Child Health Flashcards
Physical features of achondroplasia?
Trident hands
Short limbs
Lumbar lardosis
Midface hypoplasia
Causative organism for croup?
Parinfluenza virus
What is William’s syndrome?
Neurodevelopmental disorder caused by microdeletion on chromosome 7
Features of William’s?
Elfin like facies
Friendly and social
LD
Short stature
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis
If a girl has haemophilia what else do you think she has?
TURNER’S SYNDROME
Because it is X-linked recessive, if a girl is symptomatic that should raise alarm bells (Turner’s only have one X- chromosome)
7 features of DDH?
7 F’s
-First born
-Female
-Fat (macrosomia)
-Fair (caucasian)
-Feet (breech)
-F*ck all Fluid (oligohydraminos) (none)
-Family (Fam Hx)
What does this baby have?
-Retinal haemorrhages, subdural haematoma, encephalopathy
Shaken baby syndrome
If a child has dyskinetic cerebal palsay which area of the brain is affected?
Basal ganglia
Substantia nigra
(These areas are involved with regulating voluntary movement and posture)
Sausage shaped mass in abdomen?
Intussusception
What does gastroschisis refer to?
Defect lateral to umbilicus
What does omphalocele refer to?
Defect in umbilicus itself
Why is diabetes a risk factors for neonatal respiratory distress syndrome?
Insulin (increased in diabetic mothers) inhibits surfactant production and maturation of fetal lungs
First MMR vaccine given when?
12-13 months
Then
3-4 as booster
Which genetic defect puts a child more at risk of developing acute lymphocytic leukaemia?
Down’s syndrome
What heart condition is associated iwth Turner’s
Bicuspid valve
(ejection systolic murmur)
However Aortic dissection is the most serious associated heart condition
Achondroplasia has what inheritance pattern?
AD
Supravalvular aortic stenosis makes you think what?
Williams syndrome
What age do kids ask what and who Qs? (milestones wise)
3 years
What age do they ask why when and how Qs?
4 years
CXR Findings in transient tachnypnoea of the newborn?
Hyperinflation and fluid in horizontal fissue
Drug for child nocturnal eneuresis?
Desmopresin
If a man has mitochondrial genetic disease what is the likelihood that his children will inherit it?
0%
Mitochondrial always passed down mother’s line
Parallel aorta and pulmonary trunk on echo is indicative of what?
Transposition of great arteries
What do you give in transposition of great arteries?
Prostaglandin E1 to maintain ductus arteriosus
Treatment of paediatric malrotation with volvulus?
Ladd’s procedure (division of Ladd bands and widening of base of mesentery)
A child aged <3 months with a fever >38 degrees should be assessed as what?
HIGH RISK : same day paeds assessment
Good pincer grip time?
12 months
Causes of microcephaly?
Normal
Familial
Congenital infection
Perinatal brain injury
Fetal alcohol
Patau syndrome
Craniosynostosis
Cap BG of <1mmol/L is characterised as what in a neonate and what is needed to be done?
VERY LOW
Paeds team review
IV dextrose infusion
Newborn baby base line levels?
HR:100-160
RR: 30-60
Temp: 37 degrees
What is the organism causing threadworms?
Enterobius vermicularis
Sit without support timeline for kids milestones?
6-8 months
Pavlik’s harness is for what?
DDH
NOT Perthes boyyyyyyyy
Child older than 6 with Perthes?
Surgical correction
Screening newborns for heraing problems test?
Otoacoustic emission test
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Impendance audiometry testing if this is failed
What is the best predictor or clinical severity and cyanosis in tetralogy of fallot?
Degree of pulmonary stenosis
Most common cause of ambiguous genetalia?
Congenital adrenal hyperplasia
Genetic anticipation occurs in which disorders?
Trinucleotide repeat disorders
-Huntington’s
-Myotonic dystrophy
-Fragile X
-Friedreich’s ataxia
-Spinocerebellar ataxia
-Spinobulbar msucular atrophy
-Dentatorubral pallidouysian atrophy
Right atrial hypertrophy and septal and posterior leaflet of tricuspid valve attached to right ventricle? What is this?
Ebstein’s anomaly
Huntington’s inheritance?
AD
What do all breech babies at or after 36 weeks gestation require post natally and when exactly?
USS
For DDH screening
6 weeks
Investigation for intussusception?
Abdo US
Visible peristalsis makes you think what in a baby?
Pyloric stenosis
1st line investigation for DDH?
Child <4.5 months USS
Diagnosing DDH in a child >4.5 months?
X-ray
Cause of Ebstein’s anomaly?
Lithium in pregnancy
When is hand preference a concerning sign in a child?
When they have it before 12 months: cerebral palsy possibly
What genetic disorder has these features?
LD
Large low set ears
Macroorchidism
Hypotonia
Autism
Mitral valve prolapse
Newborn resuscitation guidelines recommended compressions and ventilations at a rate of what?
3:1
If a child has sus mycoplasma pneumonia what do you want to give?
Macrolide
Erythromycin
Name the syndrome:
- Microcephalic, small eyes
-Cleft lip/palate
-Polydactyly
-Scalp lesions
Patau syndrome (trisomy 13)
Name the syndrome:
-Micrognathia
-Low set ears
-Rocker bottom feet
-Overlapping of fingers
Edward’s syndrome (trisomy 18)
Micrognathia?
Lower jaw is smaller than normal
Name the syndrome:
- LD
-Macrocephaly
-Long face
-Large ears
-Macro-orchidism
Fragile X
Name the syndrome:
-Webbed neck
-Pectus excavatum
-Short stature
-Pulmonary stenosis
Noonan syndrome
Name the syndrome:
-Hypotonia
-Hypogonadism
-Obesity
Prader Willi syndrome
Name the syndrome:
-Short stature
-LD
-Friendly, extroverted
-Transient neonatal hypercalcaemia
-Supravalvular aortic stenosis
William’s syndrome
Name the syndrome:
-Characteristic cry due to larynx and neurological problems
-Feeding difficulties and poor weight gain
-LD
-Microcephaly
-Hypertelorism (eyes v far apart)
Cri du char syndrome
When is heel prick test performed?
Between 5th and 9th day of life
What does heel prick test screen for?
Sickle cell
CF
Congenital hypothyroidism
PKU
MCADD
Forceful, projectile vomiting “like a fountain”? + what invgX?
Pyloric stenosis
Abdo USS
When are bowlegs normal in kids?
3 and below
Should resolve by 4
Management of intussesception?
Air insufflation
InVgX with US (target like mass)
<5 years old child with asthma that is on SABA but not controlled yet?
Paediatric low-dose inhaled corticosteroid
> 5 years old child with poorly controlled asthma on SABA, step up management?
Paediatric moderate dose ICS
RFs for neonatal hypoglycaemia?
Preterm birth
Maternal DM
IUGR
Hypothermia
Neonatal sepsis
Inborn errors of metabolism
Chronic constipation in kids treatment?
Lifestyle/fluid advice
Movicol
Investigation for reflux nephropathy?
Micturating cystography
What are pyloric stenosis features?
Projectile, non-bile stained vomit at 4-6 weeks of life
If a baby is premature how do you work out their adjusted milestones?
The corrected premmy baby age is
Age - number of weeks born early from 40 weeks
Methylphenidate SE?
Stunted growth
When does infantile colic usually resolve by?
6 months
Management of SUFE?
Internal fixation
What inheritance is prader willi an example of?
Imprinting
-Genotype depends on whether the deletion occurs on a gene inherited from the mother or father
-Prader Willi if gene deleted from father
-Angelman if gene deleted from mother
Just in case meds for febrile seizures?
Buccal midazolam
Rectal Diazepam
What makes an innocent murmur?
Soft
Systolic
Short
Symptomless
Standing/sitting (vary with position)
What is starbismus?
Squint
Atopic eczema distribution in a 10 month old?
Face and trunk
Areas most exposed to environmental allergens and irritants
Criteria for immediate paediatric head CT?
-Loss of consciousness more than 5 minutes
-Amnesia
-Abnormal drowsiness
-3 or more discrete episodes of vomiting
-Clinical sus of NAI
-GCS 14> or baby under 1 GCS <15
-Sus of open or depressed skull injury
-Basal skull fracture signs
-Focal neurological deficit
-If under 1 year presence of bruising, swelling or lac of more than 5cm on head
-Dangerous mechanism of injury
Name the congenital heart defect based on murmur:
Pansystolic murmur in lower left sternal border?
Ventricular septal defect
Name the congenital heart defect based on murmur:
Crescendo-decrescendo murmur in upper left sternal border?
Coarctation of the aorta
Name the congenital heart defect based on murmur:
Diastolic machinery murmur in upper left sternal border
Patent ductus arteriosus
Name the congenital heart defect based on murmur:
Ejection systolic murmur in the upper left sternal border
Pulmonary stenosis
Kawasaki disease MgX?
High dose aspirin
Single dose IV immunoglobulins
Which family history disease would be expected sometimes with Hirschsprungs?
MEN 2A/B
Common condition associated with Duchenne MD?
Dilated cardiomyopathy
A loud S2 + prominent RV impulse palpable on examination?
Transposition of great arteries
Surgery for paediatric intestinal malrotation with volvulus?
Ladd’s procedure
What is elevated in biliary atresia?
Conjugated bilirubin
ABG of pyloric stenosis?
Elevated bicarb
Hypocholraemia
Hypokalaemia
InvgX for sus Meckel’s diverticulum?
Technetium scan
VSD common risk of developing what?
Endocarditis
When is MenB vaccine given?
2, 4 and 12-13 months
When is hypospadias surgery typically performed?
12 months of age
Nec Enterocolitis invgX?
Abdo X-ray
Fragile X is associated with which cardio complication?
Mitral valve prolapse
Clicky hip in newborn screening Investigation and differential?
USS (newborns bones are soft, and USS is less radiation)
DDH
What is their loss of in SCFE?
Loss of internal rotation of the leg in flexion
Constipation in children management?
Osmotic laxative
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Stimulant laxative but only once stools are soft
What is in the 6 in 1 vaccination?
Diphtheria
Tetanus
Pertussis
Polio
HiB
Hep B
When would a child start playing alongside other kids?
2 years
Acyanotic congenital heart diseases?
VSD
ASD
Patent ductus arteriosus
Coarctation of the aorta
Aortic valve stenosis
Cyanotic congenital heart diseases?
Tetralogy of fallot
Transposition of the great arteries
Tricuspid atresia
Which bony prominence is Osgood Schlatter at?
Tibial tuberosity
Poor-feeding, grunting, lethargy. What should you consider?
Neonatal sepsis
Causes of neonatal hypotonia?
Neonatal sepsis
Werdnig Hoffman disease
Hypothyroidism
Prader-willi
What is NICE guideline on vomtiing and CT post head injury in kids?
3 or more vomits, CT within an hour
What age do febrile seizures cease?
5 years old
What cyst does this describe?
Multioculated
Heterogenous
Located above hyoid
Dermoid
Soft, trans-illuminating cyst in posterior triangle?
Cystic hygroma
Name that cyst:
Lateral cyst, ancehoic appearance on US?
Branchial cyst
InvgX for SUFE?
Hip x-ray
Sus Perthe’s disease in 5 y/o boi investigation?
MRI scan
Webbed neck + pectus excavatum + short _ Pulmsten?
Noonan syndrome
Men B is given when?
2, 4, and 12 months