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Status epilepticus has been redefined from 30 minutes to just 5 minutes of continuous seizure activity, aligning better with current treatment approaches that emphasize early intervention. This includes recognizing non-convulsive status, which often presents as a prolonged postictal state with subtle eye movements or gaze deviation.

• Systematic assessment includes history of seizures, medications, shunts, trauma, potential ingestions
• Lab evaluation should include glucose, electrolytes, calcium, pregnancy testing when applicable
• Initial treatment involves two doses of benzodiazepines via IV, rectal, buccal, or intranasal routes
• Simplified dosing: midazolam/diazepam 0.2 mg/kg (max 10mg); lorazepam 0.1 mg/kg (max 4-5mg)
• Second-line agents include levetiracetam (60 mg/kg), fosphenytoin (20 PE/kg), or valproate
• For refractory status, consider ketamine, phenobarbital, or continuous infusions after intubation
• Propofol is generally avoided in children under age 3 and carries risk of propofol infusion syndrome

Season two of "The Pit" is in production with writers writing, actors acting, and producers producing. It's scheduled for release in January of next year.

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Staph Scalded Skin Syndrome presents with terrifying skin desquamation but typically heals without scarring within two weeks. This case demonstrates the classic presentation in a three-year-old child with recent URI, highlighting the typical appearance, clinical course, and management principles.

• Staph Scalded Skin Syndrome results from staphylococcal toxins that cleave the epidermis
• Most common in young children, often following upper respiratory infections
• No mucosal involvement - key differentiating factor from Stevens-Johnson Syndrome
• Treatment includes anti-staphylococcal antibiotics and supportive care
• Colonization site may be difficult to identify, often in nares or umbilical region
• Adults with renal disease are at higher risk due to impaired toxin clearance
• Requires burn-like supportive care for temperature regulation and prevention of secondary infections
• Historically had 5% mortality, likely lower with modern intensive care

Stay tuned for our upcoming comprehensive Immunism Medicine Boards preparation resources, featuring videos, questions, summaries, and study guides designed to help you excel on your exam.

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Try and guess before reading the summary.

Stevens-Johnson Syndrome presents a critical dermatological emergency characterized by mucosal lesions and diffuse rash with high mortality if untreated. Recognizing this condition requires understanding its presentation, pathophysiology, and immediate management strategies to improve patient outcomes.

• Case presentation of 20-year-old female with fever, mucosal lesions, and diffuse rash
• Mucosal involvement is the key diagnostic feature of Stevens-Johnson syndrome
• Common triggers include sulfa drugs, anti-epileptics, NSAIDs, and infections like mycoplasma
• Positive Nikolsky sign where skin cleaves and sloughs off when pressed
• SJS affects less than 10% of body surface area while TEN involves more than 30%
• Treatment includes supportive care, fluids, nutrition, and controversial steroids
• IVIG, plasmapheresis, and TNF blockers may be beneficial treatment options
• Approach treatment similar to severe burns with non-adherent dressings
• Secondary infections may require antimicrobials, but not as initial treatment
• Eye involvement requires artificial tears and careful monitoring

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