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4th year passmed > Child Health > Flashcards

Child Health Flashcards

1
Q

SUFE

A

slipped upper femoral epiphysis

obese boy with hip (+/- knee) pain

S econdary school age (10-15)

rare

loss of internal rotation whilst in flexion

M - internal fixation

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2
Q

perthe’s

A
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3
Q

developmental dysplasia of hip

A

RF: breech delivery

I: x-ray, USS

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4
Q

live attenuated vaccines:

A

MMR
Rotavirus
BCG
Smallpox

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5
Q

inactive vaccines: polysaccharides

A

Hib
Meningococcal
Pneumococcal

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6
Q

vaccinations: 2 months

A

6 in 1
ORAL rotavirus
Men B

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7
Q

6 in 1 vaccinations

A

diptheria, tetanus, pertussis, polio , Haemophilus B, hepatitis B

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8
Q

vaccinations: 3 months

A

6 in 1
Oral rotavirus
PCV

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9
Q

vaccinations: 4 months

A

6 in 1
Men B

Men B

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10
Q

vaccinations: 12-13 months

A

Hib/Men C
MMR
PCV (pneumococcal conjugate)
Men B

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11
Q

vaccinations: 2-8 years

A

Flu vaccine (annual)

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12
Q

vaccinations: 3-4 years

A

4 in 1 preschool booster (DTaP w/ MMR)

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13
Q

vaccinations: 12-13 years

A

HPV vaccination

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14
Q

vaccinations: 13-18 years

A

3 in 1 teenage booster (Diptheria Tetanus and POLIO)

Men ACWY

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15
Q

vaccinations: pregnancy

When are they offered

A

Influenza
Pertussis (2012)

16-32 weeks gesation

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16
Q

stimulants for growth

A

infants (0-3) : nutrients and insulin

child (3-12) : GH and thyroxine

pubertal (12-18): sex steroids

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17
Q

obesity causes

A

growth hormone deficiency
hypothyroidism
down’s
cushing’s
Prader-Willi

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18
Q

normal weight loss in new borns

A

5-10% of body weight

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19
Q

normal deviation from line on child’s height graph

A

+/- 2 standard deviations

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20
Q

puberty - girls

A

breasts (thelarche): budding

body hair (adrenarche): pubic and auxiliary hair

menstruation (menarche)

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21
Q

puberty - boys

A

testicular growth (10-15 years)

testicular volume >4ml

body hair: pubic and auxiliary hair

menstruation (menarche)

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22
Q

growing pains

A

NEVER present at the start of the day

worse after a day of activity

no limp, limitations of physical activity

systemically well

normal physical examination

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23
Q

precocious puberty

A

adrenal hyperplasia: low FSH & LH

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24
Q

delayed puberty

A

androgen insensitivity: primary amenorrhoea and no pubic hair

kallmann’s syndrome: hypogonadotrophic hypogonadism

klinefter’s syndrome

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25
Q

most children achieve day and night urinary continence by

A

3-4 years-old

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26
Q

Thrush of breast tx. mum and baby:

A

Maternal: topical meconazole or oral fluconazole

Baby if < 4 months: oral nystatin
Baby if > 4 months: Miconazole gel

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27
Q

developmental red flags:

A

10 weeks: smile
12 months: sit unsupported
18 months: walking

other: asymmetry of movement, visual or auditory concerns, loss of skills

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28
Q

edward’s syndrome (trisomy 18)

A

microcephaly
micrognathia
overlapping of fingers
rocker bottom feet

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29
Q

down syndrome (trisomy 21)

A

hypothyroidism
T1DM
ALL
alzheimer’s

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30
Q

noonan syndrome

A

short stature
webbed neck
pectus excavatum
pulmonic murmurs: pulmonary stenosis

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31
Q

turner syndrome

A

short stature
primary amenorrhoea
bicuspid aortic valve

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32
Q

patau syndrome (trisomy 13)

A

cleft lip
extra fingers
microcephaly
cyclopia

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33
Q

Prader-Willi

A

inheritance: imprinting

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34
Q

high temperature

A

suggests bacterial rather than viral infection

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35
Q

pierre robin syndrome

A

posterior displacement of tongue (may result in airway obstruction)
cleft palate
micrognathia

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36
Q

fragile X

A

neurodevelopment delay

facies: elongated, protruding

macroorchidism

hypotonia

recurrent otitis media

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37
Q

williams syndrome

A

Friendly extroverted personality with learning difficulties and elf like face

supravalvular aortic stenosis

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38
Q

DiGeorge syndrome (22)

A

Abormal face
Cleft lip
HYPOCALCAEMIA
increased risk of schizophrenia

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39
Q

duchenne muscular dystrophy

A

A: X-linked recessive

I: genetic testing

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40
Q

croup

A

A - parainfluenza virus

E - autumn

P - stridor (intermittent, harsh), barking cough (worse at night)

I - clinical diagnosis

M - oral dexamethasone (0.15 mg/kg), nebulised adrenaline (emergency)
admission: audible stridor at rest

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41
Q

epiglottitis

A

A - haemophilus influenzae type B

P - no prodrome, drooling, unable to swallow, muffled voice, tripod position

I: clinical diagnosis, neck xray (thumb printing)

M: airway, oxygen, IV antibiotics (ceftriaxone)

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42
Q

bronchiolitis

A

A - respiratory syncytial virus (RSV)

E - < 24 months

P - coryzal symptoms, increased work of breathing, fine inspiratory crackles

M - supportive

more severe in CHD

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43
Q

community acquired pneumonia

A

< 12 months: co-amoxiclav
> 12 months: amoxicillin

44
Q

pertussis (whooping cough)

A

A - Bordatella Pertussis

P -
1. coryzal symproms
2. paroxysms of cough / fits

I - nasal swab

M - macrolide (clarithromycin, azithromycin)

household contacts: ABx prophylaxis

absence: 48 hrs from commencing ABx

notifiable disease

45
Q

scarlet fever

A

A: GABHS and tonsilitis

P: fever, strawberry tongue, lymphadenopathy, sandpaper rash

M: oral penicillin V (10 days)

absence: 24 hours after starting ABx

notifiable disease

C: otitis media

46
Q

asthma

A
  • SABA
  • low dose ICS
  • LTRA
  • IV salbutamol
  • aminophyline

exacerbation:
- beta therapy (b2 agonist)
- steroid therapy for 3-5 days
(<2 yrs 10 mg, >2: 20 mg)

47
Q

viral induced wheeze

A

> 1 y/o

wheeze

M - SABA, oral montelukast/ inhaled corticosteroid

48
Q

acute otitis media

A

antibiotics: amoxicillin
- <2 yrs
- bilateral
- marked otorrhoea
- bulging tympanic membrane

49
Q

Features of innocent cardiac murmur in childhood:

A

soft

systolic

situational

asymptomatic

50
Q

venous hum

A

continuous murmur

heard best below the clavicles due to turbulent flow in the head and neck veins

disappears when child lies down

51
Q

murmur causes

A

1 - 2 days: transposition of great arteries, tricuspid atresia

1 - 2 months: tetralogy of fallot

52
Q

murmur - VSD

A

PANsystolic
thrills
symptoms of heart failure

inc risk of endocarditis

53
Q

murmur - coarctation of aorta

A

ejection systolic

54
Q

murmur - atrial septal defect

A

soft ejection systolic murmur

55
Q

patent ductus arteriosus

A

continuous machine-like murmur best heard below left clavicle

M: indomethacin, ibuprofen to promote duct closure

56
Q

cyanotic congenital heart diseases

A
  • Tetralogy of fallot
  • Transposition of great vessels (TGA)
  • Tricuspid atresia
  • Total anomalous pulmonary venous return
  • Truncus arteriosus

M: prostaglandin E1

57
Q

ebstein’s anomaly

A
58
Q

pyloric stenosis

A

hypertrophic pylorus

E - 2-6 weeks

P - projectile non-billious vomiting, palpable mass, hypochloraemic, hypokalaemic metabolic alkalosis

I - USS

M - ramstedt pyloromyotomy

59
Q

malrotation

A

P - billious vomiting, abdominal distension, obstruction

60
Q

biliary atresia

A

E: >2 weeks

P - billious vomiting, prolonged jaundice, hepatomegaly, splenomegaly

M: surgical (kasai procedure)

61
Q

necrotising enterocolitis

A

E - premature infants, newborn infants

P - vomiting, abdominal distension, red currant jelly stools

I: AXR (gas cysts)

62
Q

intussussception

A

E: older infants (6-18 months)

P: colicky abdominal pain, bilious vomiting, red currant jelly stool (late sign)

I: USS

63
Q

chronic diarrhoea

A

I:
bloods: anti-TTG
sweat test
stool culture
growth charts

M:
allergy trial: cows milk-free

64
Q

constipation red flags

A

failure to pass meconium w/in 48 hours
abnormal appearance of anus
constipation from birth
faltering growth

65
Q

laxative ladder

A
  1. movicol
  2. stimulant laxative
    - bisacody
    - Senna
    - glycerol
  3. osmotic laxative
    - polyethylene glycol
    - lactulose
66
Q

hirschprung’s

explosive passage of stool following PR exam:

A

delayed passage of meconium

P: vomiting, abdominal distension

I: rectal biopsy

67
Q

UTI
< 3 months
> 3 months

A

I: USS renal tract

M:
lower
- <3 months: IV amoxicillin, gentamicin
- >3 months: trimpethoprim/nitrofurantoin (3 days)

upper: IV amoxicillin, gentamicin

68
Q

congenital infections

A

toxoplasmosis: cerebral calcification, chorioretinitis, hydrocephalus

rubella

cytomegalovirus

69
Q

rash causes

A

measles

roseola

rubella

70
Q

measles

A

A: RNA Paramyxovirus

P:
prodrome: cough, fever nasal discharge

koplick spots - white spots on red background that develop on the buccal mucosa

maculopapular rash - starts on face, neck, behind ears

M:
notifiable

absence - 5 days from onset of rash (same as mumps & rubella)

C: pneumonia

71
Q

rubella

A

P:

maculopapular rash - pink; face -> whole body

lymphadenopathy: sub-occipital and post auricular

M:

absence - 5 days from onset of rash (same as mumps & measles)

72
Q

eczema

A

P
infants: face and trunk
children: extensor surfaces

M: topical emollients

73
Q

roseola infantum

A

A: Human herpes 6 (HHV-6)

P: high fever

maculopapular rash

nagayama spots: uvula and soft palate papules

M:
no absence required

74
Q

erythema infectiosum

A

aka slapped cheek or fifths disease

75
Q

ITP

A

P: post-infective, mucosal bleeding, well child

76
Q

henoch schonlein

A

I: Skin or RENAL biopsy

77
Q

kawasaki

A

large to medium cell vasculitis

P
fever > 5 days
red palms of hands
dry, cracked lips and strawberry tongue
bacterial conjunctivitis
widespread polymorphous rash

I: echocardiography

M: high dose aspirin

78
Q

Impetigo school exclusion:

A

until lesions have crusted over or 48 hours after commencing antibiotic therapy

79
Q

Scabies school exclusion:

A

Until treated

80
Q

Influenza school exclusion:

A

Till recovered

81
Q

Chicken pox school exclusion:

A

Till all lesions have crusted over

82
Q

Diarrhoea and vomiting school exclusions

A

Until symptoms have settled for 48 hours

83
Q

hand foot and mouth

A

A: coxsackie

M:

absence not required if child feels well

84
Q

febrile convulsions

A

simple: generalised tonic clonic seizure that lasts < 5 minutes

complex:
focal onset
lasts longer than 10 minutes
recurrent seizures in one febrile illness

M: midazolam (rectal or buccal)

Complete recovery of consciousness w/in one hour

85
Q

Below what age is red flag for febrile convulsions and why?

A

< 2 years

as children this age often show the classic signs and symptoms of meningitis

86
Q

Hepatic metabolism in children ->

A

Greater than in adults due to comparative size of liver thus require higher doses of anti-epileptics and theophylline. - doses should not exceed adult dose.

87
Q

temperature measurements

A

< 4 weeks: electronic thermometer in axilla

4 weeks - 5 years: electronic thermometer in axilla or infrared thermometer in axilla

88
Q

meningococcal meningitis

A

M: IM Benzyl penicillin

89
Q

bacterial meningitis

A

M:
< 3 months: IV cefotaxime + Amoxicillin
> 3 months: IV cefotaxime

90
Q

neonatal sepsis

A

infants: respiratory distresss, poor feeding, grunting, lethargy

91
Q

Autism spectrum disorder: what are the 4 domains of impairment

A

Social interactions
Thoughts and behaviours
Communication
Sensory hypersensitivity

92
Q

Cow’s milk allergy tx.

A

1st line is extensively-hydrolysed formula feed.

93
Q

hypospadias

A

M: corrective surgery before the age of 12 MONTHS - 1 year

94
Q

Undescended testes

A

M:
3 months: referral
6 months: seen by surgeon
orchidopexy to treat

95
Q

shaken baby

A

P: retinal haemorrhages, dubdural haemorrhage, encephalopathy

96
Q

Skin lesions as DDx. for NAI

A

Mongolian blue spot - birth mark

97
Q

wilm’s tumour

A

nephroblastoma

P: abdominal mass, painless haematuria, flank pain

98
Q

Second hearing test for newborns/infants if otoacoustic test is abnormal

A

Auditory brainstem response test

99
Q

genetic anticipation disorders

A

fragile X
huntington’s
myotonic dystrophy
spinocerebellar ataxia

100
Q

meningitis organisms

A

< 3 months
GBS
e.coli
listeria

3 months - 6 years
strep pneumoniae
n. meningitidis
h. influenzae

> 6 years
strep pneumoniae

101
Q

modes of inheritance

A

mitochondrial: maternal

x linked (recessive, dominant)

102
Q

neonatal hypoglycaemia

A

asymptomatic: encourage normal feeding

symptomatic: admit to neonatal unit & give 10% IV dextrose

IV 10% dextrose

103
Q

CXR features in TTN

A

Hyperinflation and fluid in the horizontal fissure

104
Q

Age to consent

Age to refuse treatment

A

16

18

105
Q

rate of chest compressions all children:

A

100-120 compressions/minute

106
Q

ciclosporin adverse effects

A 
Nephrotoxicity 
Hepatotoxicity 
Fluid retention 
Hypertension 
Hyperkalaemia

Everything UP: fluid, BP, K+, Hair, Gums, Glucose)

107
Q

AGPAR score

A

4th year passmed (28 decks)

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