- A 2-1/2 year old child has a 5 minute generalized tonic-clonic seizure with a fever of 102. Examination reveals a right otitis media, no nuchal rigidity and normal mental status one hour after the event. Neurodevelopmental status is normal. Family history is positive for maternal febrile seizures. This is the child's first seizure. Which of the following statements are true?
Your answer:
An EEG should be performed in one week
The risk of recurrence of a febrile seizure in this child is approximately 30%.
A lumbar puncture should be performed
Phenobarbital should be initiated.
- What is the fastest rate that phenytoin can be administered intravenously in a child?
Your answer:
3mg/kg/min
2mg/kg/min
50mg/min
1mg/kg/min
- All of the following statements are true Except:
Your answer:
Felbamate has been associated with aplastic anemia and liver toxicity.
Fosphenytoin cannot be given IM due to severe pain at the injection site.
Fosphenytoin can be given at an IV rate of 3mg/min.
Lamotrigine can lead to rash development, however there is no report of serious
- Simple febrile seizures are defined as all of the following Except:
Your answer:
Only two seizures in a 24 hour period
No evidence of CNS infection
Generalized seizure lasting < 15 minutes
Age range 6 months to 5 years.
- Which of the following is not a risk factor for febrile seizure recurrence?
Your answer:
Family history of febrile seizures
Age less than 24 months of age with onset of first febrile seizure
Age less than 12 months of age with onset of first febrile seizure
Temperature less than 40C with febrile seizure
- The pediatric doses of Lorazepam is 0.05-0.1 mg/kg
Your answer:
TrueFalse
- The pediatric doses of Diazepam is rectal 0.5mg/kg, IV:0.2-0.3mg/kg
Your answer:
TrueFalse
- The pediatric loading dose of phenobarbital is 15-20 mg/kg
Your answer:
TrueFalse
- The pediatric loading dose of phenytoin is 15-20 mg/kg
Your answer:
TrueFalse
- The pediatric loading dose of fosphenytoin: IV/IM 15-20 mg PE (phenytoin equivalents)/kg
Your answer:
TrueFalse
- The pediatric does of Midazolam is rectal 0.5mg/kg: IV: 0.1mg/kg: IM: 0.2mg/kg
Your answer:
TrueFalse
- A 3-month old female presents with a generalized seizure which has been present for 25 minutes. The seizure is refractory to rectal valium given by the paramedics and Ativan in the ED. Her temperature is 36.5C. There is no sign of trauma. Mother reports that she just started the baby on formula this week. All of the following are true except:
Your answer:
Patients with hyponatremic seizures typically have prolonged seizures
Patients with hyponatremic seizures tend to have higher temperatures than infants with seizures
The mother should be questioned regarding exact formula preparation
Hyponatremia may be corrected by using 4-5cc/kg of 3% saline
- The risk of development of epilepsy in the general populations is approximately 1% by age 7 years. In children with simple febrile seizures, the incidence of epilepsy is:
Your answer:
No different that the rate in the general population
Only slightly higher than the rate in the general population
30-50 times that of the general population
10 times that of the general population
- The latest ACEP article on febrile seizures recommends the following in regards to lumbar puncture for patients with febrile seizures:
Your answer:
A lumbar puncture can be deferred in patients less than 18 months of age with a simple febrile
A CT scan should be performed prior to performing a lumbar puncture
All patients less than 12 months of age should undergo lumbar puncture
All patients less than 18 months of age should undergo a lumbar puncture
- Which of the following is the most common cause of seizures in children?
Your answer:
Head injury
Fever
Hypoxia
Metabolic disturbances
Ischemia
- Which of the following is the drug of choice for neonatal seizures?
Your answer:
Phenobarbital
Fosphenytoin
Valproic acid
Phenytoin
- Which of the following causes of gastroenteritis have been associated with seizures?
Your answer:
Shigella
Campylobacter
Salmonella
Rotavirus