Principle 2

Question 1

Types of febrile seizures

_______ febrile seizures

________ febrile seizures

Answer 1

Simple

Complex

Question 2

Difference between simple and complex febrile seizures

Duration
Reoccurrence
Location

Answer 2

<15mins ; >15mins
Does not within 24hrs; Does within 24hrs
Primarily generalized ; primarily focal

Question 3

Some epilepsy syndromes typically start with FS, they include:
•___________ epilepsy with febrile seizures plus (GEFS+)
•______________ epilepsy of infancy (a.k.a. ———- syndrome)
•______________ epilepsy secondary to mesial temporal sclerosis

Answer 3

Generalized

Severe myocionic

Temporal lobe

Question 4

Pneumonia: is _______________________ caused by ____________

Pneumonitis: is a general term for _____________________ , from any cause

Answer 4

inflammation of the lung parenchyma

microorganisms

inflammation of the lungs

Question 5

Types of Asphyxia

Asphyxia ______ (_____ asphyxia)
Asphyxia _______ (_______ asphyxia)

Answer 5

livida ; blue

palida ; white

Question 6

The two types are actually a continuum:

• Asphyxia Livida : Ocurs when the hypoxemia results in ________ (due to increased concentration of ______________________)

• Asphyxia Palida: occurs, if there is ________________ , due to _____________ which makes the baby appear pale

Answer 6

cyanosis ; deoxygenated hemoglobin

no intervention; circulatory collapse

Question 7

Drugs to treat Apenea?

Answer 7

IV aminophylline, caffeine citrate

Question 8

While patients may remember their
(aura or automatisms?) , they are usually amnesic to their (aura or automatisms?)

Answer 8

aura

automatisms

Question 9

Old terms : new terms

Partial Seizures
•Simple partial seizure
• Complex partial seizure
• Secondary generalized seizure

Answer 9

Focal seizures
• Focal aware seizure
• Focal impaired awareness seizure
• Focal to bilateral seizure

Question 10

________________ seizure (Focal aware seizure)

•Results from abnormal electrical discharge from _______________________________.
•Consciousness is classically _________ in this type of seizure
•Symptoms may be motor, sensory, autonomic or psychic

Answer 10

Simple partial

a focus on one cerebral hemisphere.

preserved

Question 11

__________ Seizures (Focal impaired awareness seizure)
•Starts from a focus on one cerebral hemisphere, usually the _________ lobe

•characteristically ______ consciousness and this is usually preceded by ____/______

Answer 11

Complex Partial

temporal

impairs

Aura; automatisms

Question 12

Treatment for focal or partial seizures??

Answer 12

Carbamazepine

Sodium valproate

Question 13

____________ Seizures (Focal to bilateral seizure)
•Simple or complex partial seizure may _______ , from its focus, to involve the ________________ ; thus, said to have secondarily generalized

Answer 13

Secondarily Generalized

spread; whole brain

Question 14

Secondary generalized seizures

The spread si classically described as progression from ______ to _______ to ________ (called ________________)

Answer 14

face

Arm

Leg

Jacksonian march

Question 15

Myoclonic Seizure
Myoclonic seizure is characterized by sudden ____________ followed by very brief (<___ sec) _______________ movements of limbs and trunk

____________ is regained immediately after, and the child may frown or cry

Answer 15

loss of consciousness

1 ; arrhythmic jerking

Consciousness

Question 16

West syndrome: a triad of ________, ______________ and ___________

Answer 16

infantile spasm

developmental regression

hypsarrhythmia

Question 17

Difference between typical and atypical absence seizures

Answer 17

Patient neither change posture nor drop objects being held

Patient makes minor movements such as blinking, lip smacking, tagging on the clothes etc.

Question 18

________ epilepsy : Most common epilepsy syndrome in childhood

Answer 18

Rolandic

Question 19

Most common cause of status epilepticus in children is??

Answer 19

Sudden withdrawal of Anti-Epileptic drug

Question 20

___________ and ___________ congenital heart defects rarely cause heart failure

Answer 20

Atrial Septal Defect (ASD) and Tetralogy of Fallot (TOF)

Question 21

Peripheral edema usually involves the ________ and _________ in infants, and the _______ and ________ in older children. Occasionally the whole body is involved (____________)

Answer 21

eye lids and sacrum

feet and leg

anasarca

Question 25

Heart failure in children Cardiac Biomarkers: ventricular dilation in heart failure causes elevated ______________ (>100 pg/mL) and ____________________ . This differentiates HF from a primary respiratory process

Answer 25

Brain Natriuretic Peptide N-terminal proBNP (NT-proBNP)

Question 26

____________ accounts for approximately 90% of nephrotic syndrome cases in children

Answer 26

Idiopathic NS

Question 27

Pneumonia is usually preceded by days of ????

Answer 27

upper respiratory tract infection (URTI)

Question 28

About 85% of children with NS have ________________ type

Answer 28

minimal change NS (MCNS)

Question 29

Infections Children with NS are specially susceptible to infection, for the following reasons: •___________ •Impaired _________ of microorganisms (due to urinary loss of complement factors ____,______ etc, and alternative pathway factors _____ and ____)

Answer 29

Hypoglobulinemia opsonization C3, C5 B and D

Question 30

Investigations in nephrotic syndrome Spot urine protein: creatinine ratio: should be >____ for NS (______________urine is used)

Answer 30

2 first morning

Question 31

Indications for renal biopsy in NS - ___________ nephrotic syndrome -Age ___________ -Recurrent ___________ -Associated renal insufficiency -Hypo ___________ (___________), positive ANA or dsDNA -Relevant family history of ___________ or symptoms of ___________

Answer 31

Steroid resistant <1yror>8yr gross hematuria Hypocomplimentemia (low C3/C4), kidney disease ; systemic disease

Question 32

Complications of Long-term Steroid: __________ appearance, ________, ________, hypertension, growth delay, osteopenia, hyperglycemia, avascular necrosis etc.

Answer 32

cushingoid cataract infection

Question 33

Steroid resistant NS is caused by _________ in about 80% of cases

Answer 33

FSGS

Question 34

Possible Outcomes of Corticosteroid Therapy Response: is attainment of remission within first ________ of corticosteroid therapy •Remission: presence of ______ protein on urine dipstick (or urine protein: creatinine ratio of <0.2) for _______ consecutive days *Relapse: is presence of >____ protein on urine dipstick (or urine protein: creatinine of >2) for ____ consecutive days •Steroid Resistance: is failure to achieve remission after _______ of corticosteroids

Answer 34

4 wk <1+ 3 3+;3 8 wk

Question 35

Signs of raised intracranial pressure: ___________ , ___________, ___________ fontanel or diastasis of sutures, ___________ (___________, ptosis) or ___________ paralysis, ___________ or ___________ posturing, stupor, coma, or signs of herniation.

Answer 35

headache, vomiting bulging ; oculomotor; anisocoria, abducens ; decorticate decerebrate

Question 36

Why we give corticosteroids in meningitis

Answer 36

It inhibits production of TNF-a, thus improves overall patient outcome

Question 37

Treat T ICP:______° head-up, _________ or _________ 1g/kg, hyperventilation etc.

Answer 37

30-45 oral glycerol IV mannitol

Question 38

In meningitis Treat seizures: abort with IV _______ (0.1-0.2 mg/kg/dose); prevent recurrence with IV __________ (Loading: 15-20 mg/kg and Maintenance: 5 mg/kg/24hr)

Answer 38

diazepam phenytoin

Question 39

Physiological jaundice appears when??

Answer 39

after the first 24-36 hr of life

Question 40

1g of meconium contains _____ of bilirubin

Answer 40

5mg

Question 41

Pathological Jaundice Manifests within the ___________ of life

Answer 41

first 24-36 hr

Question 42

Causes of Enhanced Entero-hepatic circulation -Broad-spectrum antibiotic therapy -______________ nutrition (hyper-alimentation) -_______________ (Pyloric stenosis, Hirschsprung disease) -_______nutrition

Answer 42

Total parenteral nutrition Gl obstruction Undernutrition

Question 43

Neonatal jaundice appears cephalic-caudally Face at ____mg/dL Mid-abdomen at ____mg/dL Foot at ____mg/dL

Answer 43

5 15 20

Question 44

Contraindication for phototherapy?

Answer 44

Personal or family history of porphyria

Question 45

If caffeine citrate and aminophylline don’t work??

Answer 45

Give doxapram

Question 46

Fetal risk factors of RDS __________ Hypothermia (cold stress) _______ _____ sex _______ race ________ of a set of twin

Answer 46

Prematurity Hypothermia (cold stress) Asphyxia M a l e s e x White race Second of a set of twin

Question 48

Distance between the infants skin and the light source should not be > _____ cm (may be reduced to ______ cm, if temperature homeostasis is monitored)

Answer 48

50 10-20

Question 49

When adequately delivered, phototherapy should lower bilirubin by ______ mg/di over _____hr

Answer 49

1-2 4- 6

Question 50

Total blood volume is assumed to be: •_____ml/kg in preterms • ____ ml/kg in terms

Answer 50

100 80

Question 51

Apnea: is _________________ for > ________ or for any duration if accompanied by ________ and _________

Answer 51

cessation of breathing 20 sec cyanosis and bradycardia

Question 52

Classification of apnea _______ Apnea _______ Apnea _______ Apnea

Answer 52

Central Apnea Obstructive Apnea Mixed Apnea:

Question 53

Clinical Features of apnea Onset is usually between ______ of life It does not occur in the _______ and rare in the _______ of life It may occur in fairly active babies It may be accompanied by bradycardia, pallor, cyanosis and hypotonia

Answer 53

3-7 days first 24 hr first 48 hr

Question 54

TRANSIENT TACHYPNEA OF THE NEWBORN (TTN) This is a self-limiting condition, most commonly found in (term or preterm?) infants delivered via __________ • Etiology: ____________ of ___________

Answer 54

Term caesarean section slow resorption fetal lung fluid

Question 55

MECONIUM ASPIRATION SYNDROME (MAS) This is primarily a disease of ________ and __________ infants •Risk factors: fetal distress, intrauterine __________,__________, or _________

Answer 55

term and postterm asphyxia, hypoxia or acidosis

Question 56

Meconium Aspiration Syndrome Etiology: ______________ into the _________ (either in utero or with the first breath) causing ____________________________

Answer 56

aspiration of meconium lungs small airway obstruction

Question 57

PERSISTENT PULMONARY HYPERTENSION OF THE NEWBORN (PPHN) - This primarily affects ________________________ infants

Answer 57

term and postterm