SAQ 494 – Paediatrics – infant seizure with fever and shock

A 4-month-old infant presents by ambulance after a generalised convulsion lasting about 2 minutes that stopped spontaneously. He has had 24 hours of coryza and fever, received paracetamol 30 minutes ago, was born at term and is immunised. He appears listless and mottled with capillary refill time of 3 seconds.

Observation	Result
Temperature	37.8 C rectal
Heart rate	160/min
Blood pressure	80/40 mmHg
SpO2	98% on room air

List five (5) differential diagnoses.

(Marked out of 5.0)

/ 5

State four (4) management priorities.

(Marked out of 4.0)

/ 4

The child is not currently seizing. Prescribe two (2) medications.

(Marked out of 4.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Medication</th> <th>Slow release?</th> <th>Route</th> <th>Dose</th> <th>Frequency</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> <td></td> <td></td> <td></td> </tr> <tr> <td>2.</td> <td></td> <td></td> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 4

State two (2) rationales for your drug choices.

(Marked out of 2.0)

/ 2

The child begins seizing again and has IV access. Complete the active seizure algorithm.

(Marked out of 14.0)

/ 14

After the seizure stops, list your next two (2) investigations and state one pro and one con for each.

(Marked out of 6.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Investigation</th> <th>Pro</th> <th>Con</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> <td></td> </tr> <tr> <td>2.</td> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 6

Total Score: 0 / 35

Percentage: 0%