5.3.2 Coma in the pediatric patient Flashcards
Discuss the most common causes of a depressed level of consciousness in children Differentiate between different causes based on history, clinical examination and special investigations Explain appropriate special investigations based on suspected underlying pathology Recognize indications for imaging (red flags)
1
Q
Coma
A
Decreased awareness & response to the environment
2
Q
Coma vs Sleep
A
Sensory stimuli has to be applied
3
Q
Pathogenesis
A
- Bilateral cerebral hemispheres
- Thalamus
- Brainstem
- All of the above
- localisation
4
Q
Clinical approach
A
- HISTORY
- NEUROLOGICAL EXAMINATION
- GENERAL & SYSTEMIC EXAMINATION
- SIDEROOM INVESTIGATIONS
- SPECIAL INVESTIGATIONS
5
Q
History
A
FEVER
TRAUMA
accidental/non-accidental
POISONING
TOXINS
Anti-epileptics/psychotropics
CONTACT DISEASES
TB/mumps etc.
PREVIOUS ILLNESS
epilepsy
6
Q
Neurological examination : 5 questions
A
- LEVEL OF CONSCIOUSNESS
- MENINGISM
- INCREASED INTRACRANIAL PRESSURE
- LOCALIZING SIGNS
- BRAINSTEM FUNCTION
7
Q
- Level of consciousness
A
- Spectrum : when to do it
- Coma Scale (GCS) : get used to using it: NB!!
EYE OPENING
VERBAL RESPONSE
MOTOR RESPONSE
8
Q
A
