22/06 Flashcards
1
Q
what causes acute epiglottitis
A
haemophilus influenza B
2
Q
APGAR
A
Activity (muscle tone)
Pulse
Grimace (reflex irritability)
Appearance (skin colour)
Respiratory effort
3
Q
when should apgar be assessed
A
1 and 5 mins
again at 10 mins if abnormal
4
Q
adverse effect of methyphenidate
A
cardiotoxicity - perform a baseline ECG
5
Q
benign rolandic epilepsy EEG
A
centrotemporal spikes
6
Q
jaundice extending beyond physiological 2 weeks
conjugated bilirubin abnormally high
A
biliary atresia
7
Q
crosses suture lines
A
caput succedaneum
8
Q
doesnt cross suture lines
A
cephalohaematoma
9
Q
cause of erythema infectious/slapped cheek/fifth disease
A
parvovirus b19
10
Q
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)
A
scarlet fever
11
Q
what causes scarlet fever
A
Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
12
Q
what causes hand foot and mouth disease
A
coxsackie A16 virus
13
Q
Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions
A
Patau syndrome (trisomy 13)
14
Q
Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers
A
Edward’s syndrome (trisomy 18)
15
Q
Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism
A
fragile X
16
Q
Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis
A
noonan syndrome
17
Q
Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate
A
pierre-robin syndrome
18
Q
Hypotonia
Hypogonadism
Obesity
A
Prader-Willi syndrome
19
Q
Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis
A
williams syndrome
20
Q
Characteristic cry (hence the name) due to larynx and neurological problems
Feeding difficulties and poor weight gain
Learning difficulties
Microcephaly and micrognathism
Hypertelorism
A
cri du chat syndrome (chromosome 5p deletion syndrome)
21
Q
drug use increasing risk of cleft lip/palate
A
anti-epileptics
22
Q
Sensorineural deafness
Congenital cataracts
Congenital heart disease (e.g. patent ductus arteriosus)
Glaucoma
A
rubella
23
Q
Cerebral calcification
Chorioretinitis
Hydrocephalus
A
toxoplasmosis
24
Q
Low birth weight
Purpuric skin lesions
Sensorineural deafness
Microcephaly
A
cytomegalovirus
25
heart defect DMD
dilated cardiomyopathy
26
turners syndrome murmur
ejection systolic due to bicuspid aortic valve
27
peak incidence at 6 months - 3 years
more common in autumn
croup (parainfluenza virus) -> give dex
28
<1 year old
winter
bronchiolitis (RSV) -> supportive tx
29
differentiate cardiac and non-cardiac cyanosis
nitrogen washout test
30
acrocyanosis
cyanosis of the peripheries
normal finding and may persist 24-48hr
31
CF colonising organisms
Staphylococcus aureus
Pseudomonas aeruginosa
Burkholderia cepacia*
Aspergillus
32
cystic fibrosis diagnosis
sweat test, CF indicated by > 60 mEq/l
33
developmental referral
doesn't smile at 10 weeks
cannot sit unsupported at 12 months
cannot walk at 18 months
34
diagnosis of DDH
USS unless >4.5 months, then xray
35
tx of DDH
pavlik harness in children younger than 4-5 mo.
older -> surgery
36
Holds in palmar grasp
6 months
37
Points with finger
9 months
38
reaches for object
3 months
39
good pincer grip
12 months
40
head control
3 months
41
sits without support
7-8 months
42
crawls
9 months
43
walks unsupported
13-15 months
44
runs
2 years
45
tricycle
3 years
46
hops on 1 leg
4 years
47
not shy
6 months
48
shy
9 months
49
turns towards sound
3 months
50
mama dad
9 months
51
knows and responds to own name
12 months
52
2-6 words
18 months
53
combine two words
2 years
54
talks in short sentences
3 years
55
Primary hypogonadism (Klinefelter's syndrome)
high LH
low testosterone
56
hypogonadotrophic hypogonadism (kALlmans)
ALL LOW
low LH
low testosterone
57
Androgen insensitivity syndrome
high LH
normal/high testosterone
58
Testosterone-secreting tumour
low LH
high testosterone
59
often taller than average
lack of secondary sexual characteristics
small, firm testes
infertile
gynaecomastia - increased incidence of breast cancer
elevated gonadotrophin levels
klinefelters
60
'delayed puberty'
hypogonadism, cryptorchidism
anosmia
sex hormone levels are low
LH, FSH levels are inappropriately low/normal
patients are typically of normal or above average height
kallmans
61
DMD diagnosis
genetic testing
62
low insertion of the tricuspid valve resulting in a large atrium and small ventricle
atrilisation of the right ventricle
ebsteins anomaly
63
cause of ebsteins anomaly
exposure to lithium in utero
64
ebsteins anomaly murmur
tricuspid regurgitation
pansystolic murmur, worse on inspiration
65
steroid + emollient application
emollient should be applied first followed by waiting at least 30 minutes before applying the topical steroid
66
congenital cyst found in the mouth
epsteins pearl
67
when should a PPI be used for GORD in kids
unexplained feeding difficulties (for example, refusing feeds, gagging or choking)
distressed behaviour
faltering growth
68
gastroschisis
no sac -> vaginal delivery -> straight to theatre
69
omphalocele
sac -> C section -> staged repair
70
paed migraine management
ibuprofen
nasal triptan
71
bupronion CI
epilepsy
72
varenicline CI
depression
73
hypospadius
distal ventral urethral meatus
74
ITP in kids mx
usually conservative
if platelet count <10 or sig bleeding;
oral/IV corticosteroid
IV immunoglobulins
75
BCG if risk factors
at birth
76
'6-1 vaccine' (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
Men B
2 months
77
'6-1 vaccine' (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
PCV
3 months
78
'6-1 vaccine' (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Men B
4 months
79
Hib/Men C
MMR
PCV
Men B
12-13 months
80
Flu vaccine (annual)
2-8 years
81
'4-in-1 pre-school booster' (diphtheria, tetanus, whooping cough and polio)
MMR
3-4 years
82
HPV vaccination
12-13 years
83
'3-in-1 teenage booster' (tetanus, diphtheria and polio)
Men ACWY
13-18 years
84
EEG shows hypsarrhythmia
infantile spasms
85
most common loc of intussecption
ileo-caecal region
86
jaundice in first 24 hours
pathological
87
jaundice from 2-14 days
physiological
88
Pauciarticular JIA
less than 4 joints affected
89
high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel
kawasaki disease -> treat with aspirin
90
precocious puberty
cafe-au-lait spots
polyostotic fibrous dysplasia
short stature
mccune albright syndrome
91
when does meconium aspiration syndrome occur
post term deliveries
92
neck lump anterior to the sternocleidomastoid near the angle of the mandible
branchial cyst
93
neck lump midline/suprahyoid location
dermoid cyst
94
neck lump posterior to the sternocleidomastoid
lymphatic malformation/cystic hygroma
95
when is neonatal blood spot test performed
5-9 days
96
confirmed neonatal sepsis tx
intravenous benzylpenicillin with gentamicin
97
nephrotic syndrome kids
minimal change glomerulonephritis
98
Projectile non bile stained vomiting at 4-6 weeks of life
pyloric stenosis
99
Colicky pain, diarrhoea and vomiting, sausage-shaped mass, red jelly stool.
intussuseption
100
pyloric stenosis diagnosis and tx
USS and Ramstedt pyloromyotomy
101
intussuception diagnosis and tx
USS and reduction via air insufflation
102
intestinal malrotation diagnosis
upper GI contrast study and USS
103
intestinal malrotation tx
laparotomy, if volvulus is present (or at high risk of occurring) then a Ladd's procedure is performed
104
tx hirshsprungs
rectal washouts initially, after that an anorectal pull through procedure
105
meconium ileus diagnosis
X-Rays will not show a fluid level as the meconium is viscid
PR contrast studies may dislodge meconium plugs and be therapeutic --> surgery
106
biliary atresia tx
surgery - Kasai procedure
107
necrotising enterocolitis diagnosis
XRAY - pneumatosis intestinalis and evidence of free air
108
necrotising enterocolotis tx
total gut rest and TPN
babies with perforations will require laparotomy
109
which fractures is compartment syndrome most assoc with
supracondylar and tibial shaft fractures
110
splenic flexure tumour
left hemocolectomy
111
upper rectum tumour
anterior resection
112
lower rectal tumour
abdominoperineal resection
113
umbilical hernia
majority close spontaneously
114
patent ductus arteriosus
left subclavicular thrill
continuous 'machinery' murmur
large volume, bounding, collapsing pulse
wide pulse pressure
heaving apex beat
115
perthes disease mx
If less than 6 years: observation
Older: surgical management with moderate results
116
precocious puberty
before 8 in females
before 9 in males
117
pyloric stenosis
hypochloraemic, hypokalaemic alkalosis
118
Roseola infantum cause
human herpes virus 6
119
roseola infantum
high fever
followed a few days later by maculopapular rash
120
scarlet fever tx
oral penicillin V for 10 days
121
seb dermatitis
topical emollient
topical imidazole cream
122
shaken baby syndrome
retinal haemorrhages
subdural haematoma
encephalopathy
123
TOF
ventricular septal defect
right ventricular hypertrophy
right ventricular outflow tract obstruction, pulmonary stenosis
overriding aorta
124
loud single S2
prominent right ventricular impulse
'egg-on-side' appearance on chest x-ray
transposition of the great arteries
125
undescended testes mx
refer at 3 mo.
repair at 1 year
126
bilateral undescended testes
senior paediatrician within 24hours
127
diagnosis of vesicoureteric reflux
micturating cystourethrogram
look for renal scarring - DMSA scan
128
5 Ws of post-op pyrexia
-Wind (1day): atelectasis
-Water(3days): UTI
-Wound(5days): surgical site infection/abscess
-Walking(7days): DVT/PE
-Wonder-drugs(Anytime): adverse drug reaction
129
differentiate between true seizure and pseudoseizure
prolactin
130
Sudden heart failure, raised JVP, pulsus parodoxus, recent MI
left ventricular free wall rupture
131
Weber result: Lateralises to unaffected ear
sensorineural hearing loss
132
c diff
gram +ve rods
133
posterior MI ECG
tall R waves V1-2
134
lidocaine MOA
blocking sodium channels
135
Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller
dengue fever
136
Management of placental abruption when the fetus is alive, <36 weeks and not showing signs of distress
admit and administer steroids
137
indapamide
THIAZIDE DIURETIC
138
personality disorder tx
dialectal behavioural therapy
139
diarrhoea
normal anion gap acidosis
140
vomiting
metabolic alkalosis
141
COPD
NIV/BIPAP
142
OSA
CPAP
143
type 1 resp failure
CPAP
144
Patients with suspected visual loss secondary to temporal arteritis
IV methyprednisolone
145
long term mx MS
natalizumab
