Neurology Flashcards
what is the MC chromosomal disorder and cause of mental developmental disability
trisomy 21
common findings in trisomy 21
prominent epicanthal folds (monolid)
brush field spots - white, grey or brown spots on the iris
transverse, singular palmar crease (simian crease)
AV septal defects
prenatal screening for trisomy 21 and findings
biochemical screening - first trimester; low PAPP-A
nuchal translucency US - 10-13 weeks; increased nuchal fold thickness –> chorionic villus sampling or amniocentesis should be performed
MCC meningitis in adults
strep pneumo
MCC meningitis in kids
Neisseria menigitidis
meningitis in kids is associated w
a petechial rash on trunks, legs, conjunctiva
MCC meningitis in neonates
GBS
sx meningitis
fever, HA, neck stiffness, photosensitivity
brudzinski vs kernig sign
brudzinski - neck flexion produces knee or hip flexion
kernig - inability to extend knee with hip flexion
dx meningitis
Bacterial = LP + CSF exam - decreased glucose + increased neutrophils, increased protein
Viral = LP + CSF exam - normal glucose + normal or elevated protein, increased lymphocytes
Head CT before LP
tx meningitis
cef + vanc
can use dexamethasone too
PEP for meningitis
Cipro or rifampin
droplet precautions x 24 hours after starting abx
Turner’s syndrome results from
the absence of one complete set of genes located on the X chromosome or a nonfunctioning X chromosome (45 XO)
common sx in turner’s syndrome
hypogonadism - gonadal dysgenesis (streaked ovaries), absence of breasts, infertility
CV - coarctation of art, bicuspid aortic valve
PE for turner’s syndrome
short stature
webbed neck
broad chest with widely spaced nipples “shield chest”
dx turner’s syndrome
karyotyping = definitive; 45 XO
labs - low estrogen + high FSH and LH
tx turner’s syndrome
human growth hormone replacement
estradiol-progestin replacement if no breast development around pubertal age
focal (Partial) seizure with retained awareness
simple
focal (partial) seizure with impaired awareness
complex
what motor sx are common in focal seizure
jerky rhythmic movements
may start in one area and spread to other parts of affected limb/body – Jacksonian march
neurologic deficit lasting up to 24H (Todd’s paralysis)
another name for absence seizure
petit mal
sx absence seizure
they are “absent”
pause/stare - loss of awareness without loss of body tone
episodes last 5-10 min
EEG for absence seizure
bilaterally synchronous and symmetrical 3 Hertz spike and wave discharge
tx absence seizure
ethosuximide (1st)
valproate (2nd)
tonic clonic seizures are also called
grand mal
sx tonic-clonic seizure
loss of consciousness w tonic activity (contraction & rigidity) followed by 1-2 minutes of clonic activity (repetitive, symmetric, jerking movements) –> postictal confusion
may have cyanosis, tongue-biting, urinary incontience
what labs are increased immediately after a seizure
lactic acid
prolactin
what is status epilepticus
continuous seizure lasting 5 minutes or greater or 1 seizure within a 5 minute period without recovery in between episodes
is status epilepcticus an emergency
YES
tx for status epilepticus
benzodiazepines (lorazepam)
