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85 Cards in this Set
- Front
- Back
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NTD: risk factors
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1.maternal malnutrition
2.drugs 3.radiation 4.genetics 5.congenital infection |
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NTD: closes when?
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week 3-4 gestation
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drugs associated w/NTDs
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1.valproic acid
2.carbamazepine antiepileptics |
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NTD screen when?
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wk 16-18
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Cushing triad
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HTN
bradycardia Cheyne-Stokes respiration |
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upward gaze paralysis
"setting sun sign" dx? |
hydrocephalus
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clonus
(+) Babinski diplopia setting sun sign papilledema dx? |
hydrocephalus
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T/F: if increased intracranial pressure, then it's ok to LP
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false! herniation thru foramen magnum
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hydrocephalus: tx
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shunts
IV abx acetazolimide |
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indwelling shunt: most common bug
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staph epidermidis
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late indicator of hydrocephalus
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Cushing triad
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most common movement disorder
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CP
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microcephaly / macrocephaly
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2 s.d. below / above mean
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premature fusion of cranial sutures
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craniosynostosis
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craniosynostosis: causes
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1.idiopathic
2.syndrome component |
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tuberous sclerosis: inheritance pattern
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autosomal dominant
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tuberous sclerosis: sporadic / inherited cases more common?
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sporadic
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ash-leaf spots
what is it? dx? |
flat, hypopigmented macules
tuberous sclerosis |
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areas of abnl skin thickening
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shagreen patches
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tuberous sclerosis: skin sx
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1.ash-leaf spots (earliest)
2.shagreen patches 3.sebaceous adenomas 4.uncal fibromas |
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tuberous sclerosis: neuro sx
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1.mental retardation
2.seizures 3.periventricular knoblike areas ("tubers") 4.subependymal nodules 5.giant cell astrocytomas |
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tuberous sclerosis: tumors where?
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1.kidney
2.heart (rhabdomyomas) 3.retina |
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tuberous sclerosis: tx
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1.antiepileptics
2.surgical removal |
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macrocephaly: causes
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1.large brain
2.cranioskeletal dysplasias 3.storage disease 4.hydrocephalus |
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microcephaly: causes
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1.genetic (tri 21, Prader-willi)
2.congenital insults |
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craniosynostosis: sagittal suture closure -> ?
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long head, narrow face = scaphocephaly (most common)
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craniosynostosis: coronal suture closure -> ?
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wide face, boxlike skull
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craniosynostosis: tx
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surgery = controversial
if done, age < 2 |
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headaches: important to first do what?
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r/o life-threatening conditions
-tumors -intracranial bleeds -acute hydrocephalus -meningitis |
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headaches: differential
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1.vascular
2.tension 3.increased intracranial pressure 4.systemic illness (infxn) 5.sinusitis 6.dental abscess 7.poor vision 8.TMJ |
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migraines: possible etiology
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vasodilation of intracranial vessels in response to vascular/neuronal stimulus
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tension headaches: possible etiology
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prolonged low-grade muscle contraction
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headache that wakes pt fr/sleep
dx? |
increased intracranial pressure
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headache: worse w...
-lying flat -bending,sneezing,straining -n/v -personality changes, gait disturbances, vision abnlities |
increased intracranial pressure
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headaches: what to ask in HPI?
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-history (acute/chronic)
-onset -progression -severity -location -duration -timing -alleviating/exacerbating -medication response -precipitants -stress -life changes |
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papilledema + 6th nerve palsy
dx? |
increased intracranial pressure
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headache + carotid bruit
dx? |
AVMs
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complicated migraine
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accompanied/followed by...
-weakness,paralysis -sensory loss -difficulty speaking -alteration in vision/mental status |
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headaches: severe, recurrent, pounding, focal, relieved by sleep
dx? |
migraine
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headaches: diffuse, constant, symmetric, "bandlike", under stress / fatigued, not interfere w/ADL
dx? |
tension headaches
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headaches: overwt adolescent female, tetracycline / corticosteroid use
dx? |
pseudotumor cerebri
(idiopathic intracranial HTN) |
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impaired CSF resorption
papilledema nl CT dx? |
pseudotumor cerebri
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pseudotumor cerebri: tx
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-repeat LPs
-acetazolamide -surgery (optic nerve sheath fenestration) |
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migraine: tx
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1.acetaminophen
2.ibuprofen 3.metoclopramide 4.sumatriptan 5.ergotamine |
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tension headaches: tx
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1.nonprescription analgesics
2.rest 3.stress management 4.biofeedback training |
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most common cause of intracranial hemorrhage in children
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AVMSs
(abnl collection of arteries & veins) |
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encephalopathy: definition
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generalized cerebral dysfunction
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recent/concurrent febrile illness
focal findings (hemiparesis, ataxia, CN deficits) seizures dx? |
HSV encephalitis
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Reye's syndrome
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mitochondrial disorder
acute-onset encephalopathy degenerative liver dz s/p viral illness + ASA use |
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n/v
delirium stupor hypoglycemia elevated transaminases & ammonia dx? |
reye's syndrome
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EEG: focal mediotemporal spikes superimposed on diffuse slow wave pattern
CT: temporal lobe abnlities dx? |
HSV encephalitis
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status epilepticus: tx
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IV/rectal lorazepam/diazepam
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motor & vocal tics daily for > 1 yr
OCD ADHD dx? |
Tourette's syndrome
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tics
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-sudden
-involuntary -repetitive behavior |
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simple febrile seizure
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< 5-10 minutes
generalized not recurring during preciptating illness |
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complex febrile seizure
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>10-15 minutes
recur w/in 24 hrs focal features |
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goal of supportive care in severe brain injury?
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optimizing cerebral perfusion pressure
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most common cause of pediatric death & disability in developed world?
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acute head trauma (MVAs)
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EEG: hypsarrhythmia
dx? |
infantile spasms
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infantile spasms
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-recurrent
-age 2-7 months -mixed flex-ex spasms (seconds) x 100 -associated w/neurodevelopmental diseases -dx confirm by EEG (hypsarrhythmia) |
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infantile spasms -> ?
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Lennox-Gastaut's syndrome
(frequent occurences of mixed, generalized seizures refractory to meds) |
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acute, progressive, ascending paralysis/weakness, no DTRs, increased CSF protein
dx? |
GBS
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Guillan-Barre: ascending/descending weakness
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ascending
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GBS: pathophysiology
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demyelination of peripheral nerves s/p viral illness
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GBS: tx
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IVIG / plasmapheresis may hasten resolution
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resembles GBS, but ocular palsie + pupillary abnlity
dx? |
tick paralysis
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tick paralysis: tx
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remove tick
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MG: pathophysiology
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autoimmune disase of NMJ
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poliomyelitis: pathophysiology
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viral illness
anterior horn cells (spine) |
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T/F: oral polio vaccine provides herd immunity
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true!
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Clostridium botulinum: paralysis via...
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toxin which irreversibly blocks ACh release at motor endplate
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spinal muscle atrophy: pathophysiology
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inherited
degeneration of anterior horn cells & CN motor nuclei |
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Werdnig-Hoffman's disease type I
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generalized hypotonia, weakness
evident in early infancy |
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leukodystrophies
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white matter disorders
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leukodystrophies: pathophysiology
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-abnl formed myeline
-impaired conduction -rapid myelin breakdown |
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-spasticity
-developmental milestone loss -visual disturbances -personality changes -poor school performance |
leukodystrophies
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girl w/nl development until age 1, after which developed microcephaly & milestone regression
dx? |
Rett's syndrome
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-mental retardation
-seizures -autistic -hand wringing, ataxia |
Rett's syndrome
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ataxia
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inability to coordinate movement and control balance
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most common causes of ataxia in children
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1.drugs (phenytoin, carbamazepine, sedatives, hypnotics, phencyclidine)
2.acute posinfectious cerebellar ataxia |
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retinal angiomas
cerebellar hemangioblastoma renal cell CA pheochromocytoma dx? |
Von Hippel-Lindau's disease
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Von Hippel-Lindau's disease: presents at...
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adolescence or older
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port-wine stain (nevus flammeus)
progressive mental retardation seizures hemiparesis visual impairment glaucoma dx? |
Sturge-Weber's disease
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iris hamartomas (Lisch nodules)
dx? |
nf-1
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bilateral acoustic neuromas
dx? |
nf-2
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