5. 11/09/20 Flashcards
What are the differentials for a pansystolic murmur in a child?
Mitral regurgitation
VSD
What murmurs would you hear in children at the left upper sternal edge?
ASD/ pulmonary stenosis
Where does pulmonary stenosis radiate to in children?
The back and the axilla
What condition is coarctation of the aorta associated with?
Coarctation
Turn
The aorta turns
It is Turner’s syndrome
What heart conditions cause hepatomegaly in an infant?
all of them?
What else causes hepatomegaly in infants?
Neoplasm
Infection
Storage disorders
What bloods should be done for hepatomegaly
HEP A.B,C. FBC,
blood film, metabolic screen, NH4, lactate,
urine amino assay
Liver USS
If a child has arching of the back during/after feeding
Pyloric stenosis
What is carobel
Milk thickener
What is the difference between GORD and reflux?
FTT, Aspiration pneumonia, oesophageal scars- GORD
None of this- reflux
What signs of pyloric stenosis are seen on examination
Projectile vomiting
Noticeable peristalsis
What are the two reactions that occur in response to cow’s milk allergy
How do you tell them apart
IgE mediated- within 2 hours
Non- IgE mediated- 2 days- 1 weeks time
What type of babies typically get GORD?
More common in preterm
What are the treatments for cow’s milk allergy?
Amino acid feeds
Hydrolysed milk
What alternatives to cow’s milk are not recommended?
Soya (not in under 6 months)
Rice milk not recommended (arsenic <4.5 years)
Goat milk not recommended as too similar to cow’s
What is the milk ladder?
Ladder that shows how much milk should be introduced to non-IgE mediated reaction cow’s milk allergy
IgE people need skin prick test
A child has abdo pain, mass, hypertension?
Adrenal neuroblastoma or Willm’s heamatoma
What is the main cause of pyelonephritis?
E.coli
What are the two different presentations of pyelonephritis?
bacteraemia and fever >38
loin pain and bacteramia (no fever)
What do all children with pyelonephritis get?
Renal USS
What antibiotics are given for a UTI in children?
<3 months- IV ceftiaxone
>3 months IV ceftiaxone
Can add gent if not improving
What is a classical presentation o finusussception?
Crampy and getting worse
Most common cause of obstruction
6 months- 3 years
Legs drawn up , red current jelly sttols
What are the complications of intususception?
Perforation and necrosis
How do you diagnose intussusception?
Air enema and contrast, diagnostic therapy
What organism is well known for causing extreme secretory diarrhoea
Cholera
