Childhood Conditions Flashcards
What is colic?
Excessive high pitched crying
Rule of 3 - 3 hrs/day, 3 days/week, 3 weeks
How long does colic last?
Starts infancy resolves around 4-6 months
What are the signs of colic?
Difficult to comfort Red face Clenched fists Knees drawn up Excessive gas
When do you refer for colic?
Inconsolable crying
Failure to put on weight with age
What is used for OTC colic?
Infacol (simeticone)
Lactase enzyme (colief)
What is advice for colic?
Not parents fault, will grow out of it
Remove cows milk for 1 week trial
Massage tummy in circular motion
What is cradle cap?
Greasy yellow scales on scalp
Before 6 months old
Self limiting
When should cradle cap be referred?
Severe on face/body
Swelling, scratching, bleeding
Infected/inflamed
How do you treat OTC cradle cap?
Baby shampoo and soft brush
Olive oil
Capasal
Nizoral
What is the advice for cradle cap?
Common and harmless
Not contagious
Do not pick scales
What are the symptoms of meningitis in children?
Non blanching rash Flu like symptoms worsening High fever Severe muscle ache Nausea and vomiting
Stiff neck Severe headache Cold hands and feet Confusion Drowsiness Photophobia Seizures
What are the symptoms of meningitis in infants?
Floppiness/unresponsive Dislike being handled Refuse feeds Difficult to wake Rapid breathing Unusual cry Bulging fontanelle
When do you refer meningitis?
ALL suspected cases
What is the advice for meningitis?
Trust gut instincts
Bacterial meningitis is life threatening and can cause blood poisoning and limb amputation
What are the symptoms of measles?
Koplik spots
Conjunctivitis
Cold like symptoms
Fever
Rash starts behind ears then spreads to face, trunk, limbs
Red-brown confluent and blotchy rash
What are the symptoms of mumps?
Fever
Headache
Malaise
Swelling on one or both sides of face
What are the symptoms of rubella?
Lymphadenopathy
Rash starts on face then spreads to trunk and limbs
Pink-red macular non-confluent rash
When should you refer MMR?
ALL cases
What is an OTC product used for MMR?
Paracetamol
Ibuprofen
What is the advice for MMR?
Bed rest
Hydrated
Keep children off school during contagious period
Avoid acidic drinks in mumps
Children with rubella should keep away from pregnant women
How long is measles contagious for?
4 days after rash
How long is mumps contagious for?
5 days after swelling
How long is rubella contagious for?
6 days after rash
What is the most dangerous in children measles, mumps or rubella?
Measles
What are the risks associated with mumps in adults?
Risk of meningitis and sterility
Why should children with rubella stay away from pregnant women?
Foetal damage
What are the symptoms of irritant nappy rash?
Erythmatous rash on buttocks
What are the symptoms of fungal nappy rash?
Satellite rash - small red applies on outer edge
Rash concentrated in skin folds - between buttocks and under cheeks
When should you refer nappy rash?
Broken skin Severe nappy rash Yellow crust/weeping Other body areas affected OTC failure > 1 week
What is used for OTC nappy rash?
Barrier preparations
Clotrimazole - canesten antifungal
Miconazole - daktarin
Apply for 7 days after clearing to prevent it returning
What is the advice for nappy rash?
Change nappies as soon as soiled or wet
Leave nappy off to allow skin to air dry
Avoid waterproof nappies as worsens skin rash
Wash nappy area thoroughly with water or wipes
What are the symptoms of oral thrush in children?
Common in babies
White patches on tongue and mucosal surfaces inside mouth
When do you refer oral thrush?
All except babies
Recurrent infection
OTC failure > 1 week
How do you treat oral thrush OTC?
Daktarin oral gel - 4 months +
Apply QDS after meals
Continue for at least 1 week after symptoms disappear
What is the interaction between miconazole and warfarin?
Bleeding
What is the advice for oral thrush?
Use spacer and rinse mouth when using high dose ICS
Treat nappy rash if also present
Sterilise bottle teats
If breastfeeding apply miconazole cream to nipple and wipe away before feed
What are the symptoms of slapped cheek?
Bright red rash on cheeks
Light pink, lace like, itchy rash on trunk and limbs
Initial cold like symptoms
Most contagious period
When do you refer slapped cheek?
Pregnant women
Blood disorders
Symptoms of severe anaemia
What is used OTC for slapped cheek?
Paracetamol or ibuprofen
Antihistamines
What is the advice for slapped cheek?
Rest and plenty of fluids
Once rash appears it is no longer contagious
What are the symptoms of whooping cough?
Runny nose, watery eyes, sore throat, slight fever
Whooping cough
What is used OTC for whooping cough?
Fever - paracetamol or ibuprofen
What is the advice for whooping cough?
Stay away from school 5 days after starting antibiotics or 3 weeks after coughing started
Cover child’s mouth and nose with a tissue when coughing/sneezing
What are the symptoms of chicken pox?
Small red spots, very itchy and infectious blisters
First chest or face
Up to three days before - fever, headache, sore throat, myalgia, malaise
What do you use to treat chicken pox otc?
Itching - calamine, crotamiton, chlorphenamine (1+)
Fever - paracetamol, avoid ibuprofen
What is the advice for chicken pox?
Do not scratch lesions
Very contagious until lesions have crusted over
What are the symptoms of a fever in children?
High temperature above 38
Normal is 37
High grade is > 39
Feel hotter than usual
Sweaty and clammy
Flushed cheeks
When do you refer a fever in children?
< 3 months and > 38
3-6 months and > 39
> 24 hours in 3-6 months
72 hours in > 6 months
Dehydration
Febrile convulsions
Floppiness, drowsiness, persistent vomiting, rash, seizures
What is used OTC to treat fever in children?
Paracetamol 120/5mg 2 months+ over 4 kg
Ibuprofen 100mg/5ml 3 months + over 5kg
What are the doses for paracetamol in children?
3-6 months - 2.5ml
6-24 months - 5 ml
2-4 years - 7.5 ml
4-6 years - 10ml
Of 120mg/5ml suspension
QDS
Post immunisation - 2,3,4 months 2.5ml up to QDS
Meningitis B - 2.5 ml, then 2.5ml after 4-6 hours, then 2.5ml after 4-6 hours (unlicensed)
What are the doses for ibuprofen in children?
3-6 months - 2.5 ml 6-12 months - 2.5 ml TDS/QDS 1-3 years - 5 ml 4-6 years - 7.5 ml 7-9 years - 10 ml
TDS
Post immunisation - 2,3 months - 2.5 ml then further 2.5 ml if required
100mg/5ml
What are the symptoms of impetigo?
Golden crust lesions
Non-bullous - small red sores around nose and mouth, blisters and burst, can be itchy but otherwise asymptomatic
Bullous - neonates, fluid filled blisters on trunk or arms, spreads before bursting, painful and itchy, fever and swollen lymph glands
When do you refer impetigo?
All cases
Need antibiotics
Topical fusidic acid cream for mild cases in small area
Oral Flucloxacillin if severe or widespread
What is used to treat impetigo?
Paracetamol if required
What is the advice for impetigo?
Contagious - stay away from school until rash clears
Hygiene - do not share towels or tough lesions, do not scratch
What are the symptoms of scarlet fever?
Pink-red, itchy sandpaper rash
Sore throat, headache, high temperature, flushed cheeks, strawberry tongue
When do you refer scarlet fever?
Requires antibiotic
Amoxicillin for 10 days
What is the OTC product for scarlet fever?
Paracetamol
Antihistamines/calamine
What is the advice for scarlet fever?
Very contagious
Keep children off for at least 24 hours after starting antibiotics
Avoid sharing towels, clothes, bed linen, cups
Cover mouth when sneezing and coughing
