NU 331 More Neuro

What is the primary origin of neuroblastoma?

Abnormal maturation of fetal neural crest cells, most commonly in the adrenal medulla.

What are the two main catecholamines produced by the adrenal medulla?

Epinephrine (adrenaline) and norepinephrine.

What are the common sites for neuroblastoma metastasis?

Bone marrow, lymph nodes, liver, lungs, skin, and bone.

What are 'blueberries' in the context of neuroblastoma symptoms?

Painless, firm, blue-colored lumps under the skin.

What is opsoclonus?

Uncontrolled, rapid eye movements associated with neuroblastoma.

Which urine markers are tested to diagnose neuroblastoma?

VMA (Vanillylmandelic acid) and HVA (Homovanillic acid).

What is the purpose of an MIBG scan in neuroblastoma?

A nuclear medicine scan used to identify neuroblastoma sites; requires thyroid protection with iodine solution.

What is the definition of Stage 4S neuroblastoma?

Neuroblastoma in infants under 1 year old with spread to skin, liver, and bone marrow, but no bone metastasis.

What are the components of the Cushing Triad?

Increased blood pressure, decreased heart rate, and irregular respirations (a late sign of increased intracranial pressure).

How does Cushing Triad differ from Cushing Disease?

Cushing Triad is a sign of increased intracranial pressure, while Cushing Disease is a disorder caused by high cortisol levels.

What are three common medical treatments for increased intracranial pressure (ICP)?

Steroids, Mannitol, and Hypertonic Saline.

What is the difference between supratentorial and infratentorial brain tumors?

Supratentorial tumors are in the cerebrum; infratentorial tumors are in the cerebellum or brainstem.

What is a Medulloblastoma?

A common, fast-growing malignant brain tumor located in the cerebellum.

What are the classic symptoms of increased ICP in children under 18 months?

Increased head circumference and bulging fontanelles.

What is the correct post-operative positioning for a child after brain surgery?

Flat, on the side, with the head and body kept in alignment; use log-rolling for turns.

What are the clinical signs of meningitis?

Nuchal rigidity (stiff neck), fever, and potentially petechiae or purpura rash.

What is the difference in isolation precautions for bacterial vs. viral meningitis?

Bacterial meningitis requires droplet and contact precautions for 24 hours; viral meningitis requires standard precautions.

What is the Glasgow Coma Scale score range for a severe head injury?

3 to 8.

List three 'Red Flag' symptoms for a concussion.

Prolonged loss of consciousness, seizures, and severe or worsening headache.

What is the primary goal of Step 1 in concussion recovery?

Rest: limit physical and cognitive activity, avoid injury-risk activities, and ensure adequate sleep.

When is a child considered fully recovered from a concussion?

When they can perform all regular activities without experiencing any symptoms.

What is the role of the neural crest in embryonic development?

After the neural tube closes, neural crest cells migrate to form the sympathetic nervous system and the adrenal medulla.

What genetic marker is associated with higher risk neuroblastoma?

Positive N-myc (MYCN) levels.

Why is a skeletal survey performed in neuroblastoma patients?

To check for bone metastasis.

What is the difference between INSS and INRGSS staging systems?

INSS is based on surgical results, while INRGSS is based on diagnostic imaging/testing.

What is the primary treatment for bacterial meningitis?

Antibiotics, IV dexamethasone, and supportive care.

What is the recommended approach for returning to school after a concussion?

Gradual return, usually starting part-time, as part of the light activity recovery phase.