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Flashcards in Neuro Deck (35):
1

consider ___ for febrile seizure in children under 1 year of age or those unimmunized, or child who doesn't improve within 24 hrs

meningitis

2

neurofibromatosis is often associated with

developmental delay

3

Ok for concussion pt to return to school when? When to sports?

school once asymptomatic for 1 week

sports in stepwise fashion, return to previous stage if symptoms recur

4

Obtain an MRI or CT for seizures in what 3 instances?

- focal neurological exam finding
- all teens with first time seizure
- worsening seizures

5

approx half of all adolescents and children seizure disorders are

idiopathic

6

when would you refer for concussion?

- prolonged headaches/dizziness
- memory disturbances
- seizures

7

age range for breath holding spells

6 months-4 years

8

Which of the following would NOT be associated with an uncomplicated concussion:

- focal motor signs
- brief LOC
- headache
- confusion or amnesia

- focal motor signs

9

lab work up for child with seizures (7)

- blood chemistry
- CBC with diff
- septic workup
- lead screen
- toxicology screen for teens
- LFTs
- metabolic screen on infants and neonates

10

approx __% of children have seizure before age 15, but only __% have true epilepsy (recurrent seizures)

3.5%

1%

11

Gabapentin (neurontin) -anticonvulsant - side effects (4)

sedation
fatigue
dizziness
ataxia

12

Diagnostic testing if syncope

def EKG, EEG if warranted

13

Which of the following children who just had a seizure would you NOT need to order an MRI or CT?

- 6 year old with weak right hand grip
- 14 year old who just had first time seizure lasting 17 min
- 6 month old with one day history of 103 fever
- 4 year old with recent onset headaches that include AM vomiting and PM awakening

- 6 month old with one day history of 103 fever

14

if prepubertal child had more than 5 cafe au lait spots or 6 or more in poster puberal, consider

neurofibromatosis

15

most common type of cerebral palsy

spastic

16

children less than ___ years with headaches are more likely to have an organic cause

5

17

preventive meds for migraines (5)

- beta blockers (propranolol 10-20mg/day) -- not for asthma, CVD, depression, pregnancy, diabetes
- antidepressants
- antihistamines: cyproheptadine (toddlers)
- CA channel blockers
- anticonvulsants (depakote, topamax)

18

oxcarbazepine (trileptal) anticonvulsant may cause clinically significant

hyponatremia

19

mean age of onset for migraines in male and females

7.2 years boys
10.9 girls

20

3 main migraine abortive prescription meds

- triptans (contraindicated in HTN, CVD, pregnancy)
- ergotamine
- DHE (dihydroergotamine)

21

Typical symptoms of migraine headache in 14 year old usually include recurrence and:

- unilateral forehead pain, nausea, photophobia
- bilateral forehead pain, cyclical vomiting and vertigo
- unilateral forehead pain, ataxia and photophobia
- bilateral forehead pain, nausea, and an aura

- unilateral forehead pain, nausea, photophobia

22

static neuromotor disorder due to previous CMS insult

cerebral palsy

23

treatment for mild to moderate migraines

NSAIDS
acetaminophen
caffeine

24

for a seizure disorder workup, always obtain what type of EEG?

sleep-deprived with hyperventilation and photostimulation

25

dilantin (anticonvulsant) may cause ___

gum hyperplasia

26

are the majority of migraines familial?

yes

27

typically occurs while standing often preceded by a sensation of warmth, nausea, lightheadedness and visual gray out - BP drop which reduces circulation to the brain and causes LOC

neurocardiogenic syncope

28

Is amnesia a common finding in concussions?

yes

29

if seizures can be controlled for __ year(S), many children can be slowly weaned from medication with no further seizures

2

30

tegretol and depakote (anticonvulsants) may cause ___ and ____

bone marrow suppression and liver damage

31

Signs of organic etiology in 10 year old boy with history of recent onset headaches include all but:

- headaches that awaken him in the middle of the night
- accompanied by vomiting
- begin as the day progresses
- worsen with coughing

- worsen with coughing

32

most states will allow teen who has been seizure free for ___ years and demonstrated good med compliance to drive

2

33

use medication no more than ___ times a week to avoid rebound headaches

2-3

34

benign and most frequent cause of fainting in children and adolescents

neurocardiogenic syncope

35

nuchal rigidity is an early sign of meningitis in children how old?

more than 2 yrs