29/01/24 Flashcards by Lisa Azizi

dyskinetic cerebral palsy presents with

athetoid movements and oro-motor problems

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how does DMD present?

3-5?
large calves in a patient with weakness in the muscles surrounding pelvis

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spastic cerebral palsy?

hemiplegia, diplegia, quadriplegia
increased tone due to UMN

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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

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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

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head injury paeds?
high risk?

> 3 vomits
amnesia >5mins
LOC >5 mins
GCS <14

dangerous mechanism of injury

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measles occurs alongside other systemic symptomst/f

true

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what is erythema multiforme?

hypersensitivity reaction
> herpes simplex virus

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roseola infantum

high grade fever
maculopapular rash and is not itchy

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is a roseola rash itchy?

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what is acute epiglottis caused by?

haemophilus influenza type b

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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

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why are children with down’s more associated with sleep apnoea and snoring?

low muscle tone in upper airways and large tongue/adenoids

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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

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feverish child assessment

temperature
hr
rr
cap refill

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signs of dehydration

reduced skin turgor
cool extremities

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red high risk signs
activity

no response to social cues
ill to healthcare
does not wake
weak, high pitched / continous cry

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red circulation and hydration

reduced skin turgor

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other RED signs

<3 months
>38 non-blanching rash

bulging fontanelle
neck stiffness
status epilepticus
focal neurological signs
focal seizures

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what is cryptorchidism

absence of one testicle from scrotum

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what is the most common signs of neonatal sepsis

grunting
respiratory distress

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when is it classified as neonatal sepsis

<28 days

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apgar scores
low score

0-3 is very low score

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apgar score healthy

7-10

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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

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