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87 Cards in this Set
- Front
- Back
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Most severe form of spinal cord defect |
Myelomeningocoele |
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Screening done for NTD |
Maternal AFP at 16-18th week AOGA |
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Underlying cause of spina bfida |
Failure of the neural tube to close between 3rd-4th week in utero |
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Prevention of myelomeningocoele |
Folic acid RR by at least 50% 0.4mg OD 1 month prior to conception to 12 weeks AOG |
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Spina bfida associated with what malformation |
Type II Chiari HCP |
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Failure of closure of rostral neuropore Rudimentary brain with absent cerebral hemisphere and cerebellum |
Anencephaly |
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Agyria Due to faulty neuroblast migration What condition? |
Lissencephaly |
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Bilatetal clefts in the cerebral hemispheres Congenital hemiparesis What condition? |
Schizencephaly |
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Presence of cysts or cavities within the brain Associated with AVM |
Porencephaly |
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Defective cleavage of the prosencephalon, inadequate induction of forebrain What condition? |
Holoprosencephaly |
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2 mechanisms of HCP develop |
Impaired circulation and absorption of CSF Increased production of CSF |
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Type of HCP? Abnormality of the aqueduct or lesion in the 4th ventricle |
Obstructive Non-communicating *aqueductal stenosis |
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Mechanism of non-communicating HCP |
Obstruction of subarachnoid cisterns Arachnoid villi malfunction s/p SAH, inc ICP |
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How is CSF reabsorbed? |
Arachnoid villus cells located in the superior sagittal sinus *pinocytosis |
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3 causes of communicating HCP |
Meningitis Post-hemorrhagic Enlargement of the subarachnoid space Meningeal malignancy |
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3 causes of non-communicating HCP |
Aqueductal stenosis Mitochondrial Malformation - Chiari, Dandy-Walker Mass lesions |
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Setting sun sign is caused by impingement of what structure? |
Dilated suprapineal recess |
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Percussion of skull produces a separation of sutures What sign? |
Macewen sign Cracked pot sensation |
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Match condition with findings Chiari Dandy-Walker |
Foreshortened Prominent |
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MC of complication of shunt |
Staph epidermidis infection |
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Definition of seizures Paroxysmal time-limited changes in motor activity/behavior due to ? |
Abnormal electrical activity in the brain |
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Disorder of the brain characterized by an enduring predisposition to generate seizure |
Epilepsy |
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Criteria to diagnose seizure as epilepsy |
2 or more unprovoked seizures occurring in >24 hrs |
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Disorder that manifests as one or more specific seizure types Specific age of onset and prognosis |
Epileptic syndrome |
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Single nocturnal seizure with clonic movement of the mouth and gurgling Resolve by 16yrs |
Benign rolandic epilepsy |
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Definition of petit mall seizure |
Sudden cessation of motor activity or speech Blank facial expression Flickering of eyelids No aura No postictal state No loss of body tone |
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Seizure associated with sudden LOC Loss of spinchter control Post-ictal state |
GTC Tonic phase - jaw snaps then tonic spasms, apnea, cyanosis Clonic phase - 1-2 mins of rhythmic generalized muscle contractions |
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Brief symmetric contractions of the neck, trunk, extremities |
Infantile spasms |
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EEG of infantile spasms |
Hypsarrhythmia - high voltage bilaterally asynchronous slow wave activity |
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DOC for GTC seizures |
Phenobarbital Phenytoin Carbamazepine LTG VA Gabapentin |
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DOC for absence seizures |
Ethosuximide VA |
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DOC for infantile spasms |
Vigabatrin |
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Role of ketogenic diet |
Anti-convulsant effect Elevated levels of B hydroxybutarate and acetoacetate |
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MC seizure disorder in childhood |
Febrile seizure |
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Peak age of onset in febrile seizure |
14-18mos |
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Findings in febrile seizure |
Normal PE Normal EEG + family history |
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Difference between simple and complex febrile seizure |
<15 min GTC Brief period of post-ictal drowsiness Once in 24 hrs |
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3 risk factors in recurrent febrile seizure |
<18 mos Family history Low temp at time of the seizure Short duration of illness |
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Recurrence risk for recurrent febrile seizure |
4% 23% 32% 62% 76% |
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Usual cause of status epilepticus |
Breakthrough seizure Missed doses |
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DOC of status epilepticus |
Phenytoin |
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Definition of migraine |
Recurrent headache with symptom free intervals with 3 of the ff |
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5 associated factors with migraine |
Family history Relief following sleep Unilateral Aura Abdominal pain Nausea and vomiting Throbbing |
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Pathogenesis of aura in migraine |
Cortical speading depression High CNS H and K releasing glutamate and NO |
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Alice in Wonderland symptoms associated with ? |
Migraine with aura |
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Recurrent severe vomiting (5x/hr) in infants that lasts for 1-5 days |
Cyclic vomiting |
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5 indications for cranial CT and MRI in migraine |
Abnormal neurologic signs Behavioral changes Headache awakens the child during sleep Migraine and seizure Focal neurologic signs |
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Treament for migraine |
Acetaminophen 15mg/kg Ibuprofen 7.5-10mg/kg Metoclopramide IV |
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DOC for status migrainosus |
Prochlorperazine IV 0.15mg/kg Max 10mg |
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Indication for prophylaxis for migraine |
More than 2-4 severe episodes monthly Unable to attend school regularly |
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DOC for migraine prophylaxis |
Propranolol 10-20mg TID Flunarizine 5mg |
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Clinical presentation of tension/stress headache |
Onset of puberty Waxes and wanes Bandlike tightness Frontal region No nausea and vomiting |
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Gene mutation present in tuberous sclerosis |
TSC1 - hamartin TSC2 - tuberin *tumor suppresor genes |
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Characteristic brain lesion in tuberous sclerosis |
Tubers in convolutions of the cerebral hemispheres in the subependymal region *candle-dripping apperance |
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Skin lesions seen in tuberous sclerosis |
Ash leaf Shagreen patch in the lumbosacral region |
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Abnormality of neural crest differentiation Chromosome 17 defect |
Von Recklinghausen disease Neurofibromatosis 1 |
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Description of skin lesions in neurofibromatosis |
6 or more cafe au lait macules >5mm in prepubertals >15mm in postpubertal Sparing of the face |
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Hamartomas located in the iris Associated with neurofibromas |
Lisch nodules |
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B acoustic neuroma Parent/sibling/child with NF2, unilateral 8th nerve mass Neurofibroma Meningioma Glioma What condition? |
Neurofibromatosis 2 |
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MCC of meningitis in infants |
Grp B strep Enteric bacilli Lisseria |
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MCC of meningitis in children |
Strep pneumoniae H. influenzae N. meningitides |
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CSF Q/Q findings in meningitis |
Pleocytosis High protein Low glucose |
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DOC in N. meningitides? S. pneumoniae? Penicillin resistant? Partially treated? |
Pen IV 5-7 days 3rd gen Ceph or Pen IV for 10-14 days Vancomycin Ceftriaxone/Cefotaxime for 7-q0 days |
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Given in H. influenzae meningitis for reduced auditory nerve damage |
Dexamethasone if given 1-2 hrs before antibiotics |
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MC of aseptic meningitis |
Enterovirus *Coxsackie, Adenovirus, CMV |
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CSF Q/Q of viral meningitis |
Normal glucose Normal to inc protein Lymphocytosis |
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Most reliable test for brain abscess |
Cranial CT and MRI |
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DOC for unknown cause for viral meningitis |
3rd gen cephalosporin Metronidazole |
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DOC for head trauma or NSS |
Nafcillin Vancomycin 3rd gen Metronidazole |
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Indications for surgery in meningitis |
+ gas in abscess Multilocuted Posterior fossa Fungal cause Associated infections |
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Duration of treatment for viral meningitis |
4-6 weeks |
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Earliest and most constant sign in myasthenia gravis |
Ptosis EOM weakness |
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Characteristic features of myasthenia |
Rapid fatigue of muscle Proximal muscle weakneaa More symptomatic later in the day |
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Preferred diagnostic exam in myasthenia |
EMG *decremental response |
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DOC for myasthenia |
Neostigmine 0.04mg/kg IM q4-6hrs Atropine Prednisone |
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Tensilon test for MG uses what |
Edrophonium chloride IV |
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DOC for Bell's Palsy |
Oral prednisone 1mg/kg/day for 1 week |
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Associated infection with GBS |
Camphylobacter jejuni |
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Acute opthalmoplegia Ataxia Areflexia Seen in GBS What condition? |
Miller Fisher syndrome |
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CSF Q/Q for GBS |
Inc protein Normal glucose No pleocytosis *albuminocytologic dissociation |
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Treatment for GBS |
IV Ig 0.4gm/kg/day for 5 days |
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Most important risk factor in CP |
Severe postmaturity |
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2 risk factors for developing CP |
Congenital anomaloes Intrauterine exposure to maternal infections (CMV, rubella) LBW |
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Most severe form of CP |
Spastic quadriplegia |
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Common PE finding in spastic diplegia of CP |
Commando crawl |
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2nd most prevalent malignancy in childhood |
Brain tumor |
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4 common infratentorial tumors |
Cerebellar astrocytoma Medulloblastoma Brain stem glioma Ependymoma |
