9

Question 1

Common migraine in child

Answer 1

migraine without aura - any part of the head.

Question 2

What type of HA sx should be concerning of ICP

Answer 2

HA after period of laying down (early morning/after a nap), wakes them up, associated vomiting

Question 3

HA with photophobia and fever = rule out infectious like ______________

Answer 3

meningitis, encephalitis, intracranial abscess, sepsis

Question 4

Can stress in children manifest as somatic symptoms like abdominal pain, chest pain, or headaches?

Answer 4

YES

Question 5

What is Cushing’s triad?

Answer 5

Signs of + ICP = HTN, bradycardia, irregular respirations

Question 6

What do you expect to see with Romberg when there is cerebellar pathology?

Answer 6

Romberg test is abnormal (+) with eyes opened and eyes closed.

Question 7

What can ataxia be a reflection of?

Answer 7

Disease of cerebellum, the inner ear, and the dorsal columns (all involved in coordination)

Question 8

Post infectious cerebellitis

Answer 8

Post viral onset of ataxia, vomiting, nystagmus, dysarthria; Self resolves in 3ish months

Question 9

Fever, mental status change, ataxia

Answer 9

infectious cerebellitis - pathogens that cause bacterial meningitis

Question 10

Opsoclonus-myoclonus- syndrome

Answer 10

• paraneoplastic syndrome (retinoblastoma)
• ataxia
• intermittent jerking movements (myoclonus) - erratic conjugate movements of eyes (opsoclonus)

Question 11

Ataxia with neurodegenerative disease

Answer 11

Ataxia-telangiectasia and Friedreich ataxia

Question 12

Ataxia, vomiting, emesis

Answer 12

Could be: MASS, MIGRAINE, MEDS

Question 13

Basilar migraine

Answer 13

Bilateral transient blindness
Vertigo
Ataxia 
Incoordination of the limbs
Dysarthria
Bilateral limb and perioral paresthesias

Question 14

Nystagmus

Answer 14

CEREBELLAR disease
ddx = tumors, toxins, cerebellitis, MS
*most prominent when looking to side of the lesion

Question 15

Is an LP contraindicated in a patient with increased intracranial pressure?

Answer 15

YES, can lead to brain herniation

Question 16

What would you expect with a supratentorial lesion?

Answer 16

focal motor and sensory abnormalities on the side opposite to the lesion

Question 17

What is the most common childhood cancer?

Answer 17

Leukemia

Question 18

What is the most common solid tumor in children?

Answer 18

Brain tumor

Question 19

What are some genetic syndromes that predispose you to brain tumors?

Answer 19

Tuberous sclerosis, neurofibromatosis, Li-Fraumeni syndrome

Question 20

What is the most common pediatric brain tumor?

Answer 20

Medulloblastoma

Question 21

What is tx of medulloblastoma?

Answer 21

Surgical resection, radiation, and chemotherapy - *has tendency to metastasize

Question 22

Partially cystic brain tumor, good prognosis,

Answer 22

Astrocytoma

Question 23

Which domains do we address in development?

Answer 23

Gross motor
Fine motor
Communication 
Personal-social
Problem-solving

Question 24

What to worry about if a baby prefers standing over sitting?

Answer 24

Abnormally tight muscles, possibly due to a neuromuscular disorder, like CP

Question 25

Sentence length = ?

Answer 25

years old

Question 26

Will attach "mama/dada" to correct person. | Responds to one-step commands.

Answer 26

1 yr old

Question 27

What are the minimum recommended ages to screen development?

Answer 27

9 and 18 months and at 24 or 30 months

Question 28

When to screen for autism?

Answer 28

18 and 24 month visits; use the MCHAT

Question 29

Neurodegenerative diseases causes _______ of milestones

Answer 29

regression

Question 30

When does babinski (downgoing of toes) go away?

Answer 30

By 2, or when start walking

Question 31

Apgars cannot be used to predict developmental outcome but continue to be useful predicting _______

Answer 31

Neonatal survival

Question 32

Associated risk factors with CP

Answer 32

Perinatal asphyxia Chorioamnionitis Prematurity Intrauterine growth retardation

Question 33

You have a developmentally delayed child with lethargy, vomiting, coma. What is top of ddx?

Answer 33

Inborn errors of metabolism

Question 34

Males with small testes and gynecomastia

Answer 34

XXY/Klinefelter

Question 35

Macroorchidism

Answer 35

Fragile x

Question 36

What syndromes are commonly associated with intellectual disability

Answer 36

Down syndrome Fetal alcohol syndrome Fragile X syndrome

Question 37

A kid with Downs has _____ palpebral fissures

Answer 37

upslanting

Question 38

What is the std diagnostic test for Downs?

Answer 38

Lymphocyte karyotype

Question 39

Are most Downs babies born to women < 35?

Answer 39

YES

Question 40

Conditions associated with Downs

Answer 40

``` Congenital hearing loss Congenital cataracts Congenital heart disease GI atresia (Duodenal atresia) Hip dysplasia ```

Question 41

Do children with Downs have increased risk of hypothyroidism?

Answer 41

YES - need to routinely screen

Question 42

What are two antenatal diagnostic tests for Downs?

Answer 42

Amniocentesis and CVS

Question 43

Joint laxity, pectus excavatum, flat feet, large ears, large testes

Answer 43

Fragile X

Question 44

``` Webbed neck Low ear placement Edema of the hands and feet Hyperconvex nails "Shield" chest Widely spaced nipples ```

Answer 44

Turner syndrome

Question 45

Trisomy 13

Answer 45

Patau

Question 46

Trisomy 18

Answer 46

Edwards

Question 47

``` Microphthalmia Microcephaly Severe intellectual disability Polydactyly Cleft lip and palate Cardiac and renal defects Umbilical hernias Cutis aplasia ```

Answer 47

Trisomy 13/Patau

Question 48

Rocker bottom feet

Answer 48

Trisomy 15