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Flashcards > Pediatrie- Probleme Neurologice > Flashcards

Pediatrie- Probleme Neurologice Flashcards

1
Q

Cand apar Convulsiile Febrile?

A

La copii intre 6 si 60 de luni asociate cu febra
Apar in absenta infectiei, leziuni SNC, anomalii metabolice sau istoric anterior de crize in afebrilitate

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2
Q

Tablou clinic convulsii febrile

A

Febra > 38 cu cresterea rapida a temperaturei
Crize tonico clonice < 15 min
istoric familial de convulsii febrile

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3
Q

Convulsii Simple

A

Convulsii generalizate tonico clonice
<15 min
nu > 1 ep in 24h
Revenire la normal dupa convulsie

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4
Q

Convulsii complexe

A

Crize focale
>15 min
multiple crize in 24h
status postcriza prelungit sau deficit focal

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5
Q

Cand ar trebui efectuata punctia lombara? ( convulsii)

A

In cazul suspiciunii de meningita
La copii <12 care nu sunt deplin imunizati

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6
Q

Este necesar EEG de rutina in convulsii?

A

nu, de obiciei este normal cu exceptia convulsiilor atipice

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7
Q

Tratament in convulsii

A

Stabilitate respiratorie, antipiretice
Tratarea cauzei subiacente
Convulsii atipice – investigatii suplimentare ( analize de sange EEG si RMN

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8
Q

Complicatii in convulsii

A

35% au convulsii febrile recurente
risc de epilepsie usor crescut
Convulsii complexe au o probabilitate de recurenta mai mare, apar pe perioade mai lungi de timp si au un risc crescut de epilepsie.

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9
Q

Hidrocefalia copilariei cauzata de obstructia …

A

ventriculului IV ( necomunicanta)
disfunctia cisternelor subarahnoidiene sau viililor arahnoidieni

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10
Q

Semne/simptome hidrocefalie

A

Cresterea excesiva a capului
Bombarea fontanelei
Vene scalp dilatate la sugari
Letargie
Varsaturi
Inapetenta
Iritabilitate
Cefalee
Diplopie
Edem Papilar
Fuziunea deficitara a suturilor craniene la copii mai mari

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11
Q

Laborator Hidrocefalie

A

Punctie lombara daca se suspecteaza infectie

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12
Q

Investigatii hidrocefalie

A

CT RMN si ecografie = ventricoli mariti in dimensiuni

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13
Q

Acetazolamida in ce se foloseste?

A

Tratament a hidrocefaliei impreuna cu furosemid

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14
Q

Majoritatea cazurilor de hidrocefalie necesita…

A

suntarea chirurgicală

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15
Q

Antipireticeke in convusii …

A

nu scad riscul de convulsii febrile

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16
Q

Complicatii hidrocefalie

A

Risc crescut de epilepsie
Risc crescut de infectie bacteriana de sunt
50% mortalitate inainte de varsta de 3 ani in lispa tratamentului

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17
Q

Boala Tay-Sachs

A

Autosomal recessiva
absenta hexozaminidaza A( neesara pentru metabolismul gangliozidelor lipidice)

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18
Q

Care sunt mai predispusi pt Boala Tay-Sachs

A

evreii Ashkenazi
canadieni francezi

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19
Q

Semne/simptome Boala Tay-Sachs

A

Dezvoltare deficitara
Atentie scazuta
Auz exacerbat
Pete rosii ciresii pe retina
Paralizii progresiva
Pierderea vederii
Modificari ale statului mental

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20
Q

Laborator Boala Tay-Sachs

A

Scaderea activitatii hexozaminidaza A
Confirmare dg ptin testare ADN

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21
Q

Tratament Boala Tay-Sachs

A

Suportiv

22
Q

Complicatii Boala Tay-Sachs

A

Moarte in primii ani de viata

23
Q

Defecte de tub neural: tipuri

A

Spina bifida oculta cel mai benign ( defect inchidere a arcurilor vertebrale dorsale)
Meningocel defect mai larg ( hernierea meningelui, masa moale)
Mielomeningocel defect sever ( hernierea meningelui si a maduvei spinariiprin defect)
Anencefalie - absenta creierului anterior, a meningelui, unei portiuni ale cutiei craniene ( deces in cateva zile)

24
Q

Simptome mielomeningocel

A

Deficite neurologice
Incontinenta a materiilor fecale si urinii
Paralizie flasca
Sensibilitate deficitara
Semne de neuron motor periferic
Hidrocefalie

25
Q

Factori de risc defect de tub neural

A

Anticonvulsivante
aport deficitar de folat
DZ

26
Q

Risc de sdr Reye

A

Administrarea Aspirina ( ASA)

27
Q

Malformatia Arnold chiari II si malformatia Dandy Walker

A

defecte anatomice craniu asociate cu hidrocefalia

28
Q

Laborator Defecr de tub neural

A

alfa fetoproteina
acetilcolinesteraza

29
Q

Imagistica defect de tub neural

A

US in timpul sarcinii poate detecta defectele

30
Q

Tratament defect tub neural

A

Interventie chirurgicala in toate cu exceptia celor usoare
Suntare - meningocel si mielomeningocel
Femeile sa primeasca folat

31
Q

Complicatii defect tub neural

A

Risc crescut de ITU si infectii SNC
Hidrocefalie ( cazuri severe)

32
Q

Paralizia cerebrala spastica

A

cauzata de deteriorarea tractului piramidal
pareza spastica mai multe membre

33
Q

PC diskinetica

A

Apare in patologia extrapiramidala
miscari coreoatetozice,distonice, ataxice

34
Q

Paralizia cerebrala ( PC)

A

tulb functionare neuron motor – injurii snc
Majoritatea rezulta din complicatii perinatale

35
Q

Factori de risc PC

A

Prematuritatea
Retardul de crestere intrauterin
Traumatismele la nastere
Convulsii neonatale
Hemoragie cerebrala
Asfixia perinatala
Nasteri multiple
Infectii intrauterine

36
Q

Semne/simptome PC spastica

A

Tonus crescut
ROT crescute
Slabiciune
Mers anormal
Dizabilitate intelectuala
Hiperactivitate
convulsii
contracturi membre

37
Q

Simptome/Semne PC diskinetica

A

Agravate la stress – dizartria
Hiperactivitate
convulsii
contracturi membre

38
Q

Imagistica PC

A

utila in detectarea leziunilor cauzatoare

39
Q

Tratament PC

A

Terapie farmacologica- toxina botulinica, dantronele, baclofen, benzodiazepine
Fizioterapia
Tonifierea
interventia chirurgicala pt ameliorarea simptomelor si functionala

40
Q

Retinoblastomul

A

Tumora maligna a retinei la copii

41
Q

Care este cea mai frecventa tumora intraoculara la copii?

A

Retinoblastomul

42
Q

Ce creste riscul de tumora la ambii ochi?

A

Cand este afectare genetica

43
Q

Semne/Simptome Retinoblastom

A

Ex oftalmologica - reflexe slabe rosii luminoase la ochiul afectat ( leucocorie)
sau mase retiniene albe

44
Q

Laborator Retinoblastom

A

Mutatie gena RB1

45
Q

Imagistica Retinoblastom

A

US sau CT- marimea si extinderea tumorii
identificarea unei mase calcificate pe CT

46
Q

Tratament Retinoblastom

A

Enucleerea- tumori mari fara potential vizual
Radioterapia - tumori bilaterale, tumori adiacente n optic
Crioterapia sau Fotocoagularea laser- tumori mici
Chimioterapia - metastaze sau salvarea vederii

47
Q

Complicatii Retinoblastom

A

Prognostic bun in lipsa metastazelor
Daca tumora este adiacenta corneei - risc mare de pierdere a vederii

48
Q

Botulism infantil

A

Blocada presinaptica C botulinum
praf sau miere neprocesata

49
Q

Semne si simptome Botulism

A

Constipatie
Plans slab
Alimentatie deficitara
Hipotonie
Reflex de inghitire slab
Letargie
Dificultati de respirație

50
Q

Laborator Botulism

A

Ex scaun
Electromiograma

51
Q

Tratament Botulism

A

Protejarea cailor aeriene, suport respirator
Imunoglobulina botulinica iv

52
Q

Complicatii Botulism

A

Insuf respiratorie deces

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