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MJ- Peds Block 1 > Peds Neuro > Flashcards

Peds Neuro Flashcards

1
Q

LMN or UMN?

  • Flaccid paralysis
  • Decreased tone
  • Absent DTR
  • Fasciculations
  • Atrophy
A

LMN

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2
Q

LMN or UMN?

  • Spastic paralysis
  • Increased tone/DTRs
  • Minimal atrophy
  • Stiffness
A

UMN

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3
Q

Prophylaxis for migraine headaches <6 y/o

A

Cyproheptadine

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4
Q

Prophylaxis for Migraine headaches >6y/o

A

Propanolol

Topiramate

Amitryptiline

Etc

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5
Q
  • HA, blurred vision
  • Diplopia, vision loss
  • worse at night
  • PE- Papilledema
A

Pseudotumor cerebri

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6
Q

Main complication of Pseudotumor cerebri?

A

Vision loss

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7
Q

How do you tx Pseudotumor cerebri? (3 pharm, 2 sx)

A
  • Pharm:
    • Decrease Na intake
    • Acetazolamide
    • Topiramate
  • Sx:
    • Optic nn. sheath fenestration
    • CSF shunt
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8
Q

Who is Pseudotumor cerebri MC in?

A

Females of childbearing age (usually 11+)

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9
Q

Which type of CP?

  • MC type
  • UMN lesion/sxs
A

Spastic

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10
Q

What are the 4 types of CP

A
  1. Spastic (MC)
  2. Athetoid/Dyskinetic
  3. Ataxic (most rare)
  4. Atonic
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11
Q

Which type of CP?

  • Slow, smooth, writhing movements that involve distal muscles
A

Athetoid

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12
Q

WHich type of CP?

  • Decreased spontaneous movement
  • Hypotonia
  • Suppressed primitive reflexes
A

Dsykinetic CP

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13
Q

Which type of CP?

  • Wide-based gait
  • intention tremor
  • slow
  • jerking movments
A

Ataxic CP (most rare)

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14
Q

Which type of CP?

  • Severe hypotonia
  • Never stand or walk
  • Microcephaly
  • Profound intellectual disability
A

Atonic CP

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15
Q

What is a myelomeningocele

A
  • This is a type of spina bifida
  • Meninges and spinal cord exposed
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16
Q

What is a meningocele

A

Spinal canal and meninges exposed

Underlying spinal cord intact

Type of spina bifida

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17
Q

What does a dimple or tuft of hair indicate?

A

Spina bifida Occulta

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18
Q

How do you manage Spina Bifida? (2)

A

Surgical closure

VP shunt

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19
Q

Almost all patients with a myelomeningocele (type of spina bifida) also have what type of formation?

Most also have associated what?

A

Chiari II malformation (cerebellum herniates)

Associated hydrocephalus

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20
Q

What is seen on vitals in a patient with Hydrocephalus? (3)

A
  1. Bradycardia
  2. HTN
  3. Altered respiration
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21
Q

What 5 things are seen on PE in a pt with Hydrocephalus

A

1. Increased head circumference

2. Bulging anterior fontanelle

  1. Abnormal skull contour
  2. CN dysfunction
  3. Papilledema
22
Q

How do you tx hydrocephalus? (2 for sxs, 2 surgical interventions)

A
  1. sxs- Loop diuretic, Acetazolamide
  2. Sx: VP shunt, remove obstructive lesion
23
Q

What confirms dx of spinal muscular atrophy? (related to genes)

A

Homozygous deletion of exon 7 of SMN1

24
Q

What is spinal muscular atrophy? How is it inherited

A

Progressive weakness of LMNs

Autosomal recessive

25
Q
  • Decreased spont. movement
  • floppiness
  • Decreased facial expression
  • Drooling
A

Spinal muscular atrophy

26
Q

When does spinal muscular atrophy begin?

27
Q

What 3 tests are done to dx spinal muscular atrophy?

A
  1. EMG
  2. Muscle bx
  3. DNA testing
28
Q

How do you tx spinal muscular atrophy?

A

No tx-

symptom therapy (improve flexibilty, prevent infections, maintain language/intellectual stimulation)

29
Q

What causes Guillain Barre Syndrome?

A

Campylobacter Jejuni

30
Q

Hallmarks of what condition?

  • Ascending weakness
  • Loss DTRs
  • No walking/leg pain
31
Q

How do you dx GBS? (2)

A
  • LP w/ increased CSF protein WITHOUT increase in WBC
  • EMG
32
Q

What is death due to in GBS?

A

from autonomic dysfunction, respiratory failure

33
Q

How do you tx GBS? (2)

A

IVIG

Plasmapheresis

34
Q

How is Duchenne Muscular Dystrophy inherited?

A

X-linked recessive- only boys

35
Q

What protein is missing in Duchenne Muscular Dystrophy>

A

No dystrophin protein

36
Q

Gower sign

Calf hypertrophy

Waddling gait

A

Duchenne Muscular Dystrophy

37
Q

HOw do you dx Duchenne Muscular Dystrophy? (4)

A
  1. Muscle Biopsy
  2. EMG
  3. Serum CK (10-20x higher than normal)
  4. Genetic testing
38
Q

How do you tx Duchenne Muscular dystrophy?

A
  • Glucocorticoids (extend independent ambulation by 2.5yrs)- started b/w 4-8y/o
  • Supportive
39
Q

Pts with Duchenne Muscular Dystrophy are usually wheelchair bound by what age?

40
Q

How do pts w/ Duchenne Muscular dystrophy die and at what age? What is the avg lifespan?

A

Death due to PNA or CHF in early 20s

Avg lifespan=25 yrs

41
Q

Duchenne Muscular Dystrophy- Loss of UE movement by what age

42
Q

Type 1 Neurofibromatosis assoc. w/ what chrom

43
Q

Type 2 Neurofibromatosis assoc. w/ what chrom

44
Q

Neurofibromatosis type 1 or 2?

  • Skin and brain abnormalities= ____
  • More severe, spinal cord abnromalities, intracranial and spinal tumors=____
A
  • Skin and brain abnormalities= type 1
  • More severe, spinal cord abnromalities, intracranial and spinal tumors=type 2
45
Q

Neurofibromatosis type 1 or 2?

  • Cafe-au-lait spots
  • Neurofibromas
  • Seizures
  • macrocephaly
    *
46
Q

Neurofibromatosis type 1 has increased incidence of what?

A

CNS tumors- astrocytoma, meningioma, schwannoma, etc

47
Q

How do you tx Neurofibromatosis type 1

A

Surgical excision of tumors

Genetic screening for fam

48
Q

What are 6 complications of Neurofibromatosis type 1

A
  1. Seizures
  2. Deafness
  3. Short stature
  4. Early puberty
  5. HTN
  6. Optic Glioma
49
Q

Neurofibromatosis type 1 or 2?

  • Autosomal dominant
  • Vastibular Schwannoma
  • NO Cafe-au-lait spots
  • May present as loss of hearing in kids
A

Neurofibromatosis type 2

50
Q

Febrile seizures are seen at what age?

51
Q

How do you tx Febrile sz if lasting longer than 5 min

A

IV benzos or Buccal Midazolam if no IV access

MJ- Peds Block 1 (7 decks)

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