Child Health Flashcards
Presentation of bronchiolitis
A non-productive cough, tachypnoea and intercostal recession
Manage supportively
Common deficiency in cystic fibrosis
Vitamin A, D, E and K
(impaired absorption of fat soluble vitamins due to reduced pancreatic enzyme secretion)
WHat does double bubble sign indicate?
Duodenal atresia
(NOT SEEN IN OESOPHAGEAL)
Presentation of oesophageal atresia
Antenatal - Polyhydraminos
Post-natal - Respiratory distress, Distended abdomen, Choking/problems with swallowing, Saliva overflow, No NG tube passage
Baby with APGAR 4, greenish tinge to skin, intercostal recession, poor cry?
Meconium aspiration syndrome
Diagnosis of Hirschprung disease
Rectal suction biopsy
Grossly distended bowel loops and pneumointestinalis on AXR indicates?
Necrotising enterocolitis
ABG findings in pyloric stenosis?
Hypokalaemic hypochloraemic metabolic alkalosis
First line investigation in suspected vesicoureteric reflux
Micturating Cystourethrogram (MCUG)
First line antibody test for coeliac disease
Anti-tissue transglutaminase (tTG) IgA antibody
First line management of gastroenteritis
Nasogastric fluid replacement with rehydration sachets
Unvaccinated coughing baby to the point of vomiting, milky vomit, strange sound breathing in?
Whooping cough
(test for bordetella via pernasal swab)
What factors can increase risk of Neonatal Respiratory Distress Syndrome?
Premature (lack of surfactant)
Diabetic mothers
Presents with:
resents with increased work of breathing shortly after birth, and the chest x-ray demonstrating diffuse granular opacities
What pulses should be felt in an unresponsive child?
In the neck (carotid pulse) in children over 1 year
In the inner aspect of the upper arm (brachial pulse) in an infant
Vesicular rash on hands, soles of feet and buccal muscoaa?
Coxsackie A
(hand, foot and mouth disease)
Halo sign in oesophagus on CXR after possible foreign object swallow?
Button battery
Urgent endoscopy!!!!!!
What is the cause of acute bilirubin encephalopathy?
It is caused by a toxic build-up of unconjugated bilirubin
What HR in an unwell child would indicate admission to hospital?
HR 160bpm
Adrenaline dose for anaphylaxis in kids
Under 6 months - 100-150mg
6m-6y - 150mg
6-12 - 300mg
Adults - 500mg
Test contraindicated in suspected meningitis
Lumbar puncture
- risk of coning
Most common congenital heart defect in babies of diabetic mothers
Transposition of great arteries
Presentation of acute lymphocytic leukaemia
Features of bone marrow failure:
- anaemia
- neutropaenia (resulting in frequent infections)
- thrombocytopaenia (which leads to petechiae and easy bruising)
How is secondary reperfusion injury prevented?
Cool newborn to 33-34deg
- slows cerebral metabolism and subsequently slows neurotransmitter and oxygen free-radical release
First line management of meningitis if penicillin allergic
Characteristic features of scarlet fever
Sandpaper feeling rash
Strawberry tongue
- preceded by non-specific symptoms e.g. sore throat, headache, fever
2/6 pansystolic murmur suggests
VSD
Example of macrogol laxative
Movicol
Management of Hirschprung’s
Surgical removal of the aganglionic segment
What complication of Kawasaki disease does immediate IV immunoglobulin prevent?
Coronary artery aneurysm
Widespread scarring rash after tonsillitis managed with antibiotics?
EBV infection
- if viral tonsillitis is incorrectly treated with antibios e.g. amoxicillin/ampicillin
Rectal suction biopsy in Hirschprung’s would show….
Absence of ganglion cells in the colonic submucosa
How long does fever in Kawasaki have to last?
Persistent and for more than 5 days
Presentation of strangulated hernia
Generalised tenderness worse on inguinal palpation
Mass in the right inguinal region
Cremasteric reflex present/Prehn’s test negative
Mass is not reducible
Bowel sounds heard on auscultation over the mass
Aspirin given to children can cause which syndrome?
Reye’s syndrome
What does neiserria menigitides look like on gram stain?
gram-negative intracellular diplococci
First line investigation for suspected minimal change/nephrotic syndrome
Urine dip for proteinuria
- biopsy if no response to steroids
First line investigation of Perthes
X-ray
- assess density of femoral head
First line management of Perthes
Bed rest and analgesia
Physio and reduction in high impact sport
Which type of newborn head swelling crosses suture lines?
Caput Succedaneum
- Crosses Sutures
- Clears Soon
Key bits to remember in child health history taking
Birth
Vaccinations
Milestones/school attainment
Family at home
HEADSS for teenagers
Most common complication in kids with measles
Otitis media
Which drug can reduce period of infectivity in pertussis?
Clarithromycin
- give booster vaccine to any contacts
Clin pres of Turner syndrome
Short stature
Spoon nails, webbed neck
Shield chest, wide nipples
Wide carrying angle
Delayed puberty, amennorhoea
Hypothyroidism
Bicuspid aortic valve
Medical management of ADHD
Methylphenidate
Virus presenting with facial rash an flu-like symptoms causing hydrops fetalis
Parvovirus B19 (slapped cheek syndrome)
When are kids with slapped cheek syndrome not infectious anymore?
When the rash appears
Severe complication of bronchiolitis requiring lots of hospital care presenting with seizure, resp distress, pneumonia, terminal bronchiolar dilatation with areas of air trapping?
Bronchiolitis obliterans
- caused by adenovirus
Complication resulting from failure to operate on hydrocele in baby
Indirect inguinal hernia
Prescribing amoxicillin in glandular fever can result in what kind of drug reaction?
Mobiliform
Describe TTN
Caused by: delayed resorption of fluid in the lungs
Strongly associated with caesarean section and prematurity
X-ray signs: hyperinflation, and fluid in the horizontal fissure
Which test can determine whether leg length discrepancy is a femoral or tibial cause?
Galeazzi
Most common cause of neonatal sepsis
Group B strep (from genital tract)
- risk factors include prolonged prelabour rupture of membranes, intrapartum fever and suspected or confirmed bacterial infection
First line management of precocious puberty
Ref to peds
Low-set ears, microcephaly and omphalocele are characteristic of which genetic condition?
Edward’s syndrome
Management of HSP
Analgesia
Steroids if severe
Potentially anti-HT if hypertensive
What is the most common cause of rectal bleeding in kids and how is it investigated?
Meckel’s diverticulum (embryological remnant)
- investigate with Technetium scan
Managment of perforated eardrum assoc with otitis media
<4 day history - reassure and discharge
>4 day history - oral amoxicillin
When should you not prescribe antibiotics in whooping cough?
After 21 days of persistent symptoms
Most common causative organism of osteomyelitis in sickle cell
Salmonella typhi
How is Prader-Willi inherited?
Genomic imprinting
Midwife home visit finds baby to be jaundiced but otherwise well, what action should they take?
Check serum bilirubin with transcutaneous bilirubinometer if bilirubin level is >250 micromoles/L
Investigation of child with recurrent UTI after positive cultures
Request an ultrasound scan within 6 weeks and a DMSA scan 4-6 months later
What is roseola infantosum?
Benign illness characterised by several days of high temperatures followed by a widespread rash that starts on the torso/neck
After starting bilirubin phototherapy, when should levels be rechecked?
4-6 hours
Presentation of cogenital hypothyroidism
Hypotonia, macroglossia, an umbilical hernia, reduced feeding and constipation (mild soft abdominal distention)
Reed Sternberg cells on lymph node biopsy suggest…
Hodgkin’s lymphoma
What medication can be used to encourage patent ductus arteriosus in ToF?
Prostaglandins e.g. alprostadil
Management AOM with sudden otorrhoea and perforated tympanic membrane?
Immediate oral antibiotic prescription
Initial management of UTI in suspected urosepsis
Tazocin
First line for chronic constipation in kids
Movicol
- senna second line
CFTR mutation in cystic fibrosis is found on which chromosome?
Chromosome 7
Baby with stridor and coryzal symptoms…
Bronchiolitis
Management of choking infant after back blows
Chest thrusts
First line investigation of child with recurrent UTIs
Abdominal US
If a mother has preeclampsia, what type of jaundice does baby most likely have?
Haemolytic jaundice
4h old baby with jaundice and sick mum is physiological or pathological?
Pathological (less than 24h old)
ST elevation in leads V2-5 suggests infarct where?
Anterior infarct
What HIV viral load is acceptable for breastfeeding?
<20
Diagnostic investigation for eosophageal atresia
NG tube and a chest X-ray
Complication of coarctation of aorta
Cerebral aneurysm
Investigation for child under 3 months with high fevers…
Blood cultures, urine cultures and CSF cultures
- always suspect sepsis first
Key marker of biliary atresia on LFTs
Abnormally high levels of conjugated bilirubin
- also jaundice, pale stools, palpable masses in upper quadrants
Premature babies who are approaching bronchiolitis season should be started on which prophylactic therapy?
Palivisumab
How to tell if a rash is HSP not Kawasaki?
Bum and leg rash
Bloody diarrhoea
Abdo joint pain
Recent URTI
Kawasaki has strawb tongue
Breast cancer difficult to see on mammogram
Invasive lobular carcinoma
- most have MRI to ID and stage
Drugs lowering seizure threshold
“I am Tramadol’s friend, keeping life less anxious”
I for imipenem
AM for abx:penicillins, cephalosporins, metronidazole, isoniazid
Tramadols for tramadol
Friend for fentanyl
Keeping for ketamine
Life for lidocaine
Less for lithium
Anxious for antihistamines
