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Obs & Gyny - Risk Factors > Paeds Neuro > Flashcards

Paeds Neuro Flashcards

1
Q

4 types Cerebral palsy

A

1) Spastic
2) Athetoid
3) Ataxic
4) mixed

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2
Q

3x3 causes of cerebral palsy

A

Antenatal

  • Chorioamnionitis
  • Prematurity
  • Congenital malformation

Perinatal

  • Sepsis
  • Chorioamnionitis

Postnatal

  • Meningitis
  • Trauma
  • Kernicterus
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3
Q

Management of spasticity in cerebral palsy

A

Baclofen - Unknown!

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4
Q

Criteria for febrile convulsion

A
  • Ax temp >37.8

- Child between 6 months & 5 years

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5
Q

Emergency management of febrile seizure

A

1) A-E
2) Check BM
3) If >5 minutes seizing give rectal diazepam (500mcg/kg)
4) If meningococcal disease suspected benzylpenicillin

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6
Q

3 factors indicating complex febrile seizure

A

1) Focal features at onset or during the seizure.
2) Duration of more than 15 minutes.
3) Recurrence within the same febrile illness.

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7
Q

In what proportion of children do febrile seizures recur?

A

30%

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8
Q

What advice to give parents?

A
  • tepid sponging + call if fever at home

- call 999 if >5 mins long

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9
Q

Neonatal cause of meningitis

A

GBS, e.coli

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10
Q

1 month to 6 years cause of meningitis

A

Neisseria meningitides
Strep pneumonia
Haemophilus influenza

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11
Q

> 6 years meningitis

A

Neisseria meningitides

Strep pneumonia

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12
Q

> 60 years meningitis

A

Strep pneumonia

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13
Q

Investigations in child with meningitis

A

B: FBC, Blood cultures, U&Es, ESR, coagulation
O: Urine analysis, Urine microscopy and culture, lumbar puncture
X:

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14
Q

Contraindications to LP in children

A
  • Bulging fontanelle
  • Papilloedema
  • Coagulation disorder (DIC)
  • Rapid onset meningococcal disease (rash/fever)
  • Focal neurology
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15
Q

Management meningitis in children

A
  1. Antibiotics
    < 3 months: IV amoxicillin + IV cefotaxime
    > 3 months: IV cefotaxime
  2. Steroids
    if > 1 month and Haemophilus influenzae then give dexamethasone
  3. Fluids
    treat any shock, e.g. with colloid
  4. Cerebral monitoring
    mechanical ventilation if respiratory impairment
  5. Public health notification and antibiotic prophylaxis of contacts
    ciprofloxacin is now preferred over rifampicin
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16
Q

ddx for riggers

A

Biliary sepsis (part of Charcot’s triad)
Pyelonephritis.
Visceral abscess (including lung, liver and paracolic).
Malaria.

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17
Q

Inv for DMD

A
  • CK
  • Muscle biopsy
  • Genetic studies
18
Q

Management for DMD

A
  • Support in walking
  • Corticosteroids
  • cardiac & respiratory surveillance
19
Q

Temporal lobe epilepsy symptoms

A

Hallucinations (auditory/gustatory/olfactory), Epigastric rising/Emotional, Automatisms (lip smacking/grabbing), Deja vu/Dysphasia post-ictal)

20
Q

Cardiac complications of Duchenne’s muscular dystrophy

A

Dilated cardiomyopathy

21
Q

DMD vs BMD

A

BMD has ABNORMAL dystrophin

DMD has absence of dystrophin

22
Q

Outline the floppy infant

A

PARALYTIC

  • Cerebral palsy
  • Down’s syndrome
Non-paralytic
Muscular 
- DMD
NMJ
- Myasthenia Gravis 
Peripheral nerve 
- Guillan Barre
Anterior horn 
- Poliomyelitis
23
Q

What is SMA?

A

Genetic condition causing death of alpha neutrons from spinal cord to NMJ

24
Q

Symptoms of spinal muscular atrophy

A

Hyporeflexia
Fasciulation
Muscle weakness

25
Q

Investigation of SMA

A

CK
Genetic testing
EMG
Muscle biopsy

26
Q

Inheritance of SMA

A

Autosomal recessive

27
Q

Name two types of ataxia

A

FRiedRiCHS Ataxia

Ataxia telangiectasia

28
Q

Outline path of Friedrich’s Ataxia

A 
F- falls
R - recessive
ie
D - Dorsal Column involvement 
Recessive
H - Hypertrophic Cardiomyopathy
I
C - Cerebellar
S - Scoliosis
29
Q

Three useful facts about ataxia telangiectasia

A

1) Presents earlier the friedirch’s ataxia
2) telangiectasia
3) associated with lymphoma
4) associated with IgA deficiency

30
Q

What is an ataxia?

A

Cerebellar hemisphere lesion

31
Q

Causes of hydrocephalus

A

Non-communicating - congenital
- Arnold chiari malformation

non-communicating - acquired
- Cerebral aqueduct stenosis

Communicating
- Meningeal thickening (meningitis)

32
Q

Management of hydrocephalus

A

Pharmacological
- acetalazomide

Surgical
- ventricular-peritoneal shunt

33
Q

Where does IVH arise from in pre-term infants vs term infants?

A

Pre-term infants
- germinal matrix

Term infants
- Choroid plexus

34
Q

Three types of spina bifida

A

spina bifida occulta
Spina bifida cystic
- myelomeningocele - associated with areflexia & flaccid paralysis
- Meningocoele

35
Q

How to prevent spina bifida?

A

Folic acid admin

36
Q

Macroencephaly causes

A
  • normal variation or familial trait
  • disproportionate growth in chronic conditions, for example achondroplasia, sickle cell anaemia, rickets, failure to thrive
  • hydrocephalus
37
Q

Microencephaly causes

A 
Chromosomal 
- Patau's syndrome
Toxins 
- FAS
Virus
- Cytomegalovirus, Zika virus
38
Q

Most common cause brain tumour in children

A

Glioma (astrocytoma)

39
Q

Brain tumour presentation

A

Headache + red flag

40
Q

Define chronic fatigue syndrome

A

6 months fatigue +
Headache of new type, pattern, or severity.
Multi-joint pain without swelling or erythema.
Muscle pain.
Post-exertional malaise for longer than 24 hours.
Significant impairment in short-term memory or concentration.
Sore throat.
Tender lymph nodes.
Unrefreshing sleep.

41
Q

Name four head sutures

A

Metopic
Coronal
Saggital
Lamboid

Obs & Gyny - Risk Factors (18 decks)

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