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Clinical Disciplines II > Peds Neuro > Flashcards

Peds Neuro Flashcards

1
Q

Static symptom

A

-seen early and don’t change over time

Ex. cerebral palsy

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2
Q

Progressive symptom

A

degenerative disease or neoplasm

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3
Q

Intermittent symptom

A

epileptic or migraine syndromes

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4
Q

Saltatory symptom

A

bursts of symptoms followed by partial recovery

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5
Q

What should you be concerned for if the fontanelles remain bulging?

A

infection or increased ICP

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6
Q

Head circumference

A

Accelerating: possible hydrocephalus

Decelerating: possible degenerative neurologic disorder

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7
Q

What is the name for abnormal shape of the head due to premature suture closure?

A

craniosynostosis

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8
Q

Fontanelle closure

A

Posterior - 2 months
Anterior lateral - 3 months
Posterior lateral - 1 year
Anterior - 2 years

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9
Q

What can asymmetry indicate in the peds neuro exam?

A

focal brain or PNS lesion

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10
Q

When do most primitive reflexes disappear

A

4-6 months

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11
Q

Upper motor neuron lesion

A
  • Increased tone
  • Increased DTR
  • No fasciculations
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12
Q

Lower Motor neuron lesion

A
  • Decreased tone
  • Absent DTR
  • Muscle atrophy
  • Fasciculations
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13
Q

Motor neuron lesions

A

Lower - weakness

Upper - stiffness

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14
Q

Which headache pattern is the most concerning for kids?

A

Chronic progressive

-usually due to increased ICP

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15
Q

If a kid has chronic, non progressive headaches for more than 4 months what can be suspected?

A

psych factors

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16
Q

When do migraines become unilateral in childhood

A

unilateral after puberty

17
Q

Migraine headache : Acute tx

A

headache diary to help eliminate triggers (diet, menses, stress. Increase sleep exercise)

NSAIDS***
-nasal sumitriptan approved over 12 years

18
Q

Migraine headache: Prophylaxis Tx

A

<6: cyproheptadine

>6 propranolol

19
Q

Pseudotumor cerebri

A
  • 11 years and older
  • obesity is main risk factor**
  • Morbidity: vision loss** (call opthalmology)
20
Q

Cerebral Palsy

A

before, during or after birth - permanent but non-progressive brain damage

21
Q

Cerebral palsy delayed motor milestones

A
  • not sitting by 8 mo
  • Not walking by 18 month
  • early asymmetry of hand function (hand preference) before age 1
22
Q

What are the 4 major classifications of cerebral palsy

A
  1. Spastic
    -MC type**
    -features of UMN syndrome
    2 Athetoid/Dyskinetic
  2. Ataxic
  3. Atonic
23
Q

Neural tube disorder

A

Spina bifida is MC**

-Defective closure of neural tube in early gestation (about week 4)

24
Q

How do you screen for spina bifida before the baby is born?

A
  1. Alpha fetoprotein level in Mom’s serum

2. Ultrasound

25
Q

Chiari Malformation

A

parts of the brain herniate into the flow of the CSF blocking flow

(esp. the cerebellum)

26
Q

Chiari 2 (Arnold-Chiari Malformation)

A
  • herniation of the cerebellar tonsils
  • hydrocephalus
  • Myelomeningocele
27
Q

Chiari 4

A

Not compatible with life

28
Q

Almost all patients with myelomeningocele have what malformation?

A

Chiari II

and

Hydrocephalus

29
Q

You suspect the patient may have increased ICP, what sign would increase your suspicion further?

A

ocular nerve palsies

sunsetting eyes, can’t look upward

30
Q

What cells are affected in spinal muscular atrophy (LMN)?

A
  • anterior horn cells in spinal cord

- motor nuclei in the lower brainstem

31
Q

Spinal muscular atrophy

A
  • autosomal recessive (SMN1 gene)
  • Chromosome 5
  • 5 subtypes

Subtype 0 is prenatal SMA: severe weakness, hypotonia, and areflexia

32
Q

Spinal muscular atrophy: Dx

A
  • EMG
  • muscle biopsy
  • DNA testing (homozygous deletion of exon 7 of SMN1 to confirm diagnosis**)
33
Q

The majority of Guillain Barre Syndrome are caused by which bacteria

A

Campylobacter jejuni

GI or respiratory infections

34
Q

Guillain Barre

A

Ascending symmetric paralysis**

LP: Increased protein in CSF, no increased WBC

Tx: IVIG and plasmaphoresis

35
Q

Duchenne Muscular Dystrophy

A

-X-linked recessive
so, boys exhibit around age 3

  • proximal muscles affected before distal
  • Lower extremities before upper
  • Calf hypertrophy
  • Gower’s Sign**
36
Q

Duchenne Muscular Dystrophy

A

Dx:

  • Muscle biopsy
  • Myopathic EMG
  • Serum CK levels elevated
37
Q

Neurofibramatosis Type 1

A
  • cafe au lait spots
  • lisch nodules
  • optic tumor (glioma)
  • Neurofibromas
  • Freckles in Axilla
38
Q

Neurofibramatosis Type 2

A
  • Autosomal dominant
  • Bilateral vestibular schwannomas (CN VIII), uniquie to type 2

-No cafe au lait spots

Clinical Disciplines II (15 decks)

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