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Pediatrics > Psych And Neuro > Flashcards

Psych And Neuro Flashcards

1
Q

Sudden loss of consciousness followed by disorientation then slow gain of consciousness and hemipelgia.

A

Todds paralysis. Posticital paralysis after seizure.

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2
Q

Pt has spots on back and spots in eyes. Dx? What is patient prone to developing?

A

Neurofibromastosis. Cafe au lait spots and lisch nodules. Prone to developing tumors.

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3
Q

Average duration of this seizure 10-20 seconds. Consciousness is not altered. Movements characterized by asynchronous clonic or tonic movements. Pts complain of preictal aura. Have 2 of these can be what? Dx?

A

Partial (Focal Seziure). Having more than one can be complex partial seizure.

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4
Q

LOC + automatism. What kind of seizure?

A

Complex partial seizure

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5
Q

No LOC + aura

A

Simple partial seizure

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6
Q

Presence of aura is common in what type of seizure?

A

partial seizure. localized part of the brain ie smell olfactory nerve.

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7
Q

This seizure is associated with sudden cessation of motor activity and speech, common in girls, does not occur before age 5, no post ictal state, pts can experience this daily. Dx? Trx?

A

Absence Seizures. Valproate or Ethuxsuomide

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8
Q

Patients suddenly lose consciousness, their eyes roll back and their entire musculature undergoes tonic contractions, arresting breathing. There is hyperextension gives way to a series of rapid jerks. There is a period of flaccid relaxation. Prodromal symptoms occur and not auras. Dx?

A

Generalized Tonic Clonic Seizures.

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9
Q

Most common seizure in childhood. It is a brieft tonic-clonic seizure associated with fever. No longterm sequelae. Dx?

A

Simple Febrile Seizure.

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10
Q

These begin age 4 and 8 months and present as short lived symmetric contractions of neck, trunk and extremities. Name the 2 types. What are the differences? Rx?

A

Infantile spasms. Symptomatic Type of infantile spasm associated with CNS malformation (tuberous sclerosis, brain injury, inborn errors of metabolism)
Cryptogenic type better prognosis - birth hx is uneventful. Rx: ACTH

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11
Q

Neurodegenerative disorder that occurs in females and is lethal in males. (xlinked recessive) Pts experience language and motor regression. Dx?

A

Rett Syndrome

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12
Q

Facial nevus, seizure, hemiparesis, intracrainal calcifications. Dx?

A

Struge-Weber Syndrome.

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13
Q

Continuous seizure of greater than 30 min. First step? Rx?

A

Status Epilepticus. ABCs. IV, labs, Give lorazepam if seizure last greater than 5 min.

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14
Q

In children less than 3 years what is the most likely etiology of status epilepticus?

A

Fever/Febrile Seizures.

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15
Q

Infantile Spasm, Ashe leaf macule, shagreen patch, sebaceous adenoma, generalized seizures. Dx? Complications (3)

A

Tuberous sclerosis. Rhabdomyoma of the heart, retinal lesion, Polycystic or Harmatomas of the kidneys.

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16
Q

3 yo boy presents with clumsiness, difficulty climbing stairs, falls. Hypertrophy of the calves noted. Dx? Test? 3 Complications? Rx?

A

Duchenne (xlined disorder). Genetic Studies (inital diagnostic) confirm with biopsy, CPKs will be elevated. Scoliosis (due to being wheelchair bound) Cardiomyopathy, LOW IQ. Give digoxin to prevent heart failure. Chest Physiotherapy to prevent pneumonia and respiratory failure.

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17
Q

Baby presents with poor sucking and swallowing since birth. Floppy baby with poor head control. Associated ocular ptosis and weak muscles on repeted use. Dx? Test? Rx?

A

Myasthenia Gravis. EMG more diagnostic than muscle biopsy. Rx: Cholinesterase inhibiting drug. Neostigmine Bromide or Pyridostigmine.

18
Q

Cherry red macular which inborn error of metabolism?

A

Tay-Sachs diseaes.

19
Q

Ataxia before 10 years of age with dysathric speech and hypertrophic cardiomyopathy. Dx?

A

Freidrich Ataxia.

20
Q

Rx for Transverse myelitis.

A

Steroids and IVIG. Emergency. Can be caused by acute focal infectious or immune mediated illness causing swelling of the spinal cord.

21
Q

Rx for tetnus.

A

Rapid administration of Human tetnus immune globulin

22
Q

Test and Rx for Brain Aneursyms?

A

Angiography. Clipp and Coil

23
Q

These appear has lens shaped (convex) on CT 2/2 to trauma.

A

Epidural Hematoma.

24
Q

These appear concave on CT 2/2 to trauma.

A

Subdural Hematoma.

25
Q

Accelerated enlargement of the head. > 2 SD above the mean. Dx? 2 types and etiology? Test? Rx?

A

Hydrocephaus. Noncommunicating - hematoma or turmor- complete obstruction. Communicating (meningitis or intravascular hemorrahge. -exudate block the cisterns) CT/MRI. Acetazolamide Shunt, Drain if chronic condition.

26
Q

Peroneal muscle atrophy and peroneal tibial nerves. Pts present with clumpsiness, fall easy, foot drop and claw hand and are slowly progresive. Dx? Test? RX?

A

Hereditary Motor Sensory Neuropathy: Marie Charcot-Tooth disease. Progressive disease of the periphral nerve. Decreased nerve conduction studies. Stablize ankle.

27
Q

Defiant with teacher and does not comply with her request to follow the rules. Similar scenarios at home. Argumentative. Deliberately annoys others. Spiteful, vindictive, angry, resentful. Dx? Rx?

A

Oppositional Defiant Disorder. Behavioral Therapy.

28
Q

Hitting other children and stealing pens. Pokes family cat with sharp objects. Violates basic rights of others. Disregards social norms and rules. Destruction of property, theft, violation of rules. Dx? Rx?

A

Conduct Disorder. Structured Environment( Firm Rules) Psychotherapy.

29
Q

Does not do homework. Interrupts kids in class. Cant sit still. Inattentive, Hyperactive. Dx? Rx?

A

Attention Deficit/Hyperactivity Disorder (ADHD) - occurs in first 7 years of life. Psychostimulant Methylphenidate, Dextroamphetamine. Psychotherapy.

30
Q

Lines up toys in straight line. No interest in mom or dad. Speaks only when spoken too. Dx? Rx?

A

A persvasive developmental disorder: Austic Disorder. - occurs in first 3 years of life. Remedial Education. Behavioral Therapy.

31
Q

Sterotype Behavior and issues with social but no language delay. Dx?

A

Asperger syndrome.

32
Q

Uncontrolalble blinking and making involuntary barking noise. Dx? Rx?

A

Tourette Syndrome. Psychotherapy.

33
Q

Lack of involuntary urinary continence. What is the age for diurnal? What is the age for nocturnal? Rx?

A

Enuresis. Beyond age 4 is diurnal. Beyond age 6 of nocturnal. Psychotherapy. Positive reiinformcent. No liquids after dinner. Desmopressin first line then imipramine

34
Q

Repeated passage of feces into inpparopriate places (clothing and floor) Dx? Rx?

A

Encopresis. Due to anxiety or loss of sphincter tone (physiologic condition) Constipation. Psychotherapy. Positive Reinforcement. Choose time to poop everyday. Stool Softners.

35
Q

Symptoms are less intense but last longer than major depressive disorder. Chronically depressed for 1 year ( appetite and sleep disturbance, concentration, decision making issues) Dx?

A

Dysthmic Disorder.

36
Q

Rx for majore depressive disorder? What is important to rule out.

A

If suicidal or homicidal admit to hospital. (Behavior modification before medication) ALways rule hypothyroid, nutritional deficiency, chronic infection, substance abuse) CBT and SSRI. Individual or group therapy. Family therapy.

37
Q

Pain at more than 4 sites that are not intentionally produced. 2 Gi, 1 sexual or reproductive 1 Neuro age of onset < 30. Dx

A

Somatization Disoder.

38
Q

Sensory symptoms, motor deficits that are not intentionally produced. Cannot be explained by organic etiology. Dx?

A

Conversion Disorder.

39
Q

Explain the development of symptoms and the reasons for symptoms if they are conscious or unscious. Somatiform disorder. Facticious. Malingering

A

Somatoform : Unconscious. Unconscous. Facticous (Munchausen): Conscious (primary gain - anxitety). Unconscoious
Malingering: Conscious. Conscious (Secondary Gain- getting out of school)

40
Q

A kid who is immunocompromised with gradual headache development, fever and hyperactive reflexes. Dx? Name 2 main risk factors.

A

Brain abscess. Congenital heart disease and sinusitis.

41
Q

Testicular atrophy, baldness and myotonia?

A

Myotonic congenital myopathy

42
Q

Seizure with diffuse muscle aches, elevated CPK or loss of bowel or bladder control. Dx?

A

Partial seizure with secondary generalization

Pediatrics (13 decks)

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