Peds Head Injuries and Neuro

Question 1

Crescent shape on CT is what type of injury?

Answer 1

Subdural hematoma

Question 2

Subdural Hematoma results from tearing of what?

Answer 2

(U) VeinsArteries are possible as well

Question 3

Subdural Hematoma results in separation of what?

Answer 3

Arachnoid from dura

Question 4

Subdural Hematoma prognosis?

Answer 4

Poor

Question 5

Elliptical shape on CT is what type of injury?

Answer 5

Epidural hematoma

Question 6

Epidural hematoma results from tearing of what?

Answer 6

Arteries

Question 7

Epidural hematoma is bleeding into what space?

Answer 7

b/w dura and skull

Question 8

Epidural hematoma prognosis depends on what?

Answer 8

Mass effect, pushing against brain as the dura pulls away from skull

Question 9

Injury to temporal or occipital region most commonly results in what kind of bleed?

Answer 9

Epidural hematoma

Question 10

Slivers on CT is what type of injury?

Answer 10

Subarachnoid hematoma

Question 11

Blood in CSF is indicative of what injury?

Answer 11

Subarachnoid hematoma

Question 12

Concussion is?

Answer 12

Trauma-caused alteration in mental status, with or without LOC

Question 13

Concussions mechanism of injury in the brain?

Answer 13

Shearing of axons

Question 14

Seizure is?

Answer 14

Hyperdischarge of brain neurons causing involuntary behavior, motor, sensation

Question 15

Epilepsy is?

Answer 15

2+ unprovoked seizures

Question 16

Seizures can be provoked by?

Answer 16

Fever
Head trauma
Illness
Metabolic imbalance
Ingested toxin

Question 17

Seizure classes?

Answer 17

Generalized: tonic-clonic affecting entire body

Focal: from specific area of cortex, +/- spread to entire brain

Question 18

Seizure DDX?

Answer 18

Syncope (can have tonic-clonic)
Breath-holding
Tourette syndrome

Question 19

Seizure tx:  Tonic-Clonic
Absence
Partial
Neonate
Acute treatment

Answer 19

Valproic Acid (Depakote)
Ethosuximide
Carbamazepine
Phenobarbital
BZs

Question 20

Bacterial Meningitis mechanism?

Answer 20

Replication in subarachnoid space

Question 21

Bacterial Meningitis seen mostly in what population?

Answer 21

<6mo due to MMR, Hib and pneumo vaccines at 6mo

Question 22

Bacterial Meningitis most C cause <2mo?

Answer 22

E coli or Klebsiella

Question 23

Bacterial Meningitis most C cause 2-6mo?

Answer 23

S pneumo

Question 24

Bacterial Meningitis most C cause 6mo-1yr?

Answer 24

Neisseria

then S pneumo

Question 25

Bacterial Meningitis general presentation?

Answer 25

1) Insidious onset of fever and nonspecific sxs | 2) Rapid (1-2hr) onset of fever and mental status changes

Question 26

Bacterial Meningitis specific signs?

Answer 26

``` FEVER Neck pain/rigidity HA/Photophobia Mental status changes (P) Focal neuro deficits ```

Question 27

Bacterial Meningitis dx?

Answer 27

``` Lumbar puncture U = Leukocytosis Low Glucose High protein + culture ```

Question 28

Bacterial Meningitis tx: 2mo?

Answer 28

Ampicillin + Cefotax + aminogly Dexamethasone + Cefotax

Question 29

Bacterial Meningitis specialized PE tests?

Answer 29

Kernig's: straightened leg = back pain and neck flex Brudzinski's: passive neck flex = involuntary leg bending

Question 30

Bacterial Meningitis sequela?

Answer 30

Deafness | Congnitive deficits

Question 31

Viral (Aseptic) Meningitis most C cause?

Answer 31

Enterovirus

Question 32

Viral Meningitis epidemiology?

Answer 32

U < 1 yo | Summer/Winter

Question 33

Viral Meningitis presentation?

Answer 33

U fever, ST -->> | Severe HA

Question 34

Viral Meningitis dx?

Answer 34

``` Lumbar puncture = Leukopenia Neutrocytosis early Lymphocytosis later Glu and Protein N ```

Question 35

Cerebral Palsy is? Timing?

Answer 35

Brain damage affecting mm movement Before, during or after birth up to 3 yo

Question 36

Cerebral Palsy presentation?

Answer 36

Stiff or floppy Asymmetric tone/movements Miss milestones

Question 37

Cerebral Palsy Spastic Type?

Answer 37

Most C Pyramidal tract lesions Hypertone/stiffness Hyperreflex, clonus

Question 38

Cerebral Palsy Dyskinetic Type?

Answer 38

Extrapyramidal | Involuntary mvmt

Question 39

Cerebral Palsy Ataxic Type?

Answer 39

Tremors | Lost coordination

Question 40

Cerebral Palsy DDX?

Answer 40

Degenerative dis Metabolic dis Neuromuscular dis CA of brain or cord