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Neurology Flashcards

1
Q

By age 18 mo what gross motor action occurs?

A

walking up stairs

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1
Q

By age 24 mo what gross motor action occurs?

A

Running

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2
Q

By age 12 mo what gross motor action occurs?

A

walks w/ one hand held

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3
Q

By age 9 mo what gross motor action occurs?

A

pulls themselves up to stand

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4
Q

By age 6 mo what gross motor action occurs?

A

Sits momentarily

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5
Q

By age 3 mo what gross motor action occurs?

A

Supports weight on forearms

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6
Q

What fine motor skill is present at 3 mo?

A

Opens hands spontaneously

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7
Q

What fine motor skill occurs at 6 mo?

A

Transfer of objects between hands

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8
Q

What fine motor skill occurs at 9 mo?

A

Pincer grasp

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9
Q

What fine motor skill occurs at 12 mo?

A

Releases object on command

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10
Q

What fine motor skill occurs at 18 mo?

A

Feeds from a spoon

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11
Q

What social skill appears at 3 mo?

A

Smiles appropriately

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12
Q

What social skill occurs at 6 mo?

A

shows likes/dislikes

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13
Q

What social skill appears at 9 mo?

A

Plays patty-cake

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14
Q

What social skill appears at 12 mo?

A

Comes when called

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15
Q

What social skill appears at 18 mo?

A

Mimics actions

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16
Q

What social skill appears at 24 mo?

A

Plays with others

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17
Q

What language skill appears at 3 mo?

A

Coos & Laughs

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18
Q

What language skill appears at 6 mo?

A

Babbles

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19
Q

What language skill appears at 9 mo?

A

Imitates sounds

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20
Q

What language skill appears at 12 mo?

A

1-2 meaningful words

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21
Q

What language skill appears at 18 mo?

A

Knows at least 6 words

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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

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23
Q

Craniotabes is a sign of what?

A

Prematurity

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24
Q

Bulging fontanelles is a sign of what?

A

Increased ICP

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25
Q

Loud bruits are seen in which pediatric conditions?

A
  • Increased ICP
  • Severe anemia
  • AV malformations
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26
Q

Soft bruits may be normal at what age?

A

< 4 yo

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27
Q

Gower’s sign is a sign of?

A

Pelvic girdle weakness

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28
Q

A positive romberg sign is seen with what type of sensory disorder?

A

Sensory ataxia

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29
Q

Ansomia is noted in what disorders?

A
  • Zinc deficiency
  • Kallmann’s syndrome
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30
Q

Papilledema is a sign of?

A

Increased ICP

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31
Q

S/Sx of Horner’s Syndrome.

A
  • Damage to SANS nerves on side of neck
  • Contracted pupils
  • Drooping upper eyelid
  • Local inability to sweat on one side
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32
Q

Medial deviation of pupils denotes what nerve?

A

Abducens (CN VI)

33
Q

Up & Out deviation of pupils denotes what nerve?

A

Trochlear (CN IV)

34
Q

Down & Out deviation of pupils denotes what nerve?

A

Oculomotor (CN III)

35
Q

Horizontal nystagmus denotes what type of injury?

A

Labyrinth or vestibular injury

36
Q

Vertical nystagmus denotes what type of injury?

A

Brain stem

37
Q

Argyll-Robinson pupils are a sign of what disorder(s)?

A
  • Neurosyphilis
  • Diabetes
38
Q

Fixed dilated pupils appear on what condition?

A

Brain death

39
Q

What are Argyll-Robinson pupils?

A

Constrict on near objects but not with light

40
Q

Mydriasis can be indicative of?

A
  • SANS overactivity
  • Hyperthyroidism
  • Anxiety
41
Q

Miosis can be indicative of?

A
  • PANS
  • Morphine overdose
  • Neurosphilis
42
Q

The Accessory nerve affects what muscles?

A
  • SCM
  • Trapezius
43
Q

The hypoglossal nerve affects what muscles?

44
Q

What is the taste innervation of the glossopharyngeal nerve (CN IX)?

A

Posterior 1/3 of tongue

45
Q

Vagus N disruption can lead to what?

A

Paralysis of vocal cords & soft palate

46
Q

Explain caloric testing of vestibular function?

A

COWS
* Cold –> opposite
* Warm –> same

47
Q

What is the taste innervation of the facial N (CN VII)?

A

Anterior 2/3 of tongue

48
Q

Detail an UMN CN VII problem.

A
  • involves only lower part of face on the opposite side
  • Angle of mouth drops, cheeks puff loosely, can wrinkle forehead and say yes
49
Q

Detail LMN CN VII lesion.

A
  • Whole face is involved

Bell’s Palsy; Ramsay-Hutn Syndrome

50
Q

Epilepsy is defined as?

A

Recurrent seizures unrelated to fever or acute brain insult (trauma)

51
Q

How can you say a patient has had a definite seizure?

A

Altered EEG activity & LOC

52
Q

40% of childhood seizures are of what type?

53
Q

What type of seizure notes that only part of the body is involved and no LOC occurs?

A

Simple partial seizures

54
Q

What does the EEG show during partial simple seizure?

A

Spikes/waves

55
Q

Compare a simple partial seizure with a complex partial seizure.

A

Simple: part of body; no LOC
Complex: simple partial seizure + LOC; 30% have aura

56
Q

What lobe may be lesioned if a patient suffers from complex partial seizures?

57
Q

What is the presentation of absence seizures?

A
  • Body goes “limp” w/ NO jerking
  • Blank facial expression with eyelid flickering
  • No aura or post-ictal phase
  • May occur due to hyperventilation
58
Q

What may facilitate absence seizure occurence?

A

Hyperventilation

59
Q

What does the EEG show during an absence seizure?

A

3 sec spike & wave discharge

60
Q

Explain the presentation of generalized tonic-clonic seizures.

A
  • Aura w/ post-ictal phase
  • loss of bladder control
  • Vomitting and HA after seizure
  • Precipitated by fever & certain medications
61
Q

Detail, very basically, a myoclonic seizure.

A

Symmetric muscle contractions w/ loss of body tone

62
Q

Detail infantile spasms.

A
  • 4-8 mo
  • Symmetric contractions of head/neck/trunk/extremities
  • 3 types: flexor, extensor, mixed
63
Q

What is the EEG pattern of infantile spasms?

A

Hypsarrhtyhmia pattern

64
Q

When do febrile seizures peak?

A

9 mo to 5 yo (peak at 14-18 mo)

65
Q

T/F: there is a strong FMH of febrile seizures

66
Q

Febrile seizures must be associated with what?

67
Q

Many patients who have had a seizure will display what metabolic abnormality post-ictal?

A

Hypoglycemia

68
Q

What is the Tx of absence seizures?

A

Ethosuximide

69
Q

What ist he Tx of infantile spasms?

A

ACTH

can get Cushing’s syndrome

70
Q

How long does medication therapy continue for epilepsy?

A
  • Must be seizure free ≥2 years
  • Gradual withdrawal over 3-6 months
71
Q

What vessel markers are used regarding the prognosis of skull fractures?

A
  • Meningeal vessels
  • Sagittal sinus
  • Lambdoid suture
72
Q

What is a complication of skull fractures?

A

Leptomeningeal cyst
* meninges herniate between bones of fracture
* Bones cannot form together and heal

73
Q

What type of fracture gives a Raccoon eye appearance?

A

Basilar skull fracture

Otorrhea & Rhinorrhea

74
Q

What is the limit used to determine whether a skull fracture (depressed) needs surgical correction?

75
Q

How many people with a concussion experience LOC?

76
Q

What are S/Sx of a concussion?

A
  • Decreased mental status
  • Persistent confusion
  • Excessive vomiting
  • Unreliable Hx
  • Focal neurological exam
  • Seizures
  • Skull fracture
77
Q

A subdural hematoma is a sign of what type of abuse?

A

Shaken Baby syndrome

78
Q

A battle sign describes what feature of a subdural hematoma?

A

Ecchymosis behind ear

79
Q

What is the Tx of Cerebral edema?

A
  • Usually causes death
  • Elevate head to 30°
  • Hyperventilate: PCO2 = 30-35 mmHg
  • Mannitol 20% IV @ 1-1.5 g/kg
80
Q

What are S/Sx of epidural hematoma?

A
  • Bleeding in extradural space
  • Rupture of middle meningeal artery
  • Brief LOC then lucid that relapses
81
Q

What are S/Sx of subdural hematoma?

A
  • Vomiting
  • Irritability
  • Shrill cry
  • HA
  • Bulging fontanelle
  • Setting Sun eyes
  • Retinal hemorrhages
  • Battle sign

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