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Pedia > Neurology, Infectious > Flashcards

Neurology, Infectious Flashcards

0
Q

Setting sun sign

A

Downward deviation of the eyes due to impingement of the dilated supeapineal recess on the tectum

Seen in hydrocephalus

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1
Q

Folic acid supplementation for pre-pregnant women

A

0.4 mg/day

If with prior history of NTD, 4mg/day

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2
Q

Obstructive hydrocephalus - where is the pathology?

A

Obstruction within the ventricular system

Problem with the aqueduct or a lesion in the 4th ventricle (aqueductal stenosis)

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3
Q

CSF flow

A

Choroid villi - lateral ventricle - foramen of Monroe - 3rd ventricle - Aqueduct of Sylvius - into subarachnoid space - lateral - Foramen of Luschka - medial - Foramen of Magendie - arachnoid villi

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4
Q

Hydrocephalus with foreshortened occiput

A

Chiari Malformation

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5
Q

Hydrocephalus with prominent occiput

A

Dandy-Walker malformation

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6
Q

Major cause of complication of shunts for hydrocephalus

A

S. aureus

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7
Q

Epilepsy definition

A

2 or more unprovoked seizure occur at an interval greater than 24 hours apart

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8
Q

DOC for absence seizure

A

Ethosuximide

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9
Q

Duration of absence seizures

A

Rarely persist longer than 30 secs

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10
Q

Seizure with aura, rhythmic stiffening and relaxation of extremities with loss of sphincter control and LOC

A

Generalized tonic clonic seizures

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11
Q

Age group that present with infantile spasms

A

4-8 months

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12
Q

Hypsarrhythmia on EEG

A

High voltage bilaterally asynchronous, slow wave activity

Seen in Infantile spasms

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13
Q

DOC for infantile spasms

A

Vigabatrin

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14
Q

Most common seizure disorder in childhood

A

Febrile seizure

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15
Q

Peak age of children with benign febrile seizures

A

14-18 months old

Rare before 9 months and after 5 years

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16
Q

Simple vs Complex febrile seizure

A

Simple
Duration: less than 15 minutes
Once in 24 hrs
Generalized tonic-clonic

Complex
More than 15 minutes
More than once in 24 hrs
Focal seizure activity

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17
Q

Status epileptics definition

A

One seizure lasting 30 minutes
OR
Multiple seizures during 30 minutes without regaining consciousness

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18
Q

Only drug proven for migraine prophylaxis

A

Propanolol 10-20 TID for > 7 yrs old

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19
Q

In tuberous sclerosis, where are the tubers typically located

A

Subependymal region

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20
Q

Chromosome involved in Von Hippel Lindau

A

Chromosome 3 - VHL = 3 letters

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21
Q

Chromosome in Von Recklinghausen disease

A

Chromosome 17 = 17 letters!

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22
Q

Hamartomas within the iris

A

Lisch nodules

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23
Q

Most distinctive feature of NF 2

A

Bilateral acoustic neuromas

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24
Q

Mode of transmission of meningitis infection

A

Hematogenous dissemination from a distant site of infecrion

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25
Q

At what age can you start eliciting Brudzinski and Kernig signs?

A

2 and aboce

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26
Q

Kernig sign

A

Hip flexion 90 degrees with subsequent pain with extension of the leg

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27
Q

Brudzinski sign

A

Involuntary flexion of the knee and hips after passive flexion of the neck while supine

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28
Q

Contraindications to LP

A

Evidence of increased ICP
Severe cardiopulmonary compromise
Infection of the overlying skin

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29
Q

MCC of viral meningitis

A

Echovirus (Coxsackie)

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30
Q

Important imaging test to request for in MG

A

Chest CT scan - visualize presence of a thymoma

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31
Q

Diagnostic test for MG?

A

Edrophonium chloride IV - Tensilon test

Short acting cholinesterase inhibitor

Ptosis, ophthalmoplegia improves within seconds

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32
Q

Treatment for MG

A

Neostigmine 0.04 mg/kg IM q4-6 hrs

Or 0.4 mg/kg PO q4-6 hrs

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33
Q

Nerve involved in Bell’s palsy

A

Facial nerve

Weakness of facial muscles

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34
Q

Bacteria most associated with GBS

A

Campylobacter jejuni - undercooked chicken

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35
Q

Muscle weakness in GBS

A

Symmetric ascending weakness or paralysis

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36
Q

Commando crawl

A

Seen in spastic diplegia type of cerebral palsy - bilateral spasticity of legs

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37
Q

Location of most brain tumors between 2-12 yrs old

A

Posterior fossa/ infrarentorial

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38
Q

Most common location of medulloblastoma

A

Cerebellum

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39
Q

Homer Wright rosettes

A

Medulloblastoma

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40
Q

Most common infrarentorial tumor

A

Cerebellar Astrocytoma

Best prognosis

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41
Q

Origin of craniopharyngioma

A

Rathke’s pouch

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42
Q

Treatment that involves implantation of radiation seeds

A

Brachytherapy

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43
Q

Spore forming gram positive rods

A

Bacillus

Clostridium species

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44
Q

Toxin that causes whooping cough in Diptheria

A

Tracheal toxin

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45
Q

Bull neck appearance

A

Diptheria

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46
Q

Differentiate Diptheria from Strep throat

A

Diptheria

  • relative lack of fever
  • non-exudative throat
  • with gray brown adherent pseudomembrane
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47
Q

Treatment for Diptheria

A

Penicillin
Erythromycin - eliminates nasopharyngeal carriage
Antitoxin

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48
Q

Culture medium for organism causing Diphtheria

A

Tellurite plate

Tell a corny joke

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49
Q

At what phase of illness is the whooping cough present

A

Paroxysmal phase

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50
Q

When is a patient with Diphtheria most infectious

A

During the catarrhal phase

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51
Q

Culture medium for organism causing pertussis

A

Bordet Gengou agar plate

Swab from posterior nasopharynx for 15-30 seconds

52
Q

Complications of pertussis

A

HSOAP

Hemorrhage - subconj, intracranial
Seizures
Otitis media
Atelectasis, apnea, activation of latent TB
Pneumonia
53
Q

Treatment for pertussis

A

Erythromycin 40-50mg/kg/day q6 x 14 days

54
Q

Prophylaxis for pertussis

A

Erythromycin for 14 days given promptly to all household contacts and other close contacts

55
Q

Most common strains of neisseria meningitidis

A

A, B, C, Y, W135

56
Q

Vaccine for n. meningitidis available against what strains

A

Group A, B, C, Y, W135

57
Q

Most severe form of n. meningitidis infection

A

Waterhouse Friderichsen syndrome

Diffuse bilateral adrenal hemorrhage

58
Q

Most common s/s of meningococcemia

A

Fever

Petechiae, Purpura (initially morbilliform becoming petechial then purpuric within hours)

59
Q

DOC for meningococcemia

A

Penicillin G - DOC

Ceftriaxone 100mg/kg/day or Cefotaxime 200mg/kg/day

60
Q

Who are considered exposed to patients with meningococcemia

A

Contacts during the 7 days before onset of illness

Medical personnel with intimate exposure (intubation, suctioning)

61
Q

Prophylaxis for meningococcemia

A

Children: Rifampicin 10mg/kg PO q12 for a total of 4 doses
OR
< 12 yo: Ceftriaxone 125mg single dose IM

> 18 yo: Ciprofloxacin 500mg PO single dose

62
Q

Salmonella mode of transmission

A

Fecal-oral

63
Q

Rose spots

A

Maculopapular rashes on the lower chest, abdomen

Seen in typhoid fever, 2nd week (day 7-10 of illness)

64
Q

Treatment for Typhoid fever

A

Chloramphenicol 50-75 mg/kg/day for 14-21 days
OR
Amoxicillin 75-100 mg/kg/day for 14 days

If with drug resistance
FQ 15mg/kg/day for 5-7 days

If severe
Ampicillin 100mg/kg/day for 14 days
Ceftriaxone 60-75 mg/kg/day for 10-14 days

65
Q

Chronic carriers of salmonella infection have the organism in what organ? Treatment?

A

Gallbladder

Tx: Ampicillin

66
Q

Culture medium of Shigella

A

Xylose-Lysine Deoxycholate agar
SS agar
MacConkey agar

67
Q

Tx for shigella

A

Cefixime
Ceftriaxone
Azithromycin

Also give Zinc 20ng/day for 14 days

68
Q

Toddlers’ and travelers diarrhea

A

ETEC

69
Q

E. coli bacteria that will give bloody stool

A

EIEC, EHEC

70
Q

Tx for ETEC

A

Co-trimoxazole

71
Q

Vibrio cholera serogroups

A

01 and 0139

72
Q

Rice water consistency and fishy odor without abdominal pain

A

Cholera

73
Q

Culture medium for cholera

A

Cary-Blair transport medium plated onto Thiosulfate Citrate Bile Sucrose (TCBS) media

74
Q

Tx for cholera

A

Tetracycline 50mg/kg/day PO qid for 3 days
OR
Doxy 5mg/kg/day PO single dose
Co-tri 8-10 mg/kg/day bid PO

75
Q

Risus sardonicus

A

Sardonic smile due to intractable spasm of facial and buccal muscles

Seen in tetanus

76
Q

Pathogenesis of tetanus

A

Tetanospasmin binds to NM junction

Prevents the release of GABA and glycine (inhibitory NTs) leading to sustained contraction

77
Q

Opisthotonus

A

Muscle spasm where only the back of the head and the heels touch the ground

78
Q

When does neonatal tetanus present

A

Within 3-12 days of birth

79
Q

Mode of transmission of congenital syphillis

A

Transplacental transfer

80
Q

Reaction seen in 15-20% of patients with syphillis treated with penicillin

A

Jarish-Herxheimer reaction

With treatment, killed treponema release a pyrogen that causes an acute systemic febrile reaction with exacerbation of lesions

81
Q

Leptospirosis - what type of hypersensitivity reaction

A

Type 3

82
Q

Screening test for leptospirosis

A

Microscopic slide-agglutination test

83
Q

Tx for leptospirosis

A

Penicillin

Tetracycline

84
Q

Measles - what type of virus

A

Paramyxovirus

85
Q

Mode of transmission of measles

A

Droplet

86
Q

Period of communicability of measles

A

4 days before and 4 days after

87
Q

Characteristics of rash of measles

A

From hairline downward

With branny desquamation

88
Q

MC complication of measles

A

Otitis media

89
Q

Post exposure prophylaxis of measles

A

Measles Ig within 6 days of exposure

90
Q

Mode of transmission of rubella

A

Droplet or transplacentally

91
Q

Period of communicability of measles

A

7 days before and 7 days after

92
Q

Most characteristic sign of measles

A

Retroauricular, posterior cervical and post occipital lymphadenopathy

93
Q

Enanthem of measles? Of rubella?

A

Measles - Koplik

Rubella - Forscheimer spots

94
Q

Swollen glands push the ear lobe upward and outward and the angle of the mandible is no longer visible

A

Mumps

95
Q

Most frequent complication of mumps

A

Meningoencephalitis

96
Q

What causes roseola

A

HHV 6 and 7

97
Q

Nagayama spots

A

Ulcers in the uvulopalatal junction, seen in Roseola

98
Q

If with chicken pox, until when is the patient infectious?

A

Until all the lesions have crusted

99
Q

Important presentation of congenital varicella

A

Interruption of limb development - short and malformed limbs covered with cicatrix

100
Q

Lifetime risk for herpes zoster

A

10-15% with 75% of cases occurring after 45 yrs old

101
Q

When best to give acyclovir in herpes infection

A

Within 24 hours

102
Q

Post exposure prophylaxis for varicella

A

Active vaccine within 3-5 days of exposure
Anti-VZV Ig for immunocompromised, within 96 hours
Includes newborns who were exposed to moms with varicella 5 days before or 2 days after birth

103
Q

Virus that causes HFMD?

A

Coxsackie A16

104
Q

What causes herpangina

A

Coxsackie A

105
Q

What causes erythema infectiosum

A

Parvovirus B19

106
Q

Parts of the brain affected by HSV

A

Temporal lobe, frontal love, limbic system

107
Q

Test of choice in examining HSV encephalitis

A

PCR to detest HSV DNA

108
Q

Type of paralysis seen in poliomyelitis

A

Flaccid paralysis

109
Q

IPV vs OPV - which is live? Attenuated?

A

OPV - Sabin - Live

IPV - Salk - Killed

110
Q

Paul Bunnel antibodies

A

Seen in EBV - heterophil antibody

111
Q

Most feared complication of Infectious mononucleosis

A

Splenic rupture

112
Q

Gianotti-Crosti syndrome

A

Associated with infectious mononucleosis - EBV

113
Q

Most common congenital infection

A

CMV

114
Q

Strikingly enlarges epithelial or mesenchymal cells with large intranuclear inclusions

A

CMV

115
Q

Tx for CMV

A

Ganciclovir

116
Q

Influenza virus - from what family?

A

Orthomyxoviridae

117
Q

Influenza is confirmed serologically by ?

A

Hemagglutination inhibition

118
Q

Prophylaxis and tx for influenza type A outbreaks

A

Amantadine and Rimantadine

119
Q

Neuraminidase inhibitor used against influenza

A

Oseltamivir

120
Q

MOA of Osteltamivir

A

Neuraminidase inhibitor

121
Q

Worst dengue serotype

A

Type 2

122
Q

When to request for dengue NS1?

A

Days 1-4

123
Q

When is serology the dx of choice for dengue?

A

Day 5 to day 10

124
Q

Most severe disease in rabies involves what part of the brain

A

Pons and floor of the 4th ventricle

125
Q

If bleeding is induced after a dog bite on the arm, under what category does it fall?

A

Category II

Category I - licking, nibbling on intact skin
Category II - superficial abrasions without bleeding or induced bleeding
Category III - lacerations, transdermal bites, puncture with bleeding, all wounds on head and neck with or without bleeding

126
Q

Schedule for rabies vaccine post-exposure prophylaxis

A

Days 0,3,7,14,28 or 30

127
Q

Additional treatment for category III bites

A

Co-Amoxiclav 40mg/kg/day for 7 days

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