Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

🍉paeds > Neurology > Flashcards

Neurology Flashcards

1
Q

A child presents complaining of headaches, what would you want to ask?

A
  • Recurrence?
  • More than 1 type?
  • Warning?
  • SOCRATES
  • Use of analgesia?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What would you examine on a kid with a headache?

A 
Growth parameters (height, weight, OFC, BP)
Sinuses & teeth
Visual acuity, fields and fundoscopy
Listen for cranial bruit
Focal neurological signs
Cognitive/emotional status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Headaches in kids fall into 4 groups:

A
  • Migraines
  • TTHs
  • Raised ICP
  • Analgesic Overuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How would you make the diagnosis of a migraine?

A

Hemicranial, throbbing & pulsatile headache

Relieved by rest
Often photo/phonophobic

Presence of an aura

Also useful to look for FH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How would you diagnose a tension type headache?

A

If a child sufferes from a constant diffuse, symmetrical (band-like distribution) headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would you treat a migraine?

A

Give them simple analgesics for acute attacks
Maybe Triptans if bad enough

If atleast 1/wk give preventative drugs:

  • Propranolol
  • Amitriptyline
  • Valproate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you manage a tension type headache?

A

Reassure the parent it’s nothing sinister

Attend to chronic underlying physical/psychological/emotional stressors

Discourage chronic use of analgesics

If necessary you can use simple analgesics acutely and amitriptyline preventatively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you spot a medication overuse headache

A

High use of PCM/NSAIDs (more problematic if with compound analgesics e.g. cocodamol)

Pain returns before they can have another dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What would be red flags of a raised ICP headache?

A
  • Wakens them from sleep

- Aggravated by raising ICP e.g. coughing, toilet straining or bending over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Headaches are diagnosed clinically, when would you want to use imaging?

A

1) Cerebellar dysfunction e.g. ataxia
2) Raised ICP
3) New focal deficit e.g. new squint
4) Seizures
5) Personality change
6) Unexplained deterioration in schoolwork

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the major causes of fits/falls/funny turns in kids?

A

1) Epilepsy
2) Acute Symptomatic seizures e.g. febrile convulsion
3) Reflex Anoxic Seizures
4) Syncope
5) Parasomnias e.g. night terrors
6) Psychogenic Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What causes reflex anoxic seizures?

A

Trigger e.g. pain or fright –> Vagal overactivity –> bradycardia –> hypoxia & seizure

It’s not abnormal in toddlers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is an Acute Symptomatic Seizure?

A

A response to an acute insult e.g. hypoglycaemia, infection or hypoxia

The most common form is a Febrile Convulsion (very common, ~1in20 kids). Seizure ass with fever but with no intracranial inf or defined cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can you use to diagnose epilepsy?

A

Mostly a clinical diagnosis!!!

  • History
  • Video recordings
  • ECG
  • Interictal/Ictal EEG
  • MRI (For malformations)
  • Genetics (Familial & single gene disorders e.g. Tuberous Sclerosis)
  • Metabolic tests if ass with developmental delay
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes epilepsy in kids?

A

Mostly it’s idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Is childhood epilepsy generalised or focal?

A

Mostly generalised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What factors are important when determining drug treatment for epilepsy?

A
  • Age
  • Gender
  • SEizure type
  • Epilepsy type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What drugs do we use for childhood epilepsy?

A 
Generalised = Sodium Valproate
Focal = Carbamazepine

New better tolerated drugs e.g. Lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the major SEs of Anti-Epileptic Drugs (AEDs)?

A

CNS - Drowsiness, impacted learning, cognition & behaviour

Others include rashes & bone marrow problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Other than AEDs how can you treat epilepsy?

A

Some forms respond to Vagus Nerve Stimulation or Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What signs would raise concern of a neuromuscular disorder in a pre-walking child?

A
  • Floppy
  • Slips from hands
  • Paucity of limb movements
  • Alert but low motor activity
  • Delayed motor milestones
  • Myopathic facies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What signs would suggest a neuromuscular disorder in a walking child?

A
  • Frequent falls
  • Awkward/clumsy positioning e.g. holding shoulders back, belly out, walking on toes
  • Gait e.g. waddling
  • Pes Cavus & hammer toes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is pes cavus and hammer toes indicative of?

A

Charcot Marie Tooth Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How can you differentiate a neuropathy from a myopathy?

A

Myopathy:

  • Proximal weakness
  • Purely motor
  • Preserved reflexes
  • Contractures
  • ~Myocardial dysfunction

Neuropathies:

  • Distal weakness
  • ~sensory involvement
  • Loss of reflexes
  • ~Fasciculations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

List some of the major neuromuscular disorders in kids?

A

Muscular dystrophies e.g. Duchenne’s
Spinal Atrophy
Myasthenia Gravis

26
Q

How is Duchenne’s MD inherited?

A

X-linked –> female carriers and male suffers

Xp21 - the dystrophin gene

27
Q

How would you expect Duchenne’s MD to present?

A 
Delayed gross motor skills
Symmetrical proximal weakness
Waddling gait
Calf hypertrophy
Gower's Sign

~ Cardiomyopathy & Resp involvement in teens

28
Q

How do you confirm Duchenne’s?

A

Gower’s sign (required but not specific)

Raised Creatinine kinase CK (>1000)

29
Q

How do we treat Duchenne’s?

A

Steroids, thanks to this sufferers can stay on their feet etc much longer and live into early 30s

30
Q

What’s the most common cause of collapse in kids/adolescents?

A

Vasovagal Syncope

31
Q

What questions would you ask about a collapse/fit/fall to ascertain cause?

A
  • Any precipitant?
  • Any prodromal symptoms?
  • Timescale
  • Time to recover
  • Fh of epilepsy, syncope etc
  • H/o collapse
  • Fever/illness

3rd party:

  • Eye movement
  • Limb movement
  • Colour
  • Response/consciousness
32
Q

What can cause vasovagal syncope?

A
  • Missing meals (hypoglycaemia)
  • Dehydration
  • Stress
  • Posture change
  • Heat
  • Straining
  • Blood taking
  • Arrythmia e.g. Long QT
33
Q

What can you test in syncope?

A

Glc at the time
ECG for arrhythmia
BP for hypotension

34
Q

What advice would you give someone who suffers from syncope?

A
  • Reassure that it’s not something serious
  • Drink lots
  • Have proper meals
  • Take care on changing posture
  • Return if it recurs
  • Exercise legs (improves venous return)
35
Q

What is the second most common cancer in children?

A

brain tumour

36
Q

how many children present with migraines?

A

7.7% of children 10-17

37
Q

pointers (other than typical symptoms) which suggest childhood migraine?

A

Associated abdominal pain, nausea, vomiting

Focal symptoms/ signs before, during, after attack: Visual disturbance, paresthesia, weakness

‘Pallor’

Aggravated by bright light/ noise

Relation to fatigue/ stress

Helped by sleep/ rest/ dark, quiet room

Family history often positive

38
Q

seizure/fit def?

A

Any sudden attack from whatever cause

39
Q

Syncope def?

A

Faint (a neuro-cardiogenic mechanism)

40
Q

convulsion def?

A

Seizure where there is prominent motor activity

41
Q

Epileptic seizure def?

A

An abnormal excessive hyper synchronous discharge from a group of (cortical) neurons

It may have clinical manifestations

Paroxysmal change in motor, sensory or cognitive function

Depends on seizure’s location, degree of anatomical spread over cortex, duration

42
Q

examples of non-epileptic seizures?

A

Acute symptomatic seizures: due to acute insults eg. Hypoxia-ischaemia, hypoglycemia, infection, trauma

Reflex anoxic seizure: common in toddlers

Syncope

Parasomnias eg. night terrors

Behavioural stereotypies

Psychogenic non-epileptic seizures (PNES)

43
Q

what is Microcephaly?

A

OFC <2 SD: mild

OFC <3 SD: moderate/ severe

44
Q

what does microcephaly indicate?

A

small brain

‘micranencephaly’

45
Q

causes of microcephaly?

A

antenatal, postnatal, genetic and environmental

46
Q

definition of macrocephaly?

A

OFC > 2SD

47
Q

what is Plagiocephaly

A

‘flat-head’

48
Q

what is Brachycephaly

A

‘short head or flat at back’

49
Q

what is scaphocephaly?

A

‘boat shaped skull’

50
Q

Craniosynostosis

A

baby’s skull join together too early.

51
Q

Deformational plagiocephaly

A

a flat spot on one side of the head or the whole back of the head.

52
Q

Craniosynostosis

A

a condition in which one or more of the sutures close too early, causing problems with normal brain and skull growth.

53
Q

what chemically triggers an epileptic seizure?

A

epilepsy is caused by excessive for cortical neurones

  • Decreased inhibition (gama-amino-butyric acid, GABA)
  • Excessive excitation (glutamate and aspartate)
  • Excessive influx of Na and Ca ions

resulting in large scale depolarisation

54
Q

how does chemical stimulation cause an epileptic fit?

A

Chemical stimulation produces an electrical current
Summation of a multitude of electrical potentials results in depolarization of many neurons which can lead to seizures, can be recorded from surface electrodes (Electroencephalogram)

55
Q

why is an epilepsy diagnosis challenging?

A

Non-epileptic paroxysmal disorders are more common in children

Difficulty in explaining (Children are not young adults)

Difficulty in interpretation (witness)

Difficulty in interpretation and synthesising information(physician)

56
Q

pros and cons with EEG and epilepsy?

A

limited value in deciding when the individual has epilepsy

Problematic false positive rates: paroxysmal activity seen in 30%, frankly epileptiform activity in 5% of normal children

BUT good at identifying seizure types

57
Q

How do a Childs frontage’s close?

A
  1. the posterior frontalles usually close 2-3 months after giving birth
  2. The anterior frontalles closes between 1-3 years
58
Q

when measuring head size need to plot on graph with weight and heigh..

A

…

59
Q

what exactly do you measure? OFC?

A

occipital frontal circumference

60
Q

when do you measure OFC?
when is it important to measure?
do u measure parents?

A

as routine- between birth and 3 years of age
VERY important

v important if neurological or developmental symptoms

also measure parents head size tp see if it is going along with families

61
Q

most common weird head shape?

A

Deformational plagiocephaly

looks like from the top parallels gram shape

flattering at the back and frontal bone more prominent

62
Q

how does craniocinositis look like?

A

-fusing too early

caronal, saggitol or lambdoid

🍉paeds (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions