Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NEURO peds > NEURO peds > Flashcards

NEURO peds Flashcards

1
Q

What is the most important diagnostic tool in neurology?

A

History

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. headache fails to respond to therapy
  2. focal neurologic findings in first 2-6 months (palsy, diplopia, new onset strabismus, papilledema, hemiparesis, ataxia)
  3. progressively increasing frequency/ severity of HA , HA worse with valsalva
  4. HA awaken from sleep, worse in AM , AM vomiting,
  5. at -risk hx or condition : neurocutaneous disorder
A

Headache RED Flags

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

brought on by fatigue, exertion, stress, poor hydration

  • sx: constant, aching, tight, occipital, frontal or constricting band around head
  • may occur with vascular headache
  • TX: rest, analgesics
A

Tension-type headache (TTH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

symptom of depression and or anxiety

  • pain is: b/l diffuse, dull aching, present with awakening, not associated with n/v or neuro problems
  • Evaluate : CT or MRI
  • TX is difficult, ANTIDEPRESSANTS help
A

Chronic Tension Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  • severe, pulsatile (pounding)
  • u/l, can be b/l
  • frontal or temporal regions, retro orbital or cheek
  • sx: N/V, photophobia, phonophobia, vertigo, fatigue, mood alteration
  • vomiting may be only sx in younger children (abdominal migraines)
A

Migraine Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when are neuro studies warranted in someone with migraine ha?

A

worse with an awakening, awaken pt, cough or bending over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what can also cause migraines in children?

A

allergies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

treatment for migraines?

A

1 avoid triggers

  • ibuprofen or acetaminophen early in attack
  • caffeine + ergot
  • triptans
  • rest and quiet
  • avoid narcotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

TCA, beta blockers (propranolol), CCB (verapamil)

A

prevent migraines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mainly male

-

A

Cluster Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

a sudden, transient disturbance of brain function manifested, or psychic phenomena

A

Seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 or more seizures not provoked by particular event or cause

A

eiplepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

a benign condition of childhood with u/l focal seizures and speech abnormalities , often hereditary

A

Rolandic seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common type of seizure in children?

A

Partial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Children present with what in their first seizure?

A

Status Epilepticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

who has seizures in the first 28 days of life (first few days), sometimes benign familial , secondary may progress (HIE, infection, IVH, thrombus)

A

Neonatal Sz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are 6mo -6 year old seizures, usually 2-5 /o

A

Febrile Seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Seizure >30 min, sequential seizures without regain LOC > 30 mins

A

Status Epilepticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is an adjunctive test to clinical history for seizures?

A

eeg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what % of children “out grow” their seizures?

A

70-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Absent (petit mal)

  • Generalized tonic clinic (grand mal)
  • Tonic
  • Clonic
  • Atonic
A

Generalized seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Simple partial (focal)

  • Complex partial (psycho- motor)
  • Benign rolandic epilepsy
A

Partial seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q
  • Infantile spasms (West syndrome)
  • Febrile sz
  • Juvenile myoclonic
A

Other types of seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q
  • Onset of seizures begins in one area of cerebral hemisphere
  • simple = no LOC
  • complex = LOC (staring)
  • Secondarily generalized = simple or complex partial seizure that ends in a generalized convulsion
  • 40-60% of childhood epilepsies
A

Partial (focal) Epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

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

A

secondarily generalized partial focal epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Duration : 90 seconds
Sx: sudden jerking, sensory phenomena , no LOC
Post ictal Sx: transient weakness or loss of sensation

A

Simple Partial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Duration: 1-2 mins
Sz: aura, automatism (lip smack, pick at clothes, fumbling)
unaware of envt, may wander
Post ictal Sx: amnesia of sz, mild to moderate confusion, sleepiness

A

Complex Partial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

tingling of contralateral limb, face or side of body

  • tonic clonic movements if upper limb
  • head and eyes turn to opposite side
  • see flashes of light, blurring
  • sweat, flushing , pallor
A

Simple Partial seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

in impaired consciousness

  • hears music (hallucinations)
  • olfactory hallucination
  • chewing movements, picking at clothing
A

Complex Partial Sz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q
  • Seizures arise from both hemispheres simultaneously
  • Typical Absence : 6-20% children
  • Myoclonic, tonic, atonic, atypical absence sz= 10-15% of childhood epilepsies
  • Associated with underlying structure brain dz
  • DIFFICULT TO TREAT AND CLASSIFY
A

Generalized seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Duration - 2-15 seconds

  • Sx: stare, eyes fluttering, automatism (lip smack, pick clothes) help if needed
  • Post ictal sx: amnesia for seizure events, no confusion, resume activity
A

Absence (petit mal)

32
Q

Duration - 1- 2 mins

  • Sz: cy, fall, tonicity, clonicity, may have cyanosis
  • post itcal symptoms L amnesia for seizure , confusion, deep sleep
A

Generalized tonic - clonic (grand mal)

33
Q
  • Clinical spasms (1-2 seconds)
  • occurs in clusters with drowsy
  • brain insult : birth, malformation , tuberus sclerosis, metabolic origin ( hard to control, poor neurocog outcome)
  • Cryptogenic = NO underlying cause –> best outcome
A

infantile spasms (west syndrome)

34
Q
  • Onset 3-13, males more
  • 15% epileptic children
  • Normal IQ, normal exam, normal MRI
  • May have + FHx sz

Description: when awake, twitching or tingling on one side, speech arrest , my drool

A

Benign Roldandic Epilepsy

35
Q

What is this treatment for?
indicated if : seizures are frequent, socially stigma if occurs in wakefulness, anxiety provoking for parents if occur in sleep

A

Benign rolandic epilepsy

36
Q

Treatments
Avoidance for sleep deprivations
- Medications : carbamazepine, oxcarbazepine
- Time (outgrow by adolescence)

A

Benign Rolandic Epo epilepsy

37
Q
  • > 30 minutes or more continuouse seizures, recurrent seizures without regaining consciousness
  • medical emergency : structural damage, hypoxia, hypotension, death
  • most children in children under 5 (85%) especially
A

Status Epileptics

38
Q

structural damage, hypoxia, hypotension and death are associated with what sz?

A

status epilepticus

39
Q

Use this in every case of suspected seizure disorder (not febrile) , abnormal in 60-80%

A

EEG

40
Q

These are generally NOT helpful , only based on presentation and hx

A

Blood tests

41
Q

Generalized - abnormal exam or difficult to control

Focal - not benign rolandic epilepsy, all others

A

Seizure Evaluation

42
Q

WBC > 20 k = bacterial infection, left shift is seen d/t adrenocortical surge

  • Blood culture, Urine C&S
  • Lumbar puncture : under age 2 , any suggestion of meningitis
  • Electrolytes
  • Glucose
  • Neonates : consider metabolic (lactate, amonia, urine ketones)
A

Seizure Workup (mostly look for secondary sources)

43
Q

This test CANT make diagnosis of epilepsy.

  • MOST USEFUL for classifying types and guiding therapy (absence [petit mal], psychomotor [temporal lobe], generalized tonic clonic [grand mal] , infantile spasms, mixed seizure disorder
  • Useful in evaluating worsening seizures or projecting recurrence of seizures if medicine were to be stopped
A

EEG

44
Q
  1. Cannot make diagnosis of epilepsy
  2. most useful for classifying types and guiding therapy
  3. Useful in evaluating worsening seizures or projecting recurrence of seizures if medicines were to be stopped
A

EEG

45
Q
  • Antipyretic ineffective in febrile seizures
A

Treatment

46
Q

Only diazepam indicated for abortive tx if prolonged complex

A

Febrile Seizure TX

47
Q

Phenobarbital

A

Neonatal Sz

48
Q

Phenytoin, phenobarbital, carbamazepine, valproic acid, primidone

A

Generalized TC

49
Q

Ethosuximide, valproic acid

A

Absent sz

50
Q

Felbamate , gabapentin, lamotrigine, topiramate, tiagabine, vigabatrine

A

New anti-epileptics

51
Q

-2-4% of children age

A

Febrile Seizures

52
Q

type of febrile seizure

  • generalized convulsion (whole body shaking)
  • brief (
A

Simple febrile seizure

53
Q

type of febrile seizure

  • focal seizure (one side of the body shaking, staring)
  • prolonged ( >15 mins)
  • multiple in 24 hours
  • often post-ictal state
A

Complex febrile seizure

54
Q

what seizures are usually harmless?

A

febrile

55
Q

how often to febrile recurrences occur?

A

30% rate , does not change prognosis

56
Q

is the progression to epilepsy common or uncommon?

A

uncommon ( no more than 1.3% )

57
Q

febrile seizure treatment

A

usually none

58
Q

rectal diazepam

A

abort prolonged complex febrile seizure

- prevent complex febrile seizure clusters

59
Q

phenobarbital and valproic acid

A

effective in prevention of febrile seizures

60
Q

spells that mimic seizures?

A

migraine variants, benign breathholding spells, syncope, pseudoseizures

61
Q

Common features

- involuntary, children

A

Breath-Holding Spells

62
Q

Precipitated by anger, frustration, fear

- crys, stops breathing in expiration, becomes cyanotic

A

Cyanotic Spells

63
Q
  • Transient LOC and postural tone d/t cerebral ischemia and anoxia
  • prodrome : dizzy, lighthead, nausea, sweating, pallor
  • MAY HAVE JERKING MOTIONS while LOC, tonic clonic
  • Family hx + in 90%
A

Syncope

64
Q
  • neurally mediated
  • transient hypotension from vasodilation and or decreased heart rate
  • arousal 1-2 minutes up to 1 h
A

Vaso-vagal or neurocardiogenic 95%

65
Q

D/t cerebral edema, mass lesion
- S/S : infants –> bulging fontanelle, increased head circumference , separating sutures, lethargy, vomiting, FTT, “SETTING-SUN SIGN”

Children –> HA, diplopia/strabismis, papilledema, herniation syndromes

A

Increased ICP

- cystic formation on the cns tract on the 4th ventricle, end up with hydrocephalus as a result

66
Q

Location

  • supratentorial - eye forehead temple
  • infratentorial - occiput, neck
  • worse in AM , standing up, night
  • worsened by cough sneeze straining
  • OFTEN WITH VOMIT WITHOUT NAUSEA
  • subarachnoid hemorrhage : worse headache of life, suspect abuse in kids
A

Headache from Elevated ICP

67
Q

increased ICP without identifiable mass or hydrocephalus

  • obese teen girl
  • HA, tinnitus, papilledema, visual loss (normal MRI)-
  • MRI to exclude hydrocephalus or intracranial mass
  • LP : elevated opening pressure (Essential to dx)
A

Pseudotumor Cerebri

68
Q
  • brief LOC or stunned for minutes to hours
  • no localize neuro signs
  • amnesia is common and transient
  • Diagnostic - CT if hemorrhage
  • observe and hospital –> suspect abuse, abnormal vital signs
  • implications for sports- second impact syndrome
A

head injury concussion

69
Q
  • all children with amnesia or who were LOC should be evaluated in er
A

concussion

70
Q

post ___ : complain of headahce, dizziness, forgetfulness, inability to concentrate, slowing of response time, mood swing, irritable

  • resolve spontaneously
  • weeks to months
A

post concussive syndrome

71
Q

what is second impact syndrome?

A

kid isnt recovered from first concussion and gets second concussion which can worsen sx

72
Q

what are congenital malformations?

A

meningomyelocele, encephalocele, lissencephaly, pachygyria, absent corpus callosum

73
Q

neural tube forms and closes during days 0-28 of gestation

A

meningomyelocele, encephalocele

74
Q

cell proliferation and migration after 28 days

A

lissencephaly, pachygryia, absent corpus callosum

75
Q

smooth brain

A

lissencephaly

76
Q

gyri too thick and overdeveloped

A

pachygyria

77
Q

often identified on US likely to have elevated alpha fetoprotein on prenatal screen.
- Folate during pregnancy

A

meningomyelocele,

NEURO peds (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions