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Neonatal Board Questions > Neurology > Flashcards

Neurology Flashcards

1
Q

Recovery time for facial nerve palsy

A

2-3 weeks

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2
Q

Tearing, photophobia, enlarged globe

A

Glaucoma

Also have corneal edema and clouding causing dull red reflex and dampened pupillary reflex

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3
Q

Sturge Weber eye association

A

Congenital glaucoma in 30-70%

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4
Q

Syndromes associated with glaucoma

A

NF, Retinoblastoma, homocystinuria, trisomy 21, congenital rubella (also cataracts), Stickler syndrome, Sturge Weber syndrome, corticosteroids

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5
Q

CMV eye association

A

Chorioretinitis

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6
Q

Toxoplasmosis eye association

A

Chorioretinitis

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7
Q

MC outcome in infant with Cystic PVL

A 
Spastic diplegia
(Damages deeper, more medial fibers that control lower extremity function)
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8
Q

Lack of babbling by which age is concern

A

11 months

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9
Q

Echolalia begins

A

Between 15-18 months

Repetition of sounds

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10
Q

First line treatment for moderate or severe hearing loss

A

Amplification combined with intensive speech and language

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11
Q

Normal EEG of extremely preterm infant

A

Discontinuous

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12
Q

When does EEG become continuous?

A

31-33 weeks

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13
Q

Hypotonia, severe mental deficiency, ataxia

A

Angelman syndrome

Maternal deletion

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14
Q

Hypotonia, weakness, contractors, absent DTRs, tongue fasiculations

A

Spinal muscular atrophy or Werdnig Hoffman disease (degeneration of anterior horn cell)

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15
Q

First manifestation of NF-1

A

Cafe au lait macules (smooth borders)

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16
Q

When are pupils reactive to light

A

30-32 weeks

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17
Q

What age is optic nerve myelination complete?

A

24 months

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18
Q

MC etiology of congenital hearing loss

A

Genetic (MC genetic cause is connexin 26 gene mutation)

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19
Q

Abnormal hearing screen threshold

A

35 db

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20
Q

Palmar grasp reflex appears and disappears. Persistence signifies:

A

Appears 28 weeks
Established by 32 weeks
Disappears by 2-4 months
Persistence - athetoid CP

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21
Q

Moro reflex appears and disappears

A

Appears 28-32 weeks
Established by 37 weeks
Disappears by 6 months

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22
Q

Crossed extensor reflex appears and disappears

A

Leg extended and sole rubbed → opposite leg will first have flexion and then extension with fanning of toes
Appears 26 weeks
Established by 34 weeks
Disappears by 2 months

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23
Q

Rooting reflex appears and disappears

A

Appears 30 weeks
Established by 34 weeks
Disappears by 4 months

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24
Q

Tonic reflex appears and disappears. Persistence means?

A

Appears 35 weeks
Established by 1-2 months
Disappears by 6 months
Persistence: Focal cerebral abnormalities

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25
Q

Only medication to decrease IVH

A

ACS (24-48h before delivery)

Also maternal transfer before imminent preterm birth

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26
Q

Prader Willi genetic cause

A

Paternal deletion in chromosome 15q11-13

Both copies come from mother (maternal uniparental disomy)

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27
Q

Angelman genetic cause

A

Maternal deletion in chromosome 15q11-13

Both copies come from father (MANs copies) (paternal uniparental disomy)

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28
Q

Myotonic dystrophy cause

A

Trinucleotide repeat

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29
Q

Effects of Kernicterus

A 
TEAM
Teeth - dental enamel dysplasia
Eye abnormalities (paralysis of upward gaze)
Auditory dysfunction
Movement dysfunction - Athetoid CP
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30
Q

Leading cause of vision impairment in preterm infants

A

ROP

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31
Q

Threshold disease

A

ROP in Zones I or II in at least 5 contiguous or 8 total clock hours + plus disease
50% progress to stage 5

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32
Q

Treatment for threshold disease

A

Laser within 2-3 days

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33
Q

Most common area involved in ROP

A

Zone III

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34
Q

Where is Zone I of eye

A

Most posterior part of retina
Vessels closest to optic disc
Most immature zone

35
Q

ROP Stage “Distinct demarcation Line”

A

Stage 1

36
Q

ROP Stage “demarcation line is thickened and elevated, ridge”

A

Stage 2

37
Q

ROP Stage “ridge with extra retinal neovascularization

A

Stage 3

38
Q

ROP Stage with partial retinal detachment

A

Stage 4

39
Q

ROP Stage with complete retinal detachment

A

Stage 5

40
Q

What refractive errors do premature infants get?

A

Hyperopia and myopia

Myopia strongly associated with hx of significant ROP

41
Q

Up vs down slanting palpebral fissures

A

Line away from nose

Up in Downs

42
Q

Enlargement of the 4th ventricle, complete or partial absence of the cerebellar vermis, cysts

A

Dandy Walker syndrome

43
Q

Can clonus be a normal finding in newborns?

A

Yes, up to 3 months of age

44
Q

Area of brain injury in HIE

A

White matter

45
Q

EEG pattern in HIE

A

depression or burst suppression

46
Q

Acquired maternal antibodies that block Ach receptors at the NMJ

A

Transient neonatal MG

47
Q

Measures brainwaves generated in response to an auditory stimulus

A

ABR

48
Q

Measures the acoustic feedback from the cochlea in response to an auditory stimulus

A

OAE

49
Q

Which test takes longer? ABR or OAE?

A

ABR

50
Q

Which test may be unable to detect some forms of sensorineural hearing loss?

A

OAE

51
Q

ELBW population has disproportionate risk of which disability?

A

Non-verbal, math related

52
Q

MC cranial nerve to be injured at birth

A

Facial nerve

53
Q

Weakness of upper and lower facial muscles

A

Facial nerve palsy (L more likely)

54
Q

Ocular dysplasia, hydrocephalus, cerebral malformations

A

Walker Warburg syndrome

55
Q

Nerves for Erb Duchenne vs Klumpke’s palsy

A

C5-7 vs C8-T1

56
Q

Conductive hearing loss on bone and air conduction

A

Good bone conduction, poor air conduction

57
Q

Sensorineural hearing loss on bone and air conduction

A

poor air and bone conduction

58
Q

Are NTD preventable by folic acid?

A

Most but 1/3 are not preventable d/t other factors such as diabetes, inc BMI, antiepileptics (Valproic acid), Trisomy 13 and 18

59
Q

Hypomyeliniation with PVL is associated with which stage of oligodendrocyte?

A

Pre-oligodendrocyte (90% of oligodendrocyte population at 28 weeks)

60
Q

Space that subgaleal occurs

A

Subaponeurotic space

Bleeding of emissary veins between scalp and dural sinuses

61
Q

Space that cephalohematoma occurs

A

Subperiosteum

62
Q

Benefit of therapeutic hypothermia

A

25% reduction in combined death or major NDI in moderate or severe HIE

63
Q

Adverse effects of cooling

A

bradycardia, thrombocytopenia, subcutaneous fat necrosis

64
Q

MC condition misdiagnosed as neonatal seizures

A

Benign sleep myoclonus

65
Q

Why is aEEG less sensitive at picking up focal seizures?

A

Reduced number of channels

Use of a two channel aEEG with simultaneous raw EEG is more sensitive

66
Q

MCC neonatal seizures

A

Global cerebral hypoxic ischemia ie HIE

67
Q

Disability and mortality with newborn seizures

A

54% surviving children with disability

10% mortality (higher in HIE, cerebral dysgenesis and infection)

68
Q

What causes inflammation in HIE?

A

Microglia (macrophages of the brain) release cytokines, chemokine and proteases
Monocytes and neutrophils infiltrate the injured brain

69
Q

Initial treatment for spina bifida

A

Prone, sterile saline soaked dressing, plastic wrap (not bag)

70
Q

Normal resting posture at 28 weeks

A

Limbs extended

71
Q

Normal resting posture at 32 weeks

A

Slight flexion of the knee then hips

72
Q

Normal resting posture at 36 weeks

A

Flexion of all 4 extremities

73
Q

Structural or functional abnormality at an organ level

A

Impairment ie. damage to vision

74
Q

Restriction at the personal level that results from an impairment

A

Disability ie. worsening eye sight

75
Q

Disadvantage at the societal level that prevents fulfillment of the individual’s role

A

Handicap ie. inability to drive

76
Q

Testing to get with ear tags or skin pits

A

Audiologic evaluation + Renal ultrasound (especially if family history, can be Goldenhar syndrome)

77
Q

Sniffling in infant due to

A

Mucosal edema 2/2 estrogen exposure

78
Q

Negatives of Phenobarbital for seizures

A

Only 1/3 patients respond to initial bolus

Increased neuronal apoptosis and impaired ND outcomes

79
Q

How is hereditary retinoblastoma treated?

A

Chemotherapy

80
Q

Hereditary vs nonhereditary retinoblastoma

A

Hereditary in 40% RB, AD; inactivation both alleles of RB1 gene; usually bilateral
Nonhered usually unilateral

81
Q

When can fetus respond to sound?

A

20-25 weeks

82
Q

MC lesion in neonates - supratentorial vs infratentorial

A

Supratentorial

83
Q

MC presentation of congenital intracranial tumor:

A

Increasing head circumference with bulging fontanelle (50%)

Neonatal Board Questions (12 decks)

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