Neurology Flashcards by Celene Lopez

Causes of seizures may include f___, ing___, tu___, and el___ di____

fever
ingestion
tumors
electrolyte disturbances

How well did you know this?

Not at all

Perfectly

Seizure s/s include
Bo__/bl___ in____
ap___
cy___
au___

bowel/bladder incontinence
apnea
cyanosis
aura

How well did you know this?

Not at all

Perfectly

Children with seizures should be referred to the ED when the seizure lasts > __ minutes,
if child had a
h___ i___, h___ f___, or is presenting with compromised r___/c___ function

5 minutes
head injury
high fever
Respiratory/cardiac function

How well did you know this?

Not at all

Perfectly

What type of seizure affects bilateral brain hemispheres?

generalized

How well did you know this?

Not at all

Perfectly

What type of seizure causes tone loss?
a____

atonic

How well did you know this?

Not at all

Perfectly

What type of seizure affects one hemisphere?
F_____

focal

How well did you know this?

Not at all

Perfectly

What type of seizure causes rhythmic repetitive movements?
c_____

clonic

How well did you know this?

Not at all

Perfectly

What type of seizure causes extension/flexion of the head/trunk/extremities?

tonic

How well did you know this?

Not at all

Perfectly

A febrile seizure occurs on fever ____
*affects children __-___ M.O.A
*are often less than ___ minutes
*They do not reoccur within ___ hours

Rise
6-60
15
24

How well did you know this?

Not at all

Perfectly

Febrile seizures usually do not require diagnostic workup unless m____ s/s are present

meningeal

How well did you know this?

Not at all

Perfectly

Status epilepticus is a seizure lasting > ____ minutes
— or __ or more seizures occur without return to?

30 minutes
2 or more, baseline neuro status

How well did you know this?

Not at all

Perfectly

1st line status epilepticus management
a____
b_____

ABC’s
benzodiazepine administration

How well did you know this?

Not at all

Perfectly

2nd line status epilepticus management
*administering a_____ such as
—di___, k_____, or p____ load

antiepileptics
–Dilantin, keppra, phenobarbital load

How well did you know this?

Not at all

Perfectly

Children with refractory status epilepticus require a drug i___ c___ and e___

drug-induced coma
EEG

How well did you know this?

Not at all

Perfectly

Children with refractory status eplepticus may need s___ r____ or the placement of a v___ n____ s_____

surgical resection
vagal nerve stimulator

How well did you know this?

Not at all

Perfectly

Acute seizure control
*stabilize within __-___ minutes (ABC’s + IV)

*Administer initial benzos within __-___ minutes

*Administer 2nd line antiepileptics witthin __-___ minutes

0-5 minutes

5-20 minutes

20-40 minutes

How well did you know this?

Not at all

Perfectly

In children, the last choice in seizure treatment includes ph_____ due to the risk of lowering ___

phenobarbital
IQ

How well did you know this?

Not at all

Perfectly

Third-line seizure control management should be treated within __-___ minutes
—third line therapy includes re___ do___, an____ Dr___, and co___ e___ monitoring

40-60
–repeat dosing, anesthetic drips, continuous EEG

How well did you know this?

Not at all

Perfectly

How long does it take for a seizure to cause brain damage?

30 minutes

How well did you know this?

Not at all

Perfectly

The 1st line seizure diagnostic test is with an ___

EEG

How well did you know this?

Not at all

Perfectly

In an acute seizure event, what diagnostic test is quick and is able to see blood/bone/lesions/fluid?

How well did you know this?

Not at all

Perfectly

MRI’s
*have no r____
*assesses br__ ma___, sk___, and or____
*able to see is____, in___, a__m____, sp___ co___ lesions, and de___ disease

radiation
brain matter, skull, orbits

ischemia, infarcts, AV malformation, spinal cord lesions, degenerative disease

How well did you know this?

Not at all

Perfectly

MRI’s take l___ and may require s____

longer and may require sedation

How well did you know this?

Not at all

Perfectly

When obtaining an MRI, keep in mind that Bivona traches have m___ r____

metal rings

How well did you know this?

Not at all

Perfectly

When obtaining an MRI, keep in mind that shunt valve settings will c___

change

A lumbar puncture is obtained to r/o me___ or in___/in___/au___ processes

meningitis inflammatory/infectious/autoimmune

Obtain an LP in infant who are ___-___ M.O.A with an unknown vaccine status

6-12

An LP in females with pseudotumor cerebri is done to r___ c___

remove CSF

LP's are contraindicated in children with a h__ i___, obtain a C__ first

high ICP CT

LP procedure *place child in the l___ d___ position *insert needle between __-__ along the i__ c__ l___

lateral decubitus L3-L5, iliac crest line

Children who are difficult for LP should get them done in?

To prevent air leak, before removal of LP needle replace the s___

stylus

Spinal cord injury occurs most often s/p t____ such as a f___ from a tall h___ or h__/n___ t____

trauma fall from a tall height head/neck trauma

s/p trauma, younger children are prone to S____

SCIWORA spinal cord injury without radiologic abnormalities

Down syndrome children are prone to a____-a___ s___ s/p acute f___ i____

atlanto-axial subluxation flexion injury

Spinal cord Injury Impairment scale A= B,C, D = E=

complete incomplete normal

Spinal cord injury diagnostic tests include an x___ c__ m___

x-ray CT MRI

Spinal cord management 1) A___ 2) c____ i____ 3) IV s___ ( __ mg/kg)

ABC's c-spine immobilization steroids 30 mg/kg

Neurogenic shock management * f____, a__-a___ agents

fluids alpha-adrenergic

Neurogenic shock may lead to pa___ or loss of to___

paralysis loss of tone

In neurogenic shock, what criteria is used to assess the need for a CT?

chalice or pecarn criteria

Children with neurogenic shock require and art line for i___ monitoring and c___ p____ monitoring

ICP cerebral perfusion

A primary brain injury is an ___ event, for example a h____

acute hemorrhage

A secondary brain injury are the resulting s/s s/p a___ i___, for example i___

acute injury ischemia

Epidural hematoma *Dont c____ s___ l___ *stay on the s____ of i___

cross suture lines side of impact

Subdural hematoma *c___ shaped *c___ s___ but are not m___

crescent-shaped cross sutures midline

Intraparenchymal brain injuries b___ into t___

bleed into tissues

Intraventricular brain injuries b___ into v___

bleed into ventricles

hypoxic-ischemic brain injuries *develop l___ *occur if brain is hypoxic for > __-__ hours *CT will show a h___ brain

later 24-48 hyperdense

TBI management includes * minimizing se_____ brain injuries *In____, reduce ___, and minimize se____ *continuously monitor for wo____ in s/s

secondary Intubate, ICP, seizures worsening

A concussion is defined by a GCS score of __-____

13-15

A concussion is a *m____ h___ i_____ *No L____ *no routine i_____

mild head injury LOC imaging

What standardized tool is used to evaluate for concussions?

SCATS assessment

S/P concussion, kids can return to activities when they are at pre-m____ s____ and s___ f____

pre-morbid state s/s free

Cerebral palsy is a neuro in____ leading to mo____ im_____. Classified by the type of movement

insult motor impairment

In what CP are muscles unable to relax? s____

spastic

What CP is characterized by the child having movement but is unable to control muscle movement? ath_____

athetoid

In what CP is their motor impairment of the arms and legs on one side?

hemiplegic

In what CP is their motor impairment of both legs?

diplegia

In what CP is their motor impairment of all 4 extremities?

quadriplegia

Encephalitis is a condition where their is brain p____ i_____ --can be viral, bacterial, fungal, or autoimmune

parenchyma inflammation

In neonates, encephalitis is most often caused by?

HSV

In immunocompromised children, encephalitis is most often caused by?

varicella

Encephalitis s/s v___ problems, h____, n__-p____ s/s, f___, and at_____

vision headache neuropsych fever ataxia

Encephalitis management *Treat the primary cause *initiate a_____ *in 90% of cases, e___ will be abnormal

acyclovir EEG

In hydrocephalus, there is e____ CSF

excess CSF

Hydrocephalus is characterized by *r___ head g____ *e____ ventricles *trouble e____ *dy____ *h___ or w___ c___ *if severe, a_____

rapid head growth enlarged trouble eating dysphagia hoarse or weak cry apnea

Congenital hydrocephalus is often caused by a m_____

myelomeningocele

In a shunted hydrocephalus, fluid will drain into the a____ p____ s_____

abdominal pleural space

What is the most common immediate shunt placement post-op complication? *will present with s___ neck or f____

infection stiff neck or fever

Shunt malfunction is often caused by a b____ or b____ shunt. ---obtain a shunt s____ ---may also obtain a ___

blocked or broken shunt ---shunt series ---CT

Shunt over/underdraining may occur, these children require c___ f____ due to the risk for h_____

close follow up hemorrhage

If a shunt infection is suspected, you may need to t___ the s____ to obtain a c___ sample

tap the shunt CSF sample

If a shunt infection is suspected, begin a____ and then r___ the shunt once i___ has c____

antibiotics replace infection has cleared

craniosynostosis is p____ skull f____

premature skull fusion

40% of craniosynostosis children have g___ s_____

genetic syndromes

craniosynostosis will lead to brain g____ r_____

growth restriction

craniosynostosis is associated with aper_____, crou_____, p___-r____, tu____, va____ and da___ wa_____

aperts crouzanes Pierre-Robinson turner VATER dandy walker

to diagnose craniosynostosis obtain a __-skull f____, c___, and m____ ----management is with s____

3D skull film, CT, MRI surgery

craniosynostosis complications include *postop p___ and b____ *assess for S____ *Surgery is better when children are ______

pain and bleeding SIADH younger

Botulism is p_____ d_____ s_____ neuromuscular w______

progressive descending symmetrical neuromuscular weakness

Botulism is caused by __-b____ s____ ---found in contaminated s____, h____, or w_____

C. botulinum spores soil, honey, water

C.botulinim spores can be detected in s_____ ----occurs more frequently in infants < ____ M.O.A

stool 12

botulism s/s includes c_____, w____, d_____, decrease g___ response, w___ e___ m_____

constipation weakness dysphagia gag weak eye muscles

botulism txt is with botulism ____

IVIG

Guillan-barre is a p____ a____ s____ p_____

progressive ascending symmetrical paralysis

Guillan-barre most often occurs __-___ weeks s/p v____ illness or prior i____

4-6 weeks viral infection

Guillan-barre s/s include p____, n____, extremity t____, s___ loss, and g___ disturbance

pain numbness extremity tingling sensory loss gait disturbance

Guillan-barre is diagnosed through c__ p____

CSF protein

Guillan-barre treatment is with ____ or p_____

IVIG plasmapheresis

Muscular dystrophy is often diagnosed by ___ YOA

Muscular dystrophy presents with pr____ s____ pr____ w_____ --- Usually, there will be a g____ link

progressive symmetrical proximal weakness genetic

Muscular dystrophy will eventually affect the r___ center --consult with p____ --provide v___ support

respiratory pulmonology ventilation

Type 1 spinal muscular atrophy occurs in i___ by ___ M.O.A. ----babies will have f____/b___ difficulty, will often have a____ p_____ infections

infants, 6 feeding/breathing difficulty aspiration pneumonia

Type 3 spinal muscular atrophy occurs at ___ M.O.A and up ----initially these children will be able to w____ and then end up c___ b____

18 M.O.A. walk chair bound

pediatric stroke will present with se____, ap_____, fo___ and vi___ deficits

seizures aphasia focal/visual

ADEM is characterized by a br___ and ra____ e____ onset

Brief and rapid encephalitis

In ADEM their will be widespread brain i____ s/p i_____

inflammation s/p illness

ADEM s/s include w_____, p_____, and s___ like activity

weakness paralysis seizure

ADEM treatment -s____, i____, and p_____ *Children with ADEM have a high risk for r_____

steroids, IVIG, plasmapheresis -relapse

posterior reversible encephalopathy syndrome is where there is a b___ b____ b___ disruption with r____ abnormalities

blood-brain barrier radiologic

What is the most common s/s of posterior reversible encephalopathy syndrome?

seizures

brain death is i____ l___ of all brain f____

irreversible loss of all brain functions

In order to diagnose brain death, the following must be present. co___, ap____, and ab___ of br___ re____

coma apnea absence of all brainstem reflexes

brain death diagnosis is made by __ separate n___ e____ by different m____

two separate neurological exams by two different MD's

In neonates, the brain death examination is separated by?

24 hours

In infants and children, the brain death examination is separated by?

12 hours

pseudotumor cerebri is the rapid production of ____, most often in a___ f____

CSF adolescent females

pseudotumor cerebri complications include v___ l____

vision loss

pseudotumor cerebri treatment goal is to preserve the patients v_____ *assess for p_____ and cranial nerve __ p____

papilledema cranial nerve 6 palsy--problems with eye movement

Females with pseudotumor cerebri will have a normal ___ and ____

CT CSF

The diagnostic test for pseudotumor cerebri is with an ____ **The openening pressure will be > ___ mm hg

LP 280

Arteriovenous malformation is when their is an abnormal i___-c__ connection between a___ and v____

intracranial arteries and veins

children with Arteriovenous malformation are at an increased risk for?

bleeds

children with Arteriovenous malformation will present with neurologic d____, ensure to closely monitor i___

deficits ICP

The gold standard diagnostic test for AV malformation is with a?

cerebral angiography

Hypoxic ischemic encephalopathy is a consequence of prolonged b___ h____ which results in irreversible neuro sequela

brain hypoxia

Hypoxic ischemic encephalopathy management is with ___ and s___ control

ICP seizure

Hypoxic ischemic encephalopathy diagnostic studies include e___, c___, m____

EEG CT MRI

Neurofibromatosis is an ____ condition ---presents with t___ in the b___, s___, s___, and e____

inherited ---tumors brain, spine, skin, eyes

90% of children with NF will have the presence of?

cafe au lait spots

Due to tumor presence, children with NF are at risk for n____ d____

neurocognitive deficits

NF management includes close follow up of n___, h___, and o____

neuro hearing ophthalmic

Tuberous sclerosis is inherited via a___ d_____

autosomal dominance

Tuberous sclerosis includes the presence of b___ t____

Bening tumors

Tuberous sclerosis is diagnosed with ___ major criteria or __ major and __ minor criteria

2 1 and 2

Tuberous sclerosis management is with ____ control

seizure

Neurology Flashcards

(127 cards)