Pedia

Question 1

what month does the child learn to walk alone?

Answer 1

15mos

Question 2

. E test is useful.

Answer 2

Beyond 4 years of age

Question 3

The optic disc (i.e., optic nerve head) of the older child is

Answer 3

salmon-colored, which differs from

the pale gray color of the disc in an infant.

Question 4

dilatation of both pupil when light is shown in the affected eye

Answer 4

Marcus Gunn pupil- optic neuropathy, less light reaches the oculomotor nucleus , parasym response is shut off

Question 5

Adies pupil ?

Answer 5

pupil is sluggish, slowly response to light/ constrict or dilate in a dark room, cause is ciliary ganglion pathology= unresponsive to light/ accomodationtion

Question 6

No light reflex, but accommodation and convergence persists

Answer 6

Argyll robertson, cause is syphilis

Question 7

Motor: Runs stiffly; sits on small chair; walks up stairs with one hand held; explores drawers and waste
baskets
Adaptive: Piles three cubes; initiates scribbling; imitates vertical stroke; dumps pellet from bottle
Language: Ten words (average); names pictures; identifies one or more parts of body
Social: Feeds self; seeks help when in trouble; may
complain when wet or soiled; kisses parents with
pucker

Answer 7

18 mos

Question 8

Complete oculomotor nerve paralysis, movement?

Answer 8

causes the eye to position downward and outward.

Question 9

weakness of medial rectus muscle contraction of the adducting eye, which is accompanied by a monocular nystagmus in the abducting eye.

Answer 9

Internuclear opthalmoplegia, MLF lesion

Question 10

vertical nystagmus

is associated with

Answer 10

either medication or brainstem dysfunction. Persistent horizontal nystagmus indicates dysfunction of the cerebellum or brainstem vestibular system components; the nystagmus is coarser (i.e., the amplitude of movements are greater) when the direction of gaze is toward the side of the lesion.
See saw nystagmus= lesion at optic chiasm

Question 11

Function of CN VII

Answer 11

Taste -sensation over the anterior two-thirds of the tongue,

secretory fibers (parasympathetic)- innervating the lacrimal and salivary glands, and

Motor- innervation of all facial muscles are
accomplished by cranial nerve VII. Complete motor dysfunction on one side of the face ensues when the cranial nerve VII pathway is disrupted in the nucleus, pons, or peripheral nerve.

Question 12

Taste sensation in the anterior two-thirds of the tongue is in part provided by the

Answer 12

chorda tympani nerve

Question 13

? Age most children are able to identify all single

digits correctly by graphestesia

Answer 13

By 8 years of age,

Question 14

What month? and how about hands?
• Lifts head up for several seconds while prone
• Startles in response to loud noise
• Follows with eyes and head over 90-degree arc
• Smiles responsively
• Begins to vocalize single sound

Answer 14

2mos, Keeps hands predominantly fisted

Question 15

smiles, laughs responsively

head turn towards object on all directions

Answer 15

3 MONTHS
• Occasionally holds hands fisted
• Lifts head up above body plane and holds position
• Holds an object briefly when placed in hand
• Turns head toward object, fixes and follows fully in all directions
with eyes
• Smiles and vocalizes when talked to** responsively at 2mos, spontaneously at 4mos
• Watches own hands, stares at faces
• Laughs

Question 16

Turns head at direction of sound

Reaches for an object, grasps it, brings it to mouth

Answer 16

4 MONTHS
• Holds head steady while in sitting position
• Reaches for an object, grasps it, brings it to mouth
• Turns head in direction of sound
• Smiles spontaneousl

Question 17

. Transfers object from hand to hand
• Babbles
• Sits with support
• Rolls from prone to supine
• Localizes direction of sound, what structure responsible for this?

Answer 17

5–6 MONTHS
• Lifts head while supine
• Rolls from prone to supine
• Lifts head and chest up in prone position
• Exhibits no head lag
• Transfers object from hand to hand
• Babbles
• Sits with support
• Localizes direction of sound- superior olivary nucleus

Question 18

7-8 mos

Answer 18

7–8 MONTHS
• Sits in tripod fashion without support
• Stands briefly with support
• Bangs object on table
• Reaches out for people
Mouths all objects
• Says “da-da,” “ba-ba”

Question 19

sits well without support
stand with holding on
byebye 
pincer grasp
drink from cup with assistance

Answer 19

9–10 MONTHS
• Sits well without support, pulls self to sit
• Stands holding on
• Waves “bye-bye”
• Drinks from cup with assistance
• Uses pincer grasp

Question 20

creeps
walk with assiatnce
assist dressing
2-4 words, ff simple commands

Answer 20

11–12 MONTHS
• Walks with assistance
• Uses two to four words with meaning
• Creeps well
• Assists in dressing
• Understands a few simple commands

Question 21

walks by self, falls easily
crayons
pointing what wants

Answer 21

13–15 MONTHS
• Walks by self, falls easily
• Says several words, uses jargon
• Scribbles with crayon
• Points to things wanted

Question 22

built 2-4 blocks
eat ** kakain pag gusto, maghuhubad pag gusto
undress
point 2-4 body parts

Answer 22

18 MONTHS
• Climbs stairs with assistance, climbs up on chair
• Throws ball
• Builds two to four-block tower
• Feeds self
• Takes off clothes
• Points to two or three body parts
• Uses many intelligible words

Question 23

runs, walk up and down stairs
biuld 4-6 blocks tower
kick
you, me and I 
2-3 word sentences

Answer 23

24 MONTHS
• Runs, walks up and down stairs alone (both feet per step)
• Speaks in two- to three-word sentences
• Turns single pages of book
• Builds four- to six-block tower
• Kicks ball
• Uses pronouns “you,” “me,” and “I”

Question 24

How to elicit moro reflex?

Answer 24

Sudden head extension produced by a
light drop of the head
Abduction followed by adduction and
flexion of upper extremities start at around 
6 months

Question 25

Placing the index finger in the palm of the infant Flexion of fingers, fist making

Answer 25

Palmar grip, disappear at 6mos

Question 26

Palmar grip disappear at 6mos while Plantar grip at..

Answer 26

15m0s

Question 27

Asymmetric tonic neck, until what age?

Answer 27

``` 3mos, Rotation of the infant’s head to one side for 15 seconds Extension of the extremities on the chin side and flexion of those on the occipital side ```

Question 28

Response of reflex: Extension of the other lower limb, with adduction and internal rotation into talipes equinus

Answer 28

Reflex: Cross extensor: Passive total flexion of one lower | extremity , until 6 weeks

Question 29

Heel reflex

Answer 29

``` Tapping on the heel with a hammer, with the infant’s hip and knee joints flexed and the ankle joint in neutral position Rapid reflex extension of the lower extremity in question. Until 3 weeks ```

Question 30

What is Galant reflex?

Answer 30

``` Scratching the skin of the infant’s back from the shoulder downward, 2–3 cm lateral to the spinous processes Incurvation of the trunk, with the concavity on the stimulated side, until 4 month ```

Question 31

Anterior fontanel close at ---?

Answer 31

12 months , posterior- 1-2mos

Question 32

a lower motor neuron disorder commonly causing internal rotation and adduction at the shoulder, often with the “waiter’s tip” posture.

Answer 32

Erb’s brachial plexus injury

Question 33

Grasping an object with entire hand?

Answer 33

4-5 months

Question 34

Pincer grasp ?

Answer 34

9 months

Question 35

supine child by fexing the hips 90 degrees with | feet on the examination table, noting any asymmetry of femur length.

Answer 35

Galezzi sign - subluxation- partial dislocation, shorter leg - inc excursion= hypotonia

Question 36

Hypotonia in a child with hypothalamic probs and hyperphagia

Answer 36

Prader willi - ch 15q11-13- paternal | Angelman is maternal, same chromosome

Question 37

Meningio / encaphalofacial angiomatosis with cerebral calcifications, tram line calcifications on imaging, vascular venus at birth, spastic hemi, hemisensory loss at unilateral seizure

Answer 37

Sturge Weber syndrome

Question 38

Criteria of NF-1? | How many neurofibromas and plexiform neuriofibroma?

Answer 38

Any 2 of the following 6 or more Café au lait > 5mm prepubertal age and > 15 mm postpubertal 2 or more neurofibromas or 1 plexiform neurofibroma Freckling axillary or inguinal Optic pathway glioma 2 or more Lisch nodules Osseus lesion- sphenoid dysplasia or thinning of cortex withor without psudoarthroses (+) NF1 in a first degree relative

Question 39

Protein in NF-2?

Answer 39

merlin, schwannomin, NF-1 - Neurofibromin

Question 40

Abdominal reflex mediated by?

Answer 40

T8-T12 nerves, cremasteric L1-L2

Question 41

good head control when held in sitting position?

Answer 41

4 months

Question 42

Can sit without support and maintain adequate balance?

Answer 42

9mos

Question 43

crawl and pull to standing ?

Answer 43

10ms

Question 44

creep?

Answer 44

11 mos

Question 45

walk without support

Answer 45

13 mos

Question 46

a rare childhood disorder characterized by the loss of language comprehension (auditory verbal agnosia) and verbal expression (aphasia) in association with severely abnormal electroencephalographic (EEG) findings during sleep and clinical seizures in most patients.

Answer 46

Landau Kleffner syndrome (LKS) is

Question 47

Lhermittes duclos

Answer 47

tigroid pattern on cerebellum- ganglioma on cerebellum

Question 48

one hand supporting the abdomen in the prone position, the examiner fexes the infant’s head with his or her other hand. The normal response is fexion of the legs and trunk.

Answer 48

Landau reflex- appears at 5-`10mos, disappear at 2years

Question 49

Reflex- appears at 6-9mos then persist, hold baby in ventral suspension,and arms will extend in defense.

Answer 49

Parachute reflex absent = cerebral palsy asymmetrical- spastic hemiplegia

Question 50

What age does "no head lag" is seen in traction response?

Answer 50

Usually, by 3 to 5 months of age at the latest, the infant is able to participate actively with arm flexion at the elbow, and by holding the head and trunk in a straight line as the examiner pulls the child to the upright position.

Question 51

Reflexes lost as 6mos?

Answer 51

Moro, palmar 6 weeks- crossed extensor, plantar at 15mos Asymmetric tonic neck at 3mos Heel at 3 weeks

Question 52

Cherry red

Answer 52

Tay sachs, Niemann Pick and GM1

Question 53

Tay sachs has splenomegaly. T or F

Answer 53

False, Niemann pick has splenomegaly. Others with visceromegaly : Gaucher, Pompe, Faber, Mucolipidoses

Question 54

By 15 months of age, the child should have a consistent vocabulary of -------, and by 18 months, up to ----- Short phrases consisting of two or three words are usually part of the child’s repertoire by -----. By 2 years of age, most children have a vocabulary of up to -----

Answer 54

2 to 6 words 20 words 21 to 24 months 50 words

Question 55

treatment for intractable seizures in TSC?

Answer 55

Vigabatrin- inc GABA by mena sof inhibiting the gABA transaaminase

Question 56

mutations in TSC, mtoR pathways inihibitor

Answer 56

TSC1 on chromosome 9q34 encodes hamartin, whereas TSC2 on chromosome 16p encodes tuberin

Question 57

patient with cortical dysplasia + hamartomas lesions on skin?

Answer 57

Epidermal nevus syndrome - assoc with PTEN mutation ( like Primary GBM) ``` vs. Neurocutaneous melanosis - Giant hairy pigmented nevi - assoc with NRAS mutation - diffuse melanosis affecting the leptomeningies ```

Question 58

Tpe of chiari malformation with cerebellar vermis herniation + lumbar myelomeningocele?

Answer 58

II - Arnold chiari. I- cereberllar tonsils herniation + syringomyelia III- occipital encephalocele + syringomyelia + tethered cord IV- cerebellar agenesis- not compatible with life

Question 59

When would surgery be indicated in chiari malformation?

Answer 59

spasticity, ataxia, pain in the shoulders or arms, or lower cranial-nerve disease is increasing, upper cervical laminectomy and enlargement of the foramen magnum are indicated. The basic operation is suboccipital and C-1 decompression; various forms of shunting may be added if there is syringomyelia (the shunt is to the adjacent subarachnoid space) or hydrocephalus.

Question 60

a condition with low copper? opposite of Wilsons

Answer 60

Menkes - mutation of the ATP7A, copper transporting ATPase , failure of absorption of copper from the gastrointestinal tract. Most sensitive and specific detection- ratio of dopamine to norepinephrine and dihydroxyphenylacetic acid to dihydroxyphenylglycol proved. dx: Diagnosis: - Low serum copper and ceruloplasmin -reduced dopamine-B-hydroxylase iNc level of dopamine and dihydroxyphenylacetic acid (DOPAC) Reduced NE and dihydroxyphenylglycol (DHPG) Xray metaphyseal spurring mainly of femor (corner fractures) and subperiosteal calcifications of the bone shafts Arteriography – tortosoty and elongation of he cerebral and systemic arteries TXT : copper in first weeks of life, cupric salts IV or suq of copper histidine

Question 61

Hair characterisric in MEnkes

Answer 61

Pili tortis – twisted 180 degress Trichoclasis – transverse fracture of hair shaft Trichoptilosis – longitotudinal splitting of the hair shaft

Question 62

similarities and diff of Wilsons vs Menkes

Answer 62

similiar- serum copper and ceruloplasmin- decrease diff - liver cooper is inc in wilson, dec in Menkes

Question 63

TXT for PSP

Answer 63

Ldopa and anticholinergics- no benefit akinesia/ rigidity- zolpidem , GAbanergic agonist of benz receptors dystonia- benztropine, trihexylphenydyl

Question 64

perinatal conditions that could be mistaken for trauma

Answer 64

osteogenesis imperfecta and Menkes disease can present as fractures and/or intracranial hemorrhages that can be erroneously attributed to perinatal trauma.

Question 65

palpable nerves with onion bulb formation

Answer 65

CMT 1, lepromatous leprosy, refsum

Question 66

Retinitis pigmentiosa Ataxia Phytanic acid accum

Answer 66

Refsum - lipid metabolism d/o | defi of Phytanol COA hydroxylase