Neruology (paeds)

Question 1

what is the definition of childhood epilepsy

Answer 1

a chronic neurological disorder characterised by recurrent unprovoked seizures and transient signs of abnormal, XSn syncoronous neoronal activity

Question 2

what are the types of epilepsy

Answer 2

Generalised - both hemispheres involved

Focal - one part of the brain (lobar)

Question 3

what are the types of generalised seizure

Answer 3

absence

myoclonic

tonic

tonic clonic

atonic

Question 4

what are the types of focal seizure

Answer 4

fromtal

temporal

occipital

parietal

Question 5

a child has an episode where

they loose conciousness suddenly and then regain immediately

transiently and dont recognise the loss of conciousness

mum says : looks like she is day dreaming all the time

what epilepsy is this

Answer 5

absence

Question 6

a child has an episode where

very brief, usually under 30s

theres repetative jerky movements ie head ‘banging’

what epilepsy is this

Answer 6

myoclonic

Question 7

a child has an episode where

tall of a sudden they stiffen and fall (increased muscle tone)

what epilepsy is this

Answer 7

tonic

Question 8

a child has an episode where

sudden increase in tone causing fall

irregular breathing (can cause cyanosis)

rythmic jerking

xs saliva +/- tongue biting

incontenence

lasting a few mins

followed by deep sleep for hrs

what epilepsy is this

Answer 8

tonic clonic

Question 9

a child has an episode where

theres suddenly someone becomes all floppy (reduced tone)

and can be accompnied with a jerky repetative movement (myoclonic)

what epilepsy is this

Answer 9

atonic

Question 10

a child has an episode where

they begin marching and waving arms in circular motions transiently

(jacksonian marck +hyperkinetic movements)

what epilepsy is this

Answer 10

frontal lobe

Question 11

a child has an episode where

they expieriance auditory and sensory phenomane and a feeling of deja vu

theres lip smacking/sucking at clothing

what epilepsy is this

Answer 11

temporal lobe

Question 12

a child has an episode where

they report having visual distorsion

what epilepsy is this

Answer 12

occipital

Question 13

a child has an episode where

they have altered sensation on one side of the body and have a distorted body image in that time

what epilepsy is this

Answer 13

parietal

Question 14

how would you diagnose epilepsy

Answer 14

EEG

CT

PET

Question 15

what is the management of epilepsy

Answer 15

valproate

carbamezipine

lamotragine

topiramate

GABApentin in focal epilepsy

Question 16

what are SE of valproate

Answer 16

weight gain

hairloss

liver failure

Question 17

what are SE of carbamazipine

Answer 17

rash, neutropenia, hyponatremia

Question 18

what are SE of Lamotragine

Answer 18

Rash

Question 19

what are SE of GABApentin

Answer 19

insomnia

Question 20

describe Juvenile Myoclonic Epilepsy

Answer 20

teens affected mostly which have myoclonic seizures (ie repeated jerky movements) shortly after walking

Question 21

what is early onset benign occipital epilepsy syndrome

Answer 21

unresposive eye deviation

vomiting

headaches and visual disturbances

Question 22

what is autistic spectrum disorder

Answer 22

children who fail to accquire normal social and communication skills

Question 23

what is the presentation of autistic spectrum disorder

Answer 23

impaired social interactions

speech and language disorders

imposition of routienes

sensory issues

Question 24

give examples of impaired social interactions in autistic spectrum disorder

Answer 24

gaze avoidence

not seeking company from others

struggle to understand social roles and ettiquete

Question 25

what are 3 presentations of speech and language delay commin in autistic spectrum disorder

Answer 25

delayed speech over literal comprehension of speech monotenous without body language

Question 26

how do you manage autistic spectrum disorder

Answer 26

parental support applied behavioural analysis (20-30hrs x week)

Question 27

what are the three core behaviours of ADHD

Answer 27

hyperactivity innatention impulsivity

Question 28

what are three signs of hyperactivity (ADHD)

Answer 28

cant remain still talkative noisy

Question 29

what are three signs of impulsivity

Answer 29

interuptting blurting out answers difficulty waiting turns

Question 30

what is the diagnostic criteria of ADHD

Answer 30

scaring 6/9 for innatention and 6/9 for hyperactivity and impulsivity symptoms before 12y occuring in more than 1 place clear evidence of sx interefering with social and academic functions

Question 31

how do you manage ADHD

Answer 31

behavioural and educational support atomoxetine (non stimulant) methylphonidate / dexamphetamine - stimulants yearly trials off of medication

Question 32

what tools are used to diagnose ADHD

Answer 32

ADHD nurse classroom observation SNAP questionarre quantative behavioural analysis

Question 33

what is the definition of cerebral palsey

Answer 33

abnormalities of movement and psoture causing limited activity non progressive disturbances / injuries whivh occur en utero or when younger than 2y

Question 34

what is the presentation of cerebral palsey

Answer 34

reduced cognition disturbed communication perceptual and sensory disturbances behavioural disturbances seizures sendary msk prolmens manifesting over ime due to the abnormal brain developing

Question 35

what are the types of cerebral palsey

Answer 35

spastic : hemiplegic, quadroplegic, diplegic or dyskinetic

Question 36

what are the characteristics of spastic cerebral palsey

Answer 36

increased muscle tone brisk reflexes abnormal gait

Question 37

describe the presentation of hemiplegic cerebral palsey

Answer 37

facial sparing arms mostly affected

Question 38

describe the presentation of quadroplegia cerebral palsey

Answer 38

trunk has extensor posturing poor central tone all 4 limbs affected equally usually caused by hypoxic-ischemic injury (HIE)

Question 39

what is diplegic cerebral palsey

Answer 39

a type of quadroplegic cerebral palsey but legs are affected worse than arms and hand function is good

Question 40

what is diplegic cerebral palsey associated with

Answer 40

periventricular brain damage

Question 41

what is dyskinetic cerebral palsey

Answer 41

characterised by involuntary movements

Question 42

what is the presentation of cerebral palsey

Answer 42

primitive motor reflexes are present variable tone involuntray uncontrolled movements : chorea, athetosis, dystonia intellect intact developmental delay EPS

Question 43

describe chorea

Answer 43

irregular, sudden, brief non-repetative movements

Question 44

describe athetosis

Answer 44

slow writhing movements occuring distally ie at fingers

Question 45

describe dystonia

Answer 45

simultanoeus contractions of extensors and flexors of trunk causing twisting

Question 46

descrbe ataxic cerebral palsey

Answer 46

hypotonic symmetrically with unilateral signs

Question 47

what is the presentation of ataxic cerebral palsey

Answer 47

delayed motor development incoordinate movements intention tremour ataxic gait

Question 48

what are febrile convulsions

Answer 48

a fever accompnied by a seizure without an intercranial infection

Question 49

what age group is usually affected by febrile convulsions

Answer 49

6y-15y

Question 50

what feature in the Hx would reassure youits a febrile convulsions

Answer 50

early in illness/fever whentemp is still rising

Question 51

what are the features of febrile convulsions

Answer 51

breif tonic clonic no brain damage only once x illness

Question 52

what are features of a complex febrile convulsions

Answer 52

focal seizure prolonged repeated illness have high risk of developing subsequent epilepsy

Question 53

what must you do in any ?febrile convulsions

Answer 53

exclude meningitis = blood and urine cultures LP if younger than 18m

Question 54

what is the acute management of a febrile conculsion/ status epilipitcus

Answer 54

A B C measure BMs IV lorazapam \> (10mins)\> Iv lorazapam\> (5mins)\> IV lorazapam\> phenytoin over 20 mins IV\> phenobarbitol \>PICU

Question 55

what is the acute management of a febrile conculsion/ status epilipitcus IF you cant get Iv access

Answer 55

A B C BMs Ciazapam PR or Midlazapam (per osseus - POs)\> 10min\> paraldehyde PR\> get special assistance

Question 56

what is the definition of anorexia nervosa

Answer 56

slimming through self restriction (calorie) and a phobia of normal body weight

Question 57

what is the presentation of Anorexia

Answer 57

self induced weight loss low BMI laxatives/vomiting/ XS ecersise Halted pubertal developments Food idealisation Slow reflexes Ankle oedema XS hair

Question 58

what is the management of Anorexia

Answer 58

therapy fam therapy fluoxetinerefeeding psychoeductaion

Question 59

what is bulimia

Answer 59

self induced bouts of overeating and purging via: vomiting/laxatives/diuretics

Question 60

what is the presentation of bulimia

Answer 60

wide fluctuations in weight but gereally normal BMI acidosis