child health randoms

Question 1

why do kids most likely cause of arrest to be resp than cardiac

Answer 1

tachypnoeic + low sats –> tire themselves out –> hypoxic –> bradycardic as heart doesn’t have enough O2

Question 2

why is BP not super reliable in kids

Answer 2

BP crashes but can maintain for ages!

Signs of shock
- ^ HR
- ^RR
- prolonged CRT
= shocked = need resus fluids

Question 3

LEARN DEVELOPMENTAL ASSESSMENT FOR MOSLER

Question 4

how to get access in shocked child

Answer 4

2 attempts at cannula then straight for IO

Question 5

Sepsis 6 in kids

Answer 5

–> O2
–> fluids
–> Abx - ceftriaxone unless neonate is cefotaxime
<– lactate
<– bloods cultures
CONSIDER IONOTROPES

Question 6

how to tell bacterial vs viral

Answer 6

above 38 = bacterial
but also LOW TEMP ? SEPSIS

Question 7

what causes pinpoint pupils

Answer 7

opiates
organosphosphates (fertiliser)

Question 8

wheezy kid initial Mx

Answer 8

try salbutamol then ipatropium (which works better on younger age groups)

Question 9

if under 2 and wheezy diagnosis is

Answer 9

bronchiolitis

(even if NPA -ive for RSV –> then called RSV -ive bronchiolitis)

Question 10

2-5 and wheezy

Answer 10

VIW

Question 11

5+ and wheezy

Answer 11

ashtma

Question 12

Ix in ?NAI?

Answer 12

Bedside –> retinal haemorrages?
Bloods –> RBC / coag
Imaging –> skeletal survey

Question 13

High specificity injuries for NAI

Answer 13

CLASSIC METAPHYSEAL LESIONS –> bucket handle and corner fracture
got by being dragged by one leg

also
posterior rib #
scapular#
spinner process#
sternal#

Question 14

toxic trio

Answer 14

parent MH
parent susbtance abuse
parent DV

Question 15

mongolian blue spot

Answer 15

blue birthmark - typically over sacrum
common in asian/African pops
aka dermal melanocytisis

Question 16

scalded skin syndrome key difference with NAI

Answer 16

skin folds and axilla
any skin if rubbed will slide off
caused by superficial staph infection

Question 17

what happens when you refer to social care

Answer 17

refer
SW will arange assessment / strategy meeting
if needed child protection Ix
followed by case conference

Question 18

why are kids tachypneic when dehydrated

Answer 18

metabolic acidosis –> compensatory mechanism

Question 19

why can’t you correct Na+ deficit to quick

Answer 19

central pontine myelinolysis

Question 20

clostridium septicum disease

Answer 20

V HIGH MORTALITY - esp w neutropenia
produces a-toxin = breaksdown gut integrity
normally inactivated by neutrophil nucleases

Question 21

how neutropenic before severe bacterial and fungal

Answer 21

bacterial = 0.75
fungal = 0.5

Question 22

neutropenia

Answer 22

less than 2 neutrophils

Question 23

Hx difference between VIW and asthma

Answer 23

INTERVAL SX

Question 24

steroids in VIW

Answer 24

very little evidence

Question 25

1/3 rule in febrile convulsions

Answer 25

1/3 will only have 1 convulsion
1/3 will have 2-3 convulsions
1/3 will have 3+

Question 26

Parental advice for febrile convulsions

Answer 26

TIME
record
more than 5 mins –> get help
make sure safe

Question 27

seizures in kids DDx

Answer 27

• hypoglycaemia
• febrile convulsion
• epilepsy –> ask abt prematurity / resus at birth / cerebral palsy etc

Question 28

thrombocytopenia in neonate

Answer 28

• IUGR
• ITP in mum –> mums antibodies crosses placenta and destroys babies too
• SEPSIS

Question 29

what is HSP

Answer 29

-small vessel vasculitis
-MUST HAVE SKIN INVOLVEMENT (maculopapular nonblanching rash)
-kidney in 50% –> proteina nd haematuria
- high BP due to kidney
-arhtritis
-abdo pain - can be really severe (often DDx is appendicitis)
- neuro involvement –> v v rare

Question 30

Mx of HSP

Answer 30

ONLY IF SEVERE ABDO PAIN - STEROIDS
otherwise symptomatic Mx

Question 31

when does febrile seizure = status epilepticus

Answer 31

• A single seizure spanning more than 5 minutes
• 2 or more distinct seizures occurring within a 5-minute period