Answers To Questions Flashcards
Impetigo presentation?
Red spots like cigarette burn which then become yellow crust.
Skin swab needed
Streptococcus
Red discolouration on dace and swelling
Erysipelas. Can have fever, needs Abx
Group A and non group A streptococcus
Mouth sores
Vesicles oral region
Herpes simplex I
Oral acyclovir or topical
Flesh coloured dome lesions
Molluscum contagiosum
Resolves after 6-8 W
Cryotherapy or iodine solution
Poxvirus
Hair falling out
Bald patches
Tinea capitis
UV light-> green fluorescence dx
Red patches on groin and armits extending to his trunk.
Tinea corporis
Ringworm
Topical imidazoles
How does erythema nodosum typically presents?
Large patches over shins
Mycoplasma and mucobacterium tuberculosis
Causes of inconsolable crying?
Constipation
Cows molk imtolerance/lactose intoleranct
Infection:meningitis, ottitis media, UTI
Trauma eg fracture
Infantile colic Volvulus Intussusception Rectal fissure Testicular tosrion GORD
Good hx!
What hapoens in infantile colics?
Unexplained crying in otherisw well child + well fed 3 hours a day, >3 days a week, persisting for >3w.
Common 20%
Starts at 2w end at 4M.
Attacks- late afternoon evening.
Infant puuls up legs to abdo + paroxysmal screaming.
Assc sx: flushed, fists, furrowed brow.
Dx: of exclusion, unlear aetiology.
Alwrt and pink, soft abdo + bowel sounds,
Mass palpable in RUQ
- whats intususception?
Telescoping (folding into itself) of one proximal segment of bowel into a more distal one.
Leading cause of intestinal obstruction in kids aged 3M to 6Y (commoner in 3-12M)
B>G
‼️Life threatening
Mortality 2% if treated
Untreated- fatal.
Most commonly: terminal ileum moves into colon through ileocaecal valve- ileocolic intussusception.
Other types: ileo-ileal- small intestine loops intelf
Colo-colic: large bowel moves into itself.
What are some predisposing fx to intussusception?
Due to abnormalities in intestinal wall- causes obstruction- trigerring process of intussusception- pushed away
Viral illness ! Eg gastroenteritis !! Lymph nodes in intestinal wall (Peyers patches) become swollen and cause a thickening of wall
Foreign body
CF: faecal overloading
HSP- Henoch scholein purpura
Other causing abnormalities of bowel wall: Meckels Diverticulum, intestinal polyp (Peutz jeghers syndorome, familial polyposis coli)
Post abdo surgery- trauma of intestinal wall.
Features of intussusception?
Paroxysmal severe imtermittent abdo pain + draws up legs
Stool mixed with blood and mucus (redcurrant jelly stool) (late sign)
Distended abdo
VOMITTING that might become bilious
Sausage shaped mass typiccally URQ
Diarrhoa
Shock due to 3rd space fluid loss in gut
How do sx come about in Intussusception?
Causes blood vessel compression-> reduces blood supply-> venous onstruction-> + ischaemia.
-> oedema in bowel wall + bleeding- redcurrant jelly stools and distrupted peristalis (crying)
If untreated-> necrosis and perforation
Whats the classic USS sign in intussusception?
Donught or target sign apperance ie
Loop within loop characteristic.
Abdo xray- may show distended small bowel and absence of gas in distal colon.
Reserved for when perforation suspected cz radio!
How is intussusception treated?
Radiological reduction via an air or barium enema.
Air increases the pressure within the bowel, which may unfold the affected part.
Succesful >75% if early.
Only performed in absence of peritonitis.
After reduction, admission due to High recurrance rate.
Surgical reduction: manual unfolding indicated when peritonitis suspected, when enema has failed and or intussusception present >24hrs.
