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* nbme q1
 #139227  
  santabanta - 11/17/06 00:29
 
  A PREVIOUSLY HEALTHY 3 YR OLD BOY IS ADMITTED TO THE HOSPITAL THROUGH THE EMERGENCY DEPT BCAZ HE HAS BEEN HAVING GENERALIZED SEIZURES. HE HAD A FEVER THIS MORNING AND HAD ONE SEIZURE AT HOME AND ANOTHER ON THE WAY TO THE EMERGENCY DEPT. WHILE IN THE EMERGENCY DEPT HE HAD SEVERAL ADDITIONAL SEIZURES THAT WERE CONTROLLED WITH INTRAVENOUS LORAZEPAM. VITAL SIGNS ON ARRIVAL AT THE EMERGENCY DEPARTMENT WERE TEMPERATURE 39.6 C(103.3F) PULSE 110/MIN RESPIRATIONS 24/MIN AND BP 85/60 MMHG. PHYSICAL EXAM SHOWED NO ABNORMALITIES EXCEPT FOR LEFT OTITIS MEDIA AND LETHARGY. INTRAVENOUS PHENYTOIN WAS ADMINISTERED. SPINAL FLUID EXAM , SERUM ELECTROLYTE CONCENTRATIONS AND COMPLETE BLOOD COUNT WERE NORMAL. NOW IN THE HOSPITAL THE PATIENT HAS ANOTHER SEIZURE. THE PATIENT IS MANAGED APPROPRIATELY AND THE SEIZURE STOPS. WHEN DISCUSSING THIS CHILDS MANAGEMENT AND PROGNOSIS WITH THE PARENTS, IT IS MOST APPROPRIATE TO COUNSEL THEM ABOUT WHICH OF THE FOLLWOING?

A. THEIR CHILD HAS AN INCREASED RISK FOR ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

B. THEIR CHILD HAS AN INCREASED RISK FOR DEVELOPING A BRAIN TUMOR

C. THEIR CHILD IS LIKELY TO BE DEVELOPMENTALLY DELAYED

D. THEIR CHILD WILL HAVE A SEIZURE EVERY TIME HE HAS A FEVER

E. THEIR CHILD WILL PROBABLY BECOME SEIZURE-FREE AS HE BECOMES OLDER


 
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* Re:nbme q1
#561801
  joscohmd - 11/17/06 00:38
 
  e-clinically this is febrile seizure,most likely will be seizure free during adulthood  
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* Re:nbme q1
#561822
  yuvraj1001 - 11/17/06 01:08
 
  I agree this is a case of febrile seizure and will be seizure free in the adulthood.
 
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* Re:nbme q1
#562039
  pedres - 11/17/06 09:10
 
  D - YOU NEED TO COUNSEL THEM REGARDING RECURRENT ATTACKS WHICHN IS IMPORTANT THAN TELLING ABOUT PROGNOSIS .that is fine but can be told later  
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* Re:nbme q1
#562046
  dr_nuri - 11/17/06 09:15
 
  yes i wd also go for d.  
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* Re:nbme q1
#562094
  soujany - 11/17/06 09:55
 
  I too the answer is D.

Febrile seizures have a chance of recurrence everytime fever occurs. But at the same time has 1% chances of having seizures in adulthood if typical seizures, and 10% if atypical seizures. So based on one episode, we may not be able to decide if atypical or not, though it looks more like typical one.
 
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* Re:nbme q1
#562476
  pk007 - 11/17/06 13:58
 
  will go for e.
 
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* Re:nbme q1
#562481
  patrick_21 - 11/17/06 14:00
 
  answer is E  
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* Re:nbme q1
#562534
  benign1998 - 11/17/06 14:30
 
  d  
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* Re:nbme q1
#562541
  klebsiella - 11/17/06 14:32
 
  Answer---E  
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* Re:nbme q1
#562862
  tea - 11/17/06 16:28
 
  e..
 
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