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NP > Peds - Neuro > Flashcards

Peds - Neuro Flashcards

1
Q

Mechanisms of headache pain (4)

A

o VASCULAR dilation - migraine, fever
o MUSCULAR contraction - tension
o TRACTION - space-occupying lesion - tumor, hematoma, ICP
o INFLAMMATION - infection

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2
Q

OLD CARTS

A 
Onset
Location
Duration
Characteristics
Aggravating
Relieving
Treatment
Severity
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3
Q

Diagnostic testing for headache with fever

when meningitis is suspected

A

Lumbar puncture –> CSF analysis

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4
Q

CSF findings in meningitis (4)

A

o cloudy
o WBCs present
o increased protein – bacteria are protein
o decreased glucose – bacteria eat sugar

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5
Q

Differential for headache which is worst in the morning followed by vomiting, usually increasing in frequency.

A

brain tumor

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6
Q

Caution when considering lumbar puncture.

A

Do not perform if any suspicion of ICP. May cause brain herniation. :-(

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7
Q

Which type of migraine has an aura?

A

classic

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8
Q

Which type of migraine has NO aura?

A

common

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9
Q

Is migraine unilateral or bilateral?

A

unilateral and localized

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10
Q

What age does classic (w/ aura) migraine usually occur?

A

> 10 years old

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11
Q

When should prophylactic therapy be used for migraine?

A

when occurring more than 3-4 times per month or are interfering with work or school

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12
Q

Typical age range for bacterial meningitis?

A

1 month to 5 years

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13
Q

Typical age range for brain tumor in children?

A

4 to 11 years

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14
Q

Typical location for brain tumor in children?

A

infratentorial, brain stem tumors

lots of space to grow undetected

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15
Q

Migraine baseline studies

4 bw + 1 imaging

A 
For exclusion of other causes --
CMP - complete metabolic panel
CBC - complete blood count (r/o anemia)
VDRL - venereal disease research (r/o syphilis)
ESR - erythrocyte sedimentation rate
CT - cat scan
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16
Q

Agents used for prophylaxis of migraine (5)

A 
o  NSAIDS - chronic low dose
o  propanalol (Inderal) -- beta blocker
o  amatriptyline (Elavil) -- antidepressant
o  imipramine (Tofranil) -- antidepressant
o  topiramate (Topamax) -- antiepileptic
o  verapamil (Calan) -- calcium channel blocker
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17
Q

Management of acute migraine

A

o NSAIDS

o -triptans

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18
Q

These drugs are examples of what class?

Imitrex
Maxalt
Axert
Zomig

A

TRIPTANS

almotriptan
rizatriptan
sumatriptan
zolmitriptan

19
Q

Caution for use of triptans?

A

avoid in children at risk for HEART DISEASE because they can cause heart block

20
Q

A transient disturbance of cerebral function due to abnormal paroxysmal neuronal discharge in the brain.

A

Seizure disorder

21
Q

Which type of seizure occurs in only one hemisphere?

A

partial seizures

22
Q

Variant syndromes of migraine in children usually involve what?

A

The abdomen - nausea, vomiting

23
Q

Which triptan is limited to those age 12 and up?

A

almotriptan (Axert)

24
Q

Which triptan is available as a nasal spray?

A

zolmitriptan (Zomig)

25
Q

When should triptans be taken?

A

At the first sign of headache

26
Q

What are the two overarching categories of seizures?

A

Partial

Generalized

27
Q

What are the two types of partial seizures?

A

simple partial

complex partial

28
Q

Which type of partial seizure involves the loss of consciousness?

A

complex partial

29
Q

What are the four types of generalized seizures?

A

Absence
Tonic
Tonic-clonic
Atonic

30
Q

Which category of seizures involves both hemispheres of the brain?

A

generalized seizures

31
Q

What are some potential causes of seizures? (6)

A 
o  congenital
o  metabolic
o  trauma
o  tumor
o  infectious
o  fever
32
Q

What are some symptoms of a simple partial seizure?

A

motor
autonomic
sensory

** NO loss of consciousness **

33
Q

Which seizure exhibits a sudden increase in muscle tone producing a number of characteristic postures?

A

Tonic

34
Q

Is consciousness lost during a TONIC seizure?

A

It may or may not be

35
Q

Which seizure is characterized by a sudden loss of consciousness, arrested respirations, and increased muscle tone followed by bilateral rhythmic jerks?

A

Tonic-clonic

36
Q

Which type of seizure is characterized by sudden loss of muscle tone, often resulting in head drop or fall to the ground?

A

Atonic

37
Q

What drug class is used to stop convulsive seizures?

A

benzodiazepines

o  lorazepam (Ativan)
o  diazepam (Valium)
38
Q

Peak incidence of febrile seizure?

A

1 to 3 years

39
Q

When is an-illness related seizure more likely due to infection than fever?

A

> 24 hours after the onset of the fever

40
Q

A progressive, autosomal dominant, neuro-cutaneous syndrome characterized by numerous cafe au lait spots and nerve tumors

A

Neurofibromatosis / von recklinghausen disease

41
Q

Neuro-fibromatosis –

Typical signs and symptoms (6)

A 
o  multiple cafe au lait spots
o  seizures
o  neurofibromatomas
o  axillary or inguinal freckling
o  lisch nodules
o  distinctive osseous lesions
42
Q

Medications which may be associated with tics. (3)

A

o methylphenidate
o pemoline
o amphetamines

43
Q

Distinction of complex from simple motor tics

A

complex include VOCAL tics

44
Q

The most common type of headache with onset in adolescence is:

A

tension

NP (76 decks)

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