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PAEDIATRICS > Seizures and CP > Flashcards

Seizures and CP Flashcards

1
Q

Define febrile seizures

A

Occur between 6m to 6years with no underlying neurological disease

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2
Q

Define status epilepticus

A

Ongoing seizures more than 5 minutes or multiple seizures without returning to normal

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3
Q

Define partial seizures and 2 subdivisions

A

Involve only one hemisphere
Simple - no impaired consciousness
Complex- impaired consciousness

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4
Q

Define generalized seizures

A

Involve both hemispheres and associated with loss of consciousness

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5
Q

Describe history in epilepsy x10

A

Classification of seizure
Prodromal symptoms and aura
Initial localizing signs
Description of all manifestations of the seizure
Duration, frequency, time of occurrence in the day
Date and time of last seizure
Predisposing factors and postictal events

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6
Q

Physical exam inspection x3

A

Dysmorphic features
Diagnostic rashes
Asymmetry - in long standing hemiplegia

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7
Q

Investigations in epilepsy x4

A

Electroencephalogram to characterize seizure
Biological evaluation of electrolytes
Blood glucose level
Brain imaging

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8
Q

Indication for brain imaging x3

A

Focal signs- abnormal neurological findings
Developmental delay or regression
Seizure that are difficult to control

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9
Q

Common problems in management of epilepsy x3

A

Increased frequency and worsening of seizures
Intractable seizures- not responsive to treatment
Seizures changing in nature

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10
Q

Differential diagnosis of epilepsy x3

A

Syncope ie passing out
Breath holding attacks
Undiagnosed structural lesions eg tumor

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11
Q

State 5 problems that may arise with epilepsy medication

A

Wrong drug, wrong dose, adverse drug interactions, wrong diagnosis, poor compliance

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12
Q

Management during a seizure x4

A

Lie the child on the back
Dont put objects in mouth
Move any nearby objects that may be harmful
Have a time plan to seek medical attention

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13
Q

Causes of intercurrent problems affecting management of seizures x2

A

Intercurrent infection - UTI
Electrolyte imbalance induced by drugs

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14
Q

How to explain treatment to parents x4

A

Reasons for recommending treatment
Benefits and possible side effects
Probable duration

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15
Q

Why monotherapy is important x2

A

Some drugs reduce efficacy of others
Some drugs metabolize the other drug

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16
Q

Criteria for stopping seizure treatment x2

A

Seizure free for 2 to 4 years
Individualized risk benefit assessment

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17
Q

Factors affecting increased probability of seizure recurrence after stopping treatment x3

A

Abnormal neurological signs
Mixed type seizure
Focal seizures/ seizures originally difficult to treat

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18
Q

Anticonvulsants for generalized tonic clonic seizures x4

A

Carbamazepine
Phenobarbitone
Valproate
Phenytoin

19
Q

Anticonvulsants for absent seizures x3

A

Ethosuximide
Valproate
Clonazepam

20
Q

Anticonvulsants for simple and complex partial seizures x3

A

Carbamazepine
Valproate
Phenytoin

21
Q

Describe infantile seizures and their treatment

A

They look like a startle- stiff arms and legs with head bent forwards
Prednisolone

22
Q

Side effects of anticonvulsants x5

A

Acute toxicities eg nystagmus and ataxia
Chronic toxicities- teratogenicity, hematological effects
Acute idiosyncratic (abnormal physical reaction) reactions eg stevens johnson syndrome
Drug interactions between anticonvulsants
Drug interactions with other drugs

23
Q

Risk factors of febrile seizure x2

A

Age 6-60months
Temperature greater or equal to 38 degrees

24
Q

Characteristics of febrile seizures x4

A

Generalized
Usually tonic clonic
Lasting for maximum of 15 minutes
Non recurrent within a period of 24 hours

25
Q

Define a complex febrile seizure x3

A

Prolonged - greater than 15 minutes
Focal and or generalized
Recurs within 24 hours

26
Q

Febrile status epilepticus

A

Febrile seizures for greater than 30 minutes

27
Q

Define cerebral palsy

A

A non progressive disorder of motion and posture secondary to an insult in the developing brain

28
Q

General nursing management for CP x4

A

Tube feeding
Attention to toileting
Attention to skin for pressure sores
Treatment for GERD

29
Q

Purpose of physiotherapy in CP x3

A

Prevent contractures
Maintain range of movement and function
Optimize ability to cope with activities and daily living

30
Q

Function of splinting (1) and orthoses x2

A

Splinting to prevent contractures
Orthoses to improve function and prevent deformities

31
Q

Social implications of CP x4

A

Neglected siblings
Behavioral disorders
Burdens on parents
More time spent on child

32
Q

Common eye problems associated with CP x3

A

Squint
Visual fields defects
Decreased visual acuity

33
Q

Drug classes for treatment of CP x3

A

Anticonvulsants
Antispastics - diazepam
Anticholinergics - atropine for excessive drooling

34
Q

Prenatal causes of CP x8

A

Mother
Antenatal bleeding
Toxaemia of pregnancy
Infection
Radiation
Hypoxia

Baby - hydrocephalus, cerebral malformations, hypoxia, genetic factors

35
Q

Perinatal causes of CP x5

A

HIE
Asphyxia
Prematurity
Cerebral birth trauma
Kernicterus - brain damage due to high bilirubin in blood

36
Q

Postnatal causes of CP x5

A

Hypoxia
Infection
Head trauma
Toxin or drugs
Vascular - stroke, thrombosis, embolism

37
Q

Gross motor assessment in CP x5

A

Assess sitting ability
Ventral suspension
When lying supine, pull to sit
Assess tone by holding up vertically under axilla
Place in prone position (on tummy) to detect back arching

38
Q

Complications of CP x5

A

Intellectual impairment
Hearing, visual and speech abnormalities
Malnutrition

39
Q

CP investigations x3

A

TORCH screening in infants
CT and MRI

40
Q

Management team involved in cp x7

A

Social worker
Occupational therapist
Physiotherapist
Speech therapist
Orthopaedic surgeon
Psychologist
Remedial teachers
Neurologist

41
Q

Causes (2) of nutritional problems and effect

A

GERD
Inability to swallow
Failure to thrive

42
Q

Orthopaedic procedures in CP x3

A

Improve cosmesis
Correction of deformities
Improve of deformities

43
Q

CP demonstrations on physical exam x7

A

Pull to sit
Assess sitting
Standard gait exam
Prone position to check for back arching
Vertical and ventral suspension
Muscle bulb tone power reflexes

44
Q

Assessing for Complications of CP x5

A

Vision loss
Hearing loss
Microcephaly
Kyphosis inspect back
Chest infection therefore auscultate
Constipation palpate abdomen

PAEDIATRICS (20 decks)

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