Appearance

Behavior

Cooperation

Speech

Thought

Affect

Mood

Perception

Level of consciousness

Insight

Cognition

Knowledge

Endings

Reliability

mneumonic: abc stamp licker

grooming 

clothing

hygeine

accessories

spontaneity

fluency

volume

prosody

anxious

elated

angry

depressive

(can occur in combination, and often do)

illusions

hallucinations

what can induce delirium (3)?

fever

illness

anticholinergic meds (in the elderly)

alertness

orientation (x3)

stability/fluctuation

attention/registration

learning and delayed memory

judgment and problem solving

speed of processing

verbal abilities

spatial abilities and praxic actions

suicidality

homicidality

motor abnlities

accompanying impairments

anatomical and neuro-imaging findings

causation and timing

conditions associated w/ cerebral palsy (% of each)

(5)

mental retardation (52%)

epilepsy (45%)

ophthalmologic defects (28%)

speech and language disorders (38%)

hearing impairments (12%)

cerebral palsy

neurodegenerative dz

inborn errors of metabolism

traumatic lesions of the brain or spinal cord

genetic movement or muscular disorders

neoplasm

endothelial NO synthase

factor 7

plasminogen activator inhibitor-1

lymphotoxin

environmental factors related to development of periventricular leukomalacia (3)

inflammatory response

coagulation

disordered vascular response

prenatal causes of cerebral palsy (besides PVL)

(6)

- intrauterine infections (inc UTI and TORCH infs - toxo, other, rubella, CMV, herpes simplex)

- congenital brain defect

- Rh and ABO hemolytic dz of the newborn

- fetal anoxia

- hemostatic abnlities

- maternal disorders (substance abuse, metabolic abnlities, chromosomal abnlities)

perinatal causes of cerebral palsy (5)

- prematurity

- birth trauma

- hypoxic-ischemic encephalopathy

- infection w/ Group B strep

- kernicterus

- hypoxia/acidosis

- meningitis

- infection

- traumatic brain injury/battered child syndrome

- toxins (i.e., lead)

- reflux-sandifer's syndrome

- jitteriness

- benign neonatal myoclonus

- infantile masturbation

 - spasmotic torticollis

- spasms nutans

- head and neck extension and arching of torso

- associated w/ pain of reflux

- turning of neck in one direction

- resolves spontaneously

spasms nutans

- 3 characteristics

- duration

- nystagmus

- rhythmic head bobbing

- torticollis

- lasts 6 mo-2 y

- shuddering attacks

- benign paroxysmal vertigo

- breath holding spells

- night terror

- movement disorders

- migraine headache

- syncope

- narcolepsy

- pseudoseizures

simple febrile seizure

- generalized or focal?

- timing

- generalized

- single seizure per illness (or per 24 h), lasting <15 min

complex febrile seizure

- generalized or focal?

- timing

- focal

- multiple seizures w/in 24 h, lasting >15 min

- trauma

- toxins

- inf

- tumor

- old trauma

- old CVA

- old anoxia

- CNS developmental abnlity

benign neonatal familial convulsions

- inheritance pattern

- presentation

- tx

- autosomal dominant

- otherwise healthy infant has seizures marked by impaired consciousness around day 5 of life; seizures resolve by 6 mo

- phenobarbitol

benign rolandic epilepsy

- presentation

childhood absence epilepsy

- presentation

juvenile myoclonic epilepsy

- presentation

west syndrome

- age of onset

- etiology

- sx (2)

- infants (4-7 mo)

- any brain insult

- infantile spasms, developmental and cognitive impairment

west syndrome

- EEG findings

hypsarrhythmia

- chaotic, disorganized background

- multifocal spikes

- discontinuous in sleep

# of ppl w/ a dz @ a particular pt in time or during a particular period of time

newly dx'd cases of dz

1. vitals

2. head circumference

3. skin

4. percussion of sinuses

5. dilated fundoscopic exam

6. mouth and jaw exam

7. careful neurologic exam

- Htn

- febrile illness

- trauma

- migraine

- cns inf

- brain tumor

- hydrocephalus

- sah or ich

- inf of vp shunt

- drugs and toxins

- post-ictal

- migraine

- migraine equivalents

- muscle contracture/tension

- cluster

- epileptic syndromes

- neuralgia

causes of chronic progressive headache (pediatric) - (8)

- hydrocephalus

- brain tumor

- malformations (brain, vascular, bone)

- cns inf

- subdural hematoma

- pseudotumor cerebri

- htn

- drugs

- chronic daily headaches

- post-traumatic headaches

- NS maturation

- experience

- social transmission/teaching

- equilibration

schema

(Piaget)

achieving equilibrium w/ environ thru assimilation and accommodation

during each stage of development, an indiv has a particular developmental task/challenge to overcome

- sensorimotor (birth-2y)

- preoperational (2-7y)

- concrete operations (7-12y)

- basic trust vs mistrust (birth-18mo)

- autonomy vs shame/doubt (18-36mo)

- initiative vs guilt (3-5y)

- industry vs inferiority (5-12y)

- identity vs role confusion (13-21y)

- intimacy vs isolation (21-40y)

- generativity vs stagnation (40-60)

- ego integrity vs despair/disgust (60+y)

- oral (0-18mo)

- anal (18-36mo)

- phallic (3-6y)

- latency (6-11y)

- genital (11+y)

miller-dieker syndrome

- genetics

edwards syndrome- genetic defect

45X0

klinefelter's syndrome - genetic defect

wolf-hirschhorn - genetic defect

miller-dieker syndrome - genetic defect

neurofibromatosis type 1 - genetic defect

 deletion (17q11.2)

DiGeorge syndrome/velocardiofacial syndrome - genetic defect

fragile x syndrome - genetic defect

lissencephaly

- def

- associated w/ which syndrome

- absence of brain gyri

- miller-dieker s.

G-banding

- uses (2)

- chromosomal aneuploidies (i.e., Down syndrome)

- large chromosomal abnlities (i.e., Wolf-Hirschhorn)

chromosomal abnlities (from aneuploidies to subchromosomal abnlities like angelman and prader-willi)

- genetic mutations

- small chromo abnlities

factors to consider in dx of depression in pregnant woman (4)

- depressed mood

- anhedonia

- guilt/worthlessness

- thoughts of death/suicide

valproic acid - adverse efx in pregnancy

- amygdala

- hippocampus

- HPA axis

- sympathoadrenal axis

- influences blood sugar lvls

- changes immune system in complex ways

- affects behavior

- disrupts short-term memory

- has profound efx on mood

location of major portion of sympathetic NS

allostatic overload - types (2)

- ex of each type

- type 1: demand has exceeded energy supply and led to resource reallocation to prevent death (ex - ketosis in diabetes)

- type 2: energy supply may be adequate (or excessive), but social stressors lead to chronic release of stress hormones and inflammatory mediators, leading --> pathology (ex - chronic stress)

- decreased fxn

- decreased inflammation

- incr'd blood sugar

-incr'd insulin resistance

- decreased reprod

neurological fxn - stress response

- increased pyramidal firing

- increased locus ceruleus firing

- increased seizure/kindling

- decreased slow wave sleep

- increased psychological sxs

- more drug needed to achieve same efx

- w/drawal syndrome develops w/ abstinence

- more drug ingested than intended

- unsuccessful attempts to cut back

- a lot of time spent getting high/trying to acquire drug

- social, occupational activities are reduced d.t. use

- continued use despite consequences/harm

- hiv

- hep b/c

- endocarditis

- phlebitis/thrombophlebitis/PE

- meningitis

- sepsis

- tb

- skin infs

- nephropathy

- rhabdomyolysis

- impaired immune fxn

LOCATES

- location

- onset

- character

- aggravating/alleviating factors

- timing

- environment

- severity