CLIPP 19 - Roseola

Question 1

DDX AMS (7)

Answer 1

• toxic ingestion
• seizure
• syncope
• closed head injury
• infection
• intracranial process
• intussusception

Question 2

Seizure categories and features (5)

Answer 2

• generalized tonic-clonic: abrupt onset, tonic stiffening, upward eye deviation, clonic jerking of all extremeties
• simple partial: motor signs in single extremity or one side of body, may spread to become generalized
• complex partial: AMS, blanks stare, lip-smacking, drooling, gurgling, N/V, automatisms, post-ictal phase, can have secondary generalization
• absence: staring spells with automatisms, no loss of tone, minimal post-ictal phase, can be precipitated by hyperventilation or photic stimulation
• atonic: loss of motor tone

Question 3

Seizure characteristics (5)

Answer 3

• alteration of consciousness
• incontinence
• eye deviation
• uninterruptable rhythmic motor movements
• postictal state

Question 4

16 month old developmental milestones (4)

Answer 4

• consistently uses 1-4 words
• stoop and recover
• uses spoon and cup with occasional spills
• follows simple commands

Question 5

DDX generalized seizure (10)

Answer 5

• metabolic disturbance
• trauma/ICH
• genetic syndromes
• idiopathic/epilepsy
• developmental abnormalities
• hypoxia
• fever
• toxic ingestion
• meningitis/encephalitis
• mass (usually partial)

Question 6

simple vs complex febrile seizures

Answer 6

• simple: less than 15 minutes, once in 24 hours, generalized
• complex: greater than 15 minutes, more than one in 24 hours, focal

Question 7

Roseola clinical features (4)

Answer 7

• HHV-6 infection
• high fever for 3-5days in otherwise well-appearing child
• abrupt fever resolution with development of rash
• bulging fontanelle

Question 8

Serious Bacterial Infection (SBI) causes (3)

Answer 8

• bacteremia
• meningitis
• UTI

Question 9

Flu risk factors (5)

Answer 9

• children under 2
• chronic health conditions (pulm, CV, renal, hepatic, heme, metabolic, neuro, immunosuppression)
• long-term aspirin therapy
• AI/AN
• residents of chronic care facilities

Question 10

Recurrence rates of febrile seizures by age

Answer 10

• first seizure before age 1: 50%

- first seizure after age 1: 30%

Question 11

Epilepsy risk factors (3)

Answer 11

• early, recurrent, and/or complex febrile seizures
• family history of epilepsy
• abnormal development