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47 Cards in this Set

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What is Cerebral Palsey
delayed gross motor development - delays all motor skills
What are Seizures
atypical electrical discharge in the neurons of the cerebral cortex
3 types of Meningitis
1. Haempohilus influenzae B (Hib)
2. Strep pneumoniae - very common
3. Neisseria meningitidis - upper respiratory organism
What is Muscular Dystrophy
a group of genetic disorders w/ microscopic changes in specific muscles, muscle wasting, loss of strength in skeletal and voluntary muscles.
Diagnosis of Cerebral Palsey
pattern of weakness, onset, developmental delays
Clinical manifestations of Meningitis
Headache, anorextia, N&V, change in LOC, seizure, rash, nuchal rigidity, joint pain, photophobia, temp >103
Clinical manifestations of Seizures from Birth to Toddlers
Fever, URI, metabolic disorders, malformation of CNS, perinatal brain injury.
Clinical manifestations of Seizures from older children to adults
trauma, tumors, CV disease
Clinical manifestations of Seizures from Toddlers to older children
CNS infection, neurodegenerative disorders, genetic seizure disorder
Etiology of MD
A flawed gene causes MD. The gene for dystrophin is normally found in the X chromosome, if defective then no dystrophin and MD results
Describe Duchenne Muscular Dystrophy
onset <5 years of age
rapidly progressive
respiratory and cardiac failure
children affected are late to walk
pseudohypertrophy of calf muscles
gradually become clumsy
frequent falls
loss of mobility b4 age 12
death b4 mid 20s
Describe Becker Muscular Dystrophy
Onset in teens or early adulthood
progressive
slow and unpredictable course
walk becomes wide and waddling, walking on toes
loss of strength in hips, pelvis, thighs, shoulders
gradually becomes clumsy
frequent falls
loss of mobility rare b4 30
death from respiratory problems in 50s-60s
Diagnostic tests for MD
biopsy of muscle for dystrophin levels
Blood creatine kinase >3000
MRI of muscle fibers
EMG to measure action potentials
Genetic: blood/muscle tissue
Treatments for MD
PT, ROM to prevent complication r/t immobility
Meds for MD
Albuterol: suppress immune response
Steroids: treat everything
Creatinine: increases strength
Calcium blockers
What does Gentamycin do?
in 10% of cases it bypasses the defective gene allowing dystrophin to be made.
Describe Becker Muscular Dystrophy
Onset in teens or early adulthood
progressive
slow and unpredictable course
walk becomes wide and waddling, walking on toes
loss of strength in hips, pelvis, thighs, shoulders
gradually becomes clumsy
frequent falls
loss of mobility rare b4 30
death from respiratory problems in 50s-60s
Diagnostic tests for MD
biopsy of muscle for dystrophin levels
Blood creatine kinase >3000
MRI of muscle fibers
EMG to measure action potentials
Genetic: blood/muscle tissue
Treatments for MD
PT, ROM to prevent complication r/t immobility
Meds for MD
Albuterol: suppress immune response
Steroids: treat everything
Creatinine: increases strength
Calcium blockers
What does Gentamycin do?
in 10% of cases it bypasses the defective gene allowing dystrophin to be made.
Manifestations of Cerebral Palsey
*Delayed Gross motor development - Universal sign of CP
Abnormal motor performance, increased muscle tone, abnormal postures, reflex abnormalities - persistance of plantar, palmar, moro reflexes
Possible manifestations of CP
Mental retardation: <30% of children have any deficit.
>70% have typical function
Sensory impairment of CP
nystagmus (rapid eye movements), hearing loss, amblyopia (lazy eye)
Other manifestations of CP
drooling, respiratory problems, constipation, dental probs, seizures, orthopedic probs.
What is spastic CP?
most common type of CP
Increased tone w/ poor control
attempts at movement worsten problem
very limited fine motor skill
What is Dyskinetic CP?
abnormal voluntary movement
athetosis: slow wormlike undulating, writhing movement
worsen with stress and during adolescence
involves muscles of breathing and speech
What is Ataxic CP?
wide-based gait
rapid repetitive movements done poorly
purposeful movement worsens condition.
Therapy goals for CP?
lessen symptoms
PT, OT, Speech & Language therapy to:
establish communication
facilitate ambulation
provide education
promote typical socialization
Meds used in treatment of CP
Valium, Robaxin, dantrium, Baclofen, Botox
_____ is the most common serious neurological problem affecting nearly 1% of children
Epilepsy
Partial Seizure:
originates in a single area or manifests on one side of body.
Simple partial seizure:
no loss of consciousness
Complex partial seizure:
Impaired or loss of consciousness.
Generalized seizures:
occur bilaterally or from several sites. manifestations on both sides of body
Absence seizures:
sudden loss of awaremenss
children can have up to 300-400 in 1 day
Myoclonic seizure
sudden, violent muscle contraction - one or many, usually in arms
Tonic-clonic seizure:
sudden onset of rapid alternating muscle flexion/extention
Seizure Meds:
Dilantin-phenytoin - oldest, usually first drug of choice.
Not used for absence seizures, liver disease, pregnancy
More seizure meds:
valproate acid: Depakene: used in all seizure types
Not used in Liver disease, pregnancy
May cause liver failure or bone marrow failure
Monitor labs, don't crush
Diet used for Tx of Seizures:
Ketogenic Diet: high fat, low carbs, very strict.
Vagal Nerve Stimulator
Used in Tx of seizures. Vagus influences no. of seizures - stimulator applies current to vagus until seizures abate
How is meningitis spread?
Coughing, kissing, sneezing
Who is at greatest risk for meningitis
children <5, elderly, teens & young adults
Labs for viral meningitis
WBC low: <500
Protein: 50-500 mg/dL
Glucose: normal
Urine: clear, slightly cloudy
Labs for bacterial meningitis
WBC high: >1000
Protein: >500 mg/dL
Glucose: low
Urine: turbid/cloudy
Tx for meningitis
IV fluids
antibiotics: ampicillin, penicillin, cephalosporin
Codeine for cephalgia
Tylenol or ASA for fever >102
Lasix for diuresis