Peds - Neuro (Usmle, Shelf, First Aid)

Front 1

tetanus Tx

Back 1

Tetanus Ig

Penicillin G or metronidazole

Surgical debridement

Diazapam PRN for muscle relaxation / seizure control

Front 2

Progressive epilepsy, cerebellar ataxia, dysarthria

Back 2

Mycolonic epilepsy w ragged-red fibers (MERRF) - lycine point mutation in mitochondrial tRNA

Often confused with Friedreich's ataxia

Front 3

Mitochondrial encephalopathy w hemianopsia cortical blindness, motor and cognitive deficiency, die by age 20

Back 3

Mitochondrial encephalopathy, lactic acidosis, stroke like episodes (MELAS) - leucine point mutation in mitochondrial tRNA

Front 4

Sydenham's chorea is seen (what timeframe) after (what)

Back 4

Several months after GAS w subsequent rheumatic fever

2/2 Ab against basal ganglia

Front 5

Cause of adrenoleukodystrophy (demyelination of CNS / peripheral nerves, adrenal insufficiency)

Back 5

Can't catabolize LCFAs --> high levels of VLCFAs

Front 6

Rx that can unmask Tourette's

Back 6

Methylphenidate (just unmasks, doesn't cause it)

Front 7

Truncal ataxia 3 weeks after viral infection + horizontal nystagmus. Px?

Back 7

Acute cerebellar ataxia - thought to be AI response

complete recovery w/in 2 months

Front 8

Progressive ataxia with lower limbs > upper limb involvement, peripheral nerve sensory deficits, skeletal abnl, cardiomyopathy, optic atrophy, hypotonia & decr/absent DTRs.

Inheritance?

Back 8

Freidreich's Ataxia

AR - triplet expansion mutation

Front 9

Degenerative ataxia starting around age 2; can't walk by teens + oculomotor apraxia (absence of saccades)

- Incr risk of what cancers?

Back 9

AT

brain + lymphoid tumors

Front 10

First sign of botulism in infants? Older pts?

Back 10

Infants: absence of defecation

Older: CN palsies

Front 11

Brief, severe, unilateral HAs w conjunctival injection - management

Back 11

Cluster HAs - recur several times a day over several week period (can be seasonal)

Tx w O2 or steroids

PPx with Li or CCB

Front 12

Different types of migraine?

Back 12

Classic - w/aura (paresthesias most often, rarely visual disturbances)

Common - w/o aura

Complicated - w/ neuro Sx

Note: migraines in kids are often bilateral

Front 13

Decr RR, HR, incr BP =

Back 13

Cushing's triad: incr ICP

Front 14

High-output CHF, FTT with cranial bruit

Back 14

vein of Galen AVM

Front 15

Seizures + popcorn appearance on MRI

Back 15

Cavernous hemangiomas

Front 16

Fall w/ pencil in mouth - at risk for what?

Back 16

Tear in ICA intima / dissection --> stroke; may present w/ seizures

Front 17

Most freq etiology of epidural hematoma

Back 17

Temporal bone fracture - lacerates MmA --> temporoparietal bleed

Front 18

What type of bleed is assc w/ LOC then lucid interval?

Back 18

Epidural

Front 19

Rx that may help with hydrocephalus acute management?

Back 19

Acetazolamide (decr CSF production)

Furosemide

Front 20

Rosenthal fibers on CNS tumor pathology

Back 20

Dense cytoplasmic inclusions

Cerebellar astrocytoma

Front 21

CNS tumor w/ bitemporal hemianopsia or other ocular Sx + brain calcifications

Back 21

Cariniopharyngiomas

Front 22

NF 1 Sx

Back 22

Cafe au lait spots

Axillary or inguinal freckling

Iris LIsch nodules

Optic glioma

Bone lesion s- spenoid dysplasia, thinning of long bone cortex

Learning disabilities, abnl speech, seizures

Incr risk of meningiomas and astrocytomas

Front 23

NF 2 Sx

Back 23

bilateral CN VIII tumors

Multiple CNS tumors (meningioma, glioma, schwannoma)

skin cafe-au-lair spots & NFs aren't as common

Front 24

Tuberous sclerosis Sx

Back 24

Ash leaf spots

Hamartomas in periventricular region, often calcify & project into ventricles

Rhabdomyomas of heart; kidney / lung hamartomas

Seizures / infantile spasm

Adenoma sebaceum

Shagreen patch (orange-peel patch in lumbar region)

Front 25

Small blue cells

Back 25

Neuroblastoma - HVA & VMA in urine

Front 26

Horner's syndrome 2/2 mass

Back 26

Neuroblastoma

Front 27

Cape-like distribution of pain & temperature sensory loss

Back 27

Cervical syringomyelia

Front 28

Infants w/ rapid increase in head size, cystic expansion of 4th ventricle into posterior fossa, agenesis of corpus callosum

Back 28

Dandy-Walker Malformation

Front 29

Which type of Arnold-Chiari malformation is assc w/ meningomyelocele? Syringomeylia?

Back 29

meningomyelocele - Type II

Syringomeylia - Type I

Front 30

Difference b/t simple partial & complex partial seizures?

Back 30

Simple - no LOC

Complex - alteration or LOC, automatisms

(Partial = focal onset)

Front 31

Are absence seizures partial or generalized?

Tx (other than ethosuxamide)

Back 31

Generalized

Can also Tx with valproic acid

Front 32

3-hz spike & wave =

Back 32

absence

Front 33

Large amplitude chaotic multifocal spike & slowing on EEG. Tx

Back 33

Infantile spasm - characteristic w/ trunk flexion. Can be part of West syndrome (infantile spasms, dev arrest). Tx with ACTH

Front 34

Localization of seizures w/ automatisms?

Back 34

Right temporal

Front 35

Prolonged absence seizures, dev delay, refractory to AED

Back 35

Lennox-Gastaut syn

Front 36

Loss of spontaneous speech in childhood, non convulsive SE during slow-wave sleep

Back 36

Landau-Kleffner syndrome

Give high-dose BDZ before bed

Front 37

V1 facial capillary hemangioma, seizures, hemiparesis, intracranial calcifications, MR, eye vascular lesions

Back 37

Sturge-Weber syndrome

Front 38

Causes of viral meningitis

Back 38

80%: enterovirus, echovirus, coxsackievirus, nonparalytic polio

Others: HSV, EBV, mumps, flu, adenovirus

Front 39

Deafness, peg-shaped incisors, interstitial keratitis

Back 39

Hutchinson's triad: congenital syphilis

Front 40

Causes of bacterial meningitis in <1 mo & >1 mo?

Back 40

<1 mo: GBS, Listeria, E. coli, Gm neg enterics

>1 mo: S. pneumo, N. meningitidis, Hib