Clinical Reasoning Structured Reflection
List 2-3 conditions on
the differential
diagnosis
List aspects of
presentation that are
concordant with
diagnosis
1. Febrile seizure
2. Epilepsy
3. Meningitis
Generalized tonic clonic seizure
Neurologically normal child
No evidence of intracranial infection
(meningitis, encephalitis, etc.)
No focal neurologic deficits
Generalized tonic clonic seizure
Third seizure (more than 24 hours
apart)
Generalized tonic clonic seizure
“Fever” (no temp at hospital but
mom reports subjective fevers)
No true fever (though mom reports
subjective fever)
Seizure following “fever”
Seizures have happened in the past
Fully vaccinated child
Family hx of febrile seizures
Neurodevelopmental brain lesions
Neck pain/stiffness
Petechial rash
Toxic appearance
List aspects of
presentation that are
disconcordant with
diagnosis
List aspects of
presentation that are
associated with
diagnosis but are
missing from
presentation
List Diagnoses in order of likelihood:
1. Epilepsy
2. Febrile seizure
3. Meningitis
Clinical Reasoning Structured Reflection