Peds

Question 1

features of benign childhood epilepsy with centrotemporal spikes

Answer 1

infrequent partial seizures. tingling in mouth, face, drooling. unilateral upper extremity movement. rare generalized tonic clonic seizures.

most happen during sleep or when waking.

EEG will be centrotemporal spikes.

Question 2

Juvenile Myoclonic Epilepsy

Answer 2

myoclonic jerks.

EEG is 3-6 Hz polyspikes and waves.

Triggered by am wakening, lack of sleep, fatigue, etoh, photic stimulation.

Requires lifelong treatment.

Treat with valproic acid–not in adolescent girls.

Question 3

Febrile seizure age

Answer 3

bw 3m and 6y.

most common seizure in children.

Question 4

when do LP in febrile seizure

Answer 4

signs or symptoms to suggest meningitis like meningeal signs, bulging fontanel or prolong postictal state.

LP should be considered in children bw 6-12 m of age if not vaccinated for Hib or strep pneumo

LP should be considered in pt taking antibiotics

Question 5

Most common cause of infantile spasm

Answer 5

tuberous sclerosis

Question 6

characteristic eeg abnormality in infantile spasm

Answer 6

hypsarrhythmia

Question 7

Treatment goal in infantile spasm

Answer 7

normalize EEG

Question 8

drug of choice in infantile spasm and in tuberous sclerosis

Answer 8

ACTH

vigabatrin in tuberous sclerosis. can cause visual field restriction

Question 9

Characterizations of Lennox Gastaut Syndrome

Answer 9

different types of seizures
mental retardation
characteristic EEG is less than 2.5 spike and slow wave discharge

Question 10

4 most common causes of neonatal seizure

Answer 10

hypoxic ischemic encephalopathy, cns infection, intracranial bleed, brain malformation

Question 11

drug of choice for neonatal seizure

Answer 11

phenobarbital

Question 12

most common cause of flaccid paralysis in children

Answer 12

Guillain Barre syndrome

Question 13

most significant finding in GBS

Answer 13

symmetric leg weakness w/ diminished DTR

Question 14

CSF analysis in GBS

Answer 14

increased prtn with normal wbc count

Question 15

treatment of GBS

Answer 15

IVIG or plasmapheresis

Question 16

classic findings in duchenne muscular dystrophy

Answer 16

calves hypertrophy and gower’s signs

Question 17

acute ataxia definition

Answer 17

unsteadiness of walking or fine movements of less than 72 hours duration

Question 18

3 most common causes of acute ataxia in children

Answer 18

post infectious cerebellar ataxia (most common), intoxication, guillain barre syndrome.

Question 19

classic physical findings of cerebral palsy

Answer 19

peripheral hypertonia and axial hypotonia

Question 20

classic cause of spastic hemiplegia cerebral palsy

Answer 20

unilateral perinatal stroke

Question 21

drug used for migraine prophylaxis in obese children and kids with epilepsy

Answer 21

Topiramate. –use in muffin top kids

Question 22

migraine prophylactic used in depressed kids

Answer 22

amitriptyline

Question 23

migraine prophylactic contraindicated in asthmatics

Answer 23

propranolol

Question 24

7 diagnostic criteria for neurofibromatosis

Answer 24

1. 6 or more cafe au lait spots
2. 2 axillary or inguinal freckling
3. 2 neurofibroma or 1 complex neurofibroma
4. optic glioma
5. 2 lisch nodules
6. sphenoid dysplasia or long bone abnormalities
7. first degree relative with NF1.

Question 25

major criteria for tuberous sclerosis

Answer 25

ash leaf skin, shagreen patch

subependymal nodules

retinal hamartoma

cardiac rhabdomyoma

renal angiomyolipoma

lymphangioleiomyomatosis

Question 26

what disease presents with port wine stain affecting V1 and V2, leptomeningeal angiomas, seizures, unilateral glaucoma,e tc.

Answer 26

sturge weber syndrome.