Childhood Conditions Flashcards
When does teething start + general symptoms?
between 4-12 months
*mild & localised
*pain
*increased biting
*chewing
*dribbling
*gum-rubbing
*sucking
*irritability
*wakefullness
*ear-rubbing
*decreased appetite and disturbed sleep
*red and swollen gums + flushed cheeks or face
When to refer to a GP for teething?
*raised temperature above 38℃
*any changes in passage of stool (teething should not cause diarrhoea)
*infant in distress or systematically unwell
What are the treatment options for teething?
*paracetamol 120mg in 5ml sugar free oral suspension
*ibuprofen 100mg in 5ml sugar free oral suspension
both 100ml pack size
ONLY USE IF SELF CARE METHODS DONT WORK AND CHILDREN MUST BE OVER 3 MONTHS OLD!!
What is some advice for parents of teething children?
*never tie a teething ring around infants neck (may cause choking)
*teething biscuits and rusks not recommended bc sugar can cause tooth decay
*avoid objects that can easily be broken into pieces (choking hazard)
*cool sugar free drinks can help soothe gums
*DO NOT give oral gels containing salicylates to children under 16.
What are the common symptoms of threadworms?
*common in children
*itching around anus
* worms may be visible in stool
* treat if eggs or worms seen
What measures must be taken once threadworms is confirmed?
*treat all household members
*hygiene measures alone undertaken for 6 weeks
* or mebendazole and hygiene measures undertaken for 2 weeks
*hygiene measures alone is the only option for children under 6 months +preferred option for pregnant or breastfeeding women
What are the treatment options for threadworms?
*mebendazole (vermox) 100mg/5ml suspension (30ml pack size) ↑ONLY if person over 6 months + use in children under 2 years is off label ↓
*mebendazole (vermox) 100mg chewable tablets (6 tablet pack size)
What is some advice given to parents/ patients for threadworms?
*discourage nail biting and finger sucking + keep fingernails short
*avoid use of public toilets
*keep toothbrushes in a closed cupboard + rinse thoroughly before use
* don’t eat food in the bedroom
*avoid shaking any material that may be contaminated with eggs (clothes, bedding)
*wash all sleep ware + thoroughly vacuum.
What is infantile colic?
*self limiting condition which usually starts in the first few weeks of life, improves by 3-4 months and resolves by 5-6 months
What are the symptoms of infantile colic?
*crying that often occurs in the late afternoon or evening
*drawing knees up to abdomen or arching back when crying
*fist clenching/ going red in the face/passing flatus
When to refer an infant with colic?
*infants who aren’t thriving and have symptoms that aren’t improving
*symptoms that aren’t improved after 4 months
*parents feels unable to cope despite reassurance and advice
*diagnostic uncertainty
What medications are NOT recommended for infant colic?
*simeticone or lactase
*probiotic or herbal supplements
*maternal diet modification if breastfeeding or changing the infant milk formula preparation
*manipulative strategies such as spinal manipulation or cranial osteopathy
When to refer to GP for headlice?
*scalp inflammation or signs of infection
*infestation persisting after treatment with all appropriate methods
*under 6 months of age
*diagnositc uncertainty
What are the treatments + condition to treatment?
*must see live louse before you treat
*wet combing 38% and 52% at days 14-15
*physical insecticides 70% effective
*chemical insecticides malathion 0.5% aqueous liquid (derbac-M) only recommend in UK.
What are some 1st line treatment options for head lice?
*all wet combing options
(nit comb, nitty gritty, nit comb-S1 or M2, portia)
*physical insecticides e.g dimeticone 4% lotion/spray + gel
hedrin lotion/spray gel
What are some 2nd line treatments for head lice?
*physical insecticides e.g dimeticone 92% spray with comb
isopropyl alcohol/benzyl mousse 1.5%
ispropyl myristate and cyclomethicone solution
*all chemical insecticides
-malathion 0.5% aqueous liquid
What is a nappy rash? + features
*irritant contact dermatitis
-irritants such as urine, faeces + faecal enzymes lead to breakdown of skin
features:
*red patches on bottom, possibly entire area
*skin that looks sore and is hot to the touch
*spots,pimples or blisters
When to refer to the GP for nappy rash?
*severe soreness/redness with or without bacterial infection
*punched out ulcers or erosions with elevated borders
*smooth, red moist papule or nodules in nappy area
*asymptomatic cherry red 0.5-4cm plaques and nodules
*baby systematically unwell
*diagnostics uncertainty
What are the treatment options for nappy rash?
*babies over 1 month old can be treated with hydrocortisone 1% cream applied once daily for 7 days
*zinc and castor oil ointment or cream (500g or 225g GSL)
*white soft paraffin (500g GSL)
second line treatment:
*hydrocortisone 1% cream POM (15g)
3rd line treatment:
*clotrimazole 1% cream
P (20g)
What are the symptoms or possible complication to oral thrush?
*chronic pain or discomfort
*impaired speech and or chewing
*immunocompromised people may develop oesophageal candidiasis, causing painful or difficult swallowing, this can lead to systemic candidiasis
When to refer someone with oral thrush to GP?
*babies under 4 weeks old
*symptoms not resolved after 7 days of treatment
*difficulty swallowing from pain
*pregnancy or breastfeeding
*extensive,severe infection, or systematically unwell
*no obvious risk factor
*possible severe immunocompromised (due to chemo or HIV)
What are the treatment options for oral thrush?
1st line:
miconazole 20mg/g oromucosal gel sugar free POM (80g pack size)
2nd line:
nystatin oral suspension 100,000 units/ml POM (30ml pack size)
What is advice for parents for oral thrush?
*try and make sure treatment is in mouth for as long as possible - avoid swallowing immediately
*administer after meals
*maintain good dental and denture hygiene
*RISK OF ORAL THRUSH from poor inhaler techniques!!
