Childhood Flashcards
Colic
- what are the symptoms?
- what is the rule of 3
- referral if….
- OTC products that can be given?
Advice…
Symptoms:
• excessive, high-pitch crying
• rule of 3: 3 hours a day, 3 days a week
for 3 weeks
• difficult to comfort
• red in the face
• knees drawn up to stomach
• excessive gas
referral:
• inconsolable crying
• failure to put on weight with age
OTC products:
• lactase enzyme (colief) - breaks down
sugar lactose found in breast and
formula milk
• simethicone (infacol) - eliminates
trapped gas through belching/flatus
Advice:
• reassure parent it is not their fault and
baby will grow out of it
• remove cows milk - 1 week trial
• massage the tummy
• hold baby and rock during crying
episodes
1.2 cradle cap (infant seborrheic dermatitis)
Symptoms?
Referral?
OTC products?
Advice?
Symptoms:
• greasy yellow scales on scalp
• infancy before the age of 6 months
• self-limiting: clears up in a few weeks
or months
referral:
• severe on face/body
• swelling, scratching, bleeding
• infected/inflammation
OTC products:
• baby shampoo and use soft brush
• olive oil - apply to scalp overnight
• OTC shampoo
Advice:
• common and harmless • not contagious
• do not pick scales
1.3 meningitis
Symptoms? Specific? Non specific? Referral? OTC?
Symptoms:
• non-blanching rash - pale, blotchy skin
with widespread bruises which do not fade when pressed against a glass tumbler
specific symptoms:
• stiff neck
• severe headache
• cold hands and feet
• confusion, drowsiness • photophobia
• seizures
Non-specific symptoms:
• worsening flu-like symptoms • high fever
• severe muscle ache
• nausea and vomiting symptoms in infants
• floppiness
• dislike to being handled
• refuse feeds
• unusual cry or moan
Referral:
• all suspected cases require immediate
hospital admission
OTC product:
• viral meningitis does not require hospital
treatment
• symptomatic relief - paracetamol,
ibuprofen
1.4 MMR
What is measles caused by?
What is mumps caused by?
What is rubella caused by?
What are the symptoms? Of each?
Referral?
OTC
Advice?
• measles: paramyxo virus
• mumps: paramyxo virus
• rubella: RNA virus
Symptoms:
measles
• kopek spots
• conjunctivitis
• cold-like symptoms
• fever
• rash starts behind the ear and then
spreads to face, trunks and limbs
• red-brown confluent and blotchy rash
mumps:
• fever
• headache
• malaise
• selling on one or both sides of the face
rubella:
• lymphadenopathy
• rash that starts on the face then spreads
to trunks and limbs
• pink-red macular non-confluent rash
Referral:
• all cases should be referred for
confirmed diagnosis
• MMR are notifiable diseases
OTC products:
• paracetamol or ibuprofen for
symptomatic relief
Advice:
• bed rest
• hydrated
• keep children off school
• avoid acidic drinks in mumps
• children with rubella should keep away
from pregnant women
Measles:
• contagious for 4 days after rash
appears
• most dangerous childhood illness
Mumps:
• contagious for 5 days after swelling
appears
• in adults - risk of meningitis
Rubella:
• contagious for 6 days after rash
appears
• stay away from pregnant women
1.5 nappy rash
Symptoms?
Referral?
OTC?
Advice?
symptoms:
• irritant nappy rash - erythematous
rash on buttocks
• fungal nappy rash - satellite rash,
rash concentrated in skin folds
Referral:
• broken skin, severe nappy rash
• yellow crust/weeping
• other body areas affected
• OTC failure >1 week
OTC products:
• barrier preparations - form
protective layer, rehydrates and
soothes skin (bepanthen,
drapolene, sudocrem, metanium)
• anti fungal preparations -
clotrimazole, miconazole
Advice:
• skin care and nappy hygiene -
change nappies asap
• leave nappy off for a while to allow
skin to air dry
• avoid waterproof nappies
• wash area with water or wipes
1.6 oral thrush
Symptoms?
Referral?
OTC?
Advice?
symptoms:
• common in babies
• white patches on tongue and mucosal
surfaces inside mouth
referral:
• all except babies
• recurrent infection
• OTC failure >1 week
OTC products:
• 4 months + miconazole (daktarin oral
gel)
• apply QDS after meals
• continue at least 1 week after
symptoms disappear
• do not apply to back of throat WARFARIN + MICONAZOLE = BLEEDING
Advice:
• high-dose inhaled corticosteroids - use
spacer, rinse mouth after use, correct
technique
• treat nappy rash if also present
• prevent re-infection - sterilise bottle
teats
• if breastfeeding - apply cream to nipple
and wipe before a feed
1.7 slapped cheek - parvovirus
Symptoms?
Referral?
OTC?
Advice?
symptoms:
• bright red rash on cheeks
• light pink, lace-like, itchy rash on trunk
and limbs
• initial cold-like symptoms
referral:
• exposed patient groups e.g. pregnant
woman
• blood disorders
• symptoms of severe anaemia
OTC products:
• paracetamol or ibuprofen • antihistamines
Advice:
• rest and plenty of fluids
• once rash appears it is no longer
contagious
1.8 whooping cough (pertussis)
Symptoms?
Referral?
OTC?
Advice?
symptoms:
• initial symptoms - runny nose,
watery eyes, sore throat, slight fever • intense coughing bouts - expels
thick mucus and vomiting can follow, common at night
Referral:
• all cases of whooping cough - abx
given if present for less than 3
weeks
• a&e if significant breathing
difficulties
OTC products:
• fever - paracetamol or ibuprofen
Advice:
• very contagious - stay away from
school 5 days after starting antibiotics or 3 weeks after cough started whichever is sooner
• cover Childs mouth and nose with a tissue when coughing/sneezing
1.9 chickenpox - varicella zoster virus
Symptoms?
Referral?
OTC?
Advice?
symptoms:
• small red spots - very itchy and
infectious blisters -> crusts
• small red spots first appear on
chest and face before spreading to
other parts
• blisters form over the next 12 hours
and then burst and scab over the
next few days
• up to 3 days before chickenpox -
fever, headache, sore throat, myalgia, malaise
Referral:
• adults
• pregnant women
• weakened immune system
• infants under 4 weeks old
• shingles for possible antivirals
OTC products:
• itching - calamine lotion, crotamiton,
1+ chlorphenamine
• fever: paracetamol, avoid ibuprofen
Advice:
• do not scratch lesions - risk of
secondary bacteria infection
• very contagious until lesions have
crusted over
1.10 fever in children
Symptoms?
Referral?
OTC?
Advice?
symptoms:
• high temperature above 38 degrees
• high grade fever >39 degrees Associated symptoms:
• feel hotter than usual when touching
forehead, back or stomach
• sweaty and clammy
• flushed cheeks
referral:
• < 3 months old >38 degrees
• 3-6 months >39 degrees duration
• >24 hours 3-6 months
• > 72 hours in >6 months
• dehydration
• febrile convulsions
• serious signs; floppiness, drowsiness,
persistent vomiting, rash or seizures
advice:
• keep child hydrated - look for signs of dehydration
• use a digital thermometer - under armpit if under 5, ear, rectum, mouth
1.11 impetigo
Symptoms?
Referral?
OTC?
Advice?
symptoms:
• golden-crust lesions Non-bullous impetigo
• starts as small red sores around the nose
and mouth
• quickly develops into blisters and burst
• itchy but otherwise asymptomatic Bullous impetigo
• common in neonates
• starts as fluid-filled blisters on trunk or
arms/legs
• painful and itchy
• fever and swollen lymph glands is more
common
referral:
• all cases, need abx
• topic fusidic acid for mild cases and oral
flucloxacillin if severe or widespread
OTC products:
• symptomatic treatment e.g. paracetamol
Advice:
• contagious - stay away from school
• hygiene measures - do not share towels -
cut nails short
1.12 scarlet fever
Symptoms?
Referral?
OTC?
Advice?
symptoms:
• pink-red, itchy sandpaper rash
• develops 12-28 hours after initial
symptoms
• initial symptoms = sore throat,
headache, high temp, flushed cheeks
and swollen tongue
• other symptoms: strawberry tongue,
swollen lymph glands, loss of appetite
referral:
• requires abx - amoxicillin for 10 days
OTC products:
• symptomatic relief - paracetamol for
temperature, antihistamine/calamine lotion for itch
Advice:
• contagious - off for at least 24 hours
after starting antibiotics
• avoid sharing towels, clothes, bed linen
• cover mouth when sneezing/coughing
