Childrens Health Flashcards
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Whats the best prognostic factor for children up to the age of 12?
Dad jokes…
What do you call someone with no body and no nose?
NO BODY KNOWS
Did you hear about the guy who invented the knock knock joke?
He won the “NO BELL” prize
Why do crabs never give to charity?
Because they are SHELLFISH
What age is defined as a Neonate?
Birth to 1 month
What age is defined as an infant?
1 month to 1 year
What signs are there of respiratory distress?
- Tracheal tug - Retraction of suprasternal notch - Inter or subcostal indrawing
A child comes in with a loud cough and difficulty breathing, what DD are there?
- Viral Croup - Epiglossitis - Foreign body aspiration - bacterial tracheitis
What does drooling indicate in a child?
Upper airway restriction, present in Epiglottitis and bacterial tracheitis
What is Croup?
Inflammation of the larynx and trachea by a viral cause
What is the most common pathogen for Croup?
Parainfleunza virus
What symptoms can occur in Croup?
Seal bark cough Stridor Acute SoB Corhzal symptoms
What cause of SoB is likely after seeing this?
Strawberry mark = Laryngeal capillary haemangioma
Grows from 12-24 months
When can Larngomalacia cause SoB/ obstruction?
From Birth
Why is Epiglottits becoming less common?
Due to Heamophilis influenza type B
This conditions can quickly lead to airway obstruction
What is the managment of Severe Croup?
Get help - airway managment
Neb. Adrenaline - 1/1000
Oral steroids
Reassure peraent, therefore pt. keeps calm
At what age deos the MMR vaccine start?
Vaccinaiton at 1 year old
What cause of diarrehoa is unlikely after 8 weeks?
Rota virus gastroenteritis due to vaccunation
At what age does the majority of vaccination causes start?
8 weeks
Diptheria
Tetanus
Pertussis
Polio
Heamophilis infeuza type B
Pneumoccal
Mennigoccocal
Ratovirus
How old is this child?
Understands No
Makes simple sounds - “mama” “dada”
Aware of strangers
Plays peeker boo
> 8 weeks if reached development miles stones
How old is this child?
Has simple conversations
Copies others
Takes turns
> 3 years according to developemental milestones
How old is this child?
Smiles
Turns head to sound
Can track objects
Gurgling sound
> 2 months according to developemental milestones
What is Kussaul breathing and what can it indicate?
A form of hyperventilation by long, deep breaths. This increases blow of CO2
Indicates acidosis like that of DKA
Causes of large heart size on peadiatric CXR?
Large L to R chunt
VSD
PDA
Causes of small heart size on peadiatric CXR?
Fallots tetralogy
What does Plethoric mean for lungs in a CXR?
Too much blood going to the lungs leading to increased contrast on lungs.
Cause by L to R shunts, CCF, VSD, PDA
What does Oligaemic mean for lungs in a CXR?
Less blood going to the lungs and therefore lungs are blacker on CXR.
Fallot’s tertralogy
Pulmonary stenosis
What congenital heart conditions cause systolic mumurs?
Fallots tetralogy
VSD
truncus arteriosus
Why are postroglandins used in heart condistions?
Maintain patent the ductus arteriosus. Closure of the duct can be assisted with NSAIDS
What conditions has a “continous cresendo-decresendo machinary mumur?
Patent duct arteriosus
What septal defect has a pansystolic mumur?
Ventral septal defect
What symptoms and sign may a child with cardiac failure have?
SOB, Tachycardia
Poor feeding
Hepatomegaly
Acidosis
Sweating
Management of cardiac failure in children
Diuretics
ACEi
O2
Prostin
Inotropes
What signs are there of respirtory distress in baby?
Nasal flaring
Tachypnoea
Gruniting
Mild head bobbing
Intercostal breathing
Subcostal indrawing
Which conditions are asynotic congential heart diseaes?
Septal defects - VSD, ASD
Coarctation
PDA
Valvular disease
That signs may a baby with coarctation of the aorta have?
Upper limb pulses > lower limb pulse
Associated VSD and bicuspid aortic valve
What conditison are cyanotic CHD?
Fallots tetralogy
Transposition of the greater arteries
What is the clinical presentation of Fallot’s tetralogy?
Central cyanosis
Pulmonary oligaemia on CXR
Hypercyanotic episodes (tet spells) Ejection systolic mumur -PS
What heart conditions are associated with T21?
AV septal defects
What does the heal prick test for?
Metabolic conditions
Sickle cell, hypothyroidism, CF and more…
Which heart condition should we not give high concentrations of O2 to?
Patent ductus arteriosus
Maintain duct with prostin infusion
What is Harrison’s sulcus?
in-drawing of the ribs dring inspiration, indicates chornic respiratory condition or week bones
What investigation to consider with reccurent LRTI?
sweat chloride test - CF
Measurement of serum immunoglobulins - Vaccines responce, ?HIV
CT of chest
When should a metered dose inhaler be used?
> 12yo with obvious no coordination problems effecting use of MDI
A newborn has abdominal distension and vominting. Strong FH for CF. What is the likely diagnosis?
Meconium ileus
Testing for CF doesnt occr until 10d
What injuries occur in shaken baby syndrome?
subdural haemorrhage
Retinal bleeding
Hypoxaemic encephalopathy
What differentials to consider with muiltiple bruises?
NAI
Leukaemia
Aplastic anaemia
Child risk factors for abuse?
younger age
increased needs - disability
low birth weight
muitliple births
Parental risk factors for chuld abuse?
Younger parental age
mental illnes
substance abuse
lower social-economic group
Parents experince child abuse
What features of fractures are consistent with NAI?
metphyseal fractures
posterior rib
complex skull fractures
long bone fractures
What features of bruising are consistent with NAI?
Face, buttock, back
Outline of objects
Patern of fingers etc.
What burns would indicate NAI?
Glove-stockng distribution
Uniform shape - circular for cigarette burns
What should be done if there is a child protection concern?
Refer to social services
What bruises are not NAI?
Immune thrombocytopenia
Meningococcal rash
Henoch scholein purpura
Mongolion blue spot
Is this NAI?
No, this is simply a mongolion blue spot
What NAI can cause fractures?
acidental injury
oesteogenesis imperfecta (rare)
Vit C/D copper deficiency
Connective tissue disorders
JOBs syndrome
What red flags are there with peadiatric abdo pain?
poor growth
symptoms regularly waking child
<5yo
Weight loss
Blood in stools
What test is there for coelaics screen
IgA anti-tissue transglutaminase
6w of increased stool frequency ,pale bulky stools, wieght loss, fratique and pallor. FBC shows microcytic aneamia.
A classical history of coeliacs disease. Therefore TTG antibodies
DD for rapid weight loss in adolescent?
Cealiacs
T1 DM
Hyperthyroidism
Mailgnancy
Anorexia Nervosum
IBD
What is lanugo hair?
Soft body hair like that in babies.
Can indicate poor nutrition from loss of fat tissue, like that of anorexia nervosa
What is the acute treatment of anorexia nervosa?
muiltivitamines inc. vit B
increase 0.5-1kg/week
Monitor bloods
Regular ECG