Weird and Wonderful Disease States Flashcards
What is a febrile seizure?
seizures occurring in children aged 6 months to 5 years with a temperature greater than or equal to 38 C
-no signs of CNS infection or metabolic disturbance
-no history of afebrile seizure
Why do febrile seizures occur?
exact mechanism is unknown
Is recurrence of febrile seizures common?
recurrence after a first febrile seizure is common
-risk of epilepsy is not increased after a first simple febrile seizure
What are some potential risk factors for febrile seizures?
family history of febrile seizure
developmental delay
viral illness
What is the diagnosis of a febrile seizure?
suspected in children within the age range who are previously healthy with seizure and fever
diagnostic criteria:
-generalized tonic clonic activity with no focal compartment
-duration less than 15 minutes
-occurs no more than once in 24h
-no previous neurologic problems
How should febrile seizures be managed?
stabilization and monitoring
-do not put anything in their mouths
-try to roll onto their side or roll head to one side
-if longer than 3 minutes call ambulance
children should be reviewed by physician after a febrile seizure
most febrile seizures will have stopped before presentation to a HCP
Can febrile seizures be prevented?
no
anticonvulsants (continuous or intermittent) for single or recurrent febrile seizures not recommended
antipyretics do not affect illness course or neurologic complications
What are some potential causes of congenital heart disorder?
environmental
-maternal diabetes, teratogen exposure, alcohol, infection
genetics
What are the complications of congenital heart disorder?
pulmonary HTN
heart failure
death
What are the common congenital heart defects?
atrial septal defect
-hole in septum, O2 rich blood leaks into O2 poor blood
-peripheral consequences
coarctation of the aorta
-narrowing of aorta
-inefficient carrying of blood to body, increased BP, damage
hypoplastic left heart syndrome
-treated with surgery
What is the management for congenital heart defects?
surgery (#1)
pharmacological:
-diuretics (kids sensitive to fluid changes)
-ASA (one of the cases youll see it, go for chewable tabs)
-anticoag (enoxaparin, warfarin in older children)
-BP meds
-pulmonary HTN: sildenafil, tadalafil, bosentan
What is common in healthy infants?
reflux
-usually benign
When does GERD become an issue with kids?
interfering with daily activities or causes complications
-affecting growth
Describe the pathophysiology of GERD in infants.
they spend a lot of time lying down
frequent, liquid meals
short esophagus and LES
What is the main barrier to reflux?
LES
-relaxation is triggered by gastric distention
-relaxation continues into childhood but growth and upright positioning decrease reflux frequency
