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Pediatrics > Neurology > Flashcards

Neurology Flashcards

1
Q

account for the largest proprortion of congenital anomalies of the CNS

A

Neural tube defect
- result from failure of neural tube to close spontaneously between the 3rd and 4th wk of in utero development

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2
Q

What is an atypical dimple that warrants imaging?

A

deep, > 5 mm , >25 mm from anal verge

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3
Q

Which part of the brain is CSF formed?

A

ventricular system by the choroid plexus

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4
Q

Hydrocephalus resulting from obliteration of the subarachnoid cisterns or malfunction of the arachnoid villi

A

non-obstructive/communicating hydrocephalus
— most commonly follows a subarachoid hemorrhage

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5
Q

hydrocephalus resulting from obstruction within the ventricular system

A

obstructive or noncommunicating
— most commonly associated with an abnormality of the aqueduct of Sylvius or lesion in the 4th ventricle

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6
Q

most prominent sign in infants with hydrocephalus

A

accelerated rate of enlargement of the head

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7
Q

most important imaging modality in identifying the specific cause and severity of hydrocephalus

A

CT scan and/or MRI + Cranial UTZ

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8
Q

Most common megalencephalic syndrome

A

Sotos Syndrome (Cerebral gigantism)

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9
Q

Type of NTD: cerebral hemispheres are absent ir represented by membranous sacs with remnants of frontal, temporal or occipital cortex dispersed over the membrane

A

Hydranencephaly

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10
Q

major complications of shunting

A

occlusion
bacterial infection

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11
Q

represents the most severe form of dysraphism

A

Myelomeningocele

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12
Q

Folic acid supplementation is proven to reduce the incidence of NTDs in pregnancy at risk by at least 50%, thereby, it should be taken when?

A

before conception and continued until at least 12th wk of gestation

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13
Q

what dose of folic acid should be taken during pregnancy

A

0.4 mg OD
but if high risk pregnancy, 4 mg OD

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14
Q

most frequent type of recurrent headache

A

Migraine

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15
Q

definition of chronic migraine

A

if it occurs more than 15 days per month

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16
Q

most common form of migraine in both children and adults

A

Migraine without aura

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17
Q

Define status migrainosus

A

migraine that persists beyond 72 hours

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18
Q

Major risk factor for bacterial meningitis

A

lack of preexisting immunity to specific pathogens and serotypes

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19
Q

Most important step/procedure in the diagnosis of Meningitis

A

Lumbar puncture

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20
Q

contraindications of lumbar puncture

A
  • evidence of increased ICP
  • severe cardiopulmonary compromise (eg shock)
  • infection of the skin overlying the site of LP
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21
Q

initial emperic treatment for children suspected with meningitis

A

3rd generation cephalosporin (usually Ceftriaxone) + Vancomycin

22
Q

enumerate the most common neurologic sequelae from meningitis

A

hearing loss (sensorineural hearing loss - most common)
cognitive impairment
recurrent seizures
delay in acquisition of language
visual impairment
behavioral problems

23
Q

Chemoprophylaxis given for close contracts with meningococcal meningitis

A

Rifampicin (10 mkdose) q12 for 2 days or
Ceftriaxone 125 mg IM x 1 for <15 yr old
Ceftriaxone 250 mg IM x 1 for >15 yr old
or
Ciprofloxacin 500 mg PO x 1

24
Q

Prophylaxis given to all household contacts of patients with invasive disease caused by H. influenza type B

A

Rifampin (20 mkday) OD for 4 days

25
Q

Predominant organisms that cause brain abscesses

A

Streptococci sp.

26
Q

risk of developing epilepsy who have first afebrile seizure

A

30%
if normal neuro PE and other tests, 20%

27
Q

this test should be performed in all cases of a first unprovoked nonfebrile seizure to help predict the risk of seizure recurrence

A

routine EEG

28
Q

febrile seizures usually occur during this age group

A

6 and 60 months
— peak 12-18 months

29
Q

difference between simple febrile seizure and complex febrile seizure

A

SFS: generalized, lasting for 15 min (max), not recurrent within a 24 hr period
CFS: prolonged (>15 min), focal, recurs within 24 hours

30
Q

duration of Febrile status epilepticus

A

30 minutes

31
Q

percentage of neurologically healthy infants who experience at least 1 simple febrile seizure

A

between 2% and 5%

32
Q

major risk factors for recurrence of febrile seizures

A

Age < 1 yr
Duration of fever <24 hr
Fever 38-39 C

33
Q

recurrence risk of children with febrile sezure who have no risk factors

A

12%

34
Q

mutation in this gene is the most common cause of Dravet Syndrome

A

SCN1A gene

35
Q

this micronutrient deficiency is associated with an increased risk of febrile seizures

A

Iron deficiency

36
Q

most common hereditary neuromuscular disease affecting all races and ethinic groups

A

Duchenne muscular dystrophy

37
Q

clinical features of Duchenne Muscular Dystrophy

A

Progessive weakness
Intellectual impairment
Hypertrophy of the calves, with proliferation of connective tissue and progressive fibrosis in muscle

38
Q

what test is greatly elevated in DMD

A

Serum CK level
— usually at 15K to 35K
(normal <160)

39
Q

what is the type of muscle affected in autoimmune myasthenia gravis?

A

striated muscles
— particularly extraocular, palpebral muscles and swallowing

40
Q

characteristic feature of MG that distinguishes it from most other neuromuscular diseases

A

Rapid fatigue of muscles

41
Q

Primary therapeutic agent for MG

A

Cholinesterase-inhibiting drugs such as Pyridostigmine bromide (0.5-1 mg/kg/dose every 4-6, max dose 7 mkday)

42
Q

Medications that can potentiate myasthenia

A

Aminoglycosides
Beta blocking agents
Procainamide
Chloroquine
Fluoroquinolones

43
Q

autoimmune disorder thought to be a postinfectious polyneuropathy, involving mainly motor nerves

A

Guillan-Barre Syndrome

44
Q

initial symptoms of Guillan-Barre Syndrome

A

weakness usually begins in the LE, progressively involves the trunk, upper limbs and finally bulbar muscles

45
Q

diagnostic of GBS based on CSF studies

A

High CSF protein and a lack of cellular response (ctyoalbuminologic dissociation)

46
Q

Treatment for severe or rapidly progressive muscle weakness in GBS

A

IVIG (0.4 g/kg/day) for 5 consecutive doses or (1g/kg/day) for 2 days

47
Q

last function in GBS to recover

A

Tendon reflexes

48
Q

function to recover first in GBS

A

bulbar function

49
Q

most common long-term residuum of GBS

A

Fatigue

50
Q

features needed for diagnosis of GBS

A

-progressive weakness in legs and arms
- areflexia in weak limbs

51
Q

acute-onset peripheral facial nerve palsy not associated with any other cranial nerve neuropathies or brainstem dysfunction

A

Bell palsy

52
Q

most common casues of Bell palsy

A

Active/reactivation of herpes simplex or Varicella-zoster virus

Pediatrics (17 decks)

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