Abuse, Depression and Faints/Fits Flashcards
What are the 4 categories of child abuse?
1) Physical: Bruises, injury, scratches, burns, fractures
2) Emotional: Relationships (^ in criticism, V in warmth)
3) Sexual abuse: Behaviour change, physical symptoms e.g. bleeding, STI and pregnancy
4) Neglect: Care doesn’t meet needs of child (Most common!)
How is child abuse revealed?
1) Disclosure
2) Incidental findings
3) Observation e.g. detected at school
What is management for an abused child?
1) Thorough history: Good documentation and check for discrepancies
2) Examination: Use of body charts
3) Social services assessment +/- police input.
4) Tests: FBC, clotting, swabs, bone profile, skeletal survey.
What are the main symptoms of depression?
Loss of interest.
Fatigue.
Poor sleep.
Reduced appetite.
Low concentration.
Feelings of guilt and self blame.
Low confidence.
Agitated.
Hopeless.
What are the medical and non-medical treatment of depression?
Non-medical: Education, CBT, IPT and family therapy.
Medical: fluoxetine, sertraline, citalopram.
What are disposing factors for developing depression?
Family history.
Stress in pregnancy.
Poor attachment.
Poverty.
Isolation.
What are precipitating factors for developing depression?
Trauma.
Drugs.
Infections.
Puberty.
Exam stress.
Sexual abuse.
Bullying.
What are perpetuating factors for developing depression?
Chronic illness.
Malnutrition.
Ongoing neglect.
Ongoing poverty.
What is a seizure?
A convulsion caused by a paroxysmal discharge of cerebral neurones.
What is an epileptic seizure?
Excessive, unsynchronised neuronal discharges in the brain cause paroxysmal changes in behaviour, sensation or cognitive processes
What is the duration for an epileptic seizure?
30-120 seconds
What are the main signs of epileptic seizures?
1) Movement
2) Tongue biting
3) Head turning
4) Muscle pain
What are febrile convulsions?
Febrile convulsions are epileptic seizures accompanied by fever. They usually occur early in viral infection and tend to be brief generalised tonic-clonic seizures.
What are the length and signs of non-epileptic seizures?
1-20 minutes
- Eyes/closed
- Talking/crying
- Pelvic thrusting
What is the first line AED offered to those suffering from focal seizures?
Carbamazepine.
Surgery may also be offered.
What are examples of generalised seizures?
1) Tonic-clonic (Generalised)
2) Atonic
3) Tonic
4) Myoclonic
5) Absence
When would you see each type of generalised seizure?
Myoclonic: Isolated muscle jerking
Tonic: Generalised increase in tone
Atonic: Transient loss of muscle tone
Generalised T-C: Sudden onset rigid phase followed by a convulsion in which the muscles jerk rhythmically.
What is the first line AED for suffering from focal seizures?
Sodium Valproate
What investigations must you do if presenting with seizures?
Eye witness account/video is invaluable!
ECG.
EEG.
MRI or CT.
Why must you do an ECG in those suffering from seizures?
To check for arrhythmia as the cause e.g. long-QT syndrome.
What are the potential side effects of AED’s?
Cognitive disturbances
Heart disease.
Drug interactions.
Teratogenic.
Name 3 conditions that are commonly diagnosed as being epilepsy.
Sandifer syndrome.
Benign neonatal sleep myoclonus.
Syncope.
What is syncope?
Insufficient blood/O2 supply to the brain causes paroxysmal changes in behaviour, sensation and cognitive processes.
What non-neurological disease is sandifer syndrome associated with?
GORD.
Patients present with GORD and a characteristic neck movement disorder.
