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Neurology > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

What do you always include in pediatric history taking? (4)

A
  1. immunizations
  2. birth history
  3. po intake
  4. excretions: BM/urine
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2
Q

neonatal period

A

0-28 days`

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3
Q

postnatal period

A

29 days to 1 yr

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4
Q

primary HA’s - what types

A 
tension
migraine
cluster
sinus
hormonal
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5
Q

secondary HA’s - what types

A

minor illness

serious condition - CNS tumor

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6
Q

common symptom of brain abscess

A

nighttime awakening HA

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7
Q

Tension HA presentation

A

bilateral
forehead
neck
squeezing

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8
Q

Tension HA tx

A

NSAIDs

MSK relaxers

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9
Q

Migraines commonly affects who

A

teens

females

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10
Q

POUND criteria for migraines

A 
P: pulsatile
O: hours of onset
U: unilateral
N: nauseating
D: disabling
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11
Q

Migraine classic

A

aura

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12
Q

migraine common

A

no aura (80% of migraines)

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13
Q

Cluster HA presentation

A 
severe
unilateral
periorbital
lacrimation
nasal congestion
Horner's syndrome (affects trigeminal nerve): ptosis, anhidrosis, miosis
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14
Q

Cluster Tx

A

100% oxygen

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15
Q

What do you always document with a HA?

A
  • maximal at onset
  • worse HA of life
  • sudden onset

Otherwise SAH!!

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16
Q

CNS tumors have a ____ onset

A

gradual

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17
Q

CNS tumors are accompanied by ____

A

focal neuro deficit

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18
Q

MC CNS tumor

A

glioma

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19
Q

Worst CNS tumor

A

glioblastoma multiforme

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20
Q

seizure definition

A

sudden, uncontrolled electrical disturbance in the brain

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21
Q

focal seizures occur…

A

in one area of the brain

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22
Q

focal seizures are defined as…

A

simple: no loss of consciousness (LOC)

Complex: LOC or altered level of consciousness

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23
Q

generalized seizures involve…

A

both hemispheres of the brain

have a LOC

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24
Q

What is status epilepticus

A

seizure duration >5mins.

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25
Q

Tx of status epilepticus

A

lorazepam
diazepam

IV, IM, or rectal –> usually rectal

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26
Q

When you work up a seizure, you are working up….

A

the potential causes: electrolyte abnormalities, seizure medications, anemia, infections, get an ECG/CXR/CT of head

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27
Q

Febrile seizure definition

A

convulsion associated with fever > 103.0 not associated with CNS/infection/inflammation

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28
Q

febrile seizure recurrence rsik

A

30-50%

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29
Q

MC neuro disorder in infants/young children (6m-6yrs)

A

febrile seizures

30
Q

Tx of febrile seizures

A 
lower temp
rectal diazepam (>5min duration)
31
Q

Why do febrile seizures occur in young?

A

lower seizure threshold in infants places them at greater risk

32
Q

who gets breath holding spells

A

infants - 6y/o

33
Q

breath holding spells are associated with…

A

genetics
IDA

thought to be secondary to autonomic dysfunction

Autosomal dominant

34
Q

who gets vasovagal syncope

A

young and healthy

AKA “common faint”

35
Q

how long does vasovagal syncope last

A

1-2 minutes

36
Q

when does vasovagal syncope occur

A

sitting or standing

37
Q

cause of vasovagal syncope

A

neural reflex: hypotension due to bradycardia or peripheral vasodilation

type of reflex syncope

38
Q

vasovagal syncope classically due to…

A 
emotion
orthostatic
pain
fear
heat
physical activity
39
Q

atypical vasovagal syncope occurs when

A

in elderly

or recurrent in patients

40
Q

three characteristics to diagnose GBS

A
  1. progressive weakness
  2. worsening respiratory status
  3. significant bulbar weakness –> cranial nerves, dysphagia, slurred speech, difficulty handling secretions, dysphonia

ascending paralysis

41
Q

what is juvenile transient myasthenia gravis

A

rare form of MG, an autoimmune disorder of the neuromuscular junction resulting in ocular manifestations or weakness in the ocular, bulbar, limb or respiratory muscles

antibody mediated & target ACH receptors/proteins

T cell dependent

42
Q

symptoms of juvenile transient myasthenia gravis

A

progressive weakness

43
Q

treatment of juvenile transient myasthenia gravis

A

cholinesterase inhibitors for several weeks

44
Q

how do you diagnose juvenile transient myasthenia gravis

A

Ice pack test

serology: AChR-Ab

45
Q

what must you do when dealing with juvenile transient myasthenia gravis

A

rule out thymoma with a CT or MRI of chest

strong link of 30-40% have a thymoma and 30-40% will develop a thymoma

46
Q

Concussions can result in chronic traumatic encephalopathy. What is that?

A

permanent mood and behavior changes; often seen in repetitive injuries, boxers, football players, military

47
Q

imaging done with concussion

A

non-contrast CT

48
Q

ESPECIALLY GET A non-contrast CT if…

A
  • altered mental status
  • signs of skull fracture
  • severe injury mechanism (pedestrian/motorist and no helmet; fall >5ft; head struck by high-impact object)
49
Q

What causes tourettes

A

result from complex social + emotional factors multiple genetic affecting the meso-limbic circuit or cortico-striatal-thalamic-cortical circuit

50
Q

In order to have tourettes….

A

both parents must have had it

51
Q

Tourette disorder commonly affects…

A

males>females

52
Q

Tx tourettes wtih…

A

medication that treats both tics and ADHA: alpha adrenergic agonists: guanfacine or clondine

53
Q

What is cerebral palsy

A

a heterogenous group of conditions causing permanent, non-progressive motor dysfunction

Affects muscle tone, posture, movement, can cause intellectual disability, alterations in sensation and perception, seizures

54
Q

what causes cerebral palsy

A

some sort of abnormality or injury to the developing fetal or infantile brain

55
Q

PE characteristic of cerebral palsy

A

microcephaly

56
Q

Number 1 lab test for cerebral palsy

A

Tests for muscular abnormalities: elevated serum creatinine

57
Q

Huge defining characteristic of cerebral palsy

A

NON-progressive

58
Q

MC motor dysfunction in children

A

cerebral palsy

59
Q

what causes infantile botulism

A

by eating food contaminated with Clostridium Botulinum:

a Gram +, rod-shaped, spore forming anaerobe

60
Q

infantile botulism presentation

A

descending paralysis
dilated pupils
dry mouth

61
Q

infantile botulism pathogenesis

A
  • neurotoxin enters blood
  • releases out of blood into NMJ
  • binds motor nerve terminal and blocks synaptic fusion
  • blocks release of ACh or inhibits muscle contraction
  • causes muscle weakness/flaccid paralysis from upper to lower extremities
62
Q

what are Duchenne and becker muscular dystrophies

A

an inherited group of progressive myopathic disorders resulting from defects in a number of genes required for normal muscle function

63
Q

what is the primary symptom of Duchenne and becker muscular dystrophies

A

muscle weakness onset of 2-3y/o, sometimes later

Progressive weakness is the principal symptom as muscle fiber degeneration is the primary pathologic process

64
Q

what causes Duchenne and becker muscular dystrophies

A

mutations of dystrophin gene on the X chromosome

65
Q

common PE of DMD/BMD

A

gower sign: have to tripod to stand up

66
Q

Kernig sign

A

meningitis

knee flexion causes pain in neck

67
Q

meningitis agents in babies

A

E.coli (GNR)

GBS

68
Q

Tx of meningitis

A

dexamethasone and empric ABX (cephalosporins/vanco/penicillins)

69
Q

why give dexamethasone in meningitis

A

prevent hearing loss due to H. influenzae

70
Q

MC of encephalitis

A

HSV

CMV if immunocompromised

Neurology (12 decks)

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