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pediatrics > Neurology > Flashcards

Neurology Flashcards

1
Q

LMN signs

A

Hypotonia, fasciculations, decreased sensorium, flaccid paralysis, muscle atrophy

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2
Q

What are the symptoms and signs of meningitis according to age
Infants 0-3 months

A

Irritability/lethargy, poor feeding/vomiting, abnormal sleep, high pitched cry
Signs: fever, seizures, tachypnea, bulging fontanelle, opisthotonus

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3
Q

What are the symptoms and signs of meningitis according to age
4-24 months

A

Irritability/lethargy, poor feeding/vomiting, abnormal sleep, hypersensitivity, hypertonia, hypotonia!?
- peak age 6-12 months

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4
Q

What are the symptoms and signs of meningitis according to age
> 2 years

A

URTI/AOM-prodrome, headache, photophobia, nuchal rigidity, lethargy, ALOC,
Signs; fever, irritability, meningismus, increases ICP (headache, Diplopia, bradycardia with htn, sunset sign, apnea, papilledema)

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5
Q

What is meningismus

A

Triad of nuchal rigidity, photophobia, headache

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6
Q

Most common organisms in meningitis

Neonates

A

GBS ( during delivery) > e.coli, L. Monocytogenes (delivery)

  • hematogenous seeding
  • risks: NTD (s.aureus, s.epidermidis) meconium stained (listeria)
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7
Q

Most common organisms in meningitis

3 months- 6 yrs

A

> GBS
- S. pneumonia > N.meningitidis > H.Influenza TB, viral
Risk: CSF shunts (s. Epidermidis)

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8
Q

Most common organisms in meningitis

3 months - 3 years

A

H.Influenza > N. Meningitidis > strep. Pneumonia

Risk: sinusitis, AOM, endocarditis (s. Viridans, S.aureus)

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9
Q

Most common organisms in meningitis

> 6 years

A

N.Meningitidis > strep. Pneumonia

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10
Q

What is intaventricular hemorrhage

Epidemiology and risk factors

A

25 % of VLBW infants
Risk factors:
Extreme prematurity, hypoxia, pneumothorax, RDS, mechanical ventilation in preterms, AVMs, hypertension

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11
Q

What is intaventricular hemorrhage

Pathogenesis

A

Hemorrhage originating in periventricular, ependymal germinal matrix

1) fluctuating blood flow- ventilated preterm with RDS: increased ventilation pressure–> decreased CO, shifting pressures –> blood flow, fluctuating blood flow –> endothelial injury
2) increased cerebral blood flow
3) decreased cerebral blood flow
4) increases CVP
5) AVMs

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12
Q

UMN Signs

A

Clasp knife spasticity, muscle weakness, brisk DTR’S, babinski, normal nerve conduction test

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13
Q

Signs of space occupying lesion in brain/head?

A

worsen when lying down, morning vomiting, changes in mood, personality, or educational performance, visual field defect, diplopia, abnomal gait, growth failure, papilloedema, cranial bruits

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14
Q

Causes of headache

A

Primary, due to a primary malfuction of neurons: tension type, migraine
Secondary, symptom of underlying pathology: trauma, intracrainal bleeding, space occupying lesion, substance or its withdrawal, infections or meningitis, encephalitis, psychiatric, hypercapnia.

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15
Q

what is a seizure

A

an event of sudden distrubance of neurological function caused bu an abnormal of excessive neurological discharge

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16
Q

Causes of seizure

A

Epileptic: idiopathic (70-80%), secondary (cerebral dysgenesis, due to cerebral damage: (vascular ocusion, congenital infection, HIE, IVH) tumor, neurocutaneous syndrome
non-epileptic: febrile, metabolic (hypoglycemia, hypocalcemia, hypomag, hypo or hypernatremia)), head trauma, meningitis/encephalitis, poisons, toxins.

17
Q

febrile seizure: definition

A

A seizure accompanied by high fever (>39) in the abscence of intracranial infections or acute metabolic disorders.

18
Q

facts about febrile seizure

A

usually between 6 months and 6 yrs, occuring early in a viral infection when the temperarture is rising rapidly.
genetic predisposition, brief tonic clonic seizure. always rule out meningitis/encephalitis and sepsis.

19
Q

complications of febrile seizure

A

simple: do not cause brain damage, usually tonic-clonic lasting 15 min or repeated in the same illness: inc risk of epilepsy

20
Q

list different paroxymal disorders /funny turns = mimic epilepsy

A

Breath holding attacks, reflex anoxic seizure, syncope, migraine, BPV, cardiac arrhythmia

21
Q

Management of febrile seizure

A

paracetamol, undressing of child. if needed: rectal diazepam, buccal midazolam.

22
Q

neonatal seizure

diagnosis

A

Hx and PE, EEG, vitals, electrolytes, glucose, LP, culture of csf, blood and urine. imaging

23
Q

infantile spasm

A

Onset: 4-8 months, 80 % due to metabolic or developmental abnormalities, encephalopathies, or associated with neurocutaneous syndromes. Can develop into west syndrome or Lennox Gastaut. clinical: brief, repeated symmetric contractions of neck, trunk and extremities. Bezo or vigabatrin

24
Q

Lennox Gastaut

A

Onset 3-5 yrs, seen with underlying encephalopathy and brain malformation
trias: multiple seizure types, diffuse cognitive dysfunction, slow generalized spike and slow wave EEG. treatment: valproic acid, BZD

25
Q

status epilepticus

A

seizure lasting longer than 30 min or repeated seizures without a return to normal in between them. It is most common in children

26
Q

prophylaxis of meningitis

A

Hib vaccine, meningococcal vaccine, pneumococcal vaccine, BCG vaccine

AB for persons in contact: rifampine

27
Q

risk factors for meningitis

A

HIV, asplenia, prematurity, neurosurgery, sinusitis, mastoiditis, orbital cellulitis, environmental.

28
Q

floppy infant

A

a clinical condition in which the muscle tone is severely decreased. a floppy baby feels like a rag doll when held. elbows and knees are in a loosely extended form

29
Q

floppy infant tests

A

axillary suspension: when lifting the infant by the axilla, infants ars rise without reistance
traction repose: pull infants arm toward sitting position. infant will lack normal countermovement of arms, and head will lagg
ventral position: support under abdomen, baby in an inverted U position.

30
Q

Causes of floppy baby

Central

A

present with poor truncal tone.
CNS: HIE, asphyxia, malformation, cortical atrophy, TORCH
Genetic: DS, prader willi syndrme, Fragile X
Metabolic: hypothyroidism, hypoglycemia, hypopituitarism, kernicterus

31
Q

Causes of floppy baby

peripheral

A

poor antigravity movements
Motor neuron: polio, SMA
peripheral nerves: Charcot-marie-tooth syndromes
neuromuscular junction: Myasthenia g
muscle fibers: mitochondrial myoptahies, muscular dystrophy, myotonic dystrophy.

pediatrics (12 decks)

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