neuro

Question 1

key features of GBS

tpes of microcephaly

whats worse congenital microcephally or post natala

nb formicrophaly epilspesy

Answer 1

1. SUDDEN ONSER
2. SYMMETERICAL
3. ASCENDING

symeteircal - everythign low
asymeterical - just head - more common and clincially relavnt

post natal

nb! monogenic

Question 2

other symptoms of GBS

Answer 2

may have pain esp in shoulders, back , thigh
may have cranial nerve involvement
absent deep tendon reflexes vs MG

Question 3

CAUSE language regression

Answer 3

autism
epilepsy
cerebellar mutsism

Question 4

does gbs affect sensory nerves

Answer 4

yes it can affect infect sensory symptoms may be the presenting part of the disease, so patients have report parestheisas

Question 5

what kind of disease is GBS

Answer 5

lower motor neurone

polyneuropathy

Question 6

what systems does gbs affect

Answer 6

sensory motor autonomic

Question 7

autonomic problems gbs

Answer 7

~~~
urinary retention
cardiac arrhythmia
dry eyes
blurred vision
stomach pain
labile hypertension

Question 8

treatment of gbs

Answer 8

plasmapheresis (if severe)

iv immunoglobulin IV 2 G/KG 1st line

Question 9

when would kerning and brudinzki show

Answer 9

after 2 years

Question 10

signs of increased intracrhail pressure

Answer 10

can cause disorders in breathing and heart rate!
vomitting
lethargy
refusal to eat

Question 11

central facial palsy

Answer 11

the opposite lower quadrant

Question 12

peripheral facial palsy

Answer 12

half the face

Question 13

causes of torticollois

Answer 13

tumour
traumatic birth injury
early sign of hemiplegic CP

Question 14

TESTS FOR MEASURING AXIAL MUSCLES TONE

Answer 14

traction

landau

Question 15

What is contraindicated in GBS

Answer 15

corticosteroids

Question 16

sunset eyes

Answer 16

sign of increased ICP such as hydrocephalus and it affects the region of the brain that controls eyes movement as cranial nerves 3, 4, 6 get affected

Question 17

which muscles affected more in SMA and signs of sma

Answer 17

PROXIMAL MORE THAN DISTAL

floppy baby
scarf sign
knee to ear
ventral susupesion
tongue fasiculates +/fingertrtips?
frog leg positon
bell shaped abdomen

Question 18

which is the disease of anterior horn

Answer 18

SMA

POLI

Question 19

muscles affected more in neuropathy

Answer 19

distal

Question 20

dx of GBS

Answer 20

POLIO

transverse myelitis

Question 21

POLIO VS GBS

Answer 21

POLIO: asymetericl , csf is more inflammatory , autonomic dysfunction not that common like gbs, just supportive treatment , more acute , more likley to cause permanent parylis, can spread via feces , dmaages anterior horn

gbs: csf just protein,has a specific tx , more insisuious,fever is uncommon , immune mediated, cant spread from person to person , damages the myelin , more likley to have sensory abnormalities

Question 22

Sign of botulism

diagnosis

treatment

PATHOPHYS

Answer 22

constipation + descending hypotonia , drooling

toxin in stool

immunoglobulin 50mg/kg (human ) not horse

in babies its the ingetsion of sportes and go tht gut and perfom toxins and not the preformed toixn, it affectec the cranial neres (weak cry, weak suck, decreased gag reflex)

Question 23

dx myositis from myopathy

Answer 23

myositis : pain upon movement and acute and cause is enterovirus mostly CK only temporary affected for less than a month

myopathy: won’t hurt when you palpate or move

Question 24

dermatomyositis key features

Answer 24

PROXIMAL muscle weakenss
heliotrope rash
grottoes papules
elevated creatink kinase
anti JO

Question 25

antibodies in dermatomyositis features of hsv encephalitis and hwich one is more commone features of encephalits in older kids EEG csf tx

Answer 25

anti jo but also antinuclear hemorragic necrotic lesions hs1 more common but for neonatal period hs2 is common but can also be hs1 anomia (dont know the name of) aphasia - cant speak hemiparesis TEMPORAL LOBE FOCAL seizure which can become genralised unilateral or bilateral temporal periodic high waves lymphoctoisis, pleocytosis, erythroctyrachia, proteinrachia aciclovir IV for 2-3 weeks 30-60mg/kg-

Question 26

are reflexes affected in Dermatomysotis

Answer 26

no changes

Question 27

reflexes in collagen laxity

Answer 27

normal

Question 28

symptoms of collagen laxity + complications

Answer 28

hypotonia may have transitory motor delay may have no weakness or slight weakness tendon reflexes are normal mitral valve proplapse! lunation of lens aneurysms pneumothorax

Question 29

duchess CK LEVAL

Answer 29

VERY HIGH! >1000

Question 30

IS cp congenital or acquired

Answer 30

both such as torch infection cmv or acquired during birth delivery

Question 31

most common cause of cp whoch reflexes persist a complication of chicken pox

Answer 31

ANTENATAL morro, palmar, fencing acute cerebelltis - the most common type of cerebellitis

Question 32

what example is hIE in the category of cp

Answer 32

perinatal

Question 33

hie more common for

Answer 33

TERM BABIES

Question 34

CAUSES OF POST NATAL CP lennoz gastraut triad (lecture)

Answer 34

HSV ENCEPHALITIS atypical abscences, DROP attacks slow spik and waves (awake) drop attacks when asleep 10hz psychomotor retardation | meningitis

Question 35

which CP has has primitive reflexes leading in hemiplegic what is more affeted in diplegic what is more affected

Answer 35

dyskinetic upper more affcted all 4 but the lower limbs more affcted

Question 36

which cp affects arms more than legs what is paraplagia

Answer 36

quads + hemiplegic legs

Question 37

which cp is associated with epilepsy

Answer 37

deffo quadriplegic | but 50% of hemiplegic have focal epilepsy

Question 38

types of dyskinetic cp ADEM

Answer 38

dystonic and choreoathhetoid acute desiminated encepholitis after infection oR VACCINATION due to cross reaction tx methylpredinososle (multile defcits over the brain)

Question 39

unlikely to be cp if

Answer 39

``` other family members have the same “CP” ® no certain etiology ® normal MRI ® regress - motor, cognitive or other ° multisystem disease ```

Question 40

signs of hydrocephalus in babies subactute pan scelrosing

Answer 40

1. bulging fontanelle 2. prominant scalp veins 3. sunset eyes 4. increase HC after latent measles, memory loss, chnage in behavior then later comes myoconic jerks !!!!lastly persistant vegetative state - die- no cure

Question 41

NMDAR encephalitis

Answer 41

antibodies against the receptor in brain key word is dyseknias and autonomic instablitiys (hypersalvation, hyperthermia) can come as a result of HSE after recovery so dx from reactivation but you would see NEW SIGNS like the dsykinesia tx- methylpredisonlone, IVIG, plamapheresis,rituximab

Question 42

how to we treat hydrocephluas

Answer 42

1. shunt- connect from the ventricle of the brain to another area of the body to drain, like peritoneal cavity . risk is that shunt is infected and may have to be changed many time, always suspected meningitis in these kids if they have a fever 2. Endoscopic third ventriculostomy (ETV) - creating a small hole in the third ventricle of the brain (one of four fluid-filled cavities in the brain) so that the excess fluid can make its way out and relieve pressure.

Question 43

if you had to specifically decribe GBS what woul you say

Answer 43

its a lower motor neruon disease and polyneuropathy and demyelinating

Question 44

usual first symptom for gbs acute necrotiizng encephalopathy

Answer 44

tingling sensation in extremities very fatal, go into coma real fast tx with methylprednisolone similar to reyes in that it affects liver enzymes nb! thalmaus symmetrical lesions on ct

Question 45

compliation os sma

Answer 45

willl need feeing help as weak eating and get tired easily from just chewing resp fialure as muscles fail freuqnet infectins as weak cough cant clear secrtions aspirarion pneumonia scoliois- as the muslces supporting the spine

Question 46

# e examples of prenatal cp

Answer 46

TORCH genetics syndromes placental insufficnecy

Question 47

clasification of CP accourding to lesion site reyes syndrome and triggers dx

Answer 47

pyrimidal tract extrapyrimiadal cerebellar aspirin + valproate >5-10 hypoglycmeia, fatty liver, elevated transaminase , hyperammonia ryes like syndrome but no hypoglycmeia you need to check for inborn errors of metabolbilsm s happens <5