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IM 5.5 Test 4 > Neurological Dysfunction in Children > Flashcards

Neurological Dysfunction in Children Flashcards

(96 cards)

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1
Q

ICP consists of

A

Brain - 80%, CSF - 10% and blood - 10%

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2
Q

GCS parts

A

eye opening, verbal response and motor response

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3
Q

highest GCS score

A

15

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4
Q

lowest GCS score

A

3

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5
Q

when to intubate

A

<8 GCS, “less than 8, intubate”

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6
Q

pinpoint pupils indicate X2

A

opioid/barbiturate poisoning, brain stem dysfunction

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7
Q

dilated/reactive pupils common after

A

after seizures

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8
Q

dilated and fixed pupils indicate X7

A

damage to CN III, herniation, hypothermia, anoxia, ischemia, poisoning with atropine, instilling mydriatic drugs

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9
Q

bilaterally fixed pupils over 5 minutes

A

brain stem damage

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10
Q

sudden appearance of fixed/dilated pupils

A

neuro emergency - remain with child d/t high risk for respiratory arrest

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11
Q

decorticate/flexion posturing

A

dysfunction of the cerebral cortex or legions above brain stem

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12
Q

decerebrate posturing

A

dysfunction at midbrain or lesions to brain stem

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13
Q

unilateral decerebrate posutring

A

herniation - neurological emergency

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14
Q

early signs of increased ICP

A

HA, vomiting, slight personality changes, irritability, fatigue

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15
Q

late signs of increased ICP X5

A

bradycardia (<80), decreased response, posturing, pupil changes, cheyne stokes respiration,

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16
Q

indications for invasive ICP monitoring

A

GCS = 8, GCS >8, TBI with abnormal CT, deterioration of condition, subjective judgment by neurosurgeon

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17
Q

mannitol

A

osmotic diuretic used in ICP reduction

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18
Q

hypertonic saline

A

pulls fluid into vascular system

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19
Q

meds to sedate and paralyze in ICP issues

A

midazolam/versed, fentanyl, vecuronium

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20
Q

most common cause of death in 9-19 years old

A

unintentional injuries

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21
Q

coup

A

point of impact

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22
Q

contrecoup

A

point opposite of impact

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23
Q

linear fracture

A

single fracture that does not cross suture lines

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24
Q

comminuted skull fractures

A

multiple associated linear fractures

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25
comminuted skull fractures often suggest
child abuse
26
open skull fractures cause communication between
skull and scalp or mucose and URI
27
treatment for open skull fractures
increased risk of CNS infection
28
depressed skull fractures
bone broken into several irregular fragments and pushed inward
29
basilar skull fractures
bones broken at the base of the skull that usually result in dural tear
30
s/s of basilar skull fractures
bleeding at the nape of the neck, raccoon eyes, bleeding behind tympanic membrane, CSF, clear fluid around blood on sheets
31
epidural hemorrhage
blood accumulates rapidly between the dura and the skul
32
epidural hemorrhage incidence in <2
very low incidence
33
s/s of epidural hemorrhage
momentary unconsciousness, often not evident in children
34
subdural hemorrhage
a vascular injury causing bleeding between the dura and the cerebrum
35
what causes subdural hemorrhage
birth trauma, falls, assaults, violent shaking
36
s/s of subdural hemorrhage
standard increased ICP s/s, with battle signs
37
subdural hemorrhage treatment
observation, subdural taps in infants, SDH, burr hole
38
drwoning
survival at least 24 hours after submersion
39
highest age group at risk of drowning
0-4
40
<1 y/o drown in
bath tub
41
toddlers drown in
buckets
42
pre schoolers drown in
swimming pools
43
school aged and adolescent kids drown in
lakes, ponds, rivers and ocenas
44
seizures diagnosed by
Labs, LP, CT/MRI, EEG, split screen EEG
45
partial seizures
involve one area of the brain
46
generalized seizures
involve both hemispheres of brain
47
ketogenic diet is helpful in
seizure disorders
48
vagus nerve stimulation
implanted device that sends impulses to the vagus nerve with a magnet in children over 12
49
bacterial meningitis patho
inflammation of the membranes covering the brain and spinal cord
50
bacterial meningitis s/s
fever, nuchal rigidity, back pain, kernig sign, brudzinski sign,
51
bacterial meningitis dx
lumbar puncture, csf fluid analysis
52
CSF WBC bacterial
elevated neutrophils
53
CSF WBC viral
elevated lymphocytes
54
CSF protein bacterial
elevated
55
CSF protein viral
normal to slightly increased
56
CSF glucose bacterial
decreased
57
CSF glucose viral
normal
58
CSF gram stain bacterial
positive
59
CSF gram stain viral
negative
60
CSF color bacterial
turbid or cloudy
61
CSF color viral
clear
62
CSF opening pressure bacterial
elevated
63
CSF opening pressure viral
normal
64
bacterial meningitis tx
antibiotics, seizure control, 1/2 MIVF
65
complications of bacterial meningitis
cerebral edema, subdural effusion, seizures, shock, disseminated IV coag, hydrocephaly
66
viral meningitis s/s
HA, fever, photophobia, nuchal rigidity
67
viral meningitis tx
mostly symptomatic
68
rabies patho
acute infection of the nervous system that is almost always fatal
69
rabies incubation period
1-3 months but may be as short of 5 days or as long as 8 months
70
rabies s/s
agitation, LOC changes, attempts at swallowing causes hydrophobia
71
rabies tx
passive immunization asap after exposure active immunity given at same time as passive and on 3, 7, 14, 28
72
reye syndrome patho
acute illness causing encephalopathy and liver dysfunction
73
reye syndrome s/s
fever, impaired consciousness and liver dysfunction
74
reye syndrome dx
liver biopsy
75
cerebral palsy patho
non-progressive impairment of motor function
76
prenatal CP causes
maternal infection or substance abuse
77
perinatal CP causes
nuchal cord, ischemic stroke
78
postnatal CP causes
meningitis
79
spastic CP
hypertonicity
80
dyskinetic CP
abnormal movement
81
ataxic CP
coordination, balance, posture
82
mixed CP
combination of spastic and dyskinetic
83
medications for CP
dantrolene sodium, baclofen, diazepam, botox, gabapentin, anti-epiletic, levodopa, trihexyphenidyl, reserpine
84
carbamazepine
anti-epileptic
85
divalproex
antiepileptic
86
lacosamide
antiepileptic
87
levitiracetam
antiepileptic
88
oxcarbazepine
antiepileptic
89
lamotrigine
antiepileptic
90
what does levodopa treat
dystonia
91
trihexyphenidyl treats
dystonia
92
reserpine treats
hyperkinetic movement disorders
93
GBS patho
inflammation and edema of the spinal cord and cranial nerves
94
acute phase BGS
symptoms begin, may last up to 4 weeks
95
plateau GBS
consistent symptoms, days to weeks
96
recovert GBS
improvement begins, weeks to month

IM 5.5 Test 4 (3 decks)

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