Neurological Dysfunction in Children Flashcards

1
Q

ICP consists of

A

Brain - 80%, CSF - 10% and blood - 10%

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

GCS parts

A

eye opening, verbal response and motor response

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

highest GCS score

A

15

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

lowest GCS score

A

3

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

when to intubate

A

<8 GCS, “less than 8, intubate”

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

pinpoint pupils indicate X2

A

opioid/barbiturate poisoning, brain stem dysfunction

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

dilated/reactive pupils common after

A

after seizures

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

dilated and fixed pupils indicate X7

A

damage to CN III, herniation, hypothermia, anoxia, ischemia, poisoning with atropine, instilling mydriatic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

bilaterally fixed pupils over 5 minutes

A

brain stem damage

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

sudden appearance of fixed/dilated pupils

A

neuro emergency - remain with child d/t high risk for respiratory arrest

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

decorticate/flexion posturing

A

dysfunction of the cerebral cortex or legions above brain stem

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

decerebrate posturing

A

dysfunction at midbrain or lesions to brain stem

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

unilateral decerebrate posutring

A

herniation - neurological emergency

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

early signs of increased ICP

A

HA, vomiting, slight personality changes, irritability, fatigue

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

late signs of increased ICP X5

A

bradycardia (<80), decreased response, posturing, pupil changes, cheyne stokes respiration,

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

indications for invasive ICP monitoring

A

GCS = 8, GCS >8, TBI with abnormal CT, deterioration of condition, subjective judgment by neurosurgeon

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

mannitol

A

osmotic diuretic used in ICP reduction

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

hypertonic saline

A

pulls fluid into vascular system

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

meds to sedate and paralyze in ICP issues

A

midazolam/versed, fentanyl, vecuronium

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

most common cause of death in 9-19 years old

A

unintentional injuries

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

coup

A

point of impact

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

contrecoup

A

point opposite of impact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

linear fracture

A

single fracture that does not cross suture lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

comminuted skull fractures

A

multiple associated linear fractures

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

comminuted skull fractures often suggest

A

child abuse

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

open skull fractures cause communication between

A

skull and scalp or mucose and URI

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

treatment for open skull fractures

A

increased risk of CNS infection

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

depressed skull fractures

A

bone broken into several irregular fragments and pushed inward

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

basilar skull fractures

A

bones broken at the base of the skull that usually result in dural tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

s/s of basilar skull fractures

A

bleeding at the nape of the neck, raccoon eyes, bleeding behind tympanic membrane, CSF, clear fluid around blood on sheets

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

epidural hemorrhage

A

blood accumulates rapidly between the dura and the skul

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

epidural hemorrhage incidence in <2

A

very low incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

s/s of epidural hemorrhage

A

momentary unconsciousness, often not evident in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

subdural hemorrhage

A

a vascular injury causing bleeding between the dura and the cerebrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what causes subdural hemorrhage

A

birth trauma, falls, assaults, violent shaking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

s/s of subdural hemorrhage

A

standard increased ICP s/s, with battle signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

subdural hemorrhage treatment

A

observation, subdural taps in infants, SDH, burr hole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

drwoning

A

survival at least 24 hours after submersion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

highest age group at risk of drowning

40
Q

<1 y/o drown in

41
Q

toddlers drown in

42
Q

pre schoolers drown in

A

swimming pools

43
Q

school aged and adolescent kids drown in

A

lakes, ponds, rivers and ocenas

44
Q

seizures diagnosed by

A

Labs, LP, CT/MRI, EEG, split screen EEG

45
Q

partial seizures

A

involve one area of the brain

46
Q

generalized seizures

A

involve both hemispheres of brain

47
Q

ketogenic diet is helpful in

A

seizure disorders

48
Q

vagus nerve stimulation

A

implanted device that sends impulses to the vagus nerve with a magnet in children over 12

49
Q

bacterial meningitis patho

A

inflammation of the membranes covering the brain and spinal cord

50
Q

bacterial meningitis s/s

A

fever, nuchal rigidity, back pain, kernig sign, brudzinski sign,

51
Q

bacterial meningitis dx

A

lumbar puncture, csf fluid analysis

52
Q

CSF WBC bacterial

A

elevated neutrophils

53
Q

CSF WBC viral

A

elevated lymphocytes

54
Q

CSF protein bacterial

55
Q

CSF protein viral

A

normal to slightly increased

56
Q

CSF glucose bacterial

57
Q

CSF glucose viral

58
Q

CSF gram stain bacterial

59
Q

CSF gram stain viral

60
Q

CSF color bacterial

A

turbid or cloudy

61
Q

CSF color viral

62
Q

CSF opening pressure bacterial

63
Q

CSF opening pressure viral

64
Q

bacterial meningitis tx

A

antibiotics, seizure control, 1/2 MIVF

65
Q

complications of bacterial meningitis

A

cerebral edema, subdural effusion, seizures, shock, disseminated IV coag, hydrocephaly

66
Q

viral meningitis s/s

A

HA, fever, photophobia, nuchal rigidity

67
Q

viral meningitis tx

A

mostly symptomatic

68
Q

rabies patho

A

acute infection of the nervous system that is almost always fatal

69
Q

rabies incubation period

A

1-3 months but may be as short of 5 days or as long as 8 months

70
Q

rabies s/s

A

agitation, LOC changes, attempts at swallowing causes hydrophobia

71
Q

rabies tx

A

passive immunization asap after exposure

active immunity given at same time as passive and on 3, 7, 14, 28

72
Q

reye syndrome patho

A

acute illness causing encephalopathy and liver dysfunction

73
Q

reye syndrome s/s

A

fever, impaired consciousness and liver dysfunction

74
Q

reye syndrome dx

A

liver biopsy

75
Q

cerebral palsy patho

A

non-progressive impairment of motor function

76
Q

prenatal CP causes

A

maternal infection or substance abuse

77
Q

perinatal CP causes

A

nuchal cord, ischemic stroke

78
Q

postnatal CP causes

A

meningitis

79
Q

spastic CP

A

hypertonicity

80
Q

dyskinetic CP

A

abnormal movement

81
Q

ataxic CP

A

coordination, balance, posture

82
Q

mixed CP

A

combination of spastic and dyskinetic

83
Q

medications for CP

A

dantrolene sodium, baclofen, diazepam, botox, gabapentin, anti-epiletic, levodopa, trihexyphenidyl, reserpine

84
Q

carbamazepine

A

anti-epileptic

85
Q

divalproex

A

antiepileptic

86
Q

lacosamide

A

antiepileptic

87
Q

levitiracetam

A

antiepileptic

88
Q

oxcarbazepine

A

antiepileptic

89
Q

lamotrigine

A

antiepileptic

90
Q

what does levodopa treat

91
Q

trihexyphenidyl treats

92
Q

reserpine treats

A

hyperkinetic movement disorders

93
Q

GBS patho

A

inflammation and edema of the spinal cord and cranial nerves

94
Q

acute phase BGS

A

symptoms begin, may last up to 4 weeks

95
Q

plateau GBS

A

consistent symptoms, days to weeks

96
Q

recovert GBS

A

improvement begins, weeks to month