Behavior/Sports/School

Question 1

What is the difference between cyanotic and pallid breath-holding spells?

Answer 1

Cyanotic spells consist of episodes of a brief, shrill cry followed by a prolonged expiration and apnea and are predictable upon upsetting or scolding the child. They are rare before 6 months of age, peak at about 2 years of age, and resolve by about 5 years of age. Avoidance of reinforcing this behavior is the treatment of choice.
Pallid breath-holding spells are less common and are usually caused by a painful experience (such as a fall). With these events, the child will stop breathing, lose consciousness, become pale and hypotonic, and may have a brief tonic episode. Although the family may be concerned that these “tonic episodes” are seizures, the temporal relationship with an inciting event makes this diagnosis highly unlikely. These pallid events, too, resolve spontaneously. Again, avoidance of reinforcing behavior is indicated. Assuring the family that this is a benign condition is important.

Question 2

What pregnancy-related complications are teen mothers at increased risk for?

Answer 2

Poor weight gain in the mother, premature delivery, low birth weight, and an increased risk of pregnancy-induced hypertension. The risk of violence is also elevated for teen mothers.

Question 3

What are contraindications for playing contact sports?

Answer 3

Single eye, hemophilia, single kidney, and unexplained syncope (until evaluated).

Question 4

What injuries are typically seen in basketball and volleyball players?

Answer 4

Lower extremity problems, including those of the knee, with such injuries as Osgood-Schlatter disease and sprains to the ligaments of the knee. Ankle injuries, too, are quite common in these sports.

Question 5

What are the major comorbidities associated with Tourette syndrome?

Answer 5

ADHD and OCD