acutely ill child

Question 1

what do children present with?

Answer 1

Bronchiolitis/URTI/Croup
Gastroenteritis
Seizures/epilepsy
Pneumonia/LRTI
Asthma
“Viral illness”
Head injury
Abdominal pain
UTI

Question 2

describe bronchiloitis

Answer 2

acute inflammatory injury of bronchioles
viral, supportive treatment

Question 3

describe croup

Answer 3

laryngotreacheobronchitis
viral
treat with steroids

Question 4

what causes epiglottitis?

Answer 4

haemophilus influenzae type b

Question 5

what causes stridor?

Answer 5

upper airway obstruction- look for noisy breathing

Question 6

what causes wheeze?

Answer 6

lower airway problems e.g. asthma- difficult breathing out

Question 7

what are common acute CNS illnesses in children?

Answer 7

meningitis- bacterial and viral
encephalopathy- commonly viral

Question 8

how do you manage acute CNS illness in children?

Answer 8

ofetn give antibiotics and antivirals to be safe

Question 9

how do you investigate acute CNS illness in children?

Answer 9

lumbar puncture and imaging

Question 10

what causes a deep red non blanching rash in children?

Answer 10

Meningococcaeima- non blanching rash
Caused by neisseria meningitidis (does not necessarily indicate meningitis

Question 11

what are the common GI & urogenital causes of acute illness in children?

Answer 11

viral gastroenteritis, UTI- consider abnormal renal tract

Question 12

describe febrile seizures

Answer 12

short (5 mins or less) seizure seen in children under 6, caused by illness but not to do with brain

Question 13

describe reflex anoxic seizures

Answer 13

Hit your head, don’t breathe, hr slows. Usually do not require treatment unless there is a history of them

Question 14

what are the common surgical causes of acute illness in children?

Answer 14

GI obstruction, acute abdomen (appendicitis), testicular torsion

Question 15

what is the most common arrhythmia in children?

Answer 15

SVT

Question 16

what causes cardiac arrest in children?

Answer 16

respiratory failure –> respiratory arrest –> cardiac arrest
or circulatory failure caused by fluid loss or fluid maldistrubution
(respiratory arrest most common)

Question 17

what is the primary and secondary assessment of the sick child?

Answer 17

primary assessment- do they need resuscitation?
secondary assessment- what emergency treatment to give of they do not need resuscitation

Question 18

how do you do an airway manoeuvre on an under 1 year old

Answer 18

neutral neck (tilt head back in any other age)

Question 19

how do you treat shock in children?

Answer 19

20ml/kg of 0.9% saline
repeat if still shocked
may need blood in trauma / haemorrhage

Question 20

how does HIV present in babies and children?

Answer 20

Recurrent or severe common childhood illnesses eg otitis media, diarrhoea
Recurrent oral candidiasis not responding to treatment
Recurrent severe bacterial infections eg meningitis
Failure to thrive or growth failure
Generalised lymphadenopathy, hepatosplenomegaly
Persistent fever
Encephalopathy
Chronic parotitis
PJP, Kaposi sarcoma, TB, lymphocytic interstitial pneumonia….

Question 21

what is the treatment for paediatric HIV?

Answer 21

HAART: Two NRTIs plus one NNRTI or protease inhibitor
Nucleoside reverse transcriptase inhibitors eg abacavir and lamivudine
Non-nucleoside reverse transcriptase inhibitors eg efavirenz for >3yr olds
Protease inhibitor eg kaletra for <3yr olds