Neurology Flashcards
1
Q
By age 18 mo what gross motor action occurs?
A
walking up stairs
1
Q
By age 24 mo what gross motor action occurs?
A
Running
2
Q
By age 12 mo what gross motor action occurs?
A
walks w/ one hand held
3
Q
By age 9 mo what gross motor action occurs?
A
pulls themselves up to stand
4
Q
By age 6 mo what gross motor action occurs?
A
Sits momentarily
5
Q
By age 3 mo what gross motor action occurs?
A
Supports weight on forearms
6
Q
What fine motor skill is present at 3 mo?
A
Opens hands spontaneously
7
Q
What fine motor skill occurs at 6 mo?
A
Transfer of objects between hands
8
Q
What fine motor skill occurs at 9 mo?
A
Pincer grasp
9
Q
What fine motor skill occurs at 12 mo?
A
Releases object on command
10
Q
What fine motor skill occurs at 18 mo?
A
Feeds from a spoon
11
Q
What social skill appears at 3 mo?
A
Smiles appropriately
12
Q
What social skill occurs at 6 mo?
A
shows likes/dislikes
13
Q
What social skill appears at 9 mo?
A
Plays patty-cake
14
Q
What social skill appears at 12 mo?
A
Comes when called
15
Q
What social skill appears at 18 mo?
A
Mimics actions
16
Q
What social skill appears at 24 mo?
A
Plays with others
17
Q
What language skill appears at 3 mo?
A
Coos & Laughs
18
Q
What language skill appears at 6 mo?
A
Babbles
19
Q
What language skill appears at 9 mo?
A
Imitates sounds
20
Q
What language skill appears at 12 mo?
A
1-2 meaningful words
21
Q
What language skill appears at 18 mo?
A
Knows at least 6 words
22
Q
What language skill appears at 24 mo?
A
2-3 word sentences
2 at 2 yo; 3 at 3 yo; 4 at 4 yo
23
Q
Craniotabes is a sign of what?
A
Prematurity
24
Bulging fontanelles is a sign of what?
Increased ICP
25
Loud bruits are seen in which pediatric conditions?
* Increased ICP
* Severe anemia
* AV malformations
26
Soft bruits may be normal at what age?
< 4 yo
27
**Gower's sign** is a sign of?
Pelvic girdle weakness
28
A **positive romberg sign** is seen with what type of sensory disorder?
Sensory ataxia
29
**Ansomia** is noted in what disorders?
* Zinc deficiency
* Kallmann's syndrome
30
**Papilledema** is a sign of?
Increased ICP
31
S/Sx of **Horner's Syndrome**.
* Damage to SANS nerves on **side of neck**
* **Contracted pupils**
* **Drooping upper eyelid**
* Local **inability** to **sweat** on one side
32
**Medial** deviation of pupils denotes what nerve?
Abducens (CN VI)
33
**Up & Out** deviation of pupils denotes what nerve?
Trochlear (CN IV)
34
**Down & Out** deviation of pupils denotes what nerve?
Oculomotor (CN III)
35
**Horizontal nystagmus** denotes what type of injury?
Labyrinth or vestibular injury
36
**Vertical nystagmus** denotes what type of injury?
Brain stem
37
**Argyll-Robinson pupils** are a sign of what disorder(s)?
* Neurosyphilis
* Diabetes
38
**Fixed dilated** pupils appear on what condition?
Brain death
39
What are **Argyll-Robinson pupils**?
Constrict on **near objects** but not with light
40
**Mydriasis** can be indicative of?
* SANS overactivity
* Hyperthyroidism
* Anxiety
41
**Miosis** can be indicative of?
* PANS
* **Morphine overdose**
* **Neurosphilis**
42
The **Accessory nerve** affects what muscles?
* SCM
* Trapezius
43
The **hypoglossal nerve** affects what muscles?
Tongue
44
What is the taste innervation of the **glossopharyngeal nerve (CN IX)**?
Posterior 1/3 of tongue
45
**Vagus N** disruption can lead to what?
Paralysis of vocal cords & soft palate
46
Explain **caloric testing** of **vestibular function**?
COWS
* Cold --> opposite
* Warm --> same
47
What is the taste innervation of the **facial N (CN VII)**?
Anterior 2/3 of tongue
48
Detail an **UMN CN VII** problem.
* involves only **lower part of face** on the **opposite** side
* Angle of mouth drops, cheeks puff loosely, can wrinkle forehead and say yes
49
Detail **LMN CN VII** lesion.
* Whole face is involved
| Bell's Palsy; Ramsay-Hutn Syndrome
50
**Epilepsy** is defined as?
Recurrent seizures unrelated to fever or acute brain insult (trauma)
51
How can you say a patient has had a definite **seizure**?
Altered EEG activity & LOC
52
40% of childhood seizures are of what type?
Partial
53
What type of seizure notes that only part of the body is involved and no LOC occurs?
Simple partial seizures
54
What does the EEG show during partial simple seizure?
Spikes/waves
55
Compare a simple partial seizure with a complex partial seizure.
**Simple**: part of body; no LOC
**Complex**: simple partial seizure + LOC; 30% have aura
56
What lobe may be lesioned if a patient suffers from **complex partial seizures**?
Temporal
57
What is the presentation of **absence seizures**?
* Body goes "**limp**" w/ NO jerking
* **Blank facial expression** with **eyelid flickering**
* No aura or post-ictal phase
* May occur due to **hyperventilation**
58
What may facilitate **absence seizure occurence**?
Hyperventilation
59
What does the EEG show during an **absence seizure**?
3 sec spike & wave discharge
60
Explain the presentation of **generalized tonic-clonic seizures**.
* Aura w/ post-ictal phase
* **loss of bladder control**
* **Vomitting** and **HA** after seizure
* Precipitated by fever & certain medications
61
Detail, very basically, a **myoclonic seizure**.
Symmetric muscle contractions w/ loss of body tone
62
Detail **infantile spasms**.
* 4-8 mo
* Symmetric contractions of head/neck/trunk/extremities
* 3 types: flexor, extensor, mixed
63
What is the EEG pattern of **infantile spasms**?
Hypsarrhtyhmia pattern
64
When do **febrile seizures** peak?
9 mo to 5 yo (peak at 14-18 mo)
65
T/F: there is a strong FMH of **febrile seizures**
True
66
**Febrile seizures** must be associated with what?
Fever
67
Many patients who have had a seizure will display what metabolic abnormality post-ictal?
Hypoglycemia
68
What is the Tx of **absence seizures**?
Ethosuximide
69
What ist he Tx of **infantile spasms**?
ACTH
| can get Cushing's syndrome
70
How long does medication therapy continue for **epilepsy**?
* Must be seizure free ≥ 2 years
* Gradual withdrawal over 3-6 months
71
What vessel markers are used regarding the prognosis of skull fractures?
* Meningeal vessels
* Sagittal sinus
* Lambdoid suture
72
What is a complication of skull fractures?
Leptomeningeal cyst
* meninges herniate between bones of fracture
* Bones cannot form together and heal
73
What type of fracture gives a **Raccoon eye** appearance?
Basilar skull fracture
| Otorrhea & Rhinorrhea
74
What is the limit used to determine whether a skull fracture (depressed) needs surgical correction?
> 3-5 mm
75
How many people with a concussion experience LOC?
10%
76
What are S/Sx of a **concussion**?
* Decreased mental status
* Persistent confusion
* Excessive vomiting
* Unreliable Hx
* Focal neurological exam
* Seizures
* Skull fracture
77
A **subdural hematoma** is a sign of what type of abuse?
Shaken Baby syndrome
78
A **battle sign** describes what feature of a subdural hematoma?
Ecchymosis behind ear
79
What is the Tx of **Cerebral edema**?
* Usually causes death
* Elevate head to 30°
* Hyperventilate: PCO2 = 30-35 mmHg
* Mannitol 20% IV @ 1-1.5 g/kg
80
What are S/Sx of **epidural hematoma**?
* Bleeding in extradural space
* Rupture of **middle meningeal artery**
* Brief **LOC** then **lucid** that **relapses**
81
What are S/Sx of **subdural hematoma**?
* Vomiting
* Irritability
* Shrill cry
* HA
* Bulging fontanelle
* **Setting Sun eyes**
* **Retinal hemorrhages**
* **Battle sign**
