Common childhood conditions

Question 1

What can make a child particularly vulnerable to illness?

Answer 1

Prematurity 
Developmental problems 
Small for age 
Chronic illness
Social issues

Question 2

What red flags are indicative of bacterial meningitis?

Answer 2

Ill-looking child 
Neck stiffness
Bulging fontanelle 
Non-blanching purpuric rash 
Capillary refill >3 seconds 
Decreased level of consciousness 
Convulsive status epilepticus

Question 3

What red flags are indicative of pneumonia?

Answer 3

Crackles in chest
Tachypnoea (>60 breaths/ min up to 6 months, >50 breaths/ min up to 12 months and >40 breaths/ min over 12 months)
Nasal flaring
Chest recession (increased respiratory work/ use of accessory muscles)
Cyanosis
Oxygen sats <95%

Question 4

What signs are indicative of eczema?

Answer 4

Erythema 
Dry/ scaly skin 
Excoriated 
Thickened skin 
Weeping

Question 5

What is atopy?

Answer 5

Genetic tendency to develop allergic diseases such as eczema, asthma and hayfever. Typically associated with a heightened immune response to certain allergens.

Question 6

What signs are indicative of cradle cap?

Answer 6

Seborrheic dermatitis with a thick yellow crusting rash

Common in newborns

Question 7

What is neonatal milia?

Answer 7

Few to numerous lesions around nose and face
Tiny, white bumps
Heal spontaneously

Question 8

What signs are indicative of paronychia?

Answer 8

Erythema around nail
Nailbed swelling 
Pus 
Follows skin breaks (e.g. finger sucking or nail biting) 
Often staphylococcal - may need oral abx

Question 9

How do cardiovascular systems of children differ from adults?

Answer 9

Limited stroke volume - cardiac output is rate dependent

Question 10

How do renal systems of children differ from adults?

Answer 10

High vascular resistance and immature tubular function

Dehydration poorly tolerated

Question 11

How does liver function in children differ from adults?

Answer 11

Initially immature with poor processing of opioids (important in pain management)

Question 12

How does glucose metabolism differ in children compared to adults?

Answer 12

Hypoglycaemia common in stressed newborns - red flag

Question 13

How do respiratory systems of children differ from adults?

Answer 13

Less able to increase tidal volume - increase respiratory rate to compensate
Can lead to exhaustion - important in assessing severity of asthma attack!

Question 14

What findings must you record in an acute asthma attack?

Answer 14

Pulse 
Resp rate/ degree of breathlessness
Use of accessory muscles 
Wheeze
Degree of agitation/ consciousness