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Peds Boards > Neurology > Flashcards

Neurology Flashcards

1
Q
  • teenager with frontal HA or band-like pressure sensation

- Tx: eliminating the stressor

A

Tension HA

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2
Q
  • HA with photophobia

- Tx: ibuprofen, APAP, fluids and rest, ergotamines, and triptans (NOT SQ)

A

Migraine HA

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3
Q
  • progressive and intermittent visual disturbances
  • HA worse in the am, HA relieved by vomiting
  • papilledema
  • Dx: CT
A

Increased ICP

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4
Q
  • AR disease of copper metabolism
  • liver cannot get rid of copper, so it accumulates in liver, kidneys, brain, and eyes
  • younger pts present with liver disease
  • older pts have neuro/psych Sx
  • tremors, emotional problems, difficulty with handwriting, depression, and abnl eye movements
  • acute hepatic failure with dystonia and mental status changes
  • PE: KF rings
  • Dx: low ceruloplasmin, low copper in serum, increased copper in urine
  • may have hemolytic anemia and abnl Calcium metabolism
  • Tx: chelation with Penacillamine, low Cu diet, liver Tx
A

Wilson Disease

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5
Q
  • AR dz due to a defect in DNA processing and repairs
  • CNS effects, skin, and eye findings, and immunologic sequelae
  • hematologic malignancy, abnl blood values, ataxic gait, and oculocutaneous lesions
A

Ataxia Telangectasia

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6
Q
  • AR dz that accounts for half the cases of inherited ataxia
  • presents in late childhood or early adolescence with a slow and clumsy gait
  • elevated plantar arch, absent DTRs of LE, diabetes, cardiomyopathy leading to CHF
  • Tx: supportive
A

Friedrich Ataxia

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7
Q
  • -occurs a few months after a strep infx
  • elevated ASO titers
  • quick random jerky movements and fidgety
A

Syndenham Chorea

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8
Q
  • chorea, hypotonia, and emotional lability
  • AD dz with dementia
  • Sx not apparent until adulthood
  • younger children present with rigidity
A

Huntington chorea

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9
Q
  • present as eye blinking and movements of the head, face, or shoulders
  • not caused by anxiety
  • resolve on their own
  • no intervention needed
A

Simple Motor Tics

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10
Q
  • tic disorder that is present for at lease a year

- may be associated with prolonged use of stimulant meds or OCD

A

Tourette Syndrome

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11
Q
  • ataxia, gait imbalance, incoordination, neck pain, HA, and increased ICP, afebrile
  • CT or MRI is indiacted
A

Posterior Fossa Tumor

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12
Q
  • tumor that presents with pituitary and hypothalamic problems
  • visual defects, neck pain, and HA, afebrile
  • growth retardation, skull film with calcification in the sella tursica
  • supratentorial
  • Tx: surgery and XRAD
A

Craniopharyngioma

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13
Q
  • increased ICP of unknown etiology
  • papilledema and eventual optic disc atrophy and blindness
  • double vision, headache, and tinnitus
  • causes: excess Vit A, steroids, thyroxine, lithium, tetracyclines
  • Dx: MRI, LP
  • Tx: LP, Diamox
A

Pseudotumor cerebri

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14
Q
  • progressive motor weakness and areflexia
  • leg weakness and/or unsteady gait and pain
  • starts in the lower extremity and progresses upwards in a symmetric fashion (ascending)
  • difficulty rising from a sitting position or cannot shrug their shoulders
  • preceeded by a viral illness or camphylobacter
  • may be cranial nerve findings and dysautonomia
  • Dx: incr protein in the CSF
  • risk for resp failure: follow vital capacity, NIFs, or PFTs, not SpO2
  • Tx: supportive, IVIG, or plasmapheresis
A

Guillan Barre

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15
Q
  • autoimmune disorder in which patient develops Ab against the Ach receptor in the NMJ
  • weakness gets worse with activity and improves with rest
  • ptosis
  • associated with thymoma
  • Dx: tensilon test, anti-Smith Ab, EMG
  • Tx: pyridostigmine (acethylcholinesterase inhibitor), plasmapheresis, prednisone, thymectomy
A

Myasthenia Gravis

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16
Q
  • myasthenia gravis due to a genetic defect in the NMJ
  • lifelong disease
  • involves the eyes
  • responds to Tensilon
A

Congenital Myasthenia Gravis

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17
Q
  • mysasthenia gravis due to mother’s Ab that crossed the placenta
  • resolved within 6 months
  • does not involve the eyes
  • responds to Tensilon
A

Transient Myasthenia Gravis

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18
Q
  • infant with a weak cry, constipation, listlessness, hypotonia, and poor feeding
  • descending paralysis, rapid onset
  • unpasteurized honey
  • toxin blocks the release of Ach from the NMJ
  • Tx: supportive
A

Infantile Botulism

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19
Q
  • presents as proximal muscle weakness and butterfly malar rash on face, Gottron’s papules
  • elevated CPK
A

Dermatomyositis

20
Q
  • X-linked recessive (boys only)
  • significant spontaneous mutation rate (mother is not always a carrier)
  • absence of dystrophin
  • poor head control in infancy and weakness in the hip muscles, lordotic posture, Gower sign, pseudohypertrophied calves, mild MR
  • Dx: muscle Bx, elevated CPK, XP21 genetic testing
  • cardiomyopathy and heart failure, resp failure and pna are frequent causes of death
  • absence of tongue fasiculations and eye muscle involvement
A

Duchenne Muscular Dystrophy

21
Q
  • affects both striated and smooth muscle (skeletal, heart, and GI)
  • Autosomal Dominant
  • presents at 4-5 yo with muscles that have slow relaxation after contraction (myotonia)
  • endocrine problems, distal muscle wasting
  • Dx: muscle Bx, CK may be normal
A

Myotonic Muscular Dystrophy

22
Q
  • spinal pain, paresthesias, weakness, paralysis
  • fevers, localized back pain, decreased anal tone, reduced sensation in the LE, increased reflexes
  • direct extension from paraspinal tissues or seeding from a distant infection, IV drug use
  • Dx: urgent spinal imaging
  • Tx: Abx with staph coverage and emergent surgical decompression
A

Epidural Abscess

23
Q

-pt with evidence of a space occupying CNS lesion presenting with seemingly irrelevant URI findings consistent with chronic sinusitis

A

Brain Abscess

24
Q
  • post-infectious myelitis
  • due to lymphocytic infiltration and demyelination
  • fever and a sudden onset of paralysis, followed by increased tone and hyperreflexia
  • bowel and bladder dysfunction
  • CSF with increases polys and negative gram stain
  • pain on palpation of the spinal canal
  • MRI shows cord swelling
  • spontaneous recovery after a few months
A

Transverse Myelitis

25
Q
  • SMA Type 1
  • degeneration of anterior horn cells, only motor function is affected, no sensory deficits
  • presents in infancy with severe hypotonia and weakness, poor suck and tongue fasciculations*
  • Dx: muscle Bx
A

Werdnig-Hoffmann Disease

26
Q
  • lipoma, patch of hair, hemangioma, discoloration or sacral dimple
  • leg length discrepancy, elevated arches, and gait abnormalities
  • diminished sensation in the perineal area, urinary and stool incontinence, UTIs
  • Dx: MRI spine
A

Occult spinal dysraphism

27
Q
  • protrusion of the spinal cord and surrounding membranes though a defect in the vertebral column
  • early orthopedic and urological eval
A

Myelomeningocele

28
Q

-treatment for high index of suspicion for spinal trauma

A

Methyprednisolone 30mg/kg

29
Q

-seizures that occur within the first month of life and have a variety of causes from birth defects to perinatal hypoxia to drug effects

A

Neonatal Seizures

30
Q
  • seizures that occur during a rapid rise or decrease in temperature
  • occur in 2-5% of all children
A

Febrile seizure

31
Q
  • focal seizures that involve only part of the brain
  • simple have a localized motor component limited to one part of the body, can progress to other parts of the body, children remain awake
  • complex involve motor activity but child is unaware of what he or she is doing, post-ictal state present
A

Partial seizures

32
Q
  • short episodes in which the child stares into space with no awareness of the environment
  • no post ictal period
  • shorter than complex partial seizures
  • end abruptly
  • can be induced by hyperventilation
  • 3Hz spike and wave
  • AKA petit mal seizure
  • Tx: ethosuximide or VPA
A

Absence seizure

33
Q
  • seizures that present between 4 and 6 months
  • jack knifing, sudden flexion or extension of the body
  • associated with mental retardation and have a poor prognosis
  • hypsarrythmia
  • Tx: Sabril, ACTH
  • prognosis depends on developmental status prior to the onset of the seizures
  • association with tuberous sclerosis
A

Infantile Spasms

34
Q
  • seizure activity more than 30 minutes in duration
  • repeated seizures without a return to normal in between
  • Tx: ABCs, dextrose, ativan. fosphenytoin
A

Status epilepticus

35
Q
  • have an aura or prodrome, minutes, hours, or days before the seizure
  • LOC, bowel and bladder dysfunction, full body tonic clonic movements
  • tonic phase: flexion of the trunk and extension of the back, arms, and legs, lasting
A

Generalized Tonic Clonic seizures

36
Q

-potential side effect of Lamictal

A

Stevens Johnson Syndrome

37
Q
  • single or repetitive contractions of an isolated group of muscles
  • loss of muscle tone and sudden brief shock like muscle twitches with the child falling forward
  • no impairment of consciousness or memory
A

Myoclonic Seizures

38
Q
  • MC form of epilepsy in childhood
  • self-limited seizures that involve the face and unilateral sensory involvement
  • conscious but cannot talk
  • often occur at night while asleep
  • associated with migraines
  • Tx: carbamazepine
  • Dominant trait
A

Benign Rolandic Epilepsy

39
Q
  • may bathe or swim but not alone
  • may drive if on meds and seizure free for 12 months
  • may DC meds if seizure free for 2 years (unless juvenile myoclonic epilepsy)
A

Seizure Precautions

40
Q
  • static encephalopathy characterized by gross and fine motor abnormalities evident early in life
  • 10% due to birth asphyxia
  • perinatal infection is the MC risk factor
  • risk decreased by maternal preeclampsia
A

Cerebral Palsy

41
Q
  • bilateral spasticity of the legs
  • seen in preemies
  • walking is delayed
  • tip-toe walking
  • excellent prognosis with normal cognitive function without seizures
A

Spastic Diplegia

42
Q
  • weakness of the upper extremities
  • walking is delayed until age 2
  • 1/4 are cognitively impaired
A

Spastic hemiplegia

43
Q
  • increased tone in all extremities
  • lower > upper
  • more severe
  • mental retardation
  • seizures, feeding difficulties, speech and visual difficulties
A

Spastic quadriplegia

44
Q

-similar to spastic quadriplegia + dystonia and strange movements

A

athetoid cerebral palsy

45
Q
  • afebrile child with a HA, neck pain who then develops focal paralysis
  • confirm with CT then CTA
  • elevated lactate level and sensorineural deafness (mitochondrial association)
A

CVA

46
Q
  • acute onset of self-limited vertigo in the absence of vomiting or LOC
  • nystagmus and pallor
A

Benign Paroxysmal Vertigo

47
Q

-vertigo lasting for days associated with hearing loss

A

labrynthitis

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