Neuro/Developmental (6%) Flashcards

1
Q

What congenital heart disease may be present in a patient with Down Syndrome?

A

Atrioventricular septal defect

ventricular septal defect, atrial septal defect, tetralogy of Fallot, patent ductus arteriosus

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2
Q

Tx for absence sz?

Tx for Grand mal sz?

Tx for status epilepticus?

Tx for febrile myoclonus?

A

Tx for absence sz: Ethosuximide

Tx for Grand mal sz: Valproic acid, phenytoin, carbamazepine, lamotrigine

Tx for status epilepticus: Lorazepam or Diazepam, then phenytoin, then phenobarbital

Tx for febrile myoclonus: Phenobarbital

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3
Q

What will provide a definitive dx of Turner’s syndrome?

A

Karyotyping

45, XO, mosaicism, or X chromosome abnormalities

High serum FSH & LH levels

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4
Q

What does the term “mosaicism” mean in reference to Turner’s syndrome?

A

Some cells have a combination of X monosomy (45,XO - missing X chromosome), some cells that are normal (46,XX), cells with partial monosomies (X/abnormal X), or cells that have a Y chromosome (46,XY).

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5
Q

What is the recommended management of Turner’s Syndrome?

A

GH (may increase final height)

Estrogen/progesterone replacement to cause pubertal development

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6
Q

What is the Simian crease? With what d/o is it associated with?

A

Palmar crease seen in pts with Down Syndrome

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7
Q

What are the two types of meningitis?

A

Bacterial meningitis: bacterial infection of the meninges

Aseptic meningitis: NOT caused by pyogenic bacteria, includes viral fungal and TB (viral is often referred to as aseptic)

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8
Q

What are the two types of partial sz?

The four different types of generalized sz?

What is the condition called when a pt suffers from repeated generalized sz w/o recovery >30 minutes?

A

Partial: Simple Partial, Complex partial (temporal lobe)

Generalized (both hemispheres involved): Absence (petit mal), Tonic Clonic (grand mal), Myoclonus, Atonic

Status Epilepticus

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9
Q
A
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10
Q

What are some PE findings one might expect to see in a pt with Turner’s syndrome?

A

short stature, webbed neck, prominent ears, low posterior hairline, broad chest with hypoplastic widely-spaced nipples, (congenital lymphedema seen in neonates), short 4th metacarpals, high-arched palate, nail dysplasia. May have hearing loss

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11
Q

Tx for viral meningitis?

A

Supportive care (antipyretics, IV fluids, antiemetics)

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12
Q

What cardiac conditions might one expect to find in a pt with Turner’s Syndrome?

A

coarctation of the aorta (30%), mitral valve prolapse, bicuspid aortic valves, aortic dissection, HTN

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13
Q

What are the most common pathogens and their respective abx txs? for acute bacterial meningitis in the following age groups?

<1 month

1 month-18 y/o

18 y/o-50 y/o

>50 y/o

A

<em>See image below</em>

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14
Q

What shape of kidney might a pt with Turner’s Syndrome have?

A

Horseshoe kidney

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15
Q

What are some examples of meningeal sx?

A

headache/nuchal rigidity (stiff neck), photosensitivity, nausea/vomiting

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16
Q

What is a (+) Kernig’s sign?

(+) Brudzinski’s?

A

(+) Kernig’s: Inability to straighten knee with hip flexion

(+) Brudzinski’s: Neck flexion produces hip/knee flexion

17
Q

What is the recommended abx for post exposure prophylaxis against acute bacterial meningitis?

A

Ciprofloxacin 500mg PO x1 dose

18
Q

LP performed on a pt with viral meningitis will show what two findings?

A

Lymphocytosis and normal glucose

19
Q

Down Syndrome is otherwise referred to as Trisomy ____

A

Trisomy 21

as there are three copies of chromosome 21, or three copies of a region of the long arm of chromosome 21

20
Q

What viral family is the most common cause of viral meningitis?

Viral meningitis is commonly associated with (abnormal/normal) cerebral function

A

Enterovirus family (i.e. Coxsackie, Echovirus)

Normal cerebral fxn

21
Q

Teething usually begins around what age?

When is the normal range for teeth to start coming in?

By the time a child is _____, he/she will have all 20 primary teeth

What teeth usually come in first?

A

Around 6 months of age

It is normal for teething to start at any time between 3-12 months

~ 3 y/o

Lower front teeth usually come in first

22
Q

What are the hallmarks of Turner’s syndrome?

A

Hypogonadism: primary amenorrhea or early ovarian failure, failure to develop secondary sex characteristics (absence of breasts)

Short stature: with normal GH levels

Webbed neck, edema, low hairline, low set ears, widely spaced nipples

23
Q

What are febrile sz?

In what age group are they seen most commonly?

How long do they last for?

A

Febrile seizures are convulsions that can happen during a fever

They affect kids 3 months to 6 years old, and are most common in toddlers 12–18 months old

The sz usually last for a few minutes and are accompanied by a fever above 100.4°F (38°C)

24
Q

In neonates with Down Syndrome, which reflex is observed to be “poor”?

A

Moro reflex

25
What is Turner's Syndrome due to?
Group of X chromosome abnormalities Females with an absent or nonfunctional X sex chromosome
26
In simple partial sz, consciousness is fully maintained or impaired? In complex partial sz, consciousness is fully maintained or impaired?
fully maintained impaired
27
If glucose is normal, then (viral/bacterial) meningitis is most likely If WBC is predominantly neutrophils, then (viral/bacterial) is more likely
viral bacterial
28
What are Brushfield spots? With what d/o are they associated with?
Brushfield spots: white/gray/brown spots in the peripheral iris Down Syndrome
29
If a pt is high risk (FND, papilledema) and suspected to have acute bacterial meningitis, what should be done before LP to r/o mass effect?
Head CT
30
How do you definitively diagnose a pt with acute bacterial meningitis? Should you wait for dx prior to administering abx?
**LP** to examine the **CSF** ***high** 100-10,000 PMN (neutrophils), **low** glucose \<45, **increased** total protein, **increased** CSF pressure* DO NOT wait for lumbar puncture to start empiric abx