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My Final Year 4 Revision > Childrens Health > Flashcards

Childrens Health Flashcards

Yo

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1
Q

Whats the best prognostic factor for children up to the age of 12?

A

Dad jokes…

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2
Q

What do you call someone with no body and no nose?

A

NO BODY KNOWS

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3
Q

Did you hear about the guy who invented the knock knock joke?

A

He won the “NO BELL” prize

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4
Q

Why do crabs never give to charity?

A

Because they are SHELLFISH

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5
Q

What age is defined as a Neonate?

A

Birth to 1 month

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6
Q

What age is defined as an infant?

A

1 month to 1 year

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7
Q

What signs are there of respiratory distress?

A
  • Tracheal tug - Retraction of suprasternal notch - Inter or subcostal indrawing
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8
Q

A child comes in with a loud cough and difficulty breathing, what DD are there?

A
  • Viral Croup - Epiglossitis - Foreign body aspiration - bacterial tracheitis
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9
Q

What does drooling indicate in a child?

A

Upper airway restriction, present in Epiglottitis and bacterial tracheitis

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10
Q

What is Croup?

A

Inflammation of the larynx and trachea by a viral cause

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11
Q

What is the most common pathogen for Croup?

A

Parainfleunza virus

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12
Q

What symptoms can occur in Croup?

A

Seal bark cough Stridor Acute SoB Corhzal symptoms

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13
Q

What cause of SoB is likely after seeing this?

A

Strawberry mark = Laryngeal capillary haemangioma

Grows from 12-24 months

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14
Q

When can Larngomalacia cause SoB/ obstruction?

A

From Birth

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15
Q

Why is Epiglottits becoming less common?

A

Due to Heamophilis influenza type B

This conditions can quickly lead to airway obstruction

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16
Q

What is the managment of Severe Croup?

A

Get help - airway managment

Neb. Adrenaline - 1/1000

Oral steroids

Reassure peraent, therefore pt. keeps calm

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17
Q

At what age deos the MMR vaccine start?

A

Vaccinaiton at 1 year old

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18
Q

What cause of diarrehoa is unlikely after 8 weeks?

A

Rota virus gastroenteritis due to vaccunation

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19
Q

At what age does the majority of vaccination causes start?

A

8 weeks

Diptheria

Tetanus

Pertussis

Polio

Heamophilis infeuza type B

Pneumoccal

Mennigoccocal

Ratovirus

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20
Q

How old is this child?

Understands No

Makes simple sounds - “mama” “dada”

Aware of strangers

Plays peeker boo

A

> 8 weeks if reached development miles stones

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21
Q

How old is this child?

Has simple conversations

Copies others

Takes turns

A

> 3 years according to developemental milestones

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22
Q

How old is this child?

Smiles

Turns head to sound

Can track objects

Gurgling sound

A

> 2 months according to developemental milestones

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23
Q

What is Kussaul breathing and what can it indicate?

A

A form of hyperventilation by long, deep breaths. This increases blow of CO2

Indicates acidosis like that of DKA

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24
Q

Causes of large heart size on peadiatric CXR?

A

Large L to R chunt

VSD

PDA

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25
Q

Causes of small heart size on peadiatric CXR?

A

Fallots tetralogy

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26
Q

What does Plethoric mean for lungs in a CXR?

A

Too much blood going to the lungs leading to increased contrast on lungs.

Cause by L to R shunts, CCF, VSD, PDA

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27
Q

What does Oligaemic mean for lungs in a CXR?

A

Less blood going to the lungs and therefore lungs are blacker on CXR.

Fallot’s tertralogy

Pulmonary stenosis

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28
Q

What congenital heart conditions cause systolic mumurs?

A

Fallots tetralogy

VSD

truncus arteriosus

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29
Q

Why are postroglandins used in heart condistions?

A

Maintain patent the ductus arteriosus. Closure of the duct can be assisted with NSAIDS

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30
Q

What conditions has a “continous cresendo-decresendo machinary mumur?

A

Patent duct arteriosus

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31
Q

What septal defect has a pansystolic mumur?

A

Ventral septal defect

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32
Q

What symptoms and sign may a child with cardiac failure have?

A

SOB, Tachycardia

Poor feeding

Hepatomegaly

Acidosis

Sweating

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33
Q

Management of cardiac failure in children

A

Diuretics

ACEi

O2

Prostin

Inotropes

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34
Q

What signs are there of respirtory distress in baby?

A

Nasal flaring

Tachypnoea

Gruniting

Mild head bobbing

Intercostal breathing

Subcostal indrawing

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35
Q

Which conditions are asynotic congential heart diseaes?

A

Septal defects - VSD, ASD

Coarctation

PDA

Valvular disease

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36
Q

That signs may a baby with coarctation of the aorta have?

A

Upper limb pulses > lower limb pulse

Associated VSD and bicuspid aortic valve

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37
Q

What conditison are cyanotic CHD?

A

Fallots tetralogy

Transposition of the greater arteries

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38
Q

What is the clinical presentation of Fallot’s tetralogy?

A

Central cyanosis

Pulmonary oligaemia on CXR

Hypercyanotic episodes (tet spells) 
Ejection systolic mumur -PS
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39
Q

What heart conditions are associated with T21?

A

AV septal defects

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40
Q

What does the heal prick test for?

A

Metabolic conditions

Sickle cell, hypothyroidism, CF and more…

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41
Q

Which heart condition should we not give high concentrations of O2 to?

A

Patent ductus arteriosus

Maintain duct with prostin infusion

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42
Q

What is Harrison’s sulcus?

A

in-drawing of the ribs dring inspiration, indicates chornic respiratory condition or week bones

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43
Q

What investigation to consider with reccurent LRTI?

A

sweat chloride test - CF
Measurement of serum immunoglobulins - Vaccines responce, ?HIV

CT of chest

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44
Q

When should a metered dose inhaler be used?

A

> 12yo with obvious no coordination problems effecting use of MDI

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45
Q

A newborn has abdominal distension and vominting. Strong FH for CF. What is the likely diagnosis?

A

Meconium ileus

Testing for CF doesnt occr until 10d

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46
Q

What injuries occur in shaken baby syndrome?

A

subdural haemorrhage

Retinal bleeding

Hypoxaemic encephalopathy

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47
Q

What differentials to consider with muiltiple bruises?

A

NAI

Leukaemia

Aplastic anaemia

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48
Q

Child risk factors for abuse?

A

younger age

increased needs - disability

low birth weight

muitliple births

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49
Q

Parental risk factors for chuld abuse?

A

Younger parental age

mental illnes

substance abuse

lower social-economic group

Parents experince child abuse

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50
Q

What features of fractures are consistent with NAI?

A

metphyseal fractures

posterior rib

complex skull fractures

long bone fractures

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51
Q

What features of bruising are consistent with NAI?

A

Face, buttock, back

Outline of objects

Patern of fingers etc.

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52
Q

What burns would indicate NAI?

A

Glove-stockng distribution

Uniform shape - circular for cigarette burns

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53
Q

What should be done if there is a child protection concern?

A

Refer to social services

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54
Q

What bruises are not NAI?

A

Immune thrombocytopenia

Meningococcal rash

Henoch scholein purpura

Mongolion blue spot

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55
Q

Is this NAI?

A

No, this is simply a mongolion blue spot

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56
Q

What NAI can cause fractures?

A

acidental injury

oesteogenesis imperfecta (rare)

Vit C/D copper deficiency

Connective tissue disorders

JOBs syndrome

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57
Q

What red flags are there with peadiatric abdo pain?

A

poor growth

symptoms regularly waking child

<5yo

Weight loss

Blood in stools

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58
Q

What test is there for coelaics screen

A

IgA anti-tissue transglutaminase

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59
Q

6w of increased stool frequency ,pale bulky stools, wieght loss, fratique and pallor. FBC shows microcytic aneamia.

A

A classical history of coeliacs disease. Therefore TTG antibodies

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60
Q

DD for rapid weight loss in adolescent?

A

Cealiacs

T1 DM

Hyperthyroidism

Mailgnancy

Anorexia Nervosum

IBD

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61
Q

What is lanugo hair?

A

Soft body hair like that in babies.

Can indicate poor nutrition from loss of fat tissue, like that of anorexia nervosa

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62
Q

What is the acute treatment of anorexia nervosa?

A

muiltivitamines inc. vit B

increase 0.5-1kg/week

Monitor bloods

Regular ECG

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63
Q

A patient with Anorexia has refugular blood monitoring. Her phosphate drops. What does the indicate?

A

A fall in phosphate can indicate refeeding syndrome

64
Q

What types of eatng disorders are there?

A

Anorexia Nervosa

Bulimia Nervosa

EDNOS - easting disorder not otherwise specified

65
Q

What features of a history are more typical of Bulimia nervosa?

A

Bing eating followed by vomiting

Self harm

Normal wieght, unlike AN

66
Q

What common conditions are accompanied with eating disorders?

A

OCD

Depression

67
Q

What is used instead of BMI for grownig, young people?

A

Weight-height ratio

68
Q

What common causes of death are there for anorexia nervosa?

A

Refeeding syndrome - Sudden cardiac death

Suicide

69
Q

Features of bulimia nervosa?

A

gastric acid –> dental erosion, callouses on fingers

Parotid enlargement

Normal wieght

70
Q

What is found on blood test for anorexia nervosa?

WCC

ALT
Phosphate

BMs

Cortisol

A

WCC, ALT, Phosphate and BMs are normally low

Cortisol (stress) can be high

71
Q

What features of dehrydration are there in an infant?

A

Sunken fontanelle and eyes

Dry mucous membrane

Tachycardia

Redeuced CRT, skin turgor

Weight loss

72
Q

Common cause of gastritis in the UK?

A

Rota virus

Adeno cirus

73
Q

What organisms can cause blood in stools?

A

Shigella

E coli 0157

Rota virus

Campylobacter
(also thing intersusspection)

74
Q

1yo with history of paroxysmal, severe colicky pain. Child draws legs up. There is vominting and red current jelly stools. MLD?

A

Intussesception

75
Q

What cuases red current jelly stools in intussesception?

A

Mucus and blood

76
Q

Red flags in vomiting?

A

Bulgind frontanelle

Bile, blood in vomit

Abdo pain and distention

Blood in stools

Projectile vomit

77
Q

What is the most likely diagnosis for vomiting with paroxysmal cough?

A

Wooping cough

78
Q

At what age can solid foods be introduced?

A

6 months of age

79
Q

Synmptoms of hyper natraemia?

A

Jittery movements

Increased muscle tone

Hyperreflexia

Convulsions

Drowsiness or coma

80
Q

Symptoms of hyponatraemia?

A

Weakness

fatigue

headache

confusion

Nausea and vomiting

81
Q

What organisms can cause infective diarrehoa by a secretory mechaism?

A

Cholera

Ecoli

C diff

82
Q

What organisms can cause infective diarrhoea via a mucosal invasiion mechanism?

A

Campylobacter

Rota virus

Salmonella

shigealla

Therefore they cause blood and WCC in stools

83
Q

Which organisms which cuase diarrhoea are notifiable?

A

Cholera

Giardia

Salmonella

Camplylobacter

(this in not exhaustive)

84
Q

What organisms can cause Haemolytic Ureamic syndrome?

A

E coli 0169

Heamolysis and renal failure can occur

LDH raised in heamolysis

85
Q

What does the picture?

A

Intussusception

diagnose from USS

Draw this picture in OSCE

86
Q
A
87
Q

Immunisations 8 weeks

A

6 in 1 - diphtheria, tetanus, polio, whooping cough, haem influenza, hep BPneumococcal Meningococcal group BRotavirus

88
Q

Immunisations 12 weeks

A

6 in 1 - diphtheria, tetanus, polio, whooping cough, haem influenza, hep BRotavirus

89
Q

Week 16 immunisations

A

6 in 1 - diphtheria, tetanus, polio, whooping cough (pertussis), haem influenza, hep BPneumococcal Meningococcal group B

90
Q

Immunisations 1 year old

A

Haemophilia influenza, meningococcal group CPneumococcal Measles, mumps, rubella Meningococcal group B

91
Q

Immunisations 3 years and 4 months

A

4 in 1 - diphtheria, tetanus, polio, pertussis Measles, mumps, rubella MMR

92
Q

Girls age 12-13 immunisations

A

HPV 16 and 18 ( and 6 and 11- genital warts )2 doses given 6-24 months apart

93
Q

14 year old immunisations

A

3 in 1 - diphtheria, tetanus, polio Meningococcal groups A, C, W, and Y

94
Q

Immunisations aged 65

A

Pneumococcal And influenza annually

95
Q

70 year old immunisations

A

Shingles

96
Q

2 months developmental milestones - language/comms

A

Coos and gurgling soundsTurns head towards sound

97
Q

8 months developmental milestones - language/comms

A

understands nomama/dada sounds

98
Q

18 months developmental milestones - language/comms

A

says 10 words says no and shakes head

99
Q

3 years developmental milestones - language/comms

A

understands words such as in/on/under carries a convo with 2-3 sentences

100
Q

2 months developmental milestones - social/emotional

A

begin to smile at peopletries to look at parentssucks on hand to sooth

101
Q

8 months developmental milestones - social/emotional

A

stranger awareness has favourite toy

102
Q

18 months developmental milestones - social/emotional

A

temper tantrums points at something interesting

103
Q

3 years developmental milestones - social/emotional

A

shows concern if friend cryingtakes turns in games copies adults and friends

104
Q

2 months developmental milestones - cognitive/fine motor

A

begins to follow things with eyes begins to act bored

105
Q

8 months developmental milestones - cognitive/fine motor

A

transfers from one hand to the other picks up cereal with thumb and index finger plays peak a boo

106
Q

18 months developmental milestones - cognitive/fine motor

A

scribbles on own follows 1 step verbal commands

107
Q

3 years developmental milestones - cognitive/fine motor

A

copies a circle with a pencil does jig saw 3-4 pieces

108
Q

normal obs <4 month old

A

RR 30-39HR 110-159 Systolic BP 50-59

109
Q

normal obs 4 month old - 2 years

A

RR 25-34 HR 100-149Systolic BP 60-69

110
Q

Normal Obs 2-5 years

A

RR 20-29 HR 80-119 systolic BP 70-84

111
Q

normal obs 5-12 year old

A

RR 20-29 HR 70-119 Systolic BP 80-89

112
Q

Normal obs >12 year old

A

RR 15-24HR 65-99 Systolic BP 85-89

113
Q

neonatal heel prick tests for…

A

sickle cell cystic fibrosishypothyroidism isovalaric acidaemiaphenylketonuria homocystinuria (HCU)MCAD deficiency

114
Q

in a tachycardia/pnoe baby always check

A

gases glucose ammonia to look for primary cardiac or respiratory failure

115
Q

ivacaftor and lumacaftor

A

personalised treatments for delta F508 CFTR mutations. helps to get the channel to the cell membrane and enables it to work better

116
Q

mesalazine

A

5-ASA analogue used first line in ulcerative collitis

117
Q

tacrolimus

A

immunosuppresive drug used mainly to prevent organ rejection after a transplant. also used 3rd line in ulcerative colitis

118
Q

nonblanching rash- ill child- neck stiffness- fever

A

meningococcal disease

119
Q

neck stiffness, bulging fontanella, decreased consciousness, fever

A

bacterial meningitis

120
Q

focal neuro signsdecreased level of consciousnessfocal seizuresfever

A

encephalitis

121
Q

fever, bilateral conjunctival injection, change in mucous membrane, change in extremities, polymorphous rash, cervical lymphadenopathy

A

kawasaki disease

122
Q

fever, irritability, dyspnoea, dysphonia, drooling saliva

A

epiglottitis, h. influenzae type B

123
Q

if think child abuse

A

do child protection medical assessment. By social services. Hx and exam, growth chart, obs, body map, photos. Child must be questioned away from parents or carers

124
Q

Risk of rapid weight loss eg anorexia

A

refeeding syndrome, hypoglycaemia, risk of infection, cardiac arrhythmias

125
Q

differentials of rapid weight loss

A

coeliac diseaseT1DMhyperthyroidismmalignancyanorexiaIBDdepression

126
Q

treating eating disorder

A

admit to stabilise physically, start vitamins, regular obs, monitor bloods, contact local eating disorder team. diet plan, IV fluids if needed.

127
Q

diarrhoea in infant

A

usually rotavirus. could be adenovirus.

128
Q

paroxysmal severe colicky pain, pallor ,red currant jelly stool.

A

intussusception

129
Q

red flags associated with vomiting

A

blood, bile, abdo tenderness and distention, blood in stool, bulging fontanelle

130
Q

treatment for campylobacter

A

erythromycin

131
Q

c. diff treatment

A

metronidazole or vancomycin

132
Q

haemolytic anaemia, AKI, low platelet count

A

haemuolytic uraemic syndrome. usually preceded by infection

133
Q

barking cough

A

croup

134
Q

treatment of croup

A

consider admissionoxygenoral dexamethasoneparacetamol

135
Q

hypotension. bronchoconstriction or airway compromise in setting of allergy

A

anaphylaxis

136
Q

breathless baby esp when feeding

A

heart failure

137
Q

high chloride in sweat test

A

cystic fibrosis. sweat test is gold standard

138
Q

most common features of CF

A

chronic resp infection, malabsorption or failure to thrive, prolonged diarrhoea, infertility, meconium ileus,

139
Q

differentials of abdo pain in children

A

gastroenteritis, HSP, UTI, IBD, acute appendicitis, DKA, poisoning , intussusception, meckel’s diverticulum, abdominal migraines

140
Q

treatment for meningitis in children

A

ceftriaxone and if under 3 months give with amoxicillin to cover listeria

141
Q

UTI in children

A

need to do renal ultrasound scan, micturating urogram, DMSA to detect any structural abnormalities

142
Q

non blanching rash on legs and buttocksswollen and painful jointschild wellno hepatosplenomegaly or lymphadenopathy

A

HSP

143
Q

non blanching rash, pallor, lymphadenopathy, hepatosplenomegaly,

A

ALL

144
Q

white reflex in eyes

A

retinoblastoma or congenital cataracts

145
Q

lump in abdo. blood in urine

A

wilms tumour. nephroblastoma

146
Q

Seizure treatment

A

lorazepam x2phenytoin

147
Q

causes of delayed walking

A

global developmental delays, spina bifida, duchenne muscular dystrophy, developmental dysplasia of the hip, cerebral palsy, rickets

148
Q

not sitting or walking by 18 months, floppy, weak arms and legs, speaking problems, scissoring of legs, high tone.

A

cerebral palsy- ask about infections in pregnancy, difficult birth, head injury, meningitis

149
Q

treatment of cerebral palsy

A

physio, sspeech therpay, OT, medications for muscle stiffness

150
Q

progressive muscle weakness, loss of walking, scoliosis, resp weakness

A

Duchenne muscular dystrophy

151
Q

treatment of duchenne muscular dystrophy

A

steroids can slow progression of weakness but not a cure

152
Q

treatment of DKA

A

fluids, insulin. slowly correct

153
Q

what age does the anterior fontanelle close by

A

18-24 months

154
Q

positive kernigs sign

A

leg positioned with 90 degree flexed thigh and knee

subsequent extension of the knee is painful

due to meningitis or subarachnoid haemorrhaage

155
Q

positive brudzinskis sign

A

neck flexion leads to flexion of the thigh and knee

due to severe neck stiffness

sign of meningitis

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