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Peds II > Pediatric Neurology > Flashcards

Pediatric Neurology Flashcards

1
Q

What condition involves a non-progressive motor impairment due to fetal/infantile brain injury?

A

Cerebral Palsy

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2
Q

What is the most common type of Cerebral Palsy? How does this present?

A

Spastic

- Stiff/tight muscles

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3
Q

What condition involves abnormal tone/posture, retained primitive reflexes?

A

Cerebral Palsy

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4
Q

What condition involves increased CSF volume → ventricular dilation, increased ICP?

A

Hydrocephalus

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5
Q

What are the two subtypes of Hydrocephalus?

A
  • Obstructive (blockage)

- Non-obstructive (impaired absorption)

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6
Q

What is the preferred test for a newborn/infant with Hydrocephalus? What about a older infant/child?

A
  • Newborn/infant = US

- Older infant/child: MRI or CT

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7
Q

What sign/symptom is evident with Hydrocephalus?

A

Macrocephaly

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8
Q

What is Occipitofrontal Circumference (OFC) reflective of? How often should it be measured?

A

OFC reflects brain growth

- Measure EVERY well visit from birth to 3 years

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9
Q

What two conditions are considered Microcephaly?

A

Head circumference
- 2+ standard deviations BELOW mean
OR
- <5th percentile

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10
Q

What two conditions are considered Macrocephaly?

A

Head circumference
- 2+ standard deviations ABOVE mean
OR
- 97th+ percentile

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11
Q

What is the etiology for Microcephaly? What are the two subtypes?

A

BRAIN

  • Primary (congenital, lack brain development)
  • Secondary (brain injury post-natal)
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12
Q

What is the etiology for Macrocephaly?

A

ANY component of cranium (brain, CSF, blood, bone)

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13
Q

How do the etiology subtypes of Macrocephaly present (rapid growth, catch-up growth, normal growth rate)?

A
  • Rapid growth: high ICP
  • Catch-up growth: premature but neuro intact
  • Normal growth rate: family history of large heads
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14
Q

If there is a concern regarding OFC, what should be your next step in evaluation?

A

REMEASURE

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15
Q

What are the two Congenital Malformation of CNS? How are each diagnosed?

A
  • Chiari Malformations
  • Spinal Dysraphisms (Spina Bifida)

BOTH diagnosed with MRI

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16
Q

What are the two types of Chiari Malformation?

A
  • Type I: displaced caudally below foramen magnum

- Type II: TYPE I + myelomeningocele +/- hydrocephalus

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17
Q

What age group does each type of Chiari Malformation typically present?

A
  • Type I: teen, adult

- Type II: prenatally, at birth

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18
Q

What condition involves neck pain, HA, CN abnormalities, high ICP worse with cough, sneeze, Valsalva?

A

Type I Chiari Malformation

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19
Q

What condition involves dysphagia, apneic spells, and often requires surgery as treatment?

A

Type II Chiari Malformation

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20
Q

What condition can be caused by low folate, genetics, fever, uncontrolled DM, obesity?

A

Spina Bifida

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21
Q

What are the two subtypes of Spina Bifida?

A
  • Closed (occulta)

- Open (meningocele, myelomeningocele)

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22
Q

What condition involves incomplete closure of spinal cord? In what three ways might this present?

A

Spina Bifida Occulta (closed)

  • Hairy patch
  • Dark spot
  • Back swelling
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23
Q

How does Meningocele differ from Myelomeningocele? Which is more severe?

A
  • Meningocele: outpouching of spinal fluid and meninges from vertebral cleft
  • Myelomeningocele: meninges AND spinal cord protrude from vertebral cleft; MORE SEVERE
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24
Q

What condition involves outpouching of spinal fluid and meninges from vertebral cleft?

A

Meningocele (open Spina Bifida)

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25
Q

What condition involves meninges AND spinal cord protrude from vertebral cleft

A

Myelomeningocele (open Spina Bifida)

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26
Q

Which condition is often associated with Type II Chiari Malformation and Hydrocephalus?

A

Myelomeningocele (open Spina Bifida)

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27
Q

What two conditions are often associated with Myelomeningocele (open Spina Bifida)?

A
  • Type II Chiari Malformation

- Hydrocephalus

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28
Q

What type of genetic disease is Neurofibromatosis (NF1)?

A

Autosomal dominant

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29
Q

Which condition involves café-au-lait macules, neurofibromas, axillary/inguinal freckling?

A

Neurofibromatosis (NF1)

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30
Q

Which type of HA involves focal; 2-72 hours?

A

Migraine HA

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31
Q

Which type of HA involves diffuse; 30 minutes to 7 days?

A

Tension HA

32
Q

What condition involves moderate/severe pulsatile and throbbing HA?

A

Migraine HA

33
Q

Which type of HA is worse with activity?

A

Migraine HA

34
Q

What condition involves N/V, photophobia and phonophobia +/- aura?

A

Migraine HA

35
Q

What condition involves mild/moderate pressure and NON-throbbing?

A

Tension HA

36
Q

What condition involves photophobia or phonophobia (not both)?

A

Tension HA

37
Q

What condition involves idiopathic intracranial HTN → high ICP?

A

Pseudotumor Cerebri

38
Q

What population is Pseudotumor Cerebri most common?

A

Obese teen girl

39
Q

What condition presents with papilledema, also HA and vision issues?

A

Pseudotumor Cerebri

40
Q

Which peds neuro condition is a diagnosis of exclusion?

A

Pseudotumor Cerebri

41
Q

What is the treatment for Pseudotumor Cerebri?

A

Acetazolamide

42
Q

What condition involves sudden, transient brain function disturbance?

A

Seizure

43
Q

How can you differentiate seizure from epilepsy?

A

Epilepsy: 2+ unprovoked seizures more than 24 hours apart

44
Q

What are the three phases of a seizure?

A
  1. Aura (warning signs/pre)
  2. Ictal (active/during)
  3. Post-ictal (recovery/after)
45
Q

Which seizure type involves localized region of brain; often brief?

A

Focal Seizure

46
Q

Which type of seizure involves unilateral sxs or inappropriate emotions/behaviors?

A

Focal Seizure

47
Q

How can you differentiate simple from complex Focal Seizure?

A
  • Simple = conscious; seconds to minutes

- Complex = impaired awareness; 3+ minutes

48
Q

Which seizure type involves both hemispheres simultaneously?

A

Generalized Seizure

49
Q

Which type of seizure involves LOC/impaired awareness; varying post-ictal state?

A

Generalized Seizure

50
Q

What is the most common type of Generalized Seizure?

A

Clonic/tonic

51
Q

What type of seizure involves rhythmic jerking?

A

Clonic/tonic (Generalized Seizure)

52
Q

What type of seizure involves arrest in activity lasting ~10 seconds, can occur 10x/day?

A

Absence (Generalized Seizure)

53
Q

How do you diagnose an Absence (Generalized Seizure)?

A

EEG

54
Q

What is the first line treatment for Absence (Generalized Seizure)?

A

Ethosuximide

55
Q

What provokes an Absence (Generalized Seizure)?

A

Hyperventilation

56
Q

What type of seizure is associated with genetic predisposition?

A

Febrile Seizures

57
Q

Which type of Febrile Seizure is more common? What is the other kind?

A

Simple = MORE common

- Also Complex

58
Q

How can you differentiate simple from complex Febrile Seizure?

A
  • Simple: lasts less than 15 minutes

- Complex: focal, lasts 15+ minutes OR more than once per day

59
Q

How do you treat a Febrile Seizure lasting longer than 5 minutes?

A

IV benzodiazepines

60
Q

What often precedes Guillain-Barre Syndrome, and what is an example?

A

ILLNESS

- Campylobacter jejuni

61
Q

What condition involves ascending symmetric weakness; neuropathic pain?

A

Guillain-Barre Syndrome

62
Q

What is the recommended diagnostic test for Guillain-Barre Syndrome? What else can be used?

A

EMG/NCS

- Can also do CSF analysis

63
Q

What is the recommended treatment for Guillain-Barre Syndrome (2)?

A

Hospitalization!

- IVIG or plasma exchange

64
Q

What condition involves descending weakness; constipation?

A

Botulism

65
Q

What is the recommended diagnostic test for Botulism?

A

Stool sample

66
Q

What is the recommended treatment for Botulism (2)?

A

Hospitalization!

- BIG-IV or BabyBIG

67
Q

What type of genetic disease is Duchenne Muscular Dystrophy (DMD)?

A

X-linked recessive

68
Q

What condition involves onset at 2-3 years and progressive (death: 20 years)?

A

Duchenne Muscular Dystrophy (DMD)

69
Q

What condition involves Gower’s sign?

A

Duchenne Muscular Dystrophy (DMD)

70
Q

What condition involves progressive weakness, calves pseudohypertrophy?

A

Duchenne Muscular Dystrophy (DMD)

71
Q

What condition involves profoundly elevated CK (10-20 times normal)?

A

Duchenne Muscular Dystrophy (DMD)

72
Q

What is the recommended treatment for Duchenne Muscular Dystrophy (DMD)?

A

Steroids

73
Q

What condition is associated with Becker Muscular Dystrophy (BMD)?

A

Cardiomyopathy

74
Q

What condition involves CK less elevated (only 5x)?

A

Becker Muscular Dystrophy (BMD)

75
Q

How can you differentiate Duchenne Muscular Dystrophy (DMD) from Becker Muscular Dystrophy (BMD)?

A
  • DMD: earlier onset, more severe

- BMD: later onset, less severe than DMD

Peds II (12 decks)

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