Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Child's Health MBCHB > Acutely Ill Child > Flashcards

Acutely Ill Child Flashcards

1
Q

What is bronchiolitis?

A

Acute viral inflammatory injury of the bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes bronchiolitis and when does it occur?

A
  • Viral, most commonly due to respiratory syncytial virus (RSV)
  • Generally occurs in children under 1 year, most common in children under 6 months → occur in first and second winter of life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the typical presentation for bronchiolitis?

A
  • Viral URTI symptoms → running or snotty nose, sneezing, mucus in throat and watery eyes
  • Dyspnoea
  • Tachypnoea
  • Poor feeding
  • Mild fever (under 39 C)
  • Apnoeas
  • Signs of respiratory distress
  • Wheeze and crackles on auscultation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the management of bronchiolitis in children?

A
  • Supportive
    • oxygen
    • fluid therapy
    • feeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is croup?

A

Upper respiratory tract infection causing oedema in the larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes croup?

A
  • Viral
    • Classically parainfluenza virus
    • Other common causes include influenza, adenovirus and RSV
    • Used to be caused by diphtheria but this is now rare in developed countries due to vaccines.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the typical presentation of croup?

A
  • Increased work of breathing
  • ‘Barking’cough, occurring in clusters of coughing episodes
  • Hoarse voice
  • Stridor
  • Low gradefever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management of croup?

A
  • Mild croup is largely self-limiting, but treatment with a single dose of a corticosteroid (e.g. dexamethasone) by mouth may be of benefit
  • In moderate-severe croup requiring hospital admission:
    1. Oraldexamethasone - if too unwell to receive oral medication can give IM dexamethasone or nebulisedbudesonide
    2. Oxygen
    3. Nebulisedadrenaline
    4. Intubationandventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes acute asthma in children?

A

Could be triggered by any of the typical asthma triggers, such as infection, exercise or cold weather

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the typical presentation of acute asthma in children?

A
  • Progressively worsening shortness of breath
  • Tachypnoea
  • Signs of respiratory distress
  • Expiratory wheezeon auscultation heardthroughout the chest
  • The chest can sound ‘tight’ on auscultation, with reduced air entry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a sound when breathing out called?

A

Wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a sound when breathing in called?

A

Stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management of mild acute asthma?

A

Can be managed as an outpatient with regular salbutamol inhalers via a spacer (e.g. 4-6 puffs every 4 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the management of moderate-severe acute asthma?

A
  • Oxygen (at least 60%)
  • Salbutamol (neb)
  • Oral prednisolone/IV Hydrocortisone
  • Ipratropium (neb)
  • Theophylline (oral)
  • Magnesium sulphate (IV)
  • An anaesthetist (to intubate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is pneumonia?

A

Infection of the lung tissue, causing inflammation of the lungs and sputum filling the airways and alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the causes of pneumonia in children?

A
  • Bacterial - Streptococcus pneumonia is most common, others include Group A and B strep, Staph. aureus and H. influenza
  • Viral - RSV is the most common viral cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is encephalitis?

A

Inflammation of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes encephalitis?

A
  • Most commonly due to viral infection
    • HSV is most common
    • Other causes include: VZV, cytomegalovirus, EBV, enterovirus, adenovirus, influenza viru
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is meningitis?

A

Inflammation of the meninges (lining of the brain and spinal cord)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes meningitis?

A
  • Bacterial - Neisseria meningitidis (meningococcus) and Streptococcus pneumoniae (pneumococcus) in children and adults, group B strep in neonates
  • Viral - herpes simplex virus (HSV), enterovirus and varicella zoster virus (VZV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the presentation of pneumonia in children?

A
  • Cough(typically wet and productive)
  • High fever(> 38.5ºC)
  • Tachypnoea
  • Tachycardia
  • Increased work of breathing
  • Lethargy
  • Delirium (acute confusion associated with infection)
  • Bronchial breath sounds - harsh breath sounds that are equally loud on inspiration and expiration, caused by consolidation of the lung tissue around the airway
  • Focal coarse crackles- caused by air passing through sputum
  • Dullness to percussion- due to lung tissue collapse and/or consolidation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the investigations for pneumonia in children?

A
  • CXR
  • Blood cultures if signs of sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the management of pneumonia in children?

A
  • Amoxicillin first line
  • Macrolide antibiotics e.g. erythromycin can be added to cover atypical pneumonia, or as a monotherapy in penicillin allergic patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the presentation of encephalitis?

A
  • Altered consciousness
  • Altered cognition
  • Unusual behaviour
  • Acute onset of focal neurological symptoms
  • Acute onset of focal seizures
  • Fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the main investigations for encephalitis?

A

Lumbar puncture and imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the management of encephalitis?

A

Antiviral medications - aciclovir treats HSV and VZV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the presentation of meningitis?

A
  • Fever
  • Neck stiffness
  • Vomiting
  • Headache
  • Photophobia
  • Altered consciousness and seizures
  • Abscence of a rash does not exclude meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the investigation for meningitis?

A

Lumbar puncture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the management of bacterial meningitis?

A
  • Under 3 months- cefotaximeplusamoxicillin
  • Above 3 months- ceftriaxone
  • If penicillin allergic: chloramphenicol
  • Steroids e.g. dexamethasone are also used in bacterial meningitis to reduce the frequency and severity of hearing loss and neurological damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the management of viral meningitis?

A
  • Tends to be milder and often only requires supportive treatment
  • Aciclovir can be used to treat suspected or confirmed HSV or VZV infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are febrile seizures?

A
  • Type of seizure that occurs in children with a high fever e.g. due to underlying viral illness or bacterial infection
  • Occur only in children between the ages of 6 months and 5 years
  • In order the make a diagnosis of a febrile convulsion, other neurological pathology must be excluded e.g. epilepsy, meningitis, brain tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the management of febrile seizures?

A
  • Identify and manage underlying infection
  • Control the fever with simple analgesia such as paracetamol and ibuprofen
  • Reassure parents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are vasovagal episodes?

A
  • Most common cause of syncope in children
  • Type of reflex syncope, involves vagal stimulation triggered by emotional distress or orthostatic stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are triggers of vasovagal episodes?

A

Typical triggers include: prolonged standing, emotional stress, pain, the sight of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What other symptoms are present in vasovagal episodes?

A

pallor, sweating and nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the management of vasovagal episodes?

A
  • Reassurance
  • Education - avoidance of triggers, how to avert faint through manoevers to increase venous return e.g. horizonal gravity neutralisation position
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are reflex anoxic seizures?

A
  • Occur when the child is startled, most commonly a minor bump to the head
  • The vagus nerve sends strong signals to the heart that causes it to stop beating
  • The child will suddenly go pale, lose consciousness and may start to have some seizure-like muscle twitching
  • Within 30 seconds the heart restarts and the child becomes conscious again
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the management of a reflex anoxic seizures?

A

After excluding other pathology and making a diagnosis, educating and reassuring parents is the key to management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are breath holding attacks?

A
  • Involuntary episodes during which a child holds their breath, usually triggered by something upsetting or scaring them
  • They typically occur between 6 and 18 months of age and most children outgrow them between by 4 or 5 years
  • May breath out when crying and then forgot to breath in again
40
Q

What is the management of breath holding attacks?

A

After excluding other pathology and making a diagnosis, educating and reassuring parents is the key to management

41
Q

What is epilepsy?

A
  • Umbrella term for a condition where there is a tendency to have seizures
  • Seizures are transient episodes of abnormal electrical activity in the brain
  • Investigations include EEG and MRI brain
42
Q

What is the management of epilepsy?

A
  • Education about how to manage seizure
  • Anti-epileptic medication
43
Q

What are congenital heart disease in children?

A

Defect in the structure of the heart or great vessels that is present at birth

44
Q

What is the presentation of congenital heart disease in children?

A
  • Depends on type of defect, can vary from no symptoms to life-threatening
  • When present, symptoms may include:
    • Tachypnoea
    • Cyanosis
    • Poor weight gain
    • Feeling tired
    • Can progress to heart failure
45
Q

What is the most common rhythm disturbance in children?

A

Supraventricular Tachycardia

46
Q

What are the main types of SVT in children?

A
  • atrial fibrillation,
  • paroxysmal supraventricular tachycardia (PSVT),
  • atrial flutter,
  • Wolff–Parkinson–White syndrome
47
Q

What causes SVT in children?

A

Abnormally fast heart rhythm arising from improper electrical activity in the upper part of the heart

48
Q

What is the presentation of SVT in children?

A
  • Palpitations
  • Dyspnoea
  • Chest pain
  • Rapid breathing
  • Dizziness
  • Loss of consciousness
  • Heart rate of 150–270bmp during an episode
49
Q

What is seen on this ECG?

A

supraventricular tachycardia

50
Q

What are common accidents and trauma in children?

A
  • ‘Age specific’
  • RTA
  • Trampoline, sports injuries
  • Burns
  • Ingestion - accidental (more common) or intentional
  • Drowning, near drowning
  • Choking
  • Always consider possibility of NAI
51
Q

What is infective endocarditis?

A

Rare but severe bacterial infection of the heart valves

52
Q

What causes infective endocarditis?

A
  • Gram-positive bacteria represent the majority of organisms responsible for pediatric IE - includes viridans group streptococci, staphylococci and enteroccoci
  • Can also be caused by gram-negatives and fungi
53
Q

What is the presentation of infective endocarditis?

A
  • Most cases of pediatric endocarditis present subacutely - low-grade fever, malaise, myalgias, arthralgias, and headaches
  • New or changing heart murmur may be auscultated
54
Q

What is the management of infective endocarditis?

A

Obtain culture, then start empirical antibiotics, transition to specific antibiotics based on culture results

55
Q

What is gastroenteritis?

A

Inflammation all the way from the stomach to the intestines

56
Q

What is the cause of gastroenteritis?

A

Most commonly viral - rotavirus, norovirus

57
Q

What is the typical presentation of gastroenteritis?

A
  • Nausea
  • Vomiting
  • Diarrhoea
58
Q

What is the management of gastroenteritis?

A

Ensure patient remains hydrated while waiting for diarrhoea and vomiting to settle - aim for oral rehydration, may require IV fluids

59
Q

What is congenital pyloric stenosis?

A

Narrowing of the opening from the stomach to the first part of the small intestine (the pylorus)

60
Q

What is the typical presentation of congenital pyloric stenosis?

A
  • Projectile vomiting without the presence of bile (vomiting milk), most often occurs after the baby is fed
  • Keen to feed
  • The typical age that symptoms become obvious is two to twelve weeks old, most commonly 6 weeks
  • Signs of dehydration
  • Peristalsis across the abdomen
  • May feel abdomen mass
61
Q

What investigations should be done for congenital pyloric stenosis?

A

US scan upper abdomen

62
Q

What is the management of congenital pyloric stenosis?

A

Surgery - pyloromyotomy (open or lap)

63
Q

What is volvulus?

A

Loop of intestine twists around itself and the mesentery that supports it, resulting in a bowel obstruction

64
Q

What causes a volvulus?

A
  • Congenital intestinal malrotation predisposes to midgut volvulus
  • Abnormal intestinal contents e.g. meconium ileus can predispose to segmental volvulus
65
Q

What is the typical presentation of volvulus?

A
  • Abdominal pain
  • Abdominal bloating
  • Vomiting bile - green
  • Constipation
  • Bloody stool
66
Q

What investigations should be done for volvulus?

A

AXR

67
Q

What is the management of volvulus?

A

Surgery

68
Q

What is intussusception?

A

The bowel ‘invaginates’ or ‘telescopes’ into itself, narrowing the lumen, which results in a palpable mass in the abdomen and obstruction to the passage of faeces through the bowel

69
Q

What is the presentation of intussusception?

A
  • Severe, colicky abdominal pain
  • Pale, lethargic and unwell child
  • Vomiting
  • Signs of dehydration
  • ‘Redcurrantjelly stool’
  • Right upper quadrant mass on palpation
  • Can be associated with concurrent viral illness
70
Q

What is the investigation for intussusception?

A

USS - target sign

71
Q

What is the management for intussusception?

A
  • Air reduction - relieves obstruction in >85% of cases
  • Surgical reduction if non-invasive measures fail
72
Q

What is appendicitis?

A

Inflammation of the appendix; main differential for an acute abdomen presentation in a child

73
Q

What is the presentation of appendicitis?

A
  • The key presenting feature of appendicitis is abdominal pain - typically starts as central abdominal pain, that moves down to the right iliac fossa over time and eventually becomes localised in the RIF
  • Other classic features are:
    • Anorexia
    • Nausea and vomiting
    • Moderate temperature
  • Tenderness in McBurney’s point
  • Rosving’s sign- palpation of theleft iliac fossacauses pain in theRIF
  • Guardingon abdominal palpation
  • Rebound tenderness- increased pain whenquicklyreleasingpressure on the right iliac fossa
  • Percussion tenderness- pain and tenderness when percussing the abdomen
  • Painful movements (can’t jump, feels every bump on the way to hospital) suggests peritonitis
74
Q

What is the investigations for appendicitis?

A
  • Usually clinical diagnosis based on presentation and raised inflammatory markers
  • US abdomen may find the inflamed appendix - good test in children if diagnosis uncertain
75
Q

What is the management for appendicitis?

A

Appendicectomy

76
Q

What is a UTI?

A

Infections anywhere along the urinary tract - urethra, bladder, ureters and kidneys

77
Q

What is the aetiology of UTI in children?

A
  • More common in girls
  • Consider abnormal renal tract in children with repeat UTIs
78
Q

What is the presentation of UTI in babies?

A

Babies will present with very non-specific symptoms:

  • Fever
  • Lethargy
  • Irritability
  • Vomiting
  • Poor feeding
  • Increased urinary frequency
79
Q

What are the signs and symptoms of UTI in children?

A
  • Fever
  • Abdominal pain, particularlysuprapubic pain
  • Vomiting
  • Dysuria(painful urination)
  • Increased urinary frequency
  • Incontinence
80
Q

What are the investigations for a UTI?

A

Urine clean catch sample with microbiology

81
Q

What is the management of UTI in children?

A
  • All children under 3 months with a fever should start immediate IV antibiotics
  • Oral antibiotics can be considered in children over 3 months if they are otherwise well
  • Children with features of sepsis or pyelonephritis (infection affecting kidney function) will require inpatient treatment with IV antibiotics
82
Q

What is torsion of testes?

A
  • Occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum
  • Typically in teenage boys, but can occur at any age
83
Q

What is the management for torsion of the testes?

A

Surgery

84
Q

What is epididymoorchitis?

A

Acute bacterial infection of the epididymis progressing to involve the testis which occurs as a result of retrograde bacterial colonisation via the ejaculatory ducts and vas deferens

85
Q

What is the management of epididymoorchitis?

A

Analgesia and antibiotics

86
Q

What is torsion of the appendix testes?

A

The appendix testis is located at the upper pole of the testis (between the testis and the head of the epididymis)

87
Q

What is the management of torsion of appendix testes?

A

Conservative or surgical depending on symptoms

88
Q

What is hydrocele?

A

Collection of fluid within the tunica vaginalis that surrounds the testes

89
Q

What is the presentation of hydrocele?

A
  • Soft, smooth, non-tender swelling around one of the testes
  • Transilluminate with light on examination with a pen torch
90
Q

What is the management of hydrocele?

A
  • Simple hydroceles (no connection with peritoneal cavity) usually resolve within 2 years without having any lasting negative effects
  • Communicating hydroceles (have a connection with the peritoneal cavity) are managed surgically
91
Q

What is an inguinal hernia?

A

Part of the bowel pushes through a weakness in the abdominal muscles

92
Q

What is the presentation of inguinal hernia?

A

Soft lump in the inguinal region (in the groin)

93
Q

What is the management of inguinal hernias?

A

Surgical correction

94
Q

What are undescended testes?

A

In about 5% of boys the testes have not made it out of the abdomen by birth; at this point they are called undescended testes

95
Q

What is the presentation of undescended testes?

A
  • Empty scrotum
  • Testes may be palpable on physical examination
96
Q

What is the management of undescended testes?

A
  • Watching and waiting is appropriate in newborns - in most cases the testes will descend in the first 3-6 months
  • Surgical correction should be carried out between 6 and 12 months of age if testes still have not descended

Child's Health MBCHB (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions