child health Flashcards
define innocent murmur
soft systolic murmur
due to physiological conditions outside the heart
inconsequential and disappears as child grows older
common causes of cardiac failure in paediatrics
neonates: PDA, cortication of aorta, cardiomyopathy
infants: VSD, ASD, cardiomyopathy
children: cardiomyopathy
most common causative organism for infective endocarditis
strep. Viridans
dDx of acute cough in a child
URTI
croup
asthma
inhaled foreign body
dDx of acute stridor in a child
croup
epiglotitis
bacterial tracheitis
inhaled foreign body
common causes of pneumonia in children
Viral: RSV, influenza, parainfluenza
bacterial: Strep pneumoniae, mycoplasma (5-14y.o), Grp B strep (neonates)
causes of bronchiolitis
RSV, parainfluenza, influenza A, adenovirus
presentation of bronchiolitis
cough, dyspnoea, wheeze
hyperinflation, crepitations
seasonal - october-april
management of bronchiolitis
self limiting
oxygen
NG feeds and IV fluids if poor feeding
screening for CF
Screening – new-born measurement of immunoreactive trypsin levels on neonatal blood spot (heel prick)
If raised blood sent for genetic testing for CF mutations
Sweat test and genetic testing indicated in those missed by screening but presenting with meconium ileus, failure to thrive, recurrent chest infections or malabsorption
presentation of CF
recurrent chest infections/airway obstruction
pancreatic insufficiency
DIOS, meconium ileus
infertility (absence of Vas, abnormal cervical mucus)
anaemia
diabetes
management of CF
daily physiotherapy
prophylactic Abx (flucloxacillin)
high calorie diet
DIOS/meconium ileus – hydration + lactulose (surgery is 2nd line unless there is complete obstruction or perforation)
Acute RTI - oral amoxicillin (IV tobramycin and ceftazidime if severe) + salbutamol + chest physio + mucolytic
Pancreatic insufficiency – pancreatic enzyme supplements with each meal + fat soluble vitamin supplements
presentation of neonatal sepsis
collapse apnoea or resp. distress seizure poor feeding jaundice
management of hypoxic ischaemic encephalopathy
therapeutic cooling to 33.5C, initiated by 6hrs, lasts 72hrs
how is neonatal cataracts screened
check red reflex after birth
causes of neonatal jaundice
unconjugated
breast milk jaundice, haemolytic anaemias, infections/sepsis, congenital hypothyroidism
conjugated biliary atresia a1 antitrypsin deficiency neonatal hemochromatosis idiopathic neonatal hepatitis
management of neonatal jaundice
phototherapy using UV light fibre optic blankets
exchange transfusion
presentation of downs syndrome
generalised hypotonia
short neck with excess skin at nape
brachycephaly
single palmer crease, short hand/fingers and a sandal tow gap in feet
facial features (prominent epicanthic folds, upward slanting palpebral fissures, protruding tongue, flat nose, low set ears)
presentation of edwards syndrome (trisomy 18)
microcephaly, small chin, low set ears
overlapping fingers
rocker bottom feet - flexed big toe, prominent heels
VSD, ASD, PDA
presentation of patau’s syndrome
holoprosencephaly
structural eye defects
cutis aplasia
cardiac and renal defects
presentation of turner’s syndrome
downward turned mouth, downslanting palprbral fissures
webbed neck, wide spaced nipples, lymphodema
streak gonads, lack of secondary sexual development
short stature
presentation of fragile X syndrome
long face, prominent ears, large chin macroorchidism learning difficulties connective tissue problems, hyperflexibable joints, flat feet behavioural problems: ADD, Autism
causes of intellectual developmental disability
Genetics - down’s, fragile X
acquired - fetal alcohol/drug exposure, rubella
perinatal - intraventricular haemorrhage, hypoxic ischaemic encephalopathy
post natal - brain injury
benefits of breast milk
baby
all the macronutrients needed for growth and metabolism
protects child against infections
promotes development of the gut
reduces cardiovascular disease and autoimmune conditions in the child
mother
reduces risk of breast and ovarian cancer
reduces risk of diabetes
reduces risk of post natal depression
define cerebral palsy
An umbrella term referring to a non-progressive disease of the brain originating during the antenatal, neonatal, or early postnatal period when brain neuronal connections are still developing.
risk factors for cerebral palsy
prematurity maternal illness (thyroid, TORCH, factor V leiden) birth asphyxia neonatal sepsis head injury prior to 3 years
what are the TORCH infections
toxoplasmosis other (syphilis, VZV, parvovirus) rubella cytomegalovirus HSV
presentation of cerebral palsy
motor abnormalities (delayed development, paralysis, weakness, ataxia, chorea)
spasticity
feeding difficulties
speech impairment/delay in speech development
delay in cognitive/intellectual development
complications of cerebral palsy
epilepsy
behavioural problems
poor growth
osteoporosis
management of cerebral palsy
physiotherapy
speech and language therapy
botulinum toxin
surgery
presentation of neural tube defects
paralysis or sensory loss in legs LL weakness and loss of reflexes neurogenic bladder and bowel hydrocephalus chiari II malformation - learning difficulties
management of NT defects
neurosurgical repair of the cele - antenatally or by 3 months
ventriculoperitoneal shunt for hydrocephalus
IV Abx to prevent neonatal meningitis
presentation of musclular dystrophy
DMD - onset at 3, wheelchair by 12
BMD - onset at 11, wheelchair not needed/in later life
loss of limb strenghth loss of muscle tone and reflexes calf hypertrophy scoliosis and lumbar lordosis positive gowers sign
diagnosis of muscular dystrophy
genetic testing
elevated creatinine kinase
monitor resp and cardio function
management of muscular dystrophy
genetic counselling physiotherapy oral pred resp support (positive pressure ventilation) scoliosis surgery
define febrile seizure
A febrile seizure as a seizure occurring in the presence of fever in a child between the ages of 6 and 60 months who do not have an intracranial infection, metabolic disturbance, or history of afebrile seizures
