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Pediatrics I - OSCE > AFP > Flashcards

AFP Flashcards

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2
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Etiology of Acute Flaccid Paralysis

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3
Q

Etiology of Acute Flaccid Paralysis

  • Spinal Cord
A
  • Acute transverse myelitis
  • Trauma
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4
Q

Etiology of Acute Flaccid Paralysis

  • AHCs
A
  • Poliovirus & polio vaccination
  • Other neurotropic viruses e.g. CMV, EBV, HSV
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5
Q

Etiology of Acute Flaccid Paralysis

  • Peripheral Nerves
A
  • Guillain Barré syndrome
  • Critical illness neuropathy
  • Toxic neuropathy (arsenic, lead)
  • Diphtheritic neuropathy
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6
Q

Etiology of Acute Flaccid Paralysis

  • NMJ
A
  • Myasthenia gravis
  • Botulism
  • Organophosphate poisoning
  • Snakebite
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7
Q

Etiology of Acute Flaccid Paralysis

  • Muscles
A
  • Inflammatory myopathies
  • Critical illness myopathy
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8
Q

Etiology of Acute Flaccid Paralysis

  • Muscle Membrane
A
  • Familial periodic paralysis
  • 2ry hypokalemic paralysis
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9
Q

Introduction to Guillian Barré Syndrome

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10
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Etiology of Guillian Barré Syndrome

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11
Q

Etiology of Guillian Barré Syndrome

  • Causative agents
A

It occurs 2 - 4 weeks after a benign febrile illness:

  • 2/3 of cases follow a respiratory or gastrointestinal infection
  • Campylobacter infection 20 - 30%
  • Others e.g. CMV, EBV, HSV

GBS has been reported to follow:

  • Vaccinations
  • Epidural anesthesia
  • Thrombolytic Agents
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12
Q

Subtypes of Guillian Barré Syndrome

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13
Q

CP of Guillian Barré Syndrome

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14
Q

CP of Guillian Barré Syndrome

  • Motor
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15
Q

CP of Guillian Barré Syndrome

  • Sensory
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16
Q

CP of Guillian Barré Syndrome

  • Autonomic
A
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17
Q

CP of Guillian Barré Syndrome

  • CNs
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18
Q

INVx for Guillian Barré Syndrome

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19
Q

INVx for Guillian Barré Syndrome

  • CSF Analysis
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20
Q

INVx for Guillian Barré Syndrome

  • Electrophysiological Studies
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21
Q

Management of Guillian Barré Syndrome

22
Q

Management of Guillian Barré Syndrome

  • Indication of PICU Admission
23
Q

Management of Guillian Barré Syndrome

  • Specific TTT
24
Q

Management of Guillian Barré Syndrome

  • IVIG
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Management of **Guillian Barré Syndrome** - Advantages of IVIG
IVIG is the preferred immunomodulatory treatment as it is - easier to give - few side effects - the treatment can be implemented more quickly - good outcome as plasmapheresis
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Management of **Guillian Barré Syndrome** - regimens of IVIG
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Management of **Guillian Barré Syndrome** - Plasmapheresis
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Prognosis of **Guillian Barré Syndrome**
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INVx for **Myasthenia Gravis**
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INVx for **Myasthenia Gravis** - Labs
Acetylcholine receptor antibody assays: +ve in 85 % of cases - the most helpful diagnostic investigation
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INVx for **Myasthenia Gravis** - Electrophysiological Studies
- Repetitive nerve stimulation is abnormal with characteristic findings in 60%
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INVx for **Myasthenia Gravis** - Chest CT
Assessment of thymoma or thymic hyperplasia
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TTT for **Myasthenia Gravis**
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Def of **Transverse Myelitis**
Acute demyelinating disorder of the spinal cord (other parts of CNS can affected)
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CP of **Transverse Myelitis**
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CP of **Transverse Myelitis** - Motor
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CP of **Transverse Myelitis** - Sensory
- Back pain is common at the onset Els Neese - Sensory level of loss of sensation which is usually thoraci
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CP of **Transverse Myelitis** - Autonomic
- Bladder and/or bowel incontinence
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TTT of **Transverse Myelitis**
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TTT of **Transverse Myelitis** - Acute Management
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Acute Management of **Transverse Myelitis** - 1st Line
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Acute Management of **Transverse Myelitis** - 2nd Line
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Acute Management of **Transverse Myelitis** - Supportive Care
Management of bowl & bladder dysfunction
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Management of **Transverse Myelitis** - Long Term
* Physical & occupational therapy to prevent contracture * Treatment of underlying cause
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CP of **Botulism Toxicity**
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CP of **Botulism Toxicity** - Non-Specific
Dry mouth
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CP of **Botulism Toxicity** - CN
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CP of **Botulism Toxicity** - Autonomic
* Paralytic ileus advancing to severe constipation * Bladder distention advancing to urinary retention * Orthostatic hypotension
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CP of **Botulism Toxicity** - Additional Symptoms
* Deep tendon reflexes are absent. * There is NO sensory loss. * There is NO fever * Consciousness is NOT impaired
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INVx for **Botulism Toxicity**
* Toxin detection, serology * Electromyography (EMG), Nerve conduction study (NCS) * CSF examination is normal
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TTT of **Botulism Toxicity**
* Antitoxin (Human botulism Ig) * Complete recovery takes weeks to months

Pediatrics I - OSCE (20 decks)

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