week 3

Question 1

definition of febrile convulsion

Answer 1

seizure associated with fever caused by infection or inflammation outside the CNS in a child who is otherwise neurologically normal

Question 2

what is the key feature in causing febrile convulsion

Answer 2

rapid spike in temperatures

Question 3

meningitis and encephalitis are common causes of febrile convulsions - T or F

Answer 3

F, by definition these involve the CNS and are not febrile convulsions

Question 4

definition of simple febrile seizure vs complex

Answer 4

simple - generalised tonic clonic, less than 15 minutes, no recurrence within 24 hours

complex - focal seizures, more than 15 minutes, more than once in 24 hours.

Question 5

how to take a seizure history

Answer 5

ask about before, during and after.

duration, symptoms, injuries, temperature, illness

Question 6

managing febrile convulsions

Answer 6

ABCDE, BLS

protect the head

try to reduce temperature

Question 7

when to admit someone for febrile convulsions

Answer 7

first seizure
complex seizure
>5 min seizure
<18 months
GCS<15, 1 hour after seizure

Question 8

likelihood of recurrence of febrile convulsion

Answer 8

<1 yr: 50%
>3 yr: 20%

complex seizure, or famHx will have higher risk

30% of children will have recurrence

Question 9

peak incidence of febrile convulsion by age?

Answer 9

18 months

Question 10

describe myotonic, tonic and akinetic seizures

Answer 10

myoclonus - isolated muscle jerking
tonic - intense stiffening
akinetic - no movement, falling and LoC

Question 11

what kind of seizure is associated with olfactory and visual hallucinations

Answer 11

temporal lobe seizures

Question 12

what symptoms are temporal lobe seizures associated with

Answer 12

visual, olfactory hallucinations
feelings of intense deja vu
blank staring

Question 13

what are jacksonian seizures

Answer 13

seizures arising from the motor cortex

jerking movements starting from typically corner of the mouth, spreading to involve the hands and limbs.

Question 14

what complication can come after a jacksonian seizure

Answer 14

jacksonian paralysis

Question 15

definition of status epilepticus

Answer 15

seizure lasting more than 5 min, or more than 1 seizure within 5 minutes

Question 16

what is in a seizure rescue pack

Answer 16

benzodiazepam e.g. rectal diazepam or buccal midazolam

Question 17

what does SBAR stand for

Answer 17

situation
background
assessment
recommendation

Question 18

what infection is characteristically described as honey-crusted lesions

Answer 18

impetigo

Question 19

common causative organism of impetigo

Answer 19

staph aureus

Question 20

a child 9 month old has a HR of 155, is he considered tachcardic?

Answer 20

no

Question 21

what is the HR required for tachycardia in a child 1-2 years old

Answer 21

> 150 BPM

Question 22

a 3 year old child has a heart rate of 155, is he tachycardic?

Answer 22

yes, >140 is tachycardia for 2-5 year olds

Question 23

what diagnosis should be considered in a child with fever longer than 5 days?

Answer 23

kawasakis

Question 24

RR for tachypnoea in age 0-5 months

Answer 24

> 60 per minute

Question 25

RR for tacypnoea in age >12 months

Answer 25

> 40/min

Question 26

investigations to do on a child <3 months with fever

Answer 26

FBC
CRP
urine culture
blood culture
\+/- CXR
\+/- stool culture
\+/- LP

Question 27

1-6 common childhood rashes and the cause

Answer 27

Measles - measles virus
scarlet fever - strep pyogenes
Rubella - rubella virus
scalded cheek syndrome - staph aureus
slapped cheek - human parvovirus B19
roseala infantum - HHV 6 or 7

Question 28

8 herpes viruses

Answer 28

HSV 1
HSV 2
VZV
CMV
EBV
HHV 6
HHV 7 
HHV 8

Question 29

what is slapped cheek disease also known as

Answer 29

erythema infectiosum AKA fifth’s disease

Question 30

most common age for otitis media

Answer 30

6-12 months

Question 31

symptoms of otitis media

Answer 31

fever
ear pain
irritability

Question 32

signs of otitis media

Answer 32

red bulging tympanic membrane with loss of light cone

Question 33

causative organisms of otitis media

Answer 33

viral - RSV, rhinovirus

bacterial - streptococcus, HiB

Question 34

complications of otitis media

Answer 34

glue ear
mastoiditis
meningitis

Question 35

management of otitis media

Answer 35

analgesia, +/- antibiotics.

Question 36

how does glue ear develop

Answer 36

recurrent otitis media

Question 37

what is the Centor criteria?

Answer 37

to determine if antibiotics are required in tonsilitis

• cough; absence of
• exudative tonsils
• nodes (painful lymphadenopathy)
• temperature (fever)
• OR

Question 38

at what Centor score is antibiotics recommended?

Answer 38

centor score of 3 or more

Question 39

one possible complication of tonsilitis?

Answer 39

peritonsilar abscess (quinsy)

Question 40

what is the first thing to assess if a child is choking? what to do if yes or no?

Answer 40

is child coughing? is yes - encourage coughing and monitor

if no, then move onto next step

Question 41

what to assess after checking coughing in a choking child?

Answer 41

consciousness - if yes, then 5 back blows, 5 chest thrusts and reassess

if not then start BLS, 2 breathes , 15:2 then reassess check for foreign body

Question 42

biggest and most common risk factor for transient wheeze?

Answer 42

domestic smoking

Question 43

difference between croup and bronchiolitis?

Answer 43

bronchiolitis tends to be under 2 year old
croup has the characteristic barking cough
croup commonly caused by parainfluenzae virus
bronchiolitis commong caused by RSV
bronchilitis produces more severe breathing difficulty symptoms
croup causes barking cough, stridor and hoarse voice