CC Jan 2016 Febrile seizure evaluation

echoecho's version from 2016-03-27 22:14


Question Answer
Clinical evaluation is essential to determine what 3 facts of the febrile seizure?1) source of the fever 2) the relationship of the seizure to the onset of fever 3) the type of seizure
What three things should the hx include?1) whether the child received an antibiotic 2) if the child attends a daycare 3) the child's vaccination status
Fever is common in childhood and might occur coincidentally with a more serious underlying cause of the seizure, what 5 questions should be asked?1) about developmental milestones 2) ingestion of toxins 3) trauma to the CNS 4) previous seizures 5) family hx of febrile or afebrile seizures
A thorough physical exam is also mandatory to determin the ____ of the fever?source
The exam should search for signs of _____?meningitis
List the signs of meningitis on exam?1) bulging fontanelles 2) nuchal rigidity 3) irrtability 4) depressed sensorium 5) Kernig or Brudzinski signs
What neurocutaneous signs might suggest an underlying cause of the seizure?1) cafe au lait spots 2) neurofibromas
Do experts recommend blood tests in the absene of a suggestive hx or physical finding?no
A CBC, lytes and glucose are generally not helpful, what test is indicated in children who appear ill?CBC
A hx of vomiting or diarrhea may indicate the need for determining what 2 blood tests?glucose; lytes
*** The 2011 updated recommendations of the American Academy of Pediatrics states that children with meningeal signs (Kernig and/or Brudzinski sign, stiff neck) or with clinical hx or examination that suggests meningitis or intracranial infection should have what procedure?lumbar puncture
A lumbar puncture should be considred in children 6-12 months of age who have not received what vaccinations as recommended or whose immunization status is not known?1) Streptococcus pneumoniae 2) Hemophilus influenzae
While receipt of the above 2 vaccines does not totally eliminate the risk of infection, vaccination substantially _____ the risk, thus making LP less likely to be beneficial?decreases
Why is a lumbar puncture also an option for children who have had pretreatment with antibiotics (antibiotics given for another illness)?because antibiotics may mask the signs and symptoms of meningitis
Are electroencepholograms (EEGs) of value to predict recurrence of a febrile seizure or the subsequent development of epilepsy?are of minimal value
Is a routine EEG helpful in the initial evlauation of a child with a simple febrile seizure?no
Which patient type is an EEG of value?1) children with complex febrile seizures who have a recurrence without fever OR 2) in children with recurrent febrile seizures who exhibit development delays or neurologic deficits
Regardless of age, what neuroimaging studies are not routinely necessary in children with febrile seizures?1) CT 2) MRI
CT and MRI are worthwhile in what 4 patient types?1) children with focal neurologic abnormality 2) increased intracranial pressure 3) possible head injury 4) suspected structural defect in the brain
*** SUMMARY = A routine _____ is not helpful in the initial evaluation of a child with a simple febrile seizure and is therefore not indicated?EEG
*** SUMMARY = Regardless of age, neuroimaging studies such as ____ or _____ are not routinely necessary in children with febrile seizures?CT; MRI