Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHA 581 > Peds: Neurology > Flashcards

Peds: Neurology Flashcards

1
Q

Evolution of Symptoms

A

static
progressive
intermittent
saltatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Evolution of Symptoms: static

A

seen in first few months
does not change over time

congenital abnormalities/brain injury (CP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Evolution of Symptoms: progressive

A

degenerative disease/neoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Evolution of Symptoms: intermittent

A

epileptic/migraine syndromes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Evolution of Symptoms: saltatory

A

bursts of sx followed by partial recovery

vascular, demyelinating d/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Midline defects (tufts of hair, lipomas, dimpling) may indicate…

A

spina bifida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Head Circumference: accelerating pattern

A

possible hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Head Circumference: decelerating pattern

A

possible degenerative neurologic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Head Circumference: abnormal shape

A

craniosynostosis (premature suture closure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lower Motor Neuron Lesion

A 
FLACCID PARALYSIS
dec tone
ABSENT DTRs
profound muscle atrophy
FASICULATIONS PRESENT
sensory disturbances

strength: weakness
tone: dec passive tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Upper Motor Neuron Lesion

A 
SPASTIC PARALYSIS
inc tone
INC DTRs/+ babinski; w/ clonus
minimal muscle atrophy
FASICULATIONS ABSENT
sensory disturbances

strength: stiffness
tone: inc passive tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Babinski Reflex:

  • neonate response
  • older children response
A

variable

toes down is normal after 18mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Headaches: MCC

A

URI (strep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Headache Pattern: acute

A

single episode w/out prior hx

usually due to febrile illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Headache Pattern: acute recurrent

A

pattern of episodes separated by pain free intervals

migraine, tension HA pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Headache Pattern: chronic progressive

A

MOST CONCERNING PATTERN

inc ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Headache Pattern: chronic nonprogressive/daily

A

> 4mo or >15/mo

possible psych factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Headaches: worrisome symptoms

A
  • Most severe on awakening, awaken in middle of night
  • Severely exacerbated by coughing or bending
  • Acute onset without previous history
  • Present daily with progressive worsening
  • Accompanied with vomiting
  • Focal neurologic signs
  • Aggravated by Valsalva-like maneuvers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Headaches: when is imaging indicated

A

abnormal neurologic exam

concern for space occupying lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Headaches: if worse when lying flat, think …

A

inc ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Migraine:

  • onset of sx
  • what is it
A

begins in childhood

periodic HA w/ vomiting and relieved by rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Migraine: pediatric symptoms

A

frontal, bitemporal, unilateral pouding/throbbing for 2-72hrs
relieved by sleep
visual aura 15-30min prior
N/V, abd pain, phono/photophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Migraine: management

  • step one
  • acute tx
  • prophylaxis
A

eliminate triggers (diet, menses, stress)

inc exercise, adequate sleep

acute tx: NSAIDs, APAP, triptans (>12yo), antiemetics

prophylaxis:
<6: cyproheptadine
>6: propanolol, amitriptyline, topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pseudotumor Cerebri:

  • aka
  • what is it
  • MC population
A

idiopathic intracranial hypertension

inc ICP WITHOUT space occupying lesion/obstruction

females of child bearing age (peds: adolescents 11+yo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pseudotumor Cerebri: presentation

A 
HA (worse at night, aggravated by sudden mvmt)
blurred vision
diplopia
vision loss
PAPILLEDEMA

neck stiffness, tinnitus, dizziness, paresthesias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pseudotumor Cerebri: diagnosis

A

r/o other causes of inc ICP

MR –> LP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Pseudotumor Cerebri: management

A

LP (may resolve sx)
medication (acetazolamide, topiramate)
surgery (optic nerve sheath fenestration, CSF shunt)
dec salt intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Cerebral Palsy:

  • what is it
  • comorbidities
A
  • non progressive clinical syndrome w/ motor and postural dysfunction
  • results from brain injury/malformation (before, during, after birth)

intellectual disability, epilepsy, behavioral d/o, sleep d/o, blindness, deafness, bladder control d/o

**higher incidence in preterm infants

29
Q

Cerebral Palsy: 4 major classifications

A

spastic
athetoid/dyskinetic
ataxic
atonic

30
Q

Cerebral Palsy: spastic

A

MC

UMN lesion/sx

31
Q

Cerebral Palsy: athetoid/dyskinetic

A

athetoid:
slow, smooth writhing mvmt involving distal muscles

dyskinetic:
dec spontaneous mvmt hypotonia
suppressed primitive reflexes

32
Q

Cerebral Palsy: ataxic

A

rarest
wide based gait
intention tremor
slow jerking mvmts

33
Q

Cerebral Palsy: atonic

A

sev hypotonia
never stand/walk
may have cerebral dysgenesis, microcephaly, profound intellectual disability

34
Q

Cerebral Palsy:

  • treatment goals
  • approach
A 
Social and emotional development
Communication
Education
Nutrition
Mobility
Maximal independence in activities of daily living

multidisciplinary approach (PT, OT, ST, etc)

35
Q

Spina Bifida: what is it

A

neural tube disorder associated w/ folic acid

defective closure of caudal neural tube in early gestation (wk4)

36
Q

Spina Bifida: Myelomeningocele

A

meninges and spinal cord exposed
total paralysis
loss of bowel/bladder control
w/ chiari II malformation

37
Q

Spina Bifida: Meningocele

A

spinal canal and meninges exposed

underlying spinal cord intact

38
Q

Spina Bifida: Spina Bifida Occulta

A

MC
skin intact but underlying defects in bone, spinal canal
sinus tract, dimply, tuft of hair
neuro deficits

39
Q

Spina Bifida: prevention

A

folic acid supplementation

40
Q

Spina Bifida: diagnosis

A

routine screening w/

  • AFP (16-18wks)
  • US (12-14wks, 18-20wks)
41
Q

Spina Bifida: management

A

surgical closure
VP shunt
adjunct supportive therapy

42
Q

What is the relationship between Chiari II, Myelomeningocele & Hydrocephalus?

A

Almost all patients with a myelomeningocele have the Chiari II malformation, and most have associated hydrocephalus

43
Q

Hydrocephalus:

  • what is it
  • etiology
A

slowly evolving accumulation of CSF (wks-mos)

congenital or acquired

44
Q

Hydrocephalus: presentation

A

HA, vomiting, AMS, visual changes, ocular nerve palsies, focal neurologic findings

infants: nonspecific
vomiting, lethargy, irritability, bulging fontanelle, poor feeding

bradycardia
HTN
altered respiration

inc head circumference
bulging anterior fontanelle
abnormal skull contour
CN dysfunction
papilledema
45
Q

What is a classic sign of hydrocephalus?

A

looking down (EOM/eyes displaced by pressure)

46
Q

Hydrocephalus: treatment

A

temp, sx relief:

  • loop diuretic
  • acetazolamide

surgery (remove obstruction, VP shunt)

47
Q

Spinal Muscular Atrophy: what is it

A

homozygous deletion of exon 7 of SMN1 (autosomal recessive)

progressive degeneration of ant horn cells –> progressive weakness of LMN

48
Q

Spinal Muscular Atrophy: presentation

A

progressive proximal weakness
dec spontaneous mvmt
floppiness

loss of head control
loss of leg mvmt

dec facial expression and drooling

normal mental, social, language skills
sensation preserved

49
Q

Spinal Muscular Atrophy: diagnosis

A

EMG
muscle biopsy
DNA testing

50
Q

Spinal Muscular Atrophy: management

A

no treatment

symptomatic therapy

51
Q

Guillain Barre Syndrome:

  • aka
  • what is it
A

acute idiopathic polyneuritis

acute immune mediated polyneuropathy

52
Q

Guillain Barre Syndrome: presentation

A

acute paralyzing illness provoked by preceding infx

ASCENDING SYMMETRIC WEAKNESS
sensory sx
early loss of DTRs
autonomic nerve dysfunction

peds: REFUSAL TO WALK, LEG PAIN

53
Q

Guillain Barre Syndrome: etiology

A

post infectious (resp or GI infx – MC: campylobacter jejuni)

54
Q

Guillain Barre Syndrome: diagnosis

A

LP (inc CSF protein w/o inc WBC)

EMG

55
Q

Guillain Barre Syndrome: treatment

A

IVIG

plasmapheresis

56
Q

Duchenne Muscular Dystrophy: what is it

A

x linked recessive (boys)

absence of dystrophin protein

57
Q

Duchenne Muscular Dystrophy: presentation

A 
onset: 3yo
awkward gait
slower dev of milestones
mild cognitive dev
global dev delay

calf hypertrophy (toe walking)
proximal leg/pelvic weakness
GOWER’S SIGN

prox –> distal
lower –> upper

58
Q

Duchenne Muscular Dystrophy: diagnosis

A

muscle bx
EMG
serum CK (elevated)
genetic testing

59
Q

Duchenne Muscular Dystrophy: treatment

A

glucocorticoids
supportive
close pulm and cardio follow up

**risk of cardio pulm failure in 2nd-3rd decade of life

60
Q

Duchenne Muscular Dystrophy: prognosis

A

wheelchair bound by 12yo
loss of UE mvmt by 16yo
death by PNA/CHF in early 20s
avg lifespan: 25yrs

61
Q

Neurofibromatosis: what is it

A

genetic disorder in which nerve tissue grows tumors –> nerve/brain damage

62
Q

Neurofibromatosis: types

A

type 1:
chromosome 17
peripheral
skin, brain abn

type 2:
chromosome 22
central
spinal cord abn
more sev
incurable
63
Q

Neurofibromatosis Type 1: presentation

A

CAFE AU LAIT SPOTS
neurofibroma (late adolescence)
CNS tumors (astrocytomas, meningiomas, schwannomas)
cognitive impairment

64
Q

Neurofibromatosis Type 1: treatment

A

surgical excision of tumors

genetic counseling and screening (50% risk to sibs)

65
Q

Neurofibromatosis Type 1: complications

A 
seizures
deafness
short stature
early puberty
HTN
optic glioma
66
Q

Neurofibromatosis Type 2: presentation

A

B vestibular schwannomas (CNVIII tumors)

childhood loss of hearing

meningiomas, CN schwannomas, ependymomas

67
Q

Febrile Seizure: what is it

A

age dependent phenomenon
(6mo-5yr)

generalized seizure <15min
doesn’t recur during 24hr period

associated w/:
viral infx
high fever

68
Q

What is the MC neurologic disorder of infants and young children?

A

febrile seizures

69
Q

Febrile Seizure:

  • diagnosis
  • treatment
A

clinical diagnosis

IV benzos/buccal midazolam (if >5min)

PHA 581 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions