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51 Cards in this Set
- Front
- Back
history of HA and vomiting, esp without nausea is concern for what?
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ICP or tumor
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what are reasons you might want to do an MRI work up for HA? (5)
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1. worsening or severe HA
2. Vomiting (esp, w/o N --> tumor, ICP) 3. HA that occurs only at night or early morning 4. Papilledema (ICP) 5. Any focal neurologic deficits |
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What are indications for LP with HA?
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1. any sign of infection
2. papilledema after - MRI |
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Hemicranial or generalized
Occurs in less than 30% Aura is visual (scotoma) or other sensory or focal motor Aura precedes headache by 20-30 minutes |
Classic migraine
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Occurs in 60%
Associated with nausea, vomiting, photophobia, noise sensitivity Can last from an hour to several days |
common migraine
Migraine without aura |
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MC in adolescent females
Occipital headache Associated ataxia, dizziness, diplopia, hearing disturbance, paresthesias, drop attacks Neurologic symptoms are brief |
Basilar Migraine
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Rare, may be precipitated by trauma
Delirium, confusion, restlessness, combativeness Resolves with sleep May later develop into classic migraine |
confusional migraine
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Occurs mainly in younger children and girls
Vomiting and abdominal pain lasts up to 48 hrs Headache NOT usually present |
Cyclic Vomiting syndrome
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what medication may help at onset of aura HA?
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Triptans
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what is the MC generalized seizure?
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Tonic-Clonic (Grand Mal)
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Tonic stiffness and upward deviation of eyes followed by clonic jerks
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tonic clonic seizure
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do children lose consciousness in tonic clonic seziures?
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yes
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Myoclinic jerks, usually bilateral with or without loss of consciousness?
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without loss
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Onset between 1-3 y/o
Loss of body tone – wears helmet. Drop seizures Frequent underlying brain pathology |
atonic
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Occur most often age 4-8
More common in girls Staring spell without loss of consciousness – gets diagnosed mostly at school. Literrally just stare No prodrome or post-ictal period Child has no recollection of the event |
Absence (Petit Mal)
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Grand mal is what type of seizure?
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tonic-clonic
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are febrile seizures associated with how high the fever goes or how sudden the increase?
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associate with sudden increase
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how do we treat partial seizures?
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1. Phenytoin
2. Valproate 3. carbamazpeine |
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what is the criteria for status epilepticus?
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prolonged seizure of greater than 20-30 minutes
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Rapid tonic contraction of neck, limb and trunk lasting 2-10 seconds
Occur frequently when falling asleep or waking |
infantile spasms (West syndrome)
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When is the peak age for West syndrome?
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4-6 months of age
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what is the tx for infantile spasms (west syndrome)?
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1. ACTH
2. vigabitrin 3. Corticosteroids 4. Valproate 5. Pyridoxine (B6) |
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40-60% of seizures are what kind?
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partial
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Lisch nodules (iris hamartomas)
Optic nerve gliomas Scoliosis, sphenoid wing dysplasia, cortical thinning of long bones Reno-vascular hypertension Learning disabilities and ADHD common Café au lait spots (>6 spots) Axillary freckling Cutaneous neurofibromas |
NF type 1
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Bilateral vestibular schwannomas
Intracranial and spinal tumors Average life span <40 yrs |
NF type 2
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the most common known cause of infantile spasms is?
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Tuberous Sclerosis
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Ash leaft spot (Fitzpatrick patch) is seen in what? dz, what is another name for it?
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Shagreen patch
seen in Tuberous sclerosis |
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Angiomas of the leptomeninges (pia and arachnoid mater)
Ipsilateral facial port wine stain |
sturge webeter syndrome
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have to walk arms up their legs after being on all fours
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gowe'rs sign
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CPK markedly elevated due to release of enzyme with muscle deterioration
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duchenne muscular dystrophy
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do you hear a clunk in a subluxating hip or dislocated hip?
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dislocated
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Abnormal pathology of proximal medial metaphysics. Femur translating off proximal tibia
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Bounts disease
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lack of vit D bone disease
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Ricketts
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if a child has knee and thigh pain think what kind of pathology?
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hip
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Infection of bone involving periosteum, cortical bone, and medullary cavity
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osteomyelitis
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pain, restless, malaise, limb held very still. can be from a hematogenous or traumatic source
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neonatal osteomyelitis
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involucrum
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new bone formation
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if you aspirate pus from a bone what levels will indicate septic arthritis?
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> 80k
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What are the Kocher criteria used for a child with painful hip?
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1. non-weight bearing on affected side
2. sed rate elevation >40 mm/hr 3. fever 4. WBC >12k the more you have the higher the likelihood |
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noted a birth, medial deviation of forefoot, convex lateral border
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metatarsus adductus
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internal foot thigh axis seen with inverted feet
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tibial torsion
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duck walk is known as
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femoral anteroversion
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Bitsy disease
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combined deformity makes gait appear exceptionall poor. have tibial torsion and femoral anteroversion
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as babies we start off as varus or vagus? then what?
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start of as varus and then normal at 2-3 then vagus and then back to normal at 5-7 yo
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clinical findings of what pathology?
1. asymmetric abduction 2. galeazzi 3. asymmetric thigh folds 4. trendelenburg 5. short legged gait 6. telescoping |
Dislocated hip
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Top of Trochanter to ASIS passes at or superior to umbilicus
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Klisic's LIne
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idiotpathic avascular necrosis is known as?
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perthes dz
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what is the tx for perthes dz?
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maintain ROM, bracing may be needed, push head deeper into socket
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distal thigh or knee pain in adolescents, loss of IR, endocrine, renal failure. Bilateral 25-50% of the time. Chronic is >3 weeks
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Slipped capital femoral epiphysis
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referreed pain, adolescent,
examining child for limb pain and they have a limp
--get xray of both hips
likely to find
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SCFE or perches
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MC in active males during growth spurts, jumpers knee
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Sliding Larsen Johansson Syndrome
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