PALS/neuro Flashcards
reasons for AMS in peds
Alcohol Encephalopathy/mengitis Insulin Overdose Uremia Trauma/tumour/toxin ICH, infarction Psychiatric Seizures Others
encephalitis hx/exam
hx: recent illness, fever
Exam: fever, meningism, rash
Investigations: blood cultures, viral cultures, ammonia, CT scan, delayed LP
overdose/ingestions hx/exam
hx: toddler, teen, no prodrome, GIT symptoms
exam: toxidrome, pupils
IX: tox screen, COhb, egg, anion/osmolar gap
Uremia hx/exam/ix
uremia, hypoxia, shock, lyte abnormalities, dehydration, newborns with errors of metabolism, hypo/hyperthermia, hepatic/hypertensive encephalopathy, DKA
Hx: subacute onset
Ix: lytes, BUN/CR, NH3, LFTs, MetHb, Metscreen
Trauma, tumour hx./ex
tumour-prodrome, headache, vomiting, ataxia, trauma-does the hx explain the findings
Age related AMS for infants
meningitis, seizures, CNS trauma, metabolic abnormalities, dehydration, hypothermia/hyperthermia, intussuception
age related AMS for adolescent
alcohol, drugs, trauma, psychiatric disorder
status epilepticus patho
increased CBF, increased o2/glucose consumption, increased CO2 production, progressive lactic acidosis as consumption exceeds supply of substrates
Phenytoin and phenobarbitals doses
Phenytoin (IV 20m/kg over 20 min max 50mg/min)
Phenobarbitals IV 20mg/kg over 10-20mins, 100mg/min
define meningitis
bacterial meningitis is a lifethreatening illness that results from bacterial infection of the meningeal covering of the brain and spinal cord
dx of meningitis
bacteria cultured from CSF obtained from LP, the CSF also demonstrates the presence of inflammatory cells, increased protein and decreased level glucose level
causative organisms of meningitis
steptococcus
neisseria
hemophilus influenza
meningitis complications
seizures, SIADH, progressive DLOC, evolution of sepsis
Abx of meningitis of neonates and infants
neonates: cefotaxime and ampicillin + acyclovir
Infants: cefotaxime, vancomycin + acyclovir
