deficiency, renal failure, acidosis, and others

A

Metabolic

100
Q

Causes/Incidence: Seizure Disorder

3. ____ is an important cause in adolescents.

A

Trauma

101
Q

Causes/Incidence: Seizure Disorder

4. _____ and other space-occupying lesions

A

Tumors

102
Q

Causes/Incidence: Seizure Disorder

5. ______diseases: Bacterial meningitis, herpes encephalitis, neurosyphilis

A

Infectious

103
Q

Causes/Incidence: Seizure Disorder

6. The seizure threshold is lowered with _____ (easier for them to have a seizure if febrile).

A

fever

104
Q

_____Seizures

Focal origin: One hemisphere

A

Partial

105
Q

___ ____ seizures

a. No loss of consciousness
b. A variety of other symptoms (e.g. motor, autonomic, and sensory)

A

Simple partial

106
Q

_____ partial seizures

a. Impaired consciousness: Stating > ___ seconds before, during or after the symptoms described above

A

Complex

20 seconds

107
Q

______ Seizures

Bilateral, involving both hemispheres

A

Generalized

108
Q 
\_\_\_ \_\_\_\_\_\_:
Absence (petit-mal)
a. Brief "staring" episodes (10 to 20 seconds) 
b. Onset and termination are very brief 
c. Almost always begin in childhood
A

Generalized Seizures

109
Q

_____ seizure
a. A sudden increase in muscle tone producing a number of characteristic postures

b. Consciousness is usu~dly partially or completely 10st
c. Postictal alteration of consciousness is usually brief; may last several minutes

A

Tonic

110
Q

_____ ____ seizure

a. Sudden loss of consciousness with arrested respirations
b. The clonic phase involves increased muscle tone followed by bilateral rhythmic jerks lasting two to three minutes, followed by flaccid coma
c. Urinary and or fecal incontinence may occur
d. The postictal state is characterized by deep sleep for up to an hour, headache, disorientation, muscle discomfort and nausea; can last minutes to hours

A

Tonic-clonic (grand mal)

111
Q

_____ seizure
a. Sudden loss of muscle tone
b. May result in head drop or falling to the ground
An eyewitness account is extremely helpful

A

Atonic

112
Q

Management: Acute Attack

  1. Initial management is supportive as most seizures are self-limiting
    a. Maintain open airway
    b. Protect patients from injuries
    c. Administer oxygen if the patient is cyanotic.
  2. Do not force artificial airways or objects between teeth
  3. Parenteral anticonvulsants are used to stop convulsive
    seizures
    a. ______ (Ativan) or
    b. Benzodiazepines (Valium)
  4. Consider referral if:
    a. Seizures continue despite therapeutic monitoring
    through anticonvulsant levels
    b. Regression of developmental skills occurs
    c. Regression of cognitive function occurs
    d. Side effect profile is unacceptable
  5. Primary care follow-up
A

3.a. Lorazepam

113
Q

____ Seizures

Seizures occurring during the course of and as a result of fever

A

Febrile Seizures

114
Q

______ Seizures

Occur in 5% of children, peak incidence between 1 and 3 years of age

A

Febrile Seizures

115
Q

Febrile Seizures:
Risk factors include a family history of seizure disorder, ____ use by mother during pregnancy, prematurity, neonatal hospitalization > 28 days, and/or frequent infections in the first year.

A

tobacco

116
Q

Febrile Seizures:

If a seizure occurs > ___ hours after fever onset, it is likely due to infection.

A

24

117
Q

Signs and symptoms: Febrile Seizures

  1. The majority are ___ _____
  2. Most episodes last < five minutes
  3. Physical exam to rule out the infectious cause of seizure
  4. Rule out meningitis
A

tonic-clonic

118
Q

Laboratory/Diagnostics/ Febrile Seizure

  1. ______ puncture if meningitis is suspected.
  2. EEG, chemistries, and serologies are not indicated.
A

Lumbar

119
Q

Management/ Febrile Seizures

  1. ___ ___; place in the side-lying position
  2. Cooling measures
  3. Acetaminophen
A

Protect airway

120
Q

A ____ ______characterized by numerous cafe-au-lait spots on the body, and nerve tumors on the skin and in the body

A

neurocutaneous syndrome

121
Q

Signs/Symptoms
1. Multiple cafe-au-lait (CLS) spots
2. Seizures
3. Diagnostic criteria: Must have at least two
a. Six or more CLS spots > 5 mm in the prepubertal
child or > 15 mm postpubertal
b. Two or more cutaneous neurofibromas
c. Axillary or inguinal freckling
d. Two or more iris Lisch nodules
e. Distinctive osseous lesions
f. Autosomal dominant; present in a first-degree relative

A

Neurofibromatosis (von Recklinghausen Disease)

122
Q

Management of Neurofibromatosis (von Recklinghausen Disease)?
1. Refer to ______

A
  1. neurology
123
Q

_____ _____

Brief, abrupt, non-purposeful movements or utterances

A

Tic Disorders

124
Q
  1. The most common is Tourette syndrome.
  2. Movements usually involve the face, neck, or shoulders and sometimes, muscles of the limbs or other parts of the body.
  3. Other psychobehavioral problems (e.g. attention deficit hyperactivity disorder (ADHD), obsessive-compulsive behaviors)
A

Tic disorder

125
Q

Etiology and incidence; Tic Disorders
1. Frequently unrecognized as a movement disorder in children

  1. Onset is between ___ to ___ years of age.
  2. The cause is unknown.
  3. Family predisposition
  4. Associated with medications (methylphenidate, pemoline, amphetamines)
A
  1. 6 and 12 years
126
Q

Vocal tics

  1. Oropharyngeal, nasopharyngeal or laryngeal sounds 
  2. Consonants or syllables
  3. Meaningful or nonsense words or phrases
  4. \_\_\_\_\_\_ (obscene speech)
A

Coprolalia

127
Q

obscene gestures

A

Copropraxia

128
Q

obscene writing

A

coprographia

129
Q

repeating one’s own words

A

Palilalia

130
Q

repeating another’s words

A

echolalia

131
Q

Tic Disorder is management is done with collaboration with _______?

A

Neurology

Primary (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions