Common paediatric problems Flashcards
what is different about and infants larynx and epiglottis
higher anterior larynx and floppy epiglottis
what are normal RR and HR for a child under 1
HR: 110-160 RR: 30-40
when does a childs obs become adult obs
12
what are common child presentations (13)
bronchiolotis/ URTI/ croup, gastroenteritis, seizures/ epilepsy, pneumonia, food allergy, heart murmur, abnormalities, asthma, viral, head injury, abdo pain, UTI, sepsis
what is bronchiolitis and how do you manage it
acute inflamm of bronchioles usually from virus - supportive treatment
what is croup and how do you manage it
laryngotracheobronchitis from viral infections - steroids
what are symptoms of croup
barking cough, cold symptoms, heavy breathing
what are concerning features of UTI in children (8)
young, frequent, non Ecoli, poor growth/ health, poor urinary flow, raised BP, renal tract abnormalities, abdo mass
what is constipation
pain, difficulty or delayed defaecation
what is soiling and encopresis
soiling is stool in underwear, encopresis is passage of stool in abnormal places (past toilet training age)
what are rare underlying causes of constipation
Hirschprung’s, anorectal disorder, neuromuscular
what is a red flag in neonates regarding constipations
delayed passage of first stool (meconium) >24 hours after birth
what is Hirschsprung’s disease
congenital abnormality with improper innervation of large intestine
what are symptoms of Hirschsprung’s disease
failure to pass stool in first 48 hours, abdo distension, bile stained vomit
how do you treat Hirschsprung’s disease
fix surgically
what are differentials of abdo pain in a child
coeliac, IBD, malrotation, volvus, obstruction, intussception, appendicitis
what are concerning features of abdo pain in a child
weight loss, GI bleeding, significant vomit with bile, severe diarrhoea, recurrent mouth ulcers
what are red flags regarding headaches
on walking, coughing, vomiting, gait disturbance, cranial nerve palsy
what are cardiac red flags
during exercise, FH of sudden death, syncope, murmur, SOB/ pale/ sweaty, congenital heart disease
what are symptoms of sepsis
core temp <36 or >38, tachycardia, altered mental state, cool peripheries
what are the sepsis 6
GIVE: O2, fluids, IV ab’s
TAKE: lactate levels, UO, blood culture
what is a classic presentation of pyloric stenosis
6 week old vomiting milk (bumps on abdomen that move with peristalsis)
what is pyloric stenosis
pyloric muscle too thick causing upper GI obstruction
how do you fix pyloric stenosis surgically
small incision in muscle
if an neonate is vomiting green bile what is it assumed to be until proven otherwise
malrotation or volvulus
what are symptoms of intussusception
pain that comes and goes in abdo, ‘red jelly’ stool, vomiting.
what is seen on USS in intussusception
target lesion USS and pseudo kidney
how do you treat intussusception
blow air through bowel via anus
what are symptoms of appendicitis
very tender to movement, fever, RIF pain
how do you identify appendicitis
USS
when presenting with acute scrotum, what should you want to exclude first
tortured scrotum
what is the main cause of an acute scrotum in children
hydatid of morgagni
what are symptoms of hydatid of morgagni
BLUE DOT, small, tortured, necrotic tissue from leftover female development
what are symptoms of idiopathic scrotal oedema
red, swollen, extends to peritoneum and upper groin
how do you treat undescended testes
palpable = surgery to move it down unpalpable = lap surgery to find it
what test is done to identify and undescended teste
soap bubble test
what is paraphimosis and how do you treat it
foreskin can’t be pulled back over penis - squeeze out oedema
what is BXO
scarring over foreskin opening
how do you treat BXO
steroids or circumcision
what is the most common congenital penile problem
hypospadias - urethra comes out at wrong place in penis
what is hydrocele
fluid accumulation around testes
