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PEDS > Neuro > Flashcards

Neuro Flashcards

1
Q

most important diagnostic tool in neuro

A

history

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2
Q

what test can see the posterior fossa bets?

A

MRI

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3
Q

what is a good eval for hydro, hemorrhage, gross structures, calcification

A

US

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4
Q

when do HAs typically begin normally?

A

middle school aged

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5
Q

when do you do a CT/ MRI for HA in a kid

A

Concern about sub-arachnoid, subdural hematoma

Concern about increased IC pressure or hemorrhage

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6
Q

Red flags for HA

A 
fails to respond to tx
focal neurological findings (first 2-6 months)
progressive frequency/ severity
awake from sleep, worse in morning
AM vomiting
at risk hx or condition
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7
Q

What are some focal neurologic findings

A 
CN VI palsy
diplopia 
new onset strabismus
papilledema
hemiparesis
ataxia
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8
Q

can you have photophobia or phonophobia w/ a tension type HA?

A

Yes, but usually only have 1

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9
Q

Constant, aching, tight

Occipital, frontal or constricting band around head

A

Tension type HA

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10
Q

chronic tension HA is often a sign of what

A

depression and/or anxiety

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11
Q

Severe, pulsatile (pounding)
unilateral, can be bilateral
Frontal or temporal regions, retro orbital or cheek

A

Migraine hA

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12
Q

what may be the only symptoms of migraine in a kid

A

vomiting

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13
Q

tx for migraine

A 
Ibuprofen APAP early
caffiene + ergot 
triptans and DHE 
rest and quiet 
avoid opioids
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14
Q

Migraine prevention

A 
TCA
beta blockers (propranolol) 
Calcium channel blockers (verapamil)
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15
Q

A sudden, transient disturbance of brain function manifested by involuntary motor, sensory, autonomic, or psychic phenomena

A

Seizure

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16
Q

2 or more seizures not provoked by particular event or cause.

A

Epilepsy

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17
Q

a benign condition of childhood with unilateral focal seizures and speech abnormalities, often hereditary.

A

Rolandic epilepsy

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18
Q

when should you do studies w/ a migraine

A

worse on awakening
awakens pt
worse with cough or bending over

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19
Q

Seizure > 30 min

Sequential seizures without regain LOC > 30min

A

Status epilepticus

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20
Q

Onset of seizure begins in one area of one cerebral hemisphere (apparent clinically or via the EEG) with no LOC

A

simple focal seizure

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21
Q

Onset of seizure begins in one area of one cerebral hemisphere (apparent clinically or via the EEG) with altered LOC (staring)

A

complex focal seizure

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22
Q

a simple or complex partial seizure that ends in a generalized convulsion

A

secondary generalized seizure

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23
Q

Seizures arise from both hemispheres, simultaneously

A

generalized seizure

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24
Q

unique to kids 6 month- 6 years. happens with changing temp. doesn’t tend to cause damage or increase risk of epilepsy

A

febrile seizure

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25
Q

if a second seizure is going to occur, when is it likely?

A

within 6 months after 1st seizure

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26
Q

if a second seizure is going to occur, when is it likely?

A

within 6 months after 1st seizure

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27
Q

what type seizures are frequently associated w/ underlying structural brain dz?

A

generalized seizures

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28
Q

what type of partial seizure may have an aura/ automatisms?

A

Complex partial

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29
Q

what type seizure will a patient be confused for generalized?

A

generalized tonic-clonic

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30
Q

symptoms in infants that occur in clusters when drowsy. Have severely abnormal EEG pattern. Due to brian injury at birth and are hard to control.

A

Infantile spasm (west syndrome)

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31
Q

if a patient has infantile spasms with no hx of birth problems or MRI or meatbolic origin is there a better or worse outcome.

A

Better

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32
Q

usually 3-13 years old. Normal IQ and MRI. will have twitching and tingling when awake and grand mal when asleep. often runs in families

A

Benign rolandic epilepsy (benign focal epilepsy of childhood)

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33
Q

when do you Tx for benign rolandic epilepsy

A

only if seizures are frequent, problem in school or anxiety

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34
Q

effective txs for benign rolandic epilspey

A

avoidance of sleep deprivatoin
carbamazepine, oxcarbamazepine
will usually outgrow

35
Q

when is status epilepticus common

A

children under 5, especially <12 months

36
Q

can status epilepticus be the first seizures?

A

yes, often happens

37
Q

most common cause of status epilepticus in children

A

Infection and metabolic disorders

38
Q

too much potassium can lead to what?

A

arrhythmia

39
Q

do you tx febrile szs?

A

no

40
Q

what is a complex febrile seizure?

A

one side of body shaking, staring
prolonged (>15-20 minutes)
multiple in 24 hours
more likely to lead to epilepsy

41
Q

If you do have to tx a febrile seizure what do you give?

A

rectal diazepam

42
Q

can syncope have rhythmic jerking?

A

Yes, can have some

43
Q

can syncope have rhythmic jerking?

A

Yes, can have some

44
Q

Transient LOC and postural tone due to cerebral ischemia or anoxia.

A

syncope

45
Q

can syncope have a prodrome?

A

Yes Dizziness, lightheadedness, nausea, sweating, pallor

46
Q

Neurally mediated
Transient hypotension from vasodilation and/or decreased heart rate
Arousal 1-2 min up to 1h

A

Vaso-vagal or neurocardiogenic syncope

47
Q

tx for syncope

A

Direct management of any cardiac cause

Reassurance and avoidance of triggers for vaso-vagal stimulation

48
Q

causes of increased ICP

A

Cerebral edema

Mass lesion

49
Q

children will have HA, diplopia/ strabismus, papilledema, herniation syndromes

A

increased ICP

50
Q

management for hydrocephalus caused by obstruction that will get better as kid ages

A

shunt that drains into peritoneal cavity

51
Q

where is pain with supratentorial elevated ICP

A

eye
forehead
temple

52
Q

where pain with infratentorial increased ICP

A

occiput

neck

53
Q

when are HA from elevated ICp worse

A

morning
awakening
standing up
at night

54
Q

Increased intracranial pressure without identifiable mass or hydrocephalus. Obese teenage girl with HA tinnitus, papilledema, visual loss. normal MRI>

A

pseudotumor cerebri

55
Q

most common causes or childhood stroke

A

cyanotic heart dz
sickle cell anemia
meningitis
hypercoaguable state

56
Q

symptoms of childhood stroke

A

hemiplegia, unilateral weakness, seizures.

57
Q

most common cause of concussion in children

A

fall

58
Q

Brief loss of consciousness or stunned for minutes to hours. Amnesia is common and transient

A

Head Injury -Concussion

59
Q

what kids with a concussion should be evaluated

A

All children with amnesia or who were unconscious should be evaluated in ER.

60
Q

what will a meningomyelocele often have on prenatal screen?

A

elevated alpha fetoprotein

61
Q

displaced cerebellum through foramen magnum into spinal canal – posterior laminectomy. Sx will hve progressive ataxia or vertigo. low lying tonsils alone

A

Arnold Chiari I

62
Q

displaced cerebellum plus meningomyelocele – surgical repair and shunt. low lying tonsils + hydrocephalus

A

Arnold Chiari II

63
Q

occipital encephalocele – surgical repair

Hydrocephalus common

A

Arnold Chiari III (anencephaly)

64
Q

smooth brain
Severe delay, seizures. Associated with syndromes
Most common disorder of neuronal migration

A

Lissencephaly

65
Q

Premature closure of sutures

Sporadic and idiopathic

A

Craniosynostosis

66
Q

what type Craniosynostosis will have a short wide head (brachycephalic)

A

coronal sutures

67
Q

Tx for craniosynostosis

A

Treatment is surgical excision of fused suture line – best done prior to 6 months of age

68
Q

Autosomal Dominant

Café au lait spots - >6 of 5mm prepubertal pt

A

Neurofibromatosis

69
Q

AD, rare , characterized by benign tumors in vital organs such as the brain, eyes, kidneys, heart and skin. will have ash leaf spots, Adenoma Sebaceum
Shagreen Patch

A

Tuberous sclerosis

70
Q

Diagnostics for tuberous sclerosis

A

CT for calcified nodules

MRI for demyelination

71
Q

Unilateral port wine stain over upper face

Follows cranial nerve V. Can have leptomeningeal vascular anomaly and calcifications can lead to seizures.

A

Sturge Weber

72
Q

Impairment of coordination and balance of voluntary movement

Cerebellar problem

A

ataxia

73
Q

most common cause of ataxia in children

A

post-infectious or drug intoxication

74
Q

Sudden onset of ataxia,staggering, frequent falls
Nystagmus, vomiting, irritaility, lethargy possible
Sensory and reflexes preserved
No evidence increased ICP
will recover in 1-4 weeks

A

post infectious acute cerebellar ataxia

75
Q

do you need to tx post infectious acute cerebellar ataxai

A

No, most get between in 1-4 weeks by themselves

76
Q

kids uses hands to walk up legs to standing position

A

Gower sign

77
Q

what are 2 disorders of the anterior horn cells?

A

Spinal muscular atrophy (SMA)

poliomyelitis

78
Q

If you have a lower motor neuron lesions will be it be high tone or low tone?

A

low tone

79
Q

Neuromucular junction problem

A

Myasthenia gravis

80
Q

muscle weakness, which may manifest with floppiness, delayed motor milestones, unsteady gait or muscle fatiguability. Progressive with normal mental development but body fails.

A

SMA (spinal muscular atrophy)

81
Q

> 10 years old, ophthalmoplegia and ptosis, loss of facial expression and difficulty chewing

A

Juvenile myasthenia gravis

82
Q

Similar to Duchenne except later, less severe

Death usually in adulthood

A

Becker muscular dystrophy

83
Q 
X-Linked recessive
Onset at 2-6 yrs
Proximal muscles affected before distal
Waddling gait, difficulty with stairs
pseudohypertrophic calf 
Gower Sign – pelvic weakness
Elevated CPK 
75% mortality by age 20
A

Duchenne muscular dystrophy

84
Q

what is used to tx spastic cerebral palsy?

A

botox

PEDS (11 decks)

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