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Neuro 13 Peds Neuro
Pediatric Neurology
Question | Answer |
---|---|
What is the treatment of acute dystonia and how does it differ from the treatment of tardive dyskinesia? | Acute dystonia: tx with anticholinergics (benztropine or diphenhydramine) Tardive dyskinesia: switch to atypical or low potency neuroleptics |
What EEG pattern is seen in cases of absence seizures? | Spike and wave pattern 3 cycles/second |
What are the MC primary sources of mets to the brain? | Lung, Breast, Melanoma. Also kidney (renal cell CA), and GI (colon CA) |
Downward displacement of the cerebellar tonsils and medulla through the forman magnum | Arnold Chiari Malformaion |
Which type of Arnold Chiari is most common and is often asymptomatic? | Type 1. May see HA and/or cerebellar sx. Type 2 usually has other neuro anomalies. |
What other neuro anomalies are associated with an Arnold-Chiari malformation? | Hydrocephalus, syringomyelia, and myelomeningocele |
What is the preferred tx for febrile seizures? | Acetaminophen or ibuprofen. NO ASPIRIN! |
Which element of the quad/triple screen is abnormal in cases of neural tube defect? | AFP is elevated |
What neural tube defect matches the following description?: incomplete closure of the dorsal vertebral arches, often at the lumbosacral junction | spina bifida occulta |
What neural tube defect matches the following description?: condition where the above defect is severe enough for there to be herniations of the meninges | meningocele |
What neural tube defect matches the following description?: a more severe defect in which the spinal cord and meninges have herniated through | myelomeningocele |
What neural tube defect matches the following description?: failure of closure of the anterior portion of the neural tube resulting in lack of forebrain, meninges, and parts of the skull | anencephaly |
What is the definitive treatment for persistent hydrocephalus? | Surgical shunt |
An infant has persistent primitive reflexes, involuntary grimacing, tendency to drool, and delayed psychomotor development. What is the diagnosis? | Dystonic Cerebral palsy |
Neonate with lethargy, decreased spontaneous movement, hypotonia, and suppressed primitive reflexes. WHat is the cause? | Cerebral palsy with encephalopathy |
Name 3 disorders associated with cerebral palsy. | 1. Mental retardation 2. Epilepsy 3. Sensory impairment (speech, hearing, vision) |
Retinoblastoma can be detected from what part of the PE? | Fundoscopic exam: look for absent red reflex |
What is the next step when a retinoblastoma is suspected on PE? | US and CT |
What does cerebral palsy look like in a neonate? | Lethargy, decresed spontaneous movement, hypotonia, and suppressed primitive reflexes |
What 4 medications are often used to treat spasticity in cerebral palsy? | Dantrolene, baclofen, benzos, botox |
MCC seizures in children? | Febrile seizures |
When should an LP be performed in a child with febrile seizures? | 1. If meningitis is suspected 2. Any child <12mos |
What drug class should NOT be used to treat febrile seizures? | Anticonvulsants |
Name 2 malformations associaged with hydrocephalus in children. | 1. Arnold-Chiari type 1 2. Dandy-Walker |
What is the difference btwn non-communicating and communicating hydrocephalus? | Non-communicating: obstruction of CSF circulation in 4th cerebral ventricle Communicating: dysfunction of subarachnoid cisterns or arachnoid villi |
AR disorder caused by absence of hexosaminidase A. | Tay-Sachs dz |
What is the f'n of hexosaminidase A? | Enzyme req'd for lipid ganglioside metabolism (absent in Tay Sachs) |
What are the ophthalomologic findings in Tay Sachs? | Cherry red spots on retina |
What is the proper dosage in a normal child-bearing woman of folate to prevent neural tube defects? | 400mcg/d |
What is the appropriate dose of folate in a woman with a past history of having a child with neural tube defects or a woman on anticonvulsants (carbamazepine, valproic acid)? | 4mg/d |
What are the 4 components of the quad screen? | AFP, beta-hCG, estriol, inhibin A |
What changes in AFP are seen with neural tube defects? | Increased AFP (also seen in omphalocele and gastroschisis) |
MC intraocular tumor in children? | Retinoblastoma |
What gene mutation is associated with retinoblastoma? | RB1 |