neurology rando

Question 1

Criteria for brain death

Answer 1

multiple exams - usually 2 - at least 6-24 hours after onset of coma (24 hours for young babies, 12 for everyone else)
CRITERIA:
- unresponsive to stimuli
- no brainstem function: cold caloric (oculovestibular) ; doll’s eye reflex (oculocephalic); corneal reflex, gag, cough, pupils
- apnea test
- 2 physicians to do the test
- normal body temperature - >33 C
- no confiding meds
- no spontaneous movements, no interaction with environment, motor GCS

Question 2

How to calculate sensivitiy

Answer 2

true positive/ (true positive + false negatives)

ability to identify person with disease aka to rule out disease if test if negative

Question 3

How to calculate specificity

Answer 3

true negative/(true negative + false positive)

ability to identify person without disease with a negative test aka to rule in disease if test if positive

Question 4

Positive predictive value

Answer 4

probably that person has disease if test is positive

true positive/(true positive + false positive)

Question 5

negative predictive value

Answer 5

true negative /(true negative + false negative)

Question 6

Limits of confidentiality

Answer 6

harm to self
others
risk (abuse or neglect)
reportable disease

Question 7

How to calculate relative risk
The study shows of the 50 children wearing the bracelet, only 10 had a seizure. OF the 50 without the bracelet, 30 had a seizure. What is the relative risk reduction?

Answer 7

relative risk reduction
relative risk then do 1-relative risk 
relative risk = a/a+b / (c/c+d) 
10/50/ 30/50 = 0.33
therefore relative risk reduction is 1-0.33 = 0.67
if relative risk is

Question 8

Risk factors for child abuse (maternal)

Answer 8

lack of supports
mental health
violence towards mom herself
poor coping skills
chronic illness

Question 9

Risk factors

Answer 9

chronic illness
age of infant
behavioural issues

Question 10

family

Answer 10

low SES
lack of support
isolation

Question 11

Contraindication to barium/air enema

Answer 11

perforation
pneumatosis intestinalis
unstable patient
ischemia

Question 12

When might barium/air enema not work

Answer 12

if pathologic lead point - i.e. lymphoma or Meckel
prolonged where necrosis and perforation
ileoileal intussusception

Question 13

Surgical problems in HSP

Answer 13

perforation
testicular torsion
intussusception