3: Sick Child 1 - Common acute illnesses

Question 1

Do children have the same diseases as adults?

Answer 1

No

Question 2

Children have (larger / smaller) heads than adults.

Answer 2

larger heads

Question 3

How do children’s airways differ from adults?

Answer 3

Larynx is more anterior - more difficult to access

Different respiratory infections e.g bronchiolitis

Question 4

Children have (faster / slower) heart rates than adults.

Answer 4

faster HRs

Question 5

Children have (faster / slower) respiratory rates than adults.

Answer 5

faster

Question 6

Children have (higher / lower) systolic BPs than adults.

Answer 6

lower systolic BPs

Question 7

Children have (larger / smaller) occipital bones than adults.

Answer 7

larger

their heads have larger surfaces areas than when in adulthood

Question 8

What is the blood volume of a baby in ml/kg?

Answer 8

80ml/kg

so a 3kg child will have 240ml of blood

Question 9

What change occurs with regard to haemoglobin when you are born?

Answer 9

Foetal Hb > Adult Hb

Question 10

What are the three big causes of childhood mortality?

Answer 10

INFECTION

Prematurity

Birth trauma / hypoxia

Question 11

Which continent has the highest child mortality rate?

Answer 11

Africa

Question 12

What respiratory diseases commonly affect children?

Answer 12

Bronchiolitis

Croup

Pneumonia

Question 13

Which GI disease commonly affect children?

Answer 13

Gastroenteritis

Question 14

What are common chronic diseases seen in children?

Answer 14

Epilepsy

Asthma

Coeliac / IBD

Question 15

What complication of infection is the commonest reason for acute illness in children?

Answer 15

Sepsis

Question 16

Any site of infection can develop into what?

Answer 16

Sepsis

Question 17

What is acute inflammation of the bronchioles called?

Answer 17

Bronchiolitis

Question 18

What infectious agent tends to cause bronchiolitis?

Answer 18

Respiratory syncytial virus (RSV)

fact from 1st year

Question 19

How is bronchiolitis treated?

Answer 19

No anti-virals for RSV, so SUPPORTIVE:

Oxygen

Anti-inflammatories

Nutrition

Question 20

What is croup?

Answer 20

Infection of larynx, trachea, or upper bronchial tree

Question 21

What is the classical symptom of croup?

Answer 21

Barking cough

Question 22

What is the treatment for croup?

Answer 22

Oral steroid

to limit inflammation and avoid need for intubation

Question 23

What is the diagnostic sign of croup on a neck X-ray?

Answer 23

Steeple sign

narrowing of pharynx

Question 24

How is aspiration of foreign bodies confirmed?

Answer 24

Chest x-ray

PA AND lateral so you’re sure it’s not somewhere else

Question 25

How do children present after aspiration of a foreign body?

Answer 25

**Acute onset** respiratory distress +/- Cough and haemoptysis

Question 26

Does every child with a wheeze have asthma?

Answer 26

**No**

Question 27

What causes exacerbations of asthma in the a) summer b) winter?

Answer 27

**a) Atopy** e.g hayfever **b)** **Viral infection**

Question 28

What infection of the lower respiratory tract commonly affects children? Which genetic disorder predisposes you to it?

Answer 28

**Pneumonia** **CF**

Question 29

What are CNS infections commonly seen in children?

Answer 29

**Meningitis** **Encephalitis**

Question 30

Which investigation has a very low threshold for use in children with unexplained septic symptoms?

Answer 30

**Lumbar puncture**

Question 31

What classically appears with meningococcal sepsis?

Answer 31

**Non-blanching rash** e.g vasculitic, purpuric

Question 32

Which type of rash **disappears** when pressed on?

Answer 32

**Viral exanthems** NOT MENINGOCOCCAL RASHES

Question 33

How will parents describe a seizure?

Answer 33

**"Funny turn"**

Question 34

Parents should be advised to take a ___ of their child's seizure.

Answer 34

**video**

Question 35

What is a febrile seizure?

Answer 35

**Seizure caused by rapid increase in temperature** (e.g in fever) **in small children**

Question 36

What is a vasovagal episode?

Answer 36

**"Fainting"** **Physiological response to stress (e.g the sight of blood): decrease in heart rate and vasodilation causes syncope** common at all ages

Question 37

What chronic disease causes seizures in children?

Answer 37

**Epilepsy**

Question 38

How are accidents and trauma managed?

Answer 38

**BLS** basic life support (probs revise this too)

Question 39

What should always be considered in children who present with trauma?

Answer 39

**Non-accidental injury**

Question 40

What physiological problems do burns cause?

Answer 40

**Skin broken, so:** barrier to infection lost fluid loss

Question 41

\_\_\_ of toxic / caustic materials is a common childhood accident.

Answer 41

**Ingestion**

Question 42

Why must you always consider NAI?

Answer 42

**To protect safety and welfare of the child**

Question 43

What is the most common GI disease in children?

Answer 43

**Viral gastroenteritis**

Question 44

How is gastroenteritis managed?

Answer 44

**Supportive** rehydration therapy (you can make it at home)

Question 45

What GI presentation is caused by congenital bowel problems, volvulus and intussusception?

Answer 45

**Obstruction**

Question 46

Which congenital bowel disease is only seen in children?

Answer 46

**Pyloric stenosis**

Question 47

What is the most common cause of an acute abdomen in older children?

Answer 47

**Acute appendicitis**

Question 48

What GI cause of UTI should be considered in children?

Answer 48

**Congenitally abnormal renal tracts** e.g fistulae

Question 49

What UG disease should be considered in ill boys?

Answer 49

**Testicular torsion**

Question 50

What are the most common group of cardiovascular diseases seen in kids?

Answer 50

**Congenital heart diseases** causing cyanosis and heart failure

Question 51

Are arrythmias, MIs and thromboembolic diseases commonly seen in children?

Answer 51

**No**