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Phase 3a > Neruology (paeds) > Flashcards

Neruology (paeds) Flashcards

1
Q

what is the definition of childhood epilepsy

A

a chronic neurological disorder characterised by recurrent unprovoked seizures and transient signs of abnormal, XSn syncoronous neoronal activity

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2
Q

what are the types of epilepsy

A

Generalised - both hemispheres involved

Focal - one part of the brain (lobar)

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3
Q

what are the types of generalised seizure

A

absence

myoclonic

tonic

tonic clonic

atonic

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4
Q

what are the types of focal seizure

A

fromtal

temporal

occipital

parietal

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5
Q

a child has an episode where

they loose conciousness suddenly and then regain immediately

transiently and dont recognise the loss of conciousness

mum says : looks like she is day dreaming all the time

what epilepsy is this

A

absence

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6
Q

a child has an episode where

very brief, usually under 30s

theres repetative jerky movements ie head ‘banging’

what epilepsy is this

A

myoclonic

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7
Q

a child has an episode where

tall of a sudden they stiffen and fall (increased muscle tone)

what epilepsy is this

A

tonic

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8
Q

a child has an episode where

sudden increase in tone causing fall

irregular breathing (can cause cyanosis)

rythmic jerking

xs saliva +/- tongue biting

incontenence

lasting a few mins

followed by deep sleep for hrs

what epilepsy is this

A

tonic clonic

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9
Q

a child has an episode where

theres suddenly someone becomes all floppy (reduced tone)

and can be accompnied with a jerky repetative movement (myoclonic)

what epilepsy is this

A

atonic

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10
Q

a child has an episode where

they begin marching and waving arms in circular motions transiently

(jacksonian marck +hyperkinetic movements)

what epilepsy is this

A

frontal lobe

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11
Q

a child has an episode where

they expieriance auditory and sensory phenomane and a feeling of deja vu

theres lip smacking/sucking at clothing

what epilepsy is this

A

temporal lobe

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12
Q

a child has an episode where

they report having visual distorsion

what epilepsy is this

A

occipital

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13
Q

a child has an episode where

they have altered sensation on one side of the body and have a distorted body image in that time

what epilepsy is this

A

parietal

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14
Q

how would you diagnose epilepsy

A

EEG

CT

PET

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15
Q

what is the management of epilepsy

A

valproate

carbamezipine

lamotragine

topiramate

GABApentin in focal epilepsy

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16
Q

what are SE of valproate

A

weight gain

hairloss

liver failure

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17
Q

what are SE of carbamazipine

A

rash, neutropenia, hyponatremia

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18
Q

what are SE of Lamotragine

A

Rash

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19
Q

what are SE of GABApentin

A

insomnia

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20
Q

describe Juvenile Myoclonic Epilepsy

A

teens affected mostly which have myoclonic seizures (ie repeated jerky movements) shortly after walking

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21
Q

what is early onset benign occipital epilepsy syndrome

A

unresposive eye deviation

vomiting

headaches and visual disturbances

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22
Q

what is autistic spectrum disorder

A

children who fail to accquire normal social and communication skills

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23
Q

what is the presentation of autistic spectrum disorder

A

impaired social interactions

speech and language disorders

imposition of routienes

sensory issues

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24
Q

give examples of impaired social interactions in autistic spectrum disorder

A

gaze avoidence

not seeking company from others

struggle to understand social roles and ettiquete

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25
Q

what are 3 presentations of speech and language delay commin in autistic spectrum disorder

A

delayed speech

over literal comprehension of speech

monotenous without body language

26
Q

how do you manage autistic spectrum disorder

A

parental support

applied behavioural analysis (20-30hrs x week)

27
Q

what are the three core behaviours of ADHD

A

hyperactivity

innatention

impulsivity

28
Q

what are three signs of hyperactivity (ADHD)

A

cant remain still

talkative

noisy

29
Q

what are three signs of impulsivity

A

interuptting

blurting out answers

difficulty waiting turns

30
Q

what is the diagnostic criteria of ADHD

A

scaring 6/9 for innatention and 6/9 for hyperactivity and impulsivity

symptoms before 12y

occuring in more than 1 place

clear evidence of sx interefering with social and academic functions

31
Q

how do you manage ADHD

A

behavioural and educational support

atomoxetine (non stimulant)

methylphonidate / dexamphetamine - stimulants

yearly trials off of medication

32
Q

what tools are used to diagnose ADHD

A

ADHD nurse classroom observation

SNAP questionarre

quantative behavioural analysis

33
Q

what is the definition of cerebral palsey

A

abnormalities of movement and psoture

causing limited activity

non progressive disturbances / injuries whivh occur en utero or when younger than 2y

34
Q

what is the presentation of cerebral palsey

A

reduced cognition

disturbed communication

perceptual and sensory disturbances

behavioural disturbances

seizures

sendary msk prolmens

manifesting over ime due to the abnormal brain developing

35
Q

what are the types of cerebral palsey

A

spastic : hemiplegic, quadroplegic, diplegic

or

dyskinetic

36
Q

what are the characteristics of spastic cerebral palsey

A

increased muscle tone

brisk reflexes

abnormal gait

37
Q

describe the presentation of hemiplegic cerebral palsey

A

facial sparing

arms mostly affected

38
Q

describe the presentation of quadroplegia cerebral palsey

A

trunk has extensor posturing

poor central tone

all 4 limbs affected equally

usually caused by hypoxic-ischemic injury (HIE)

39
Q

what is diplegic cerebral palsey

A

a type of quadroplegic cerebral palsey but legs are affected worse than arms and hand function is good

40
Q

what is diplegic cerebral palsey associated with

A

periventricular brain damage

41
Q

what is dyskinetic cerebral palsey

A

characterised by involuntary movements

42
Q

what is the presentation of cerebral palsey

A

primitive motor reflexes are present

variable tone

involuntray uncontrolled movements : chorea, athetosis, dystonia

intellect intact

developmental delay

EPS

43
Q

describe chorea

A

irregular, sudden, brief non-repetative movements

44
Q

describe athetosis

A

slow writhing movements occuring distally ie at fingers

45
Q

describe dystonia

A

simultanoeus contractions of extensors and flexors of trunk causing twisting

46
Q

descrbe ataxic cerebral palsey

A

hypotonic symmetrically with unilateral signs

47
Q

what is the presentation of ataxic cerebral palsey

A

delayed motor development

incoordinate movements

intention tremour

ataxic gait

48
Q

what are febrile convulsions

A

a fever accompnied by a seizure without an intercranial infection

49
Q

what age group is usually affected by febrile convulsions

A

6y-15y

50
Q

what feature in the Hx would reassure youits a febrile convulsions

A

early in illness/fever

whentemp is still rising

51
Q

what are the features of febrile convulsions

A

breif

tonic clonic

no brain damage

only once x illness

52
Q

what are features of a complex febrile convulsions

A

focal seizure

prolonged

repeated illness

have high risk of developing subsequent epilepsy

53
Q

what must you do in any ?febrile convulsions

A

exclude meningitis =

blood and urine cultures

LP if younger than 18m

54
Q

what is the acute management of a febrile conculsion/ status epilipitcus

A

A B C

measure BMs

IV lorazapam > (10mins)> Iv lorazapam> (5mins)> IV lorazapam> phenytoin over 20 mins IV> phenobarbitol >PICU

55
Q

what is the acute management of a febrile conculsion/ status epilipitcus IF you cant get Iv access

A

A B C

BMs

Ciazapam PR or Midlazapam (per osseus - POs)> 10min> paraldehyde PR> get special assistance

56
Q

what is the definition of anorexia nervosa

A

slimming through self restriction (calorie)

and

a phobia of normal body weight

57
Q

what is the presentation of Anorexia

A

self induced weight loss

low BMI

laxatives/vomiting/ XS ecersise

Halted pubertal developments

Food idealisation

Slow reflexes

Ankle oedema

XS hair

58
Q

what is the management of Anorexia

A

therapy

fam therapy

fluoxetinerefeeding

psychoeductaion

59
Q

what is bulimia

A

self induced bouts of overeating and purging via:

vomiting/laxatives/diuretics

60
Q

what is the presentation of bulimia

A

wide fluctuations in weight but gereally normal BMI

acidosis

Phase 3a (22 decks)

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