29/01/24 Flashcards
dyskinetic cerebral palsy presents with
athetoid movements and oro-motor problems
how does DMD present?
3-5?
large calves in a patient with weakness in the muscles surrounding pelvis
spastic cerebral palsy?
hemiplegia, diplegia, quadriplegia
increased tone due to UMN
what is needed to keep open ductus arteriosus?
why would you want to keep it open?
prostaglandin
so in situations where the oxygen supply etc would decrease like TGA
what is TGA?
is this an emergency?
what is initial mx?
aorta comes from right ventricle and the pulmonary artery from the left ventricle
medical emergency
prostaglandin e1
head injury paeds?
high risk?
> 3 vomits
amnesia >5mins
LOC >5 mins
GCS <14
dangerous mechanism of injury
measles occurs alongside other systemic symptomst/f
true
what is erythema multiforme?
hypersensitivity reaction
> herpes simplex virus
roseola infantum
high grade fever
maculopapular rash and is not itchy
is a roseola rash itchy?
no
what is acute epiglottis caused by?
haemophilus influenza type b
The mother of a 6-week-old baby girl born at 32 weeks gestation asks for advice about immunisation. What should happen regarding the first set of vaccines?
Give as per normal timetable
why are children with down’s more associated with sleep apnoea and snoring?
low muscle tone in upper airways and large tongue/adenoids
what do VSD put you at risk of?
why?
endocarditis
moves at high velocity across VSD’s stenotic /leaky valves or PDA
high velocity flow allows for the sticking of clotting factor
due to endothelium exposing vWF elements to defects so bacteria then adhere to defect
feverish child assessment
temperature
hr
rr
cap refill
signs of dehydration
reduced skin turgor
cool extremities
red high risk signs
activity
no response to social cues
ill to healthcare
does not wake
weak, high pitched / continous cry
red circulation and hydration
reduced skin turgor
other RED signs
<3 months
>38 non-blanching rash
bulging fontanelle
neck stiffness
status epilepticus
focal neurological signs
focal seizures
what is cryptorchidism
absence of one testicle from scrotum
what is the most common signs of neonatal sepsis
grunting
respiratory distress
when is it classified as neonatal sepsis
<28 days
apgar scores
low score
0-3 is very low score
apgar score healthy
7-10
1 points apgar for colour
body pink
extremities blue
causative agent in croup
parovirus
why is pseudomonas aeruginosa bad in cystic fibrosis?
Pseudomonas aeruginosa, which is an opportunistic gram-negative bacteria that causes significant morbidity and mortality in patients with cystic fibrosis (CF)
how is pseudomonas mx in CF?
oral ciprofloxacin
what are the contraindications of lumbar puncture?
focal neurological signs
papilloedema
significant bulging of fontanelle
DIC
signs of cerebral herniation
meningococcal septicaemia
Ix?
blood cultures
serum lactate
blood glucose
coagulation screen
U&E’s
why is a lumbar puncture contraindicated in meningococcal septicaemia?
purpuric rash suggests coagulopathy - DIC?- therefore LP could risk a bleed > haematoma in spinal cord > irreversible neuro damage
mx of meningitis
abx
steroids
fluids - colloid
cerebral monitoring
mechanical vebtilation if needed
when are steroids given in meningitis management?
have to be over 3 months
purulent CSF. WCC >1000
protein concentration >1g/litre
bacteria on gram stain
urgent fluid resus?
children
gluten free crystalloids
bolus of 20ml/kg <10 mins
10-20ml/kg over less than 10 mins is fluid resus for which age group?
neonates
clinical dehydration signs?
Sunken eyes
Dry mucous membranes
Tachycardia
Tachypnoea
Normal peripheral pulses
Normal capillary refill time
Reduced skin turgor
Normal blood pressure
hypernatraemic dehydration:
jittery movements
increased muscle tone
hyperreflexia
convulsions
drowsiness / coma
cradle cap rash mx?
what causes it?
seborrhoeic dermatitis
baby shampoo and baby oil
overactive sebaceous glands
impetigo mx?
fusidic acid
abx cream
retinoblastoma
what is it?
most common ocular malignancy
autosomal dominant caused by loss of function of TS gene on chromosome 13
features of retinoblastoma?
absence of red reflex
white pupil
strabismus
mx?
enucleation
external beam radiation
chemo
photocoagulation
coxsackie virus causes what?
hand foot and mouth disease
_______ is considered the gold standard for detecting renal parenchymal defects, such as scarring due to vesicoureteric reflux
Radionuclide scan using dimercaptosuccinic acid (DMSA).
is the carotid pulse assessed in under 12 months?
what other pulses are not checked in infant
No
neither is the radial pulse used
meckel’s diverticulum presents with?
rule of what applies?
mimics appendix pain in 1-2 yr olds
two feet proximal to ileocaecal valve
painless GI bleed
rule of 2’s
2%
2 feet from ileocaecal valve
2 inches
Ix for meckles diverticulum?
99m technetium
mesenteric arteriography may also be used in more severe cases
pathophysiology of meckles diverticulum
normally, in the foetus, there is an attachment between the vitellointestinal duct and the yolk sac. This disappears at 6 weeks gestation
the tip is free in the majority of cases
associated with enterocystomas, umbilical sinuses, and omphaloileal fistulas.
arterial supply: omphalomesenteric artery.
typically lined by ileal mucosa but ectopic gastric mucosa can occur, with the risk of peptic ulceration. Pancreatic and jejunal mucosa can also occur.
mx of kawasaki disease?
high dose aspirin 7.5-12.5mg/kg 4x a day for 2 weeks
2.5mg/kg daily for 6-8 weeks
IV immunoglobulins 2g/kg daily for one dose treatment given within 10 days of onset of symptoms
what makes up the apgar score?
actrivity
pulse
grimace
appearance
respiration
screen for __________ in people with down’s syndrome who participate in sport
why?
atlanto-axial instability -
increased risk of neck dislocation
osteochondritis disease
older children
separation of fragment of cartilage
typically in the knee, ankle, elbow
associated wiht sports
joint swelling
pain
mechanical symptoms such as locking / catching
osteoid osteoma
localized pain that is worse at night and relieved by NSAIDs
only one side
benign bone tumour swelling / tenderness
webbed neck think turners or?
noonan
learning diff and macrocephaly
fragile X
fragile X
macrocephaly
;long face
large ears
large orchids
mycoplasma pneumonia is mx?
macrolide abx
erythrmycin
huntingtons disease autosomal dominant or recessive?
dominant
chondromalacia patellae
runners knee
cartilage underneath patella deteriorates and softens
this condition is more common among young athletes
Osgood-Schlatter disease
(tibial apophysitis)
pain
tenderness
swelling over tibial tubercle
pulmonary hypoplasia
causes
congenital diaphragmatic hernia
underdeveloped lungs
>oligohydramnios
>tet of fallot
>osetogenesis imperfecta
