CLIPP 19: 16 month male with seizures

Question 1

How can acetaminophen be given to a child who refuses PO?

Answer 1

Suppository

Question 2

Are febrile seizures genetic?

Answer 2

Yes, unclear how though

Question 3

Differential for a seizure + fever?

Answer 3

Febrile Seizure
CNS infection
Head injury/post-trauma seizure
Ingestion/poisoning
Idiopathic seizure/epilepsy

Question 4

What is the most common cause of a serious bacterial illness in children?

Answer 4

UTI

Question 5

How might a UTI present in a young child?

Answer 5

UTI commonly presents as fever without a focus on physical examination and a relatively unremarkable review of systems.

Often accompanied by fussiness and decreased appetite

Question 6

What is more common: simple or complex febrile seizure?

Answer 6

Simple febrile seizures are more common than complex febrile seizures

Question 7

What is the time difference between a simple and complex febrile seizure?

Answer 7

> 15 minutes –> complex febrile seizure

Question 8

How many times in a 24 hour period does a complex febrile seizure occur?

Answer 8

> 1

Question 9

Are complex febrile seizures focal or generalized?

Answer 9

Focal

Question 10

What is the risk of recurrence if a child has his first febrile seizure before age 12 months

Answer 10

the recurrence risk for a second febrile seizure is about 50%

Question 11

What is the risk of recurrence f a child has his first febrile seizure after age 12 months?

Answer 11

the recurrence risk is about 30%

Question 12

What is the risk of developing epilepsy in a child with a febrile seizure

Answer 12

In a child who has a febrile seizure, the risk of developing epilepsy is slightly increased above the 0.5-1% baseline population risk

Question 13

If a child is having a seizure, after how long should you call 911?

Answer 13

5 minutes

Question 14

What are other names for Roseola?

Answer 14

Roseola infantum is also known as exanthem subitum, or sixth disease

Question 15

What age group is most susceptible to roseloa?

Answer 15

<2

Question 16

What causes roseola?

Answer 16

Human herpesvirus-6 (HHV-6) is an important etiologic agent of roseola. About 30 percent of children with primary HHV-6 infection will develop roseola

Question 17

What is the time frame of rash and fever in roseola?

Answer 17

A high fever (38.5 to 40.5 C) for 3-5 days in a typically fairly well-appearing child, followed by abrupt resolution of fever and development of a maculopapular rash

Question 18

How might a shigella infection cause a seizure?

Answer 18

Shigella sonnei causes bloody diarrhea and WBCs in the stool on Wright stain. Rarely, children infected with Shigella can suffer from seizures due to neurotoxin release

Question 19

age range for febrile seizures?

Answer 19

These are relatively common occurrences in Charlie’s age range (6 months to 5 years), and the first priority would be to identify the source of fever and treat it.