6- sports physical Flashcards
vasovagal syncope
self-limited systemic hypotension due to altered neurocardiogenic reflexes leading to bradycardia and/or peripheral vasodilation.
Children frequently describe prodromal symptoms that include dizziness, lightheadedness, sweating, nausea, weakness, and visual changes.
red flags for syncope
A family history of seizures, sudden death, myocardial infarction in family members < 30 years of age
All syncope associated with exercise or exertion must be considered dangerous and requires a thorough cardiac evaluation.
Prolonged LOC (> 5 minutes), association with chest pain or palpitations, an abnormal cardiac examination, or history of cardiac disease all favor the diagnosis of cardiac syncope.
Facial cyanosis, aura, frothing at the mouth, tongue biting, slow recovery or postictal drowsiness and prolonged mental status changes or confusion after the event suggest a seizure.
Syncope in the supine position; convulsion before LOC; warm, flushed or cyanotic skin color rather than pallor and diaphoresis - all suggest seizure rather than syncope.
evaluate one time syncope
EKG
most common cause of chest pain in adolescents
musculoskeletal- Precordial catch syndrome
Precordial catch syndrome
benign sporadic onset of sharp pain, usually along the left sternal border, which is often exacerbated with deep inspiration. These pains are brief, lasting seconds to a few minutes, and resolve spontaneously. The pain can often be “broken” with a forced deep inspiration. It is often not associated with exercise.
Costochondritis
benign chest pain
due to inflammation and typically will last for hours or days.
red flags for chest pain
Pain triggered by exertion or stress Pressure or crushing sensation 10-15 min Syncope, palpitations Murmur, thrill, hyperdynamic precordium
red flags for murmurs in adolescents
Louder than grade III/VI
Any diastolic murmur
Any murmur that increases with standing or Valsalva
vaccines in age 11
HPV
Trap
Meningococcal ACYW Conjugate vaccine
