childhealth treatment

Question 1

treatment criteria for NAS

Answer 1

-if feeding becomes a problem
-profuse vomit/diarrhoea
-baby remains unsettled after 2 consecutive feeds

Question 2

medications used for NAS

Answer 2

oral morphine solution

Question 3

breast thrush treatment

Answer 3

miconazole gel
if not going then oral as well

Always treat baby too!

Question 4

Lactating Mastitis treatment

(and when to give antibiotics- 3 reason and what antibiotics to presribe)

Answer 4

1st line analgesia and resting and still breast feed from affected breast. rest and express is the alternative.

if there is a nipple fissure, symptoms not improving aftr 24hrs, (+) milk culture prescribe:
1st line: flucoxaxillin
2nd line: clindamycin

Question 5

non lactating mastitis treatment

Answer 5

co-amoxiclav

if penicillin allergic: clarithomycin (or erythromycin)

Question 6

does a women with breast abscess continue breastfeeding?

Answer 6

yes, including the affected breast. if they r struggling wiht breat fedding then express the milk.

Question 7

intussusception treatment

Answer 7

1st line: reduction using floroscopy (blows air through)
(ileo-colic intussusceptions most reliably removed using ^this method)

2nd: surgery (for long ileo-ileal intussceceptions)

Question 8

constipation in children treatment (no red flags)

Answer 8

1st: movical paediatric plain (using an escalating dose)
2nd: add stimulant laxative (senna) after 2 weeks if not improved
3rd: if movical not tolerated do a stimulant laxative with an osmotic laxative (lactulose)

Question 9

hyposadias treatment
(include what must not occur before treatment)

Answer 9

refer to specialist, corrective surgery is around 12 months of age

the child must not be circumsised prior to surgery
in boys with very distal disease, no treatment may be needed

Question 10

threadworms treatment

Answer 10

one dose of mebendazole to affected patinet and their whole household

Question 11

meningitis in children <3months antibiotic treatment

Answer 11

IV cefotaxime and amoxicillin to cover for listeria

steroids contraindicted. do not prescribe.

Question 12

meningitis in childresn >3months treatment

Answer 12

IV dexamethasone and IV cefotaxime

Question 13

croup treatment

Answer 13

immedietley give a single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity

If severe give nebulised adrenaline as well

Question 14

emergency croup treatment

Answer 14

single dose of oral dexamethasone + high flow oxygen and nebulised adrenaline

Question 15

pertussis treatment (whooping cough)

Answer 15

oral macrolide (eg. azithromycin) if onset of cough is within the previous 21 days

household contacts should be offered antibiotic prophylaxis

Question 16

should a child with pertussis be excluded? if so how long

Answer 16

yes, up until 48hrs after commencing antibiotic or

21 says from onset of symptoms if no antibiotics

Question 17

undescended test in child management

Answer 17

review at 3 months old, if persistent then refer

Question 18

hypoglycaemia in infant treatement

Answer 18

asymptomatic: bottle feed and monitor

symptomatic: admit to neonate ward and give IV 10% dextrose

Question 19

when should a child with croup be admitted

Answer 19

if they have any evidence of a narrowed airway/ struggling to breathe at rest eg. stridor at rest

Question 20

billiary atresia treatment

Answer 20

surgery (kasai procedure)

Question 21

anaphlyaxis treatment in those <6 yrs old

Answer 21

150 micrograms IM adrenaline (1:1000)

then:
high flow oxygen
IV fluids if in shock
hydrocortisone
monitor for 12 hrs

Question 22

anaphylaxis treatment in those >6 yrs old

Answer 22

300 migrograms IM adrenaline (1:1000)

then:
high flow oxygen
IV fluids if in shock
hydrocortisone
monitor for 12 hrs

Question 23

when to stop phototherapy for hyperbilinurubia in babies
and what to do after

Answer 23

when levels fall to >50mmol/L
after stopping recheck bilurubin in 12-18 hrs time
if it remains the same then no further monitoring is needed however if it rises check another 12 hrs later and consider restarting phototherapy

Question 24

acute epiglottitis treatment

Answer 24

Immediete senior ENT help
Do no examine throat

IV ceftriaxone + oxygen

Question 25

pertussis Investigations

Answer 25

1st line: nasal swab for bordatella pertussis
PCR and serology increasingly used

Question 26

chickenpox treatment

Answer 26

calamine lotion to stop itch

(Calamine Calms the itch)

Question 27

UTI tx

Answer 27

<3 months IV Abx
>3months= po Abx

Question 28

Developmental dysplasia treatment:
Dislocated/unstable hip

Answer 28

Pavlike harness 6 weeks

Question 29

Developmental hip dysplasia:
Persistent dislocation >18months

Answer 29

Open surgical reduction/osteotomy

Question 30

SUFE treatment

Answer 30

Pin femoral head

Question 31

Pyloric stenosis treatment

Answer 31

Ramstedt pyloromyotomy

Question 32

necrotising entercolitis tx

Answer 32

NIL BY ORAL, clindamycin and cefotaxime

immediete referral to neonate surgical team

Question 33

child cows milk protein allergy tx

Answer 33

extensive hydrolysed formula (eHF)

if severe/persisting use: amino acid based formula

Question 34

cerebral palsy spasticity treatment

Answer 34

oral diazepam & oral baclofen

Question 35

Kawasaki disease treatment

Answer 35

high dose aspirin and a single dose of intravenous immunoglobulin

Question 36

management for hirschsprungs disease

Answer 36

initially: rectal washouts/bowel irrigation

definitive: surgery rescection of colon

Question 37

tx for nocturnal enuresis

Answer 37

1st line: enuresis alarm

iif reward system etc has been tried then pharmacological management: desmopressin

Question 38

most important intervention for reducing likeliehood of hypoxia induced brain damage in baby

Answer 38

therapeutic cooling

Question 39

patent ductus arteriosus tx

Answer 39

indomethacin (closes the duct)

Question 40

what drug used to keep patent ductus arteriosus open

Answer 40

prostaglandins

Question 41

Tx for NRDS

Answer 41

ventilate and intra-tracheal surfactant

Question 42

transient tachypnoea of newborn tx

Answer 42

self limiting, resolves after 24 hrs