7&11 - Paediatrics Flashcards
Childhood vaccination schedule:
8 Weeks (3) 12 Weeks (3) 16 Weeks (2) 1 Year (4)
Childhood vaccination - First Year
8 Weeks:
I) 6 in 1
[Dipth, Polio, Pertusis, Tetanus, HiB, HepB]
II) Rotavirus
III) Men B
12 Weeks:
I) 6 in 1
II) Rotavirus
III) PCV
16 Weeks
I) 6 in 1
II) Men B
1 Year
I) Men B
II) Hib/MenC
III) PCV
IV) MMR
Vaccination schedule aged 1 - 18
1 Year 2-10 Years 3 Years 4 months 12 Years 14 Years
Vaccinations 1-18
1 Year: I) Men B/Hib II) Men C III) PCV IV) MMR
2-10 Years:
Flu
3y4m:
I) MMR
II) 4 in 1 boost
[Polio, dipth, pertusis, tetanus]
12-13: HPV
14:
3 in 1 (Td/IPV)
[Tet, Dipth, Polio]
Men ACWY
Viral Wheeze (< 3y) RFs
- 1/3 children
- Around smoke
- Premature bronchiolitis
Viral wheeze (< 3y) Tx
- SABA Inhaler
2. SABA Nebulizer + Prednisolone 2-3 days
Viral Wheeze DDs
- Asthma (persistant + triggers)
- Infection (coarse crackles + productive cough)
- Foreign body (sudden + choking + voice change)
Osgood Schlatter’s Presentation
- Unilateral knee pain (apophysitis)
- Growth spurt
- Tender on exam
- Exacerbated by exercise
Osgood Schlatter Management
Osgood Schlatter’s Management
- Paracetamol and NSAIDs (swelling)
- Exercise modification
Osgood Schlatter’s DDs
Osgood Schlatter’s DDs
- Knee injury (trauma hx and S&S)
- Perthes (Femoral head necrosis, males 4-8, hyper-coagulable)
- SCFE (Slipped capital femoral epiphysis — groin or knee pain and limp, high BMI, Trendelenburg Gain)
Toddler’s Diarrhoea History
Toddler’s Diarrhoea History
1-5 YO 2+ weeks diarrhoea 3+ daily stools - Watery - Pale - Smelly
Normal PR
Toddler’s diarrhoea management
Toddler’s diarrhoea management
- Increase fat eg. Whole milk
- Avoid fluids
- Avoid fruit juice
Toddler’s diarrhoea DDs
- Viral GI Infx
- IBD
- Intolerance
- Caeliac
Threadworms Treatment
Enterobius vulniculnaris
- Mebendazole cream
Twice, 14 days apart
Whole household - Hygiene
- Clean nails
Paediatric GORD Management
- 4 Weeks PPI
- Ranitidine
- Refer
Paediatric GORD History
- Heartburn
- Vomitting
- Hicupping
- Feeding iritability
- Reduced sleep
Paediatric GORD DDs
- Psych?
- Reflux w/o pain - Migraine
- Mesenteric adenitis:
- recent URTI
- diffuse pain,
- viral lymphadenopathy (usually cervical)
- fever
Infantile Colic Criteria
Infant Colic:
- > 3 months
- 3+ hours of crying daily
- 3+days of crying per week
- 3+weeks
Knees-clutched-to-chest pain
Infant colic Mx
Infant colic Mx
- Hold and rock baby
- Warm baths
- White noise/TV
Four elements of child development?
Child development
- Gross motor
Sitting/support
Walking - Fine motor + Vision
- Speech and language
- Social interaction
Child development milestones?
Child development milestones:
Newborn:
Symmetrical flexed posture
Head-lag on pulling-up
6-8 weeks:
Raises head when prone
6-8 months:
Sits
10months
Stands
12-18 months
Walks
2-2.5 years
Walks steadily, runs, jumps
Baby bac meningitis
- Mx
NICE - Bacterial Meningitis
- Older than 3/12
- IV Ceftriaxone - Younger than 3/12
- IV Amoxicillin or ampicillin - Travelled outside UK
- Vancomycin in addition - If on calcium-containing infusions
- Cefotaxime
Baby rash
- Red Flags
Baby rash - red flags
- Fever
- Drowsy
- Meningism
Child cough
- Red flags
Child cough: red flags
- High fever
- Unwell
- ‘Up and down’
- Not eating or drinking
Baby Crying - ICON
- Acronym
- Aims
- ICON
I Infant crying is normal
C Comforting can help
O Ok to walk away
N Never, ever shake a baby
- Prevention of abusive head trauma
Infant development
- 0-3 months
0-3 months development
GM
- Raise head
- Hands to mouth
FM
- Grip objects
- Swipe at objects
Social
- Smile and return smile
- Track objects
Infant development
- 4-6 months
4-6 months development
- Roll front-to-back
- and back-to-front - Speech-like sounds
- Laugh
- Grab objects
- Sit up with support
Infant development
- 7-9 months
7-9 months development
- Start to crawl
- Shuffle, army, hands and knees - Sit unsupported
- Respond to name
- Mama and Dada
- Clap and play peekaboo
- Pull up into standing
Infant development
- 10-12 months
10-12 months development
- Pincer grasp
- Feeding
- Moving around on foot
- Three-ish words
- Point
- Pretend-play actions
- First steps
Bronchiolitis
- S&S
Bronchiolitis S&S
< 3YO, prematurity, Winter
- Cough
- Tachypnoea
- Wheezing
- Retractions, grunting, flaring
- Fever/rhinitis
Infantile colic
- S&S
Infantile colic S&S
- RFs
- 5mo, food sensitive
- cigarette smoke, psychosocial - Generally well
- Normal urine
- No recurrent vomiting
- Normal temperature
- No diarrhoea
- Normal abdomen and ear
Infantile colic
- Mx
Infantile Colic Mx
- Upright feeding
- Burping after feeding
- Well fitting bottle - Elimination diet
- Reassurance
Mesenteric adenitis
- S&S
Mesenteric adenitis S&S
- Diffuse abdo pain
- Recent URTI
- Fever
- Abdo tenderness
- Rhinorrhoea
- Hyperaemic pharynx
Pediculosis capitis
- Mx
Headlice management
<2 mo
- Mechanical removal
- Treatment of contacts
> 2mo
- Pediculicide
- Dimeticone (physical)
- Permethrin/Pyethrin - Benzyl alcohol/ivermectin
- Contacts
- Mechanical/occlusive
- Combing + Petrolium Jelly
