Brainscape's Knowledge GenomeTM

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


See full index

paediatrics > paediatric neurology > Flashcards

paediatric neurology Flashcards

1
Q

clinical evaluation of childhood headache disorders

A

isolated acute
recurrent acute
chronic progressive
chronic non-progressive

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

pointers to childhood migraine

A
  • assoc abdo pain, nausea, vomiting
  • focal symptoms/signs before, during, after attack: visual disturbance, paresthesia, weakness
  • pallor
  • aggravated by light/noise
  • relation to fatigue/stress
  • helped by sleep, rest, dark, quiet
  • FH often positive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

features of tension type headahce

A

diffuse, symmetrical
band-like distribution
present most of time
contant ache

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

features of migraine

A 
hemicranial pain 
throb/pulsatile
abdo pain, nausea, vomit
relieved by rest 
photo/phono-phobia
visual, sensory, motor aura
FH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pointers to raised intracranial pressure

A

aggravated by activities that raise ICP e.g. coughing, bending

woken from sleep with headache +/- vomiting

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

pointers to analgesic overuse headache

A

headache is back before allowed to use another dose

paracetamol/NSAIDs

partic problem with compound analgesics e.g. cocodamol

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

indications for neuroimaging

A
  • features of cerebellar dysfunction
  • features of raised ICP
  • new focal neurological deficit e.g. new squint
  • seizures, esp focal
  • personality change
  • unexplained deterioration of school work
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

migraine management

A

acute attack: effective pain relief, triptans

preventative (at least 1wk): pizotifen, propranolol, amitryptyline, topiramate, valproate

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

tension type headache treatment

A
  • reassurance: no sinister cause
  • attention to underlying physical, psychological, emotional problems

acute attacks: simple analgesia

prevention: amitryptiline

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

seizure/fit

A

any sudden attack from whatever cause

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

syncope

A

faint - a neuro-cardiogenic mechanism

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

convulsion

A

seizure where there is prominent motor activity

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

epileptic seizure

A

an electrical phenomenon

an abnormal excessive hyper-synchronous discharge from a group of cortical neurons

paroxysmal change in motor, sensory or cognitive function

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

what does seizure manifestation depend on

A

seizure location
degree of anatomical spread over cortex
duration - of abnormal electrical discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

epilepsy

A

a tendency to recurrent, unprovoked (spontaneous) epileptic seizures

EEG for supportive evidence - single epileptic seizure doesn’t mean they have epilepsy

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

non-epileptic seizures and other mimics in children

A
  • acute symptomatic seizures
  • reflex anoxic seizure
  • syncope
  • parasomnias e.g. night terror
  • behavioural stereotypies
  • psychogenic non-epileptic seizure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

acute symptomatic seizures

A

due to acute insults to brain e.g. hypoxia-ischaemia, hypoglycaemia, trauma, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

reflex anoxic seizures

A

vagal overstimulation, always provoked/triggered by certain stimuli

common in toddlers

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

febrile convulsion

A

seizure occurring usually between 3mo and 5yrs, assoc with fever but without evidence of intracranial infection or defined cause of seizure

commonest cause of acute symptomatic seizure in childhood

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

what is an epileptic fit chemically triggered by

A

decreased inhibition (gama-amino-butyric acid, GABA)

excessive excitation (glutamate and aspartate)

excessive influx of Na and Ca ions

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

mechanism of epileptic fit

A

triggered by imbalance between excitatory and inhibitory neurones

chemical stimulation produces an electrical current

summation of a multitude of electrical potentials results in depolarisation of many neurones which can lead to seizures, can be recorded from surface electrodes (electroencephalogram)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

types of epileptic seizures

A

partial/focal seizures

generalised seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

partial/focal seizures

A

seizure focus restricted to 1 hemisphere/part of one hemisphere

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

generalised seizure

A

neurones recruited from both halves of brain - both hemispheres involved

25
Q

childhood vs adult onset epilepsies

A

majority generalised
majority idiopathic
seizures subtle in childhood - can be missed by parents/carers
diagnosis challenging - large no paroxysmal evens in kids, difficulty getting good history

26
Q

stepwise approach to diagnosing epilepsy

A
  • is the paroxysmal event epileptic in nature?
  • is it epilepy?
  • what type of seizures are occuring?
  • what is the epilepsy syndrome?
  • what is the aetiology?
  • what are the social and educational effects on the child?
27
Q

role of the EEG

A

-limited value in deciding when the pt has epilepsy

role in assessing and managing diagnosed epilepsy. useful in identifying seizure types, seizure syndrome and aetiology

28
Q

diagnosing epilepsy

A

history
video of event
ECG in convulsive events (rule out long QT syndrome)
EEG
MRI brain - aetiology
genetics
metabolic tests - esp if assoc with developmental delay/regression

29
Q

management of epilepsies in children

A

anti-epileptic drugs is diagnosis clear, they control seizures - not a cure

start with 1 AED and slow upward titration until side-effects manifest or drug considered inefficient

30
Q

drug treatment of epilepsy

A

generalised epilepsies: sodium valproate (not for girls) or levetiracetam

focal epilepsies: carbamazepine

other: steroids, immunoglobulines, ketogenic diet (for drug-resistant epilepsies)

31
Q

epilepsy management: surgery

A

vagal nerve stimulator

resection

32
Q

head size problems

A

macrocephaly

microcephaly

33
Q

in infant skull: what suture holds the frontal bones together

A

metopic suture

34
Q

in infant skull: what suture holds parietal bones together

A

sagittal suture

35
Q

in infant skull: why are sutures open

A

to allow brain to grow

36
Q

order in which fontanelles close

A

posterior fontanelle usually closes 2-3mo after birth

gradual fusion of sutures

anterior fontanelle usually closed between 1-3yoa (avg 18mo)

37
Q

when is OFC measured

A

routine between birth-3yrs

should be interpreted of rest of family - measure parents to see if kid is inkeeping with rest of family

38
Q

microcephaly definition

A

mild: OFC <2 standard deviations below mean

moderate/severe: OFC < 3 SD

39
Q

what does microcephaly indicate

A

usually indicates small brain

‘micranencephaly’

40
Q

causes of microcephaly

A

antenatal
postnatal
genetic
environment

41
Q

macrocephaly definition

A

OFC > 2SD

42
Q

macrocephaly: what is indicated if they’re crossing centiles upwards

A

underlying brain or CSF is expanding in a way it shouldn’t

43
Q

plagiocephaly

A

flat head - usually one one side

44
Q

brachycephaly

A

short head which is also flat at back

45
Q

scaphocephaly

A

head with unusual boat shape

46
Q

craniosynostosis

A

premature fusion of cranial sutures

if they fuse too quickly brain has no room to grow and may end up with very odd head shape

47
Q

what direction to skull bones normally grow

A

perpendicular to the sutures

48
Q

deformational plagiocephaly

A

most common reason for abnormal head shape

to do with the position child is in e..g how they sleep, lie

49
Q

when to suspect a neuromuscular disorder

A 
baby floppy from birth
slips from your hands
paucity of limb movements
alert but less motor activity 
delayed motor milestones
able to walk but frequent falls
50
Q

duchenne muscular dystrophy: genetics

A

Xp21, dystrophin gene

male infants

x-linked

51
Q

duchenne muscular dystrophy: presentation

A 
delayed gross motor skills 
symmetrical proximal weakness
Gower's sign positive
waddling gait
cardiomyopathy 
respiratory involvement in teens

elevated creatinine kinase levels

52
Q

anatomical approach to neuromuscular conditions: muscle

A

muscular dystrophies
myopathies - congenital and inflammatory
myotonic syndromes

53
Q

anatomical approach to neuromuscular conditions: neuromuscular junction

A

myasthenic syndrome

54
Q

anatomical approach to neuromuscular conditions: nerve

A

hereditary or acquired neuropathies

55
Q

anatomical approach to neuromuscular conditions: anterior horn cell

A

spinal muscular atrophy

56
Q

myotonia

A

inability for muscle to relax after contraction - sustained muscle contraction

57
Q

simple vs complex febrile seizure

A

simple <10mins, generalised, doesn’t reccur in 24hrs

complex >10/15mins, focal, recurs within 24hrs

58
Q

treatment complex febrile seizure

A

rectal diazepam

buccal midazolam

59
Q

features febrile seizure

A 
6mo-5yrs
assoc fever
generalised tonic clonic
3-6mins
recover within an hour

paediatrics (68 decks)

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