Neuro/MSK Flashcards
HIE
- primary energy failure?
- secondary energy failure?
- primary energy failure: immediate necrotic cell death from decreased phosphocreatine and ATP - infant may be able to recover
- secondary energy failure (6-48 hours): glutamate (excitatory) release –> calcium influx into cells –> free radicals –> caspases –> apoptosis
Goal of TH is to reduce apoptosis
Whats parts of the brain are affected in:
- HIE
- metabolic disorders
- kernicterus
- PLIC
- PLIC
- basal ganglia, globus pallidus, and cerebellum
Dandy Walker
posterior fossa cyst and cerebellar hypoplasia, 4th ventricle enlargement
Treatment of SIADH, central DI, and nephrogenic DI
SIADH: too much ADH
– fluid restriction, lasix if needed
Central: ADH not produced
– DDAVP
Nephrogenic: ADH produced but kidneys can’t respond
– Thiazides (paradoxical effect; increases prox reabsorption of Na and water)
If you see term infant with IVH or thalamic hemorrhage, what should you think of?
cerebral sinovenous thrombosis - get MRI
What do periodic lateralized epileptiform discharges suggest?
HSV or stroke
What electrolyte abnormality do infants with holoprosencephaly have?
hypernatremia (central DI from abnormal hypothalamus which sets an abnormal osmostat; pituitary is actually fine)
What nerve roots are affected in:
- Erb’s palsy
- Waiter’s tip
- Klumpke’s
- Horner’s
- Erb’s palsy (grasp present, biceps absent) - C5-6
- Waiter’s tip (grasp present) - C7
- Klumpke’s (grasp absent) - C8-T1
- Horner’s (ptosis, miosis, anhydrosis) -
Most common cranial nerve injury during birth?
facial nerve (asymmetric cry, can’t close eye on that side) - give eye drops and tape eyelid
Which craniosynostosis repair is for cosmetic reasons? Which is for brain growth?
sagittal for cosmetic reasons
coronal (or if multiple sutures) for neurodevelopment
Brain tumors in neonate…
- most common type?
- supratentorial or infratentorial?
- common presentation?
- teratoma
- supratentorial
- bulging fontantelle or macrocephaly
Fingers:
- hyperconvex fingernails and polydactyly?
- hypoplastic fingernails and overlapping fingers?
- shortened fourth finger?
- clinodactyly of fifth finger?
- 3,4 syndactyly?
- hyperconvex fingernails and polydactyly: T13
- hypoplastic fingernails and overlapping fingers: T18
- shortened 4th finger: Turners
- clinodactyly: Downs
- 3,4 syndactyly: triploidy
diurnal variation in CP-like symptoms?
Dopa-responsive dystonia - treat with small doses of dopamine
- Primary neurulation problems?
- Secondary neurulation problems?
- Ventral induction?
- Neural migration?
- Organization?
- Myelination?
- Primary neurulation - myelomeningocele, arnold-Chiari
- Secondary neurulation - Spinal problems
- Ventral induction - Agenesis of corpus collosum
- Neural migration - lissencephaly, schizencephaly, pachygyria
- Organization - T21, autism
- Myelination - prematurity, malnutrition
Do hearing tests detect high or low frequency hearing loss better?
Better at detecting high frequency hearing loss better
