Pediatrics Flashcards
(70 cards)
1
Q
What do you always include in pediatric history taking? (4)
A
- immunizations
- birth history
- po intake
- excretions: BM/urine
2
Q
neonatal period
A
0-28 days`
3
Q
postnatal period
A
29 days to 1 yr
4
Q
primary HA’s - what types
A
tension migraine cluster sinus hormonal
5
Q
secondary HA’s - what types
A
minor illness
serious condition - CNS tumor
6
Q
common symptom of brain abscess
A
nighttime awakening HA
7
Q
Tension HA presentation
A
bilateral
forehead
neck
squeezing
8
Q
Tension HA tx
A
NSAIDs
MSK relaxers
9
Q
Migraines commonly affects who
A
teens
females
10
Q
POUND criteria for migraines
A
P: pulsatile O: hours of onset U: unilateral N: nauseating D: disabling
11
Q
Migraine classic
A
aura
12
Q
migraine common
A
no aura (80% of migraines)
13
Q
Cluster HA presentation
A
severe unilateral periorbital lacrimation nasal congestion Horner's syndrome (affects trigeminal nerve): ptosis, anhidrosis, miosis
14
Q
Cluster Tx
A
100% oxygen
15
Q
What do you always document with a HA?
A
- maximal at onset
- worse HA of life
- sudden onset
Otherwise SAH!!
16
Q
CNS tumors have a ____ onset
A
gradual
17
Q
CNS tumors are accompanied by ____
A
focal neuro deficit
18
Q
MC CNS tumor
A
glioma
19
Q
Worst CNS tumor
A
glioblastoma multiforme
20
Q
seizure definition
A
sudden, uncontrolled electrical disturbance in the brain
21
Q
focal seizures occur…
A
in one area of the brain
22
Q
focal seizures are defined as…
A
simple: no loss of consciousness (LOC)
Complex: LOC or altered level of consciousness
23
Q
generalized seizures involve…
A
both hemispheres of the brain
have a LOC
24
Q
What is status epilepticus
A
seizure duration >5mins.
25
Tx of status epilepticus
lorazepam
diazepam
IV, IM, or rectal --> usually rectal
26
When you work up a seizure, you are working up....
the potential causes: electrolyte abnormalities, seizure medications, anemia, infections, get an ECG/CXR/CT of head
27
Febrile seizure definition
convulsion associated with fever > 103.0 not associated with CNS/infection/inflammation
28
febrile seizure recurrence rsik
30-50%
29
MC neuro disorder in infants/young children (6m-6yrs)
febrile seizures
30
Tx of febrile seizures
```
lower temp
rectal diazepam (>5min duration)
```
31
Why do febrile seizures occur in young?
lower seizure threshold in infants places them at greater risk
32
who gets breath holding spells
infants - 6y/o
33
breath holding spells are associated with...
genetics
IDA
thought to be secondary to autonomic dysfunction
Autosomal dominant
34
who gets vasovagal syncope
young and healthy
AKA "common faint"
35
how long does vasovagal syncope last
1-2 minutes
36
when does vasovagal syncope occur
sitting or standing
37
cause of vasovagal syncope
neural reflex: hypotension due to bradycardia or peripheral vasodilation
type of reflex syncope
38
vasovagal syncope classically due to...
```
emotion
orthostatic
pain
fear
heat
physical activity
```
39
atypical vasovagal syncope occurs when
in elderly
or recurrent in patients
40
three characteristics to diagnose GBS
1. progressive weakness
2. worsening respiratory status
3. significant bulbar weakness --> cranial nerves, dysphagia, slurred speech, difficulty handling secretions, dysphonia
ascending paralysis
41
what is juvenile transient myasthenia gravis
rare form of MG, an autoimmune disorder of the neuromuscular junction resulting in ocular manifestations or weakness in the ocular, bulbar, limb or respiratory muscles
antibody mediated & target ACH receptors/proteins
T cell dependent
42
symptoms of juvenile transient myasthenia gravis
progressive weakness
43
treatment of juvenile transient myasthenia gravis
cholinesterase inhibitors for several weeks
44
how do you diagnose juvenile transient myasthenia gravis
Ice pack test
serology: AChR-Ab
45
what must you do when dealing with juvenile transient myasthenia gravis
rule out thymoma with a CT or MRI of chest
strong link of 30-40% have a thymoma and 30-40% will develop a thymoma
46
Concussions can result in chronic traumatic encephalopathy. What is that?
permanent mood and behavior changes; often seen in repetitive injuries, boxers, football players, military
47
imaging done with concussion
non-contrast CT
48
ESPECIALLY GET A non-contrast CT if...
- altered mental status
- signs of skull fracture
- severe injury mechanism (pedestrian/motorist and no helmet; fall >5ft; head struck by high-impact object)
49
What causes tourettes
result from complex social + emotional factors multiple genetic affecting the meso-limbic circuit or cortico-striatal-thalamic-cortical circuit
50
In order to have tourettes....
both parents must have had it
51
Tourette disorder commonly affects...
males>females
52
Tx tourettes wtih...
medication that treats both tics and ADHA: alpha adrenergic agonists: guanfacine or clondine
53
What is cerebral palsy
a heterogenous group of conditions causing permanent, non-progressive motor dysfunction
Affects muscle tone, posture, movement, can cause intellectual disability, alterations in sensation and perception, seizures
54
what causes cerebral palsy
some sort of abnormality or injury to the developing fetal or infantile brain
55
PE characteristic of cerebral palsy
microcephaly
56
Number 1 lab test for cerebral palsy
Tests for muscular abnormalities: elevated serum creatinine
57
Huge defining characteristic of cerebral palsy
NON-progressive
58
MC motor dysfunction in children
cerebral palsy
59
what causes infantile botulism
by eating food contaminated with Clostridium Botulinum:
a Gram +, rod-shaped, spore forming anaerobe
60
infantile botulism presentation
descending paralysis
dilated pupils
dry mouth
61
infantile botulism pathogenesis
- neurotoxin enters blood
- releases out of blood into NMJ
- binds motor nerve terminal and blocks synaptic fusion
- blocks release of ACh or inhibits muscle contraction
- causes muscle weakness/flaccid paralysis from upper to lower extremities
62
what are Duchenne and becker muscular dystrophies
an inherited group of progressive myopathic disorders resulting from defects in a number of genes required for normal muscle function
63
what is the primary symptom of Duchenne and becker muscular dystrophies
muscle weakness onset of 2-3y/o, sometimes later
Progressive weakness is the principal symptom as muscle fiber degeneration is the primary pathologic process
64
what causes Duchenne and becker muscular dystrophies
mutations of dystrophin gene on the X chromosome
65
common PE of DMD/BMD
gower sign: have to tripod to stand up
66
Kernig sign
meningitis
knee flexion causes pain in neck
67
meningitis agents in babies
E.coli (GNR)
| GBS
68
Tx of meningitis
dexamethasone and empric ABX (cephalosporins/vanco/penicillins)
69
why give dexamethasone in meningitis
prevent hearing loss due to H. influenzae
70
MC of encephalitis
HSV
CMV if immunocompromised
