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Peds clerkship > Neuro > Flashcards

Neuro Flashcards

1
Q

def. of epilepsy

A

chronic, recurrent, unprovoked seizures

- 2 or more afebrile seizures

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2
Q

main types of seizures

A
  1. partial - discrete areas of brain
    - simple - focal neuro signs with no impaired consciousness
    - complex - focal neuro with impaired cons
  2. generalized - whole brain
    - absence - staring spells, consc impaired
    - myoclonic - rapid jerks
    - tonic - rigid and stiff
    - clonic - rhythmic jerks
    - tonic-clonic - jerk and stiff
    - atonic - loss of tone
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3
Q

DDx for seizure

A
  • syncope
  • breath holding spells
  • GERD
  • self stim behaviour - ASD
  • chorea
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4
Q

Phx for seizures

A
  • ABC
  • general for Infeciton
  • neuro exam - LOC, meningitis, focal neuro
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5
Q

imaging for seizure

A
  • labs based on Hx
  • CT or MRI
  • LP to examine CSF
  • ECG, EEG
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6
Q

mgmt of seizure

A 
- rule out provoked causes
meds after 2 unprovoked or 1 unprovoked with abnoral EEG
- valproic acid for general
- carbamazepine for partial
surgical
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7
Q

def. status epilepticus

A

def is 30 minutes, but should treat if longer than 5

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8
Q

mgmt of stat epi

A

p 208

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9
Q

2 main types of febrile seizures

A
  1. simple febrile - brief, generalized and once in 24 hrs

2. complex - >15 mintues with or without focal features or recurs in 24 hours

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10
Q

tests for febrile seizures

A
  • labs as indicated
    LP
  • for those under 12 months
  • or meningeal signs
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11
Q

mgmt of feb. seizure

A

safety - none in mouth, roll on side

  • treat infection
  • Tx of fever not effective
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12
Q

prog. of febrile seizures

A

simple
- increased risk of another
complex
- increased risk of epi, not another febrile

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13
Q

most common headache in children

A

migraine

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14
Q

5 main classes of HA and some types

A
  1. acute general
    - infections
    - CSF leak
    - post-ictal
    - HTN
  2. acute local
    - sinusitis
    - AOM
    - TMJ
    - eye strain
  3. acute recurrent
    - migraine
    - cluster
    - tension
    - exertional
  4. chronic progessive
    - ICP
    - CNS tumor
    - pseudotumor cerebri
    - venous thrombus
  5. chronic non-prgressive
    - depression
    - chronic tension
    - post-concussion
    - caffeine or analgesic induced
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15
Q

when to image HA (red flags)

A
  • neuro Sx
  • progressive pattern
  • new or severe
  • increased with strain,cough sneeze
  • explosive or suddne
  • systemic Sx
  • sleep related - in AM or wakes up
  • clinical suspicion
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16
Q

mgmt for all HA

A
  • education
  • sleep hygene
  • diary
  • exercise, regualr meals
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17
Q

mgmt of migraines

A
  • tylenol
  • advil
  • 5-HT1 agon
  • triptans
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18
Q

mgmt of tension

A

advil/tylenol

19
Q

def. of cerebral palsy

A

non-progressive motor impairments caused by lesions or injuries to dev. brain
- hypertonia is primary abnormality

20
Q

risk factors for CP

A
  • premature
  • LBW
  • breech birth
  • multiples
  • toxins
  • maternal seizures
  • asphyxia
  • hemmorage
  • post-natal meningitis
21
Q

4 main types of CP

A
  1. spastic - stiffness
    - hemi, di or quadraplegic
  2. ataxic
  3. dyskinetic - invol, uncontrolled movements
  4. mixed
22
Q

Phx for CP

A
  • complete PE
  • screen for accompanying impariments
  • neuro exam
23
Q

invest for CP

A

MRI - for etiology and timing

EEG - only in children with CP and suspected sizures

24
Q

mgmt of CP

A
  • physio
  • OT
  • speech therapy
  • assistive devices
  • medical therapy
25
Q

def. of hypotonia

A

reduced restistance to passive ROM in joints

26
Q

DDx for hypotonia

A
  1. cerebral
    - congenital
    - chromosomes
    - metabolic
  2. spinal cord disorders
    - hypoxic ischemic myelopathy
  3. polyneuropathies
  4. disorders of neuromusc. transmission
    - MG or botulism
  5. muscular dystrophies
27
Q

important part of HPI

A

onset - floppy at birth or progressive

28
Q

maternal Hx questions for hypotonia

A
  • toxins
  • decreased fetal movelment in utero
  • APGAR
29
Q

Phx for hypotonia

A
  1. tone
    - lying
    - horizontal suspension
    - vertical suspension
    - in traction
  2. strength/power
  3. muscle bulk
  4. deep tendons
  5. plantar response
  6. laxity
30
Q

labs for hypotonia

A
  • CBC
  • ext. lytes
  • LFTs
  • renals
  • Ammonia
  • glucose
  • karyotype/FISH
31
Q

imaging for dystonia

A

MRI for central

32
Q

neuromusc. tests for hypotonia

A

CK
EMG
muscle Bx

33
Q

table for hypotonia

A

p216

34
Q

most common causes of head trauma

A
  1. falls
  2. sports related
  3. hit with object
  4. bike or MV
35
Q

classification of severity by GCS

A

mild - 14-15
mod - 9-13
severe

36
Q

when to xray head

A
37
Q

when to CT (CATCH rule) 7

A

any of

1. GCS

38
Q

mgmt of mild, mod and severe head

A 
mild
- DC to respnosible parents
- observe if LOC
mod
- CT
severe
- stabilize and intubate, then CT
- then trauma center
39
Q

def. concussion

A

mild TBI caused by mech forces

40
Q

main Sx of concussion

A 
usual Sx
- HA, NV, dizzy, photo/phonophobia
behav. changes
cog impairments
sleep disturbances
41
Q

red flags for concussion

A
  • worsening HA
  • seizures
  • increased confusion
  • cannot recognize ppl and places
  • strange behav. changes
  • repeated vomiting
42
Q

Phx for concussion

A 
HEENT exam
CNs
motor - pronator drift
sensation
reflexes
balance
coordination
cognition
43
Q

mgmt of concussion

A

graded return to work/play

see table p221

Peds clerkship (22 decks)

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