Psych/Neuro Flashcards

1
Q

investigations when possible diagnosis of Autism

A
  • school observation
  • ADI-R
  • ADOS-2
  • DISCO
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2
Q

what 3 functional domains does the ADI-R focus on

A
  • language and communication
  • reciprocal social interactions
  • restricted, repetitive and stereotyped behaviours and interests
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3
Q

DISCO stands for

A

diagnostic interview for social and communication disorders

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4
Q

MRI scan findings in those with autism

A

brain enlargement - especially in occipital, parietal and temporal lobes;

could be due to neuronal death, increased neurogenesis or even increased production of glial cells or vasculature

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5
Q

what does Sally-Anne test assess

A

theory of mind

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6
Q

licensed pharmacological treatment for aggressive behaviour in children

A

Risperidone

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7
Q

psychotherapy for both parents and autistic patient

A
  • CBT
  • behavioural management programmes
  • TEACCH
  • Educational psychology
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8
Q

medications used as adjuncts for ASD to psychological interventions

A

SSRI

Risperidone antipsychotic

Melatonin - help to reduce sleep latency

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9
Q

how is pain illicit in a child for GCS assessment

A

pressing hand on supra-orbital notch; beneath the end of the eyebrow with thumb

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10
Q

differentials for a 2 year old with seizures

A
  • febrile convulsion
  • epilepsy
  • encephalitis/meningitis
  • sepsis
  • brain tumour
  • metabolic disorders
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11
Q

immediate management of seizure

A

ABC assessment
High flow oxygen
blood glucose measurement

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12
Q

management of status epilepticus

A
  • High flow oxygen, ABC, Bm
  • Midazolam
  • Lorazepam
  • Phenytoin (over 20 mins)
  • RSI with thiopentone (if seizure has lasted longer than 30 mins)
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13
Q

when to do RSI with theopentone for status epilepticus

A

seizure lasting longer than 30 minutes

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14
Q

how long does a simple febrile seizure last

A

< 15 mins

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15
Q

differences between simple and complex febrile seizures

A

simple

  • last less than 15 mins
  • resolve within 24 hours
  • no neurological deficits
  • fever present
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16
Q

following what seizure may a Tods palsy occur
and
what is a Tods palsy

A

following a complex febrile seizure

Tods palsy = focal weakness in part or all of body following a seizure and usually subsides after 48 hours

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17
Q

3 indications for an urgent CT head/MRI

A
  • encephalitis/coma
  • suspected raised ICP
  • progressive neurological deficit
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18
Q

indications for elective MRI

A
  • child < 2 years
  • focal neurological deficits
  • focal epilepsy
  • assoc. learning difficulties
  • epilepsy resistant to full doses of appropriate drugs
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19
Q

when to do an elective EEG

A
  • development of language regression

- strong suspicion of epilepsy

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20
Q

definition of epilepsy

A

recurrent transient paroxysmal attacks of disturbed consciousness and sensorimotor function resulting from abnormal electrophysiological discharges of cerebral neurones

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21
Q

5 types of generalised seizures

A
  • tonic clonic
  • absene/petit mal
  • myoclonic
  • tonic
  • atonic/akinetic
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22
Q

feature of a partial seizure

A

aura = describes the effects of initial focal electrical events e.g. unusual smell, tingling in a limb, strange inner feeling

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23
Q

types of partial seizures

A
  • simple partial

- complex partial

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24
Q

what does early hand preference before 12 months indicate a higher risk of

A

higher risk of hemiplegia on non dominant side

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25
Q

causes of delayed walking

A
  • duchennes
  • spina bifida
  • developmental dysplasia of hip
  • rickets
  • cerebral palsy
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26
Q

name for the life long condition that affects movement and coordination caused by a problem with the brain that occurs before, during or soon after a birth

A

cerebral palsy

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27
Q

symptoms of cerebral palsy

A
  • delay in reading developmental milestones
  • too stiff/too floppy
  • weak arms/legs
  • fidgety/clumsy
  • waling on tip toes
  • swallowing and learning difficulties
28
Q

causes of cerebral palsy

A
  • bleeding into brain
  • decreased oxygen supply to brain
  • meningitis
  • brain injury
  • damaged brain during or soon after birth
29
Q

MRI finding in cerebral palsy

A

periventricular leucomalacia

30
Q

typical presentation of cerebral palsy

A
  • poor feeding
  • floppy at birth/hypotonia
  • fits in a neonate
  • delayed meeting developmental milestones
31
Q

4 common presentations of cerebral palsy

A
  • hemiplegia
  • diplegia
  • quadriplegic
  • dyskinetic
32
Q

features of scissoring gait in cerebral palsy

A
  • talipes equinovarus deformity
  • adduction of hips with scissoring
  • plantar flexion of feet
  • inward pointing knees
  • assoc. rotation and swaying of trunk
  • tip toeing
33
Q

charity for supporting cerebral palsy

A

scope

34
Q

what is scope and what does it offer?

A

charity for cerebral palsy

offers

  • support info for families
  • support groups
  • online community
35
Q

chemical that is

  • neurotoxic
  • high levels can result in respiratory signs
A

ammonia

36
Q

2 types of inborn errors of metabolism

A
  • urea cycle disorders

- organic acidaemias

37
Q

features of urea cycle disorder

A
  • high ammonia
  • liver dysfunction
  • metabolic alkalosis
38
Q

acid base imbalance caused by urea cycle disorders

A

metabolic alkalosis

due to high ammonia acting as a respiratory stimulant

39
Q

acid base imbalance from organic acidaemias

A

mixed metabolic acidosis + high ammonia

40
Q

ammonia scavenging medications

A
  • Na benzoate

- Na Phenylbutyrate

41
Q

what is metabolic acidosis corrected by

A

IV Na Bicarb

42
Q

serious complication of high ammonia

A

mild cerebral oedema causing seizures

43
Q

9 common conditions that the heel prick test tests for

A
  • cystic fibrosis
  • MSUD
  • sickle cell
  • hypothyroidism
  • PKU
  • MCAD
  • homocystinuria
  • isovolemic acidaemia
  • glutamic aciduria
44
Q

treatment of PKU

A

phenylalanine free diet, supervised by specialist dietician and paediatrician

45
Q

standardised questionnaire to assess for ADHD

A

Conner’s rating scale

46
Q

protective factors for cerebral palsy

A
  • Mg Sulfate
  • abx
  • corticosteroids
47
Q

what is periventricular leukomalacia

A

cystic changes occuring in the periventricular white matter; caused by infection/inflammation resulting in prematurity and MRI change

48
Q

global developmental delay

A

significant delay in milestones in 2 or more areas (more/=2 SD below the mean)

49
Q

risk factors for cerebral palsy

A
  • prematurity
  • intrauterine infections
  • birth asphyxia
  • meningitis
  • CP arrest
50
Q

what is ataxic gait characterised by

A

shaky movements, imbalances, caused by cerebellar damage

51
Q

what is spastic gait characterised by

A

muscles appear tight and stiff… due to damage to motor cortex

52
Q

what is dyskinetic gait characterised by

A

involuntary movements; due to damage to basal ganglia

53
Q

most common type of cerebral palsy

A

spastic

54
Q

3 medx to manage hypertonia

A
  • baclofen
  • diazepam
  • botulinum toxin
55
Q

3 key features of autism

A
  • communication difficulties
  • social interaction difficulties
  • inflexible thinking
56
Q

cause of autism

A
  • unknown
  • positive fhx
  • assoc. with other medx conditions
57
Q

what is CAHMS role in autism

A

helping families understand their child and put in strategies to cope with their behaviour

58
Q

3 features of ADHD

A
  • inattention
  • hyperactivity
  • impulsivity
59
Q

cause of ADHD

A
  • genetic factors
  • head injury
  • prematurity
  • low birth weight
60
Q

duration of symptoms for a diagnosis of ADHD

A

6 symptoms of inattention + 6 symptoms of hyperactivity present in 2 situations for more than 6 months

61
Q

who does the ADHD assessment

A
  • psychiatrist
  • paediatrician
  • social worker
  • learning disability specialist
62
Q

rating scale for ADHD

A

conners scale

63
Q

charities that support ADHD

A

Young minds

ADDiss

64
Q

CNS stimulants for ADHD treatment

A
  • Methylphenidate

- Dexamphetamine

65
Q

side effects of Methylphenidate

A
  • abdo pain
  • insomnia
  • headaches
  • weight loss
66
Q

non pharmacological treatments for ADHD

A
  • behavioural interventions: star charts + focused praise,
  • organisational skills
  • time management
  • anger + stress management
  • attention deficit disorder information + support service