Child health

Question 1

Paediatric BLS

Answer 1

Give 5 rescue breaths

Check pulse:
- brachial or femoral in infants (<1 year)
- femoral in children

Chest compression 15:2 with a rate of 100-120/min

Children: compress lower part of sternum
Infants: two thumb technique

Question 2

Testicular torsion
- pathophysiology
- Sx
- Mx

Answer 2

Twist of the spermatic cord resulting in testicular ischaemia and necrosis.

Sx:
Pain sudden onset
Lower abdo
Nausea/vomiting
Tender testes retracted upwards
Cremasteric reflex lost
Elevation of testis does not ease pain (Prehns sign)

Mx:
Urgent surgical exploration (often bilateral fixation)

Question 3

Child abuse:
presentation

Answer 3

Presentation:
bruising
common fracture: radial, humeral, femoral
torn frenulum (forcing a bottle into a Childs mouth)
burns or scalds
failure to thrive
STIs e.g. chlamydia, gonorrhoea, trichomonasas

Question 4

Scarlet Fever
- cause
- symptoms
- diagnosis
- management
- complications

Answer 4

Cause: group A strep -> streptococcus pyogens

Sx:
fever: typically lasts 24 to 48 hours
malaise, headache, nausea/vomiting
sore throat
‘strawberry’ tongue
rash (sandpaper)

Mx: oral penicillin V for 10 days (azithromycin if PA)
return to school 24h after
notifiable disease

Complication:
- otitis media
- rheumatic fever
- acute glomerulonetphritis

Scarlet fever rash

Question 5

Downs syndrome
- prenatal testing

Answer 5

Prenatal testing:
- nuchal translucency: raised
- B-hCG: raised
- PAPP-A: low