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2018 Peds Royal College diagnostic criteria > 2018 Peds Royal College diagnostic criteria > Flashcards

2018 Peds Royal College diagnostic criteria Flashcards

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1
Q

Functional constipation

A

Developmental age of 4 with no signs of IBS

  1. Two or fewer defecations in the toilet per week
  2. One fecal incontinence per week
  3. History of retentive posturing or volitional stool retention
  4. History of painful or hard bowel movements
  5. Large fecal mass in the rectum
  6. Large diameter stools that may obstruct the toilet
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2
Q

Cyclic vomiting syndrome

A

At least 5 attacks in any interval, or a minimum of 3 attacks during a 6-month period
Episodic attacks of intense nausea and vomiting lasting 1 hour-10 days and occurring at least 1 week apart
Stereotypical pattern and sx in the individual patient
Vomiting during attacks occurs at least 4 times/hr for at least 1 hr
Return to baseline health between episodes
Not attributed to another disorder

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3
Q

PANDAS

A

Prepubertal onset
OCD, tics or both
Sudden onset of symptoms
Temporal relationship between exacerbations and GAS infection
Neurological abnormalities present during periods of exacerbations

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4
Q

Neurofibromatosis

A

2 or more of:

  • Cafe au lait spots (more than 6, > 5mm if prepubertal, > 15mm if postpubertal)
  • Axillary or inguinal freckling
  • Neurofibromas (2 or more, or 1 plexiform neurofibroma)
  • 2 or more lisch nodules (iris hamartomas)
  • Skeletal changes (sphenoid dysplasia)
  • First-degree relative with NF1
  • Optic glioma
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5
Q

10 signs of primary immunodeficiency

A
  1. 4 or more new ear infections within 1 year
  2. 2 or more serious sinus infections in 1 year
  3. 2 or more months on antibiotics with little effect
  4. 2 or more pneumonias within 1 year
  5. Failure to thrive
  6. Recurrent deep skin or organ abscesses
  7. Persistent thrush in mouth or fungal skin infection
  8. Need for IV antibiotics to clear infection
  9. 2 or more deep-seated infections including septicemia
  10. Family history of PI
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6
Q

Diagnostic criteria for CF

A 
Presence of typical features, OR
History of CF in a sibling, OR
Positive newborn screen
PLUS
Lab evidence of CFTR dysfunction
- 2 x positive sweat chloride test
- 2 identified CF mutations
- Abnormal nasal potential difference
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7
Q

Functional dyspepsia

A 
1 or more of:
- Bothersome post-prandial fullness
- Early satiation
- Epigastric pain
- Epigastric burning
AND no evidence of structural disease (including upper endoscopy) that can explain the symptoms
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8
Q

Rheumatic fever

A 
2 major criteria or 1 major plus 2 minor
PLUS evidence of GAS infection
Major criteria:
- Polyarthritis
- Carditis
- Subcutaneous nodules
- Erythema marginatum
- Sydenham's chorea
Minor criteria:
- Fever
- Arthralgia
- Elevated acute phase reactants
- Prolonged PR interval
Exception: chorea only
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9
Q

Oligoarthritis

A

Arthritis in 1-4 joints in the first 6 months of disease

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10
Q

Abdominal migraine

A

Child complains of abdo pain plus 2 of:

  • Anorexia
  • Nausea
  • Vomiting
  • Pallor
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11
Q

SLE

A

Need 4 or more of:

  1. Malar rash
  2. Discoid rash
  3. Cytopenia
  4. Positive Anti-dsDNA or Anti-Smith
  5. Positive ANA
  6. Arthritis (2 or more joints)
  7. Photosensitivity
  8. Oral or nasal mucocutaneous ulcerations
  9. Nephritis
  10. Encephalopathy (seizures, psychosis)
  11. Serositis (pericarditis, pleuritis)
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12
Q

Migraine without aura

A 
At least 5 attacks
Headaches last 4-72 hr
Headaches with at least 2 of:
- Unilateral location
- Pulsatile quality
- Moderate or severe pain intensity
- Aggravation by or causing avoidance of routine physical activity
During the headache, at least 1 of:
- Nausea and/or vomiting
- Photophobia and phonophobia
Not attributed to another disorder
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13
Q

Juvenile dermatomyositis

A
  1. Symmetrical proximal muscle weakness
  2. Characteristic skin changes: Gottron papules, heliotrope rash
  3. Elevated muscle enzymes: CK, AST, LDH, aldolase
  4. Abnormal EMG: denervation and myopathy
  5. Abnormal muscle biopsy: necrosis and inflammation
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14
Q

Systemic JIA

A 
Arthritis affecting 1 or more joints
Daily or quotidian fever for at least 2 weeks
Plus, 1 or more of:
- Evanescent erythematous rash
- Generalized lymphadenopathy
- Hepatomegaly and/or splenomegaly
- Serositis
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15
Q

Nephrotic sydrome

A
  1. Nephrotic range proteinuria
  2. Hyperlipidemia
  3. Edema
  4. Hypoalbuminemia
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16
Q

Kawasaki disease

A

5 days of fever, plus at least 4 of:

  • Bilateral non-purulent conjunctivitis
  • Unilateral cervical adenopathy
  • Polymorphous rash
  • Oral/lip lesions
  • Changes in peripheral extremities
17
Q

Endocarditis (Duke criteria)

A

2 major, 1 major + 3 minor or 5 minor
Major criteria:
- Echo evidence of endocarditis (vegetations, abscess or new valve regurg)
- Positive blood cultures (x 2 for usual pathogen, > 2 for atypical pathogens)
Minor criteria:
- Predisposing condition or IVDU
- Fever
- Embolic phenomena (Janeway lesions, conjunctival hemorrhages, splinter hemorrhages, septic pulmonary infarcts, major arterial emboli)
- Immune phenomena (Osler nodes, Roth spots, GN, arthritis)
- Microbiologic evidence (+ blood culture but not meeting major criterion, + serology of active IE organism infection)

18
Q

Tuberous sclerosis

A

Major features:

  • Facial angiofibromas
  • Periungual fibromas
  • Ash leaf spots (3 or more)
  • Shagreen patch
  • Retina nodular hamartomas
  • Cortical tuber
  • Subependymal nodule
  • Subependymal giant cell astrocytoma
  • Cardiac rhabdomyoma
  • Lymphangiomatosis
  • Renal angiomyolipoma

Minor features:

  • Dental enamel pits
  • Hamartomatous rectal polyps
  • Bone cysts
  • Cerebral white matter radial migration lines
  • Gingival fibromas
  • Non-renal hamartomas
  • Retinal achromic patch
  • Confetti skin lesions
  • Multiple renal cysts
19
Q

Prophylaxis for infectious endocarditis

A
  1. Prosthetic cardiac valves
  2. Previous infective endocarditis
  3. Unrepaired cyanotic congenital heart disease including palliative shunts and conduits
  4. Completely repaired congenital heart defect with prosthetic material or device during the first 6 months after the procedure
  5. Cardiac transplant recipients with cardiac valvulopathy
  6. Rheumatic heart disease if prosthetic valves or prosthetic material is used.
20
Q

Macrophage activation syndrome

A
  1. Extremely high ferritin
  2. Decreased fibrinogen
  3. Elevated lipids
  4. Elevated D-dimer
  5. Low ESR but high CRP
21
Q

Disseminated intravascular coagulation

A

Elevated INR
Decreased fibrinogen
Decreased platelets
Increased fibrin-degradation products

22
Q

PID minimum diagnostic criteria

A 
Lower abdo pain plus either:
1. Adnexal tenderness
2. Uterine tenderness
3. Cervical motion tenderness
Increased specificity if she also has:
1. Fever
2. Discharge
3. WBC on microscopy
4. Elevated ESR or CRP
5. Positive GC/chlam testing
23
Q

CRAFFT criteria for substances

A
  1. Ridden in a car driven by someone intoxicated, or driven a car while intoxicated
  2. Using the substance to relax
  3. Using the substance alone
  4. Forgets things they have done while intoxicated
  5. Family or friends telling them they should cut down on use
  6. Gotten into trouble while using the substance
24
Q

3 components of autism diagnosis

A
  1. Symptoms present in early developmental period
  2. Deficits in communication and social interaction
  3. Restricted, repetitive patterns in behaviour and areas of interest

2018 Peds Royal College diagnostic criteria (1 decks)

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