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CPNP AC flash cards > Neurology > Flashcards

Neurology Flashcards

1
Q

Causes of seizures may include f___, ing___, tu___, and el___ di____

A

fever
ingestion
tumors
electrolyte disturbances

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2
Q

Seizure s/s include
Bo__/bl___ in____
ap___
cy___
au___

A

bowel/bladder incontinence
apnea
cyanosis
aura

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3
Q

Children with seizures should be referred to the ED when the seizure lasts > __ minutes,
if child had a
h___ i___, h___ f___, or is presenting with compromised r___/c___ function

A

5 minutes
head injury
high fever
Respiratory/cardiac function

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4
Q

What type of seizure affects bilateral brain hemispheres?

A

generalized

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5
Q

What type of seizure causes tone loss?
a____

A

atonic

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6
Q

What type of seizure affects one hemisphere?
F_____

A

focal

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7
Q

What type of seizure causes rhythmic repetitive movements?
c_____

A

clonic

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8
Q

What type of seizure causes extension/flexion of the head/trunk/extremities?

A

tonic

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9
Q

A febrile seizure occurs on fever ____
*affects children __-___ M.O.A
*are often less than ___ minutes
*They do not reoccur within ___ hours

A

Rise
6-60
15
24

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10
Q

Febrile seizures usually do not require diagnostic workup unless m____ s/s are present

A

meningeal

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11
Q

Status epilepticus is a seizure lasting > ____ minutes
— or __ or more seizures occur without return to?

A

30 minutes
2 or more, baseline neuro status

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12
Q

1st line status epilepticus management
a____
b_____

A

ABC’s
benzodiazepine administration

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13
Q

2nd line status epilepticus management
*administering a_____ such as
—di___, k_____, or p____ load

A

antiepileptics
–Dilantin, keppra, phenobarbital load

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14
Q

Children with refractory status epilepticus require a drug i___ c___ and e___

A

drug-induced coma
EEG

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15
Q

Children with refractory status eplepticus may need s___ r____ or the placement of a v___ n____ s_____

A

surgical resection
vagal nerve stimulator

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16
Q

Acute seizure control
*stabilize within __-___ minutes (ABC’s + IV)

*Administer initial benzos within __-___ minutes

*Administer 2nd line antiepileptics witthin __-___ minutes

A

0-5 minutes

5-20 minutes

20-40 minutes

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17
Q

In children, the last choice in seizure treatment includes ph_____ due to the risk of lowering ___

A

phenobarbital
IQ

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18
Q

Third-line seizure control management should be treated within __-___ minutes
—third line therapy includes re___ do___, an____ Dr___, and co___ e___ monitoring

A

40-60
–repeat dosing, anesthetic drips, continuous EEG

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19
Q

How long does it take for a seizure to cause brain damage?

A

30 minutes

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20
Q

The 1st line seizure diagnostic test is with an ___

A

EEG

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21
Q

In an acute seizure event, what diagnostic test is quick and is able to see blood/bone/lesions/fluid?

A

CT

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22
Q

MRI’s
*have no r____
*assesses br__ ma___, sk___, and or____
*able to see is____, in___, a__m____, sp___ co___ lesions, and de___ disease

A

radiation
brain matter, skull, orbits

ischemia, infarcts, AV malformation, spinal cord lesions, degenerative disease

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23
Q

MRI’s take l___ and may require s____

A

longer and may require sedation

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24
Q

When obtaining an MRI, keep in mind that Bivona traches have m___ r____

A

metal rings

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25
Q

When obtaining an MRI, keep in mind that shunt valve settings will c___

A

change

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26
Q

A lumbar puncture is obtained to r/o
me___ or
in___/in___/au___ processes

A

meningitis
inflammatory/infectious/autoimmune

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27
Q

Obtain an LP in infant who are ___-___ M.O.A with an unknown vaccine status

A

6-12

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28
Q

An LP in females with pseudotumor cerebri is done to r___ c___

A

remove CSF

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29
Q

LP’s are contraindicated in children with a h__ i___, obtain a C__ first

A

high ICP
CT

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30
Q

LP procedure
*place child in the l___ d___ position
*insert needle between __-__ along the i__ c__ l___

A

lateral decubitus
L3-L5, iliac crest line

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31
Q

Children who are difficult for LP should get them done in?

A

IR

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32
Q

To prevent air leak, before removal of LP needle replace the s___

A

stylus

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33
Q

Spinal cord injury occurs most often s/p t____ such as a f___ from a tall h___ or h__/n___ t____

A

trauma
fall from a tall height
head/neck trauma

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34
Q

s/p trauma, younger children are prone to S____

A

SCIWORA

spinal cord injury without radiologic abnormalities

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35
Q

Down syndrome children are prone to a____-a___ s___ s/p acute f___ i____

A

atlanto-axial subluxation

flexion injury

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36
Q

Spinal cord Injury Impairment scale
A=
B,C, D =

E=

A

complete

incomplete

normal

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37
Q

Spinal cord injury diagnostic tests include an
x___
c__
m___

A

x-ray
CT
MRI

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38
Q

Spinal cord management
1) A___
2) c____ i____
3) IV s___ ( __ mg/kg)

A

ABC’s
c-spine immobilization
steroids 30 mg/kg

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39
Q

Neurogenic shock management
* f____, a__-a___ agents

A

fluids
alpha-adrenergic

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40
Q

Neurogenic shock may lead to pa___ or loss of to___

A

paralysis
loss of tone

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41
Q

In neurogenic shock, what criteria is used to assess the need for a CT?

A

chalice or
pecarn criteria

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42
Q

Children with neurogenic shock require and art line for i___ monitoring and c___ p____ monitoring

A

ICP
cerebral perfusion

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43
Q

A primary brain injury is an ___ event, for example a h____

A

acute
hemorrhage

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44
Q

A secondary brain injury are the resulting s/s s/p a___ i___, for example i___

A

acute injury
ischemia

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45
Q

Epidural hematoma
*Dont c____ s___ l___
*stay on the s____ of i___

A

cross suture lines
side of impact

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46
Q

Subdural hematoma
*c___ shaped
*c___ s___ but are not m___

A

crescent-shaped
cross sutures
midline

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47
Q

Intraparenchymal brain injuries b___ into t___

A

bleed into tissues

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48
Q

Intraventricular brain injuries b___ into v___

A

bleed into ventricles

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49
Q

hypoxic-ischemic brain injuries
*develop l___
*occur if brain is hypoxic for > __-__ hours
*CT will show a h___ brain

A

later
24-48
hyperdense

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50
Q

TBI management includes
* minimizing se_____ brain injuries
*In____, reduce ___, and minimize se____
*continuously monitor for wo____ in s/s

A

secondary
Intubate, ICP, seizures
worsening

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51
Q

A concussion is defined by a GCS score of __-____

A

13-15

52
Q

A concussion is a
*m____ h___ i_____
*No L____
*no routine i_____

A

mild head injury
LOC
imaging

53
Q

What standardized tool is used to evaluate for concussions?

A

SCATS assessment

54
Q

S/P concussion, kids can return to activities when they are at pre-m____ s____ and s___ f____

A

pre-morbid state
s/s free

55
Q

Cerebral palsy is a neuro in____ leading to mo____ im_____. Classified by the type of movement

A

insult
motor impairment

56
Q

In what CP are muscles unable to relax?
s____

A

spastic

57
Q

What CP is characterized by the child having movement but is unable to control muscle movement?

ath_____

A

athetoid

58
Q

In what CP is their motor impairment of the arms and legs on one side?

A

hemiplegic

59
Q

In what CP is their motor impairment of both legs?

A

diplegia

60
Q

In what CP is their motor impairment of all 4 extremities?

A

quadriplegia

61
Q

Encephalitis is a condition where their is brain p____ i_____
–can be viral, bacterial, fungal, or autoimmune

A

parenchyma inflammation

62
Q

In neonates, encephalitis is most often caused by?

A

HSV

63
Q

In immunocompromised children, encephalitis is most often caused by?

A

varicella

64
Q

Encephalitis s/s
v___ problems, h____, n__-p____ s/s, f___, and at_____

A

vision
headache
neuropsych
fever
ataxia

65
Q

Encephalitis management
*Treat the primary cause
*initiate a_____
*in 90% of cases, e___ will be abnormal

A

acyclovir
EEG

66
Q

In hydrocephalus, there is e____ CSF

A

excess CSF

67
Q

Hydrocephalus is characterized by
*r___ head g____
*e____ ventricles
*trouble e____
*dy____
*h___ or w___ c___
*if severe, a_____

A

rapid head growth
enlarged
trouble eating
dysphagia
hoarse or weak cry
apnea

68
Q

Congenital hydrocephalus is often caused by a m_____

A

myelomeningocele

69
Q

In a shunted hydrocephalus, fluid will drain into the a____ p____ s_____

A

abdominal pleural space

70
Q

What is the most common immediate shunt placement post-op complication?

*will present with s___ neck or f____

A

infection

stiff neck or fever

71
Q

Shunt malfunction is often caused by a b____ or b____ shunt.
—obtain a shunt s____
—may also obtain a ___

A

blocked or broken shunt
—shunt series
—CT

72
Q

Shunt over/underdraining may occur, these children require c___ f____ due to the risk for h_____

A

close follow up
hemorrhage

73
Q

If a shunt infection is suspected, you may need to t___ the s____ to obtain a c___ sample

A

tap the shunt
CSF sample

74
Q

If a shunt infection is suspected, begin a____ and then r___ the shunt once i___ has c____

A

antibiotics
replace
infection has cleared

75
Q

craniosynostosis is p____ skull f____

A

premature skull fusion

76
Q

40% of craniosynostosis children have g___ s_____

A

genetic syndromes

77
Q

craniosynostosis will lead to brain g____ r_____

A

growth restriction

78
Q

craniosynostosis is associated with aper_____, crou_____, p___-r____, tu____, va____ and da___ wa_____

A

aperts
crouzanes
Pierre-Robinson
turner
VATER
dandy walker

79
Q

to diagnose craniosynostosis obtain a __-skull f____, c___, and m____
—-management is with s____

A

3D skull film, CT, MRI
surgery

80
Q

craniosynostosis complications include
*postop p___ and b____
*assess for S____
*Surgery is better when children are ______

A

pain and bleeding
SIADH
younger

81
Q

Botulism is p_____ d_____ s_____ neuromuscular w______

A

progressive descending symmetrical neuromuscular weakness

82
Q

Botulism is caused by __-b____ s____
—found in contaminated s____, h____, or w_____

A

C. botulinum spores
soil, honey, water

83
Q

C.botulinim spores can be detected in s_____
—-occurs more frequently in infants < ____ M.O.A

A

stool
12

84
Q

botulism s/s includes
c_____, w____, d_____, decrease g___ response, w___ e___ m_____

A

constipation
weakness
dysphagia
gag
weak eye muscles

85
Q

botulism txt is with botulism ____

A

IVIG

86
Q

Guillan-barre is a p____ a____ s____ p_____

A

progressive ascending symmetrical paralysis

87
Q

Guillan-barre most often occurs __-___ weeks s/p v____ illness or prior i____

A

4-6 weeks
viral
infection

88
Q

Guillan-barre s/s include p____, n____, extremity t____, s___ loss, and g___ disturbance

A

pain
numbness
extremity tingling
sensory loss
gait disturbance

89
Q

Guillan-barre is diagnosed through c__ p____

A

CSF protein

90
Q

Guillan-barre treatment is with ____ or p_____

A

IVIG
plasmapheresis

91
Q

Muscular dystrophy is often diagnosed by ___ YOA

A

2

92
Q

Muscular dystrophy presents with pr____ s____ pr____ w_____
— Usually, there will be a g____ link

A

progressive symmetrical proximal weakness

genetic

93
Q

Muscular dystrophy will eventually affect the r___ center
–consult with p____
–provide v___ support

A

respiratory
pulmonology
ventilation

94
Q

Type 1 spinal muscular atrophy occurs in i___ by ___ M.O.A.

—-babies will have f____/b___ difficulty, will often have a____ p_____ infections

A

infants, 6

feeding/breathing difficulty
aspiration pneumonia

95
Q

Type 3 spinal muscular atrophy occurs at ___ M.O.A and up

—-initially these children will be able to w____ and then end up c___ b____

A

18 M.O.A.

walk
chair bound

96
Q

pediatric stroke will present with se____, ap_____, fo___ and vi___ deficits

A

seizures
aphasia
focal/visual

97
Q

ADEM is characterized by a
br___ and ra____ e____ onset

A

Brief and rapid encephalitis

98
Q

In ADEM their will be widespread brain i____ s/p i_____

A

inflammation s/p illness

99
Q

ADEM s/s include w_____, p_____, and s___ like activity

A

weakness
paralysis
seizure

100
Q

ADEM treatment
-s____, i____, and p_____

*Children with ADEM have a high risk for r_____

A

steroids, IVIG, plasmapheresis

-relapse

101
Q

posterior reversible encephalopathy syndrome is where there is a b___ b____ b___ disruption with r____ abnormalities

A

blood-brain barrier
radiologic

102
Q

What is the most common s/s of posterior reversible encephalopathy syndrome?

A

seizures

103
Q

brain death is i____ l___ of all brain f____

A

irreversible loss of all brain functions

104
Q

In order to diagnose brain death, the following must be present.
co___, ap____, and ab___ of br___ re____

A

coma
apnea
absence of all brainstem reflexes

105
Q

brain death diagnosis is made by __ separate n___ e____ by different m____

A

two separate neurological exams by two different MD’s

106
Q

In neonates, the brain death examination is separated by?

A

24 hours

107
Q

In infants and children, the brain death examination is separated by?

A

12 hours

108
Q

pseudotumor cerebri is the rapid production of ____, most often in a___ f____

A

CSF
adolescent females

109
Q

pseudotumor cerebri complications include v___ l____

A

vision loss

110
Q

pseudotumor cerebri treatment goal is to preserve the patients v_____
*assess for p_____ and cranial nerve __ p____

A

papilledema
cranial nerve 6 palsy–problems with eye movement

111
Q

Females with pseudotumor cerebri will have a normal ___ and ____

A

CT
CSF

112
Q

The diagnostic test for pseudotumor cerebri is with an ____
**The openening pressure will be > ___ mm hg

A

LP
280

113
Q

Arteriovenous malformation is when their is an abnormal i___-c__ connection between a___ and v____

A

intracranial
arteries and veins

114
Q

children with Arteriovenous malformation are at an increased risk for?

A

bleeds

115
Q

children with Arteriovenous malformation will present with neurologic d____, ensure to closely monitor i___

A

deficits
ICP

116
Q

The gold standard diagnostic test for AV malformation is with a?

A

cerebral angiography

117
Q

Hypoxic ischemic encephalopathy is a consequence of prolonged b___ h____ which results in irreversible neuro sequela

A

brain hypoxia

118
Q

Hypoxic ischemic encephalopathy management is with ___ and s___ control

A

ICP
seizure

119
Q

Hypoxic ischemic encephalopathy diagnostic studies include e___, c___, m____

A

EEG
CT
MRI

120
Q

Neurofibromatosis is an ____ condition
—presents with t___ in the b___, s___, s___, and e____

A

inherited
—tumors
brain, spine, skin, eyes

121
Q

90% of children with NF will have the presence of?

A

cafe au lait spots

122
Q

Due to tumor presence, children with NF are at risk for n____ d____

A

neurocognitive deficits

123
Q

NF management includes close follow up of n___, h___, and o____

A

neuro
hearing
ophthalmic

124
Q

Tuberous sclerosis is inherited via a___ d_____

A

autosomal dominance

125
Q

Tuberous sclerosis includes the presence of b___ t____

A

Bening tumors

126
Q

Tuberous sclerosis is diagnosed
with
___ major criteria or
__ major and __ minor criteria

A

2
1 and 2

127
Q

Tuberous sclerosis management is with ____ control

A

seizure

CPNP AC flash cards (10 decks)

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