100. Case Studies 1 Flashcards
What are the principles of management for paediatrics?
What’s in the child’s best interest Will investigations change management, are they relevant? What do the parents expect Blood tests aren’t always a necessity IV fluids aren’t routine Oral is a good option Avoid rectal routes unless essential Be guided by the weight and use the BNFc
How much feed volume should a child take per day?
140-180ml/Kg/day
What is a pound?
Around half a kilo (0.453kg)
What is an ounce?
Around 30mls (0.28mls)
Is the 98th centile high or low?
High
What would you ask about in a child with constipation?
Fluid
Fibre
Fruit and veg
Bristol stool chart
How would you examine a child with constipation?
Neuro exam Palpate rest of tummy Crohn’s, IBD- nail changes, other manifestations Inspect lower spine and anus DO NOT DO A RECTAL EXAM
How do you manage constipation?
Laxatives for at least a few months (movicol)
Dietary advice (more fruit, fibre, fluids, less milk)
A toilet routine
You have a child with suspected GORD. What do you suspect?
Forceful vomiting?
Feeding- cows milk or not? How many mls (over feeding)
Weight+ stools constant
How do you treat GORD?
Change feeding position- head up
Adjust feed volume (aim for 150ml/kg/day)
Thicken feeds-
Acid suppression
What tests do you do for coeliacs?
FBC, CRP, bone profile, vit d status LFT’s U&E’s- general wellbeing Heamotinics Coeliac serology + IgA test Stool culture Small bowel biopsy
Differential diagnosis for green vomit and weight loss 2 days
Sepsis
Atresia
Vulvolus
Intusucception
How do you manage moderate bronchiolitis?
Oxygenation
Hydration- in feeds, suck bogies out of nose to help feeding (nasopharyngeal aspirate), NG tube, IV- last resort
How do you treat croup?
Desamethasone
Done examine throat
