NP619 Module 7 & 8 Flashcards

Question

MD-Creatinine Kinase is elevated | can do a muscle biopsy

Answer 1

Refer to Neuro Referr to PT/OT Refer to First Steps program

Answer 2

not sure when it displaces so must check FOR A FULL YEAR!!!! If not caught it affects movility and abnormalities of the femoral head and the acetabelum Get a plain frog leg view or ultrasound

Answer 3

Barlow=(click of exit) push down and see if you can put joint out of socket one hip at a time-knee flexed and extended Thigh back and out!! Hips are adducted

Answer 4

Galeazzi is noted with the observed discrepancy in knee heights when infant is supine. the sacrum is flat on the table and the knees and hips are bent

Answer 5

worn 3 mos by children 3 mos and younger and older children 4 mos or older a period of double their age. Should be worn 23 hours a day Traction or cast would be next.

Answer 6

Click may just be ligament

Answer 7

Repetitive motion is the problem

Answer 8

The premature closing of suture lines 2 most common forms: Scaphocephaly (boat head) long and narrow Sagittal suture fuses, Most common. 54-58% Brachycephaly is if the coronal sutures fuse too soon, the head is flattened. 18-29%

Answer 9

``` Macrocephaly>2 standard deviations above normal for age, gender and gestation Hydrocephalis enlarged ventricular system megaencephaly-from metabolic conditions 97th percentile and higher ```

Answer 10

Ask if it was round at birth teach parents to turn head treat torticollis with stretching orthotic device-helmet

Answer 11

household or close contacts (individuals who slept and ate in the same household with the patient) and intimate nonhousehold contacts who have had mucosal exposure to the patient’s secretions (such as a boyfriend or girlfriend). Individuals who have had direct exposure to the patient’s secretions through shared utensils or toothbrushes, kissing, and school/daycare contacts in the prior seven days should receive chemoprophylaxis.four or more hours with the index case for 5-7 days before the illness

Answer 12

``` S. pneumoniae (47%), N meningitidis (25%), ```

Answer 13

Close contact (for more than eight hours) with someone with N. meningitidis infection Contact with oral secretions of someone with N. meningitidis infection

Answer 14

poorly sensitive but highly specific for bacterial meningitis. K=patient supine flex knee and thigh to 90 degrees pain in the hamstring when leg is extended is a + sign B=flex neck and reflex flexion of the hips is a + sign

Answer 15

A recent history of upper respiratory tract infection is common in children with bacterial meningitis; children are also more likely than adults to experience a seizure.12 The illness course varies, with progression over hours to several days.

Answer 16

Abuse-call CPS and police | ASK; who, what, where, when

Answer 17

Something wrong in the brain or CNS

Answer 18

``` Lethargy / decreased muscle tone Extreme irritability Decreased appetite, poor feeding or vomiting for no apparent reason Grab-type bruises on arms or chest No smiling or vocalization Poor sucking or swallowing Rigidity or posturing Difficulty breathing Seizures Head or forehead appears larger than usual or soft-spot on head appears to be bulging Inability to lift head Inability of eyes to focus or track movement or unequal size of pupils ```

Answer 19

No LOC, minor head injury normal mental status, no abnormal findings or focal findings on exam, including fundoscopic, no evidence of skull fx THEN YOU CAN OBSERVE WITH NO CT/SKULL FILMS

Answer 20

Helmets cut risk for head injury by 80% if worn properly | If worn wrong, then twice as likely to have a head injury

Answer 21

Tension-like a band around the head. Migraine=pain, n/v, visual changes common vs classic (aura)

Answer 22

worse on wakening may improve with vomiting ``` Variables that predict a presence of a space-occupying lesion include: HA of less than 1 month absence of family hx of migraine abnormal neurological findings on exam gait abnormalities occurrence of seizures ```

Answer 23

Should only be considered with an abnormal neurologic exam or other physical findings that suggest CNS disease

Answer 24

``` >5 with features from below lasts 1-72 hours bilateral or uni (frontal or temporal) pulsating moderate to severe intensit aggravated by routine physical activities AND n/v photophobia ```

Answer 25

Children <6 ibuprofen is effective and acetaminophen Work on triggers Give antiemetic early for nausea Child must be 12 for migraine triptans A neurologist can give a triptan earlier if he wants. You should refer for this if younger than 12

Answer 26

chronic that recur without any external disorder REFER Order lab tests based on historic or clinical findings such as vomiting dehydration, or failure to return to baseline alertness

Answer 27

In the child with a NONFEBRILE first seizure, LP is of limited value. The EEG is recommended as part of the neurodiagnostic evaluation of the child with an apparent first unprovoked seizure.

Answer 28

Consider MRI with a signficant cognitive or motor impairment unexplained abnormalities a seizure of partial onset with or without secondary generalization an EEG that does not represent a benign partial epilepsy of childhood or primary generalized epilepsy in children under 1 year of age

Answer 29

medication is typically started after 2 unprovoked seizures Involve neuro and peds monotherapy is the gold standard routine blood tests may actually lead to unnecessary changes and more problems in asymptomatic patients, BUT do if suspect toxicity therapy maintained for two years of seizure free period and then d/c?

Answer 30

Psuedo=The EEG may be normal Look for in children who have witnessed a seizure in another, who have seizures that occur in the same situations, does not decrease with anticonvulsants, and whose seizures appear "suggestable" True -Seizure is like epilepsy. Brain activity depolarization of the neurons is widespread

Answer 31

Discuss safety issues with the parents. Drowning, machinery, careful of being in high places,

NP619 Module 7 & 8 Flashcards

(55 cards)