4.6.2013(pediatrics) 27 Flashcards
(121 cards)
0
Q
Age of occurrence of febrile seizures
A
6mon-5yrs
1
Q
Commonest cause of seizures in early childhood
A
Febrile seizures
2
Q
Temperature and febrile seizures
A
Not related to degree of temperature
But related to rate of rise of temperature
3
Q
Postictal confusion in febrile seizures
A
Absent
EEG changes may be seen
4
Q
Recurrent febrile seizures
A
30-50%
5
Q
Type of febrile seizures
A
More than 90% are generalised
6
Q
Most commonly associated with febrile seizures
A
Acute respiratory illness
7
Q
Features of atypical febrile seizures
A
Less common
Lasts for more than 15min
More than 1 seizure on same day
Convulsions are focal
8
Q
Risk factor for recurrence of febrile seizures
A
Positive family history
Neurodevelopment abnormalities
Atypical
Early onset<1yr
9
Q
Anticonvulsants in febrile seizures
A
Seizures lasting >5min
Diazepam is DOC
phenobarbitone
10
Q
Intermittent prophylaxis
A
Diazepam
11
Q
Continuous prophylaxis
A
Sodium valproate
Phenobarbitone
12
Q
Hypsarrythmia type of seizure
A
Infantile myoclonus
13
Q
Infantile spasm
Synonyms
A
Infantile Myoclonic epilepsy
West syndrome
14
Q
Onset of Myoclonic epilepsy
A
3-8months
15
Q
Triad of west syndrome
A
Salaam spells(sudden dropping of head and Flexion of arms)
Mental retardation
Diffuse voltage slow spike and chaotic activity
16
Q
Time of occurrence of west syndrome
A
Occur in clusters on waking up
17
Q
Rx of infantile spasms
A
Vigabatrin(DOC)
ACTH
corticosteroids
18
Q
Rx of JME
A
Valproate
19
Q
Duration of Rx of janz syndrome
A
Life long treatment
20
Q
Drugs used in Myoclonic epilepsy
A
Valproate Lamotrigine Topiramate Zonisamide Felbamate Clonazepam
21
Q
Most common cause of seizure in newborn
A
HIE
22
Q
Causes of neonatal seizures
A
HIE hypocalcemia Hypoglycaemia Meningitis Polycythemia
23
Q
Electrolyte disturbances causing neonatal seizures
A
Hyponatremia
Hypocalcemia
Hypomagnesimia
Hyperammonemia
24
Vitamin deficieny that can cause neonatal seizures
B6 deficiency
Autosomal recessive condition
25
Mech of pyridoxine responsive neonatal seizures
Impaired activity of glutamic acid decarboxylase
26
Neonatal seizures with best prognosis
Hypocalcemic seizures
Worst prognosis: idiopathic seizures
27
Ocular subtle seizure
Tonic horizontal deviation
| Sustained eye opening with ocular fixation or eyelid fluttering
28
Examples of subtle seizures
Ocular
Orofacial lingual movements(chewing,tongue thrusting,lip smacking)
Limb movements(cycling,paddling,boxing jabs)
Autonomic dysfunction
Apnea
29
DOC for neonatal seizures
Phenobarbitone
30
First step in neonatal seizures
10% dextrose followed by calcium gluconate
31
Number of absence seizures per day
Multiple
32
Postural control in absence seizure
No loss
33
Psychomotor epilepsy
Complex partial seizures
34
Drugs used in absence seizures
Valproate
Ethosuximide
Lamotrigine
Clonazepam
35
Characteristics of jitteriness
Stimulus sensitive
Can be abolished by passive restraint
Not associated with ocular or autonomic features
Jitteriness and seizures may both have same frequency of movement
36
Signs in meningitis
Kernig
Brudzinski
Tachy cerebrale
37
Tachy cerebrale
Skin flushing when abdomen is scratched
38
Kernig sign
Inability to extend knee>135degrees when hip is flexed to 90 degrees
39
Most common presentation of neonatal meningitis
Poor feeding
40
Most common complication of meningitis in children
Seizures
41
CSF in fungal meningitis
PMN 5-500
| But mononuclear cells predominate
42
Causes of neonatal meningitis
```
GBS
E.coli
Klebsiella
Listeria
S.aureus
CONS
Streptococcus fecalis
```
43
Common causes of meningitis in children aged 2months to 3yrs
Pneumococci>meningococci>H.influenzae
44
Commonest cause of meningitis
| 3yrs -20yrs
Meningococci
45
Commonest cause of meningitis
| >20yrs
Pneumococci
46
Neonatal menigitis and pneumonia caused by
Strep fecalis
| S.agalactiae
47
Rx of penicillin resistant meningococci
Ceftriaxone or cefotaxime+ vancomycin
48
Most common involuntary movement in TBM
Hemiballismus
Tremors come second
49
Raised ICT finding absent in infants
Papilledema
Due to open sutures and bulging fontanelle
50
Most common CNS tumor in infants
Choroid plexus tumor
| Teratoma
51
Midline swelling arising in cerebellum
Medulloblastoma
In adults medulloblastoma is lateral
52
Cerebellar astrocytoma gender commonly affected
Common in both males and females
53
Scoliosis is common in which type of CP
Spastic quadriplegia
54
Most common type of CP
Spastic CP
55
Types of spastic CP
Spastic quadriparesis
Spastic diplegia
Spastic hemiplegia
56
Progression of CP
Non progressive
57
Types of CP
Spastic
Hypotonic/atonic
Extra pyramidal
Mixed type
58
Seizures are common in which type of CP
Spastic CP
59
Severe mental retardation is found in which CP
Hypotonic or atonic CP
60
Not found in CP
Microcephaly
61
Eye abnormalities in CP
Strabismus
Cataract
Coloboma
Refractive errors
62
CP common in preterm babies
Spastic diplegia
63
Most common site of neural tube defect
Lumbosacral region
64
Prophylaxis of neural tube defect
400microg
65
Prevention of neural tube defect
First baby with NTD,mother taking valproate
| 4mg
66
Causes of NTD
Maternal diabetes
Trisomy 13 and 15
Zinc and folate deficiency
Maternal exposure to alcohol,radiation,valproate,CBZ
67
Biochemical markers for NTD
Alpha fetoprotein
| Acetylcholineesterase
68
Caudal neuropore closes by
27days
Cranial neuropore closes by 23 days
69
Neural tube defects
```
Dermal sinus
Tethered cord
Syringomyelia
Diastematomelia
Lipoma involving conus medullaris
```
70
```
Feature not seen in sacral meningomyelocele
Spasticity of lower limbs
Hydrocephalus
Bladder incontinence
Lax anal sphincter
```
Spasticity of lower limbs
71
Common cause of communicating hydrocephalus in children
Subarachnoid hemorrhage
72
Infections associated with hydrocephalus
TBM
| pneumococcal meningitis
73
```
All are signs of raised ICT in a neonate except
Enlarged head
Crackpot sign
Sunset sign
Papilledema
```
Papilledema and crackpot sign(macewan sign) occur only after sutural closure
74
Earliest sign of raised ICT in infants
Separation of cranial sutures
75
CT and MRI in NPH
Normal
| Normal or small ventricular size
76
Infectious causes of pseudotumor cerebri
Poliomyelitis
GBS
chronic otitis media
77
Metabolic causes of pseudotumor cerebri
```
Hyper and hypovitaminosis A
Iron deficiency
Hypocalcemia
Hyperparathyroidism
Adrenal insufficiency
Steroid withdrawal
Prolonged steroid therapy
Tetracycline
Nalidixic acid
Amiodarone
Nitrofurantoin
Chronic CO2 retention
Lead poisoning
```
78
Drugs causing pseudotumor cerebri
```
Prolonged steroid therapy
Tetracycline
Nalidixic acid
Amiodarone
Nitrofurantoin
```
79
MR classification
51-70 mild
36-50 moderate
21-35 severe
0-20 profound
71-90 borderline intelligence
80
Predisposing factors for MR
```
Low socioeconomic strata
Advanced maternal age
Genetically transmitted
LBW
consanguinity
```
81
Metabolic causes of MR
```
PKU
homocystinemia
Histidinemia
Organic aciduria
Galactosemia
```
82
Chromosomal disorders associated with MR
Down
Fragile X
Klinefelter
83
Developmental defects causing MR
Microcephaly
Craniostenosis
Cretinism
Porencephaly
84
Post natal factors causing MR
Hypoglycemia
Kernicterus
Child abuse
85
Fat infiltration in Reyes syndrome
Fatty infiltration of liver and kidney(PCT)
86
Infections causing Reyes syndrome
```
Influenza A,B
varicella
Echo virus-2
Adenovirus
EBV
Coxsackie A
```
87
Acid base disorder in Reyes syndrome
Mixed respiratory alkalosis and metabolic acidosis
88
Anterior fontanelle normally closes by
12-18 months of age
89
Delayed closure of anterior fontanelle
```
Achondroplasia
Osteogenesis imperfecta
Cleidocranial
Pyknodysostosis
Apert syndrome
Hallerman steriff syndrome
Kenny syndrome
Russell silver syndrome
13,18,21 trisomies
Congenital rubella
Congenital syphilis
Thalassemia major
Cretinism
Hypophosphatasia
VitD deficiency rickets
Malnutrition
Prematurity
IUGR
hydrocephaly
```
90
Bulging anterior fontanelle
```
Crying infant
Raised ICT
pseudotumor cerebri causes
Vit D dependant rickets
Maple syrup urine disease
Galactosemia
Urea cycle enzyme defects
Congenital hypophosphatasia
```
91
Infantile tremor syndrome is common in
Boys
92
Characteristic of infantile tremor
Coarse
6-12 cycles per second
Initially intermittent but later continuous
93
Features of infantile tremor syndrome
Hyper pigmentation of extremities
Cortical atrophy
Pallor
Self limiting disorder
94
Premature closure of sagittal suture
Dolicho/scaphocephlay
95
Premature closure of coronal suture
Brachycephaly
96
Premature closure of metopic suture
Trigonocephaly
97
Turret skull
Oxycephaly,acrocephaly,terrencephaly
| Premature closure of all sutures
98
Intelligence in type 1 NF
Impaired
99
Leukemia associated with NF
Juvenile myelomonocytic Leukemia
| Myelodysplastic syndrome
100
Tumors associated with NF1
```
Leukemia
Rhabdomyosarcoma
Optic glioma
Meningioma,ependymomas,astrocytoma
Pheochromocytoma
```
101
Type of seizures in Tuberous sclerosis
Infantile spasms
102
Mulberry tumors in retina
Tuberous sclerosis
103
GIT abnormality in Tuberous sclerosis
Hamartomatous rectal polyps(minor)
104
Oral cavity manifestations of tuberous sclerosis
Minor
Multiple randomly distributed pits in dental enamel
Gingival fibromas
105
Skin manifestations of TS
Major
Facial angiofibromas or forehead plaques
Nontraumatic ungual or periungual fibroma
Hypo melanocytic macules
Shagreen patch
Minor
Confetti skin lesions
106
Kidney manifestations of TS
Angiomyolipoma(major)
| Multiple renal cysts(minor)
107
CNS manifestations of TS
```
Major
Cortical tuber
Subependymal nodule
Subependymal giant cell astrocytoma
Minor
Cerebral white matter radial migration lines
```
108
Ocular findings of TS
Multiple retinal Nodular hamartoma (major)
| Retinal achromic patch(minor)
109
Skeletal abnormality in TS
Bone cysts(minor)
110
Neurocutaneous syndrome with glaucoma
Sturge weber
111
Most frequent AV malformation in neonates
Vein of Galen
112
GCS score when intubation is needed
8 or less
113
Epilepsy with worst prognosis
Infantile spasm
114
Most severe papilledema is caused by
posterior fossa tumor
115
CSF protein content in premature babies
63mg%
Normal babies-73mg%
After 7 days 15-40mg%
116
Preferred corticosteroid in cerebral Edema in children
Dexamethasone
117
Banana sign is seen in
Spina bifida
| Lemon sign is also seen
118
Acquired cause for aqueductal stenosis
Neonatal Meningitis
Intrauterine viral infections
SAH
MUMPS meningoencephalitis
119
Type of herniation common in children with progressive hydrocephalus
Central transtentorial herniation
120
Porencephaly is seen in
Dandy walker syndrome
