Basic paeds for 3B

Question 1

Necrotising enterocolitis

Answer 1

Rfx = premature, low birth weight, formula feeding.
S+S = diarrhoea, abdo distension, vomiting.
Can lead to peritonitis, perforation and sepsis.
Ix = AXR shows dilated bowel loops, pneumatosis intestinals (air in wall) and portal venous air.
Mx =d rip + suck = NBM, NG tube, fluids, ABx, may need surgery.

Question 2

Kawasaki’s Disease

Answer 2

Medium vessel vasculitis.
S+S = Fever >5 days
Bilateral conjunctivitis
Rash in trunks
Lymphadenopathy
Erythematous mouth and pharynx, strawberry tongue or red, cracked lips
Swelling and desquamation of hands
Ix = angiogram as increased coronary artery aneurysm.
Rx = IVIG and aspirin.

Question 3

Intussusception

Answer 3

Small bowel (e.g. ileum to caecum) telescopes on itself. Peristalsis leads to ischaemia and perforation.
RFx = male in first year of life.
S+S = Episodic, inconsolable, colic (leg indrawing), red current jelly stool, palpable sausage mass.
Ix = USS shows target sign, AXR shoes absent distal bowel gas, distended small bowel, sausage shape mass in RLQ, enlargement of Payer's patches.
Rx = fluid, air enema, surgical.