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3a Child Health > Neurology and Psychiatry > Flashcards

Neurology and Psychiatry Flashcards

1
Q

What is ADHD?

A

A neurodevelopmental conditional with hyperactivity, impulsivity and inattention

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2
Q

What are the risk factors for ADHD?

A

low parental education, parental smoking, maternal depression, low birth weight, prematurity

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3
Q

What is there reduced function of in ADHD?

A

The frontal lobe which controls executive function

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4
Q

What is the first line medication for ADHD?

A

Methylphenidate

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5
Q

What is Methylphenidate?

A

ADHD medication that is a CNS stimulant and requires ECG baseline before starting

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6
Q

What is ASD?

A

A neurodevelopmental disorder with abnormal social interaction, communication and restricted, repetitive behaviours

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7
Q

What are the risk factors for ASD?

A

male, family history, chromosomal abnormality such as Downs

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8
Q

What are some presentations of autism?

A

Social interaction - unable to interpret cues, inability to form attachments and understand emotion
Communication - delayed or minimal speech, impaired make believe, lack of gestures, monologues, endless questions
Restricted behaviour - tendency to restrict change, inability to adapt to new environments

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9
Q

What are the features of anorexia nervosa?

A

excessive weight loss, lanugo hair, amenorrhoea, hypotension, hypokalaemia, hypothermia, depression, skin pallor and dryness, oedema, osteopenia, cardiac complications

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10
Q

What is the BMI for extreme anorexia nervosa?

A

Under 15

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11
Q

What is refeeding syndrome?

A

Occurs when there has been severe nutritional deficit for an extended period and patients start to eat again

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12
Q

What can refeeding syndrome cause?

A

Hypomagnesaemia, hypokalaemia, hypophosphataemia

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13
Q

What is bulimia nervosa?

A

Episodes of binge eating where a person suffers a loss of control and eats more than usual.

This goes alongside compensatory mechanisms to prevent weight gain including self-induced vomiting, laxatives and heavy exercise.

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14
Q

What is the presentation of bulimia nervosa?

A

binge eating, body image distress, uncomfortable eating with others, mood disturbance, purging, tooth erosion, weight fluctuation, swollen salivary glands, abdo pain

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14
Q

What is Russel’s sign?

A

Calluses on the knuckles where they have scraped their teeth in bulimia nervosa

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15
Q

What can hypokalaemia show on ECG for bulimia?

A

Increased P wave amplitude, prolonged PR, ST depression, T wave flattening and prominent U waves

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16
Q

What is the first line treatment for bulimia?

A

SSRI - fluoxetine then sertraline

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17
Q

Name 4 complications of bulimia nervosa?

A

Gastric ulcers, irregular menstrual cycles, osteoporosis, heart problems including heart failure

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18
Q

What is a febrile convulsion?

A

A type of seizure that occur in children with a high fever not caused by epilepsy or other neurological pathology.

19
Q

What is the typical age of a febrile convulsion?

A

6 months to 5 years

20
Q

What is a simple febrile convulsion?

A

Generalised tonic clonic seizure of less than 15 minutes

21
Q

What is a complex febrile convulsion?

A

Partial or focal seizure lasting more than 15 minutes

22
Q

What has to be excluded in febrile convulsions?

A

Epilepsy, meningitis, encephalitis, intracranial space occupying lesions, syncopal episode, trauma

23
Q

What are the two branches of seizures?

A

Generalised and focal

24
Q

What is a tonic clonic seizure?

A

Loss of consciousness with tonic (muscle tensing) and clonic (jerking) with tongue biting, irregular breathing, groaning and irritable confusion afterwards

25
Q

What is the treatment for tonic clonic seizures?

A

Sodium valporate or lamotrigine in girls

26
Q

What is an absence seizure

A

typically in childhood - stare into space then return to normal within 10-20 second

27
Q

What is the treatment for absence seizures?

A

Ethosuximide or lamotrigine in girls

28
Q

What are atonic seizures?

A

Brief lapses in muscle tone

29
Q

What are myoclonic seizures?

A

Sudden brief muscle contractions where patient doesn’t lose consciousness

30
Q

What are frontal lobe seizures?

A

Motor or premotor cortex that can lead to clonic movements travelling proximally (Jacksonian march)

31
Q

What are temporal lobe seizures?

A

The most common with strange warnings, aura, lip smacking, automatisms and deja vu

32
Q

What is the treatment of focal seizures?

A

Lamotrigine

33
Q

What are the investigations for epilepsy?

A

History, EEG, brain MRI, ECG, electrolytes and blood glucose

34
Q

How does sodium valporate work?

A

Increases GABA activity in the brain which has a relaxing effect

35
Q

What are the side effects of sodium valporate?

A

Teratogenic, hair loss, tremor, weight gain

36
Q

What are the side effects of carbmazepine?

A

Agranulocytosis, aplastic anaemia, ataxia, induces the P450 drug system

37
Q

What is a side effect of lamotrigine?

A

Stevens Johnson syndrome

38
Q

What is status epilepticus?

A

Seizure back to back without regaining consciousness or seizure more than 5 minutes

39
Q

How do you manage status epilepticus?

A

Benzodiazepines, lorazepam then phenytoin

40
Q

Which diagnostic tool is used for ADHD?

A

DSM-5

41
Q

Describe inattention in ADHD

A

Easily distracted
Forgetful in daily activities
Finds it difficult to organise task + activities
Does not appear to be listening when spoken to directly

42
Q

Describe ‘hyperactivity’ as applied to ADHD

A

Cannot remain seated and talks excessively

43
Q

In some adults diagnosed with anxiety / depression, what underlying condition might they have?

A

ADHD

44
Q

What is the treatment for autism?

A

No medication
Educational support
Verbal support
SLT

3a Child Health (14 decks)

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