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Year 3 Paeds > Core conditions > Flashcards

Core conditions Flashcards

1
Q

What is bronchiolitis

A

inflammation of the small airways

reduction in lumen size due to mucous hypersecretion, bronchospasm, inflammatory exudate

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2
Q

Is bronchiolitis largely bacterial, viral or fungal?

Which pathogen accounts for 80% of cases

90% of children affected are aged?

A

viral

RSV (respiratory syncitial virus)

1-9 months old

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3
Q

Clinical features of bronchiolitis

A
  • coryza initially
  • end-inspiratory crackles
  • dry cough
  • wheeze
  • breathing difficulties
  • recessions (intercostal, subcostal, sternal)
  • poor fedding
  • nasal flaring
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4
Q

how is bronciolitis diagnosed?

A

clinically

measure pulse oximetry

blood gas

CXR if concerned about respiratory failure

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5
Q

after how long does the severity of bronchiolitis peak?

under what conditions would you admit someone with bronchiolitis? (2)

A

3/4/5 days

admit if needing:

  1. breathing support
  2. feeding support
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6
Q

Describe the management of bronchiolitis

A

supportive

  1. humidified oxygen— 2L nasal canula
  2. CPAP (Continuous positive airway pressure) - if ventilation required
  3. Feeding support- NG feeds or Iv fluids
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7
Q

What is Croup

most commonly caused b y what kind of virus

What is the difference between croup and bronhiolitis

A

viral laryngotracheobronchiolitis

parainfluenza viruses (rhinovirus, RSV, influenza)

croup targets the upper respiratory tract while bronchiolitis targets the lower respiratory tract

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8
Q

what is the standard age range for croup

A

6 months to 6 years (peak age 2)

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9
Q

clinical featrues of croup

A

coryza and fever

hoarseness

barking cough (worse at night)

stridor

variable SOB

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10
Q

management of croup

A
  1. observe
  2. oral or nebularised steroids

for a seveere upper airway obstruction (nebularised adrenaline and oxygen)

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11
Q

Acute epiglotitis is caused by which pathogen?

what is epiglotitis?

Why is epiglotits an emergency?

A

epiglotitis is caused by H. Influenzae B

intense swelling of the epiglottis and sepsis

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12
Q

presentation of epiglotitis

incidence is reduced by 99% due to what

A
  1. high grade fever
  2. unwell looking child
  3. drooling
  4. no cough
  5. soft stridor

universal vaccination

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13
Q

Constipation what is it

A

infrequent passing of dry, hardened stool

associated with straining, pain or bleeding

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14
Q

what numbers does the bristol stool chart range

type 1 on the Bristol stool chart

describe a poo at the highest stage

A

1—->7

1= hard rabbit droppings

stage 7- wet like gravy

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15
Q

clinical features of constipation

management for constipation

A
  • infrequent bowel movements
  • straining
  • abdominal pain
  • loss of appetite

encourage fluids

encourage healthy, fibre rich diet

toileting routine

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16
Q

what are the 4 types of laxative

A
  1. Bulk forming laxatives
  2. osmotic laxatives- magnesuim hydroxide
  3. disaccharides and alditols- lactulose
  4. Emollients (hydrating)- parafin oil, docusate sodium
  5. Stimulant laxatives- senna
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17
Q

Red flags in paeds. What is each suggestive of?

  1. failure to pass meconium in 24 hours of life
  2. faultering growth
  3. abnormal limb neurology/ deformity
  4. scaral dimple over natal cleft
  5. perianal bruising
A
  1. hirschrpung’s disease
  2. hypothyroidism, coeliac disease
  3. lumbrosacral pathology
  4. spina bifida occulta
  5. sexual abuse
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18
Q

Iron deifiency

presentation

causes

A
  • fatigue
  • slow feeding
  • pica
  • pallor
  • inadequate intake– diet, growth spurt
  • malabsorption- coeliac disease
  • blood loss- menstruation, meckel’s diverticulum
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19
Q

investigation for iron deficiency

management of iron deficiency

A

FBC— Hb and MCV decreases,,,, look for microcytic cells

look for derceased serum ferritin

management

iron supplementation

dietary advice- iron rich foods, vitamin C

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20
Q

ITP- immune thrombocytic cytopaenia

which kind of cell is destroyed? How are they destroyed?

presentation of ITP

A

platelets are destroyed by autoantibodies

presentation

  • usually children aged 2-10
  • 1-2 weeks after viral infection
  • petechiae, purpura, superficial bruising
  • epistaxis (nose bleed)
  • uncommon to get profuse bleeding
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21
Q

how is ITP diagnosed?

investigations

treatment of ITP

A

diagnosis of exclusion

investigations

  • FBC- look for low platelets
  • blood film
  • bone marrow biopsy

treatment of ITP

Observation. Self resolves in 6-8 weeks

may need steroids or IV Ig

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22
Q

cystic fibrosis

inheritance pattern

what protein does it affect? what is that protein’s function? what happens without it

A

autosomal recessive condition

(therefore if Xx and Xx have 4 kids; 1 will be affected xx, 2 will be carriers Xx and one will be free of it XX)

it affects the CFTR protein (membrane chloride channel). It carries out sodium transportation. A dysfuncitonal channel will produce thickened, sticky secretions

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23
Q
A
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24
Q

Presentation of Cystic fibrosis in neonates and children

A

since introduction of the heel prick test, most cases are picked up via screening

neonates- meconium ileus

children- frequent infection, failure to thrive, wheeze, cough, steatorrhoea

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25
Q

Which conditions are commonly present with Cystic fibrosis?

A
  • sinusitis
  • pancreatitis
  • diabetes
  • fertility
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26
Q

investigations for CF

management in CF

A
  • heel prick test
  • sweat test- high chloride
  • genetic testing for mutations (change in F508)

lifelong MDT aproach

  • Resp: mucolytics, prophylactic antibiotics, chest physio, vaccines
  • GI: annual OGTT, creon replacement
  • Targeted: Ivacaftor/ lumacaftor
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27
Q

Coeliac disease pathophysiology

gliadin + glutenin =

presentation of coeliac disease

A
  • gluten broken down to gliadin and glutenin. Gliadin causes damaging immune response in proximal small intestinal mucosa
  • gliadin + glutenin = gluten

presentation of coeliac disease

classical presentation vvvv

  • malabsorption at 8-24 after weaning
  • faltyering growth and buttock wasting
  • abdominal pain and distension
  • abnormal stools
  • dermatitis herpetiformis ( scalp, shoulders, buttocks, elbows and knees)

Non specific GI symptoms

Anaemia (iron and/or folate deficiency)

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28
Q

investigations for coeliac disease

management

A

1) bloods- serological screening tests

  • Anti-tTG (immunoglobulin A tissue transaminase antibodies)
  • EMA (endomysial antibodies)

2) biopsy- mucosal changes of the small intestine (villous atrophy, flattened villi, crypt hyperlasia, lymphocyte infiltration)

management for coeliac disease

gluten free diet under dietician supervision

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29
Q

What is meningitis?

Caused more by bacteria or viruses? Which one has more severe consequences?

Presentation?

A
  • inflammation of the meninges
  • most commonly viral but bacterial more severe

presentation

  • fever
  • headache
  • vomitig/ poor feeding
  • drowsiness
  • photophobia
  • hypotonia
  • seizures
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30
Q

examination findings of meningitis

A
  • purpuric rash (meningococcal disease)
  • neck stiffness
  • bulging fontanelle (division on superior aspect of infants skull)
  • back arching
  • Brudzinki + kernig sign positive
  • shock
  • Altered conscious level
  • focal neurology
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31
Q

Common casuative agents of meningitis at different ages

bacterial

  • neonates
  • 1 mo-6 years
  • >6 years

viral

A

Neonates

  • group B streptococcus
  • Listeria monocytogenes
  • E. Coli

1 mo- 6 years

  • Neisseria meningitides
  • Streptococcus pneumoniae
  • Haemophilus influenzae

Over 6 years

  • Neisseria meningitides
  • Streptococcus pneumoniae

Viral causes of meningitis

Enteroviruses, Epstein- barr virus (EBV), adenovirus, mumps

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32
Q

investigation for meningitis

A
  • FBC, CRP
  • coag + U and E’s
  • LFTs
  • Blood glucose
  • Blood gas
  • Blood cultures
  • Viral PCR
  • Lumbar puncture
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33
Q
  • Appearance
  • WBCs
  • Protein content
  • Glucose content

Of csf of someone with normal health, bacterial and viral infection

A

Normal

Appx: clear

WBCs: 0-5/mm3

Protein: 0.15-0.5g/L

Glucose: >50% of blood

Bacterial

Appx: turbid

WBCs: large increase in polymorphs

Protein: large increase

Glucose: large increase

Viral

Appx: clear

WBCs: increase lymphocytes

Protein: normal/ raised

Glucose: normal / decreased

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34
Q

management of meningitis

A

IV antibiotics- usually cephalosporin

Dexamethosone in bacterial infections over 3 months

supportive therapy- e.g,. fluids, oxygen

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35
Q

What is gastro-oesophageal reflux disease

if it causes significant problems whay is it called

A

involunatry passage of stomach contents into the oesophagus

common in infancy and is usually benign and self limiting

its called GORD if it causes dysfunction

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36
Q

presentation of infants and older chidlren with reflux disease

A

infants:

  • recurrent vomiting or regurgitation after feeds
  • discomfort lying flat after feeds
  • usually well and normal growth

older children:

  • heartburn
  • epigastric pain
  • vomiting
37
Q

How is reflux disease diagnmosed?

relfux disease has a higher prevalence in children with

management

A

diagnosed clinically with no need for investigations

higher incidence in cerebral palsy or neurodevelopmental disease

management

  • reassurance- usually resolves by age 1
  • feeding assessment
  • smaller, more frequent feeding
  • feed thickeners
  • alginate therapy (gaviscon)
  • 4 week trial of PPI or H2 receptor antagonist
38
Q

What is appendicitis

presentation

A

inflammation of the appendix

Presentation

Symptoms:

  • abdominal pain (initially central and collicky, later localises to RIF)
  • anorexia
  • vomiting

Signs:

  • Fever
  • Pain aggravated by movement
  • Tenderness and guarding in RIF (mcBurney’s point)

If unwell abnormal observations, high temperature—— perforation?

39
Q

investigations for appendicits

Complications of appendicitis

Management

A

Investigations

  • Full blood count- increase WCC
  • CRP
  • Ultrasound scan

Complications

  • Perforation
  • Sepsis
  • Abscess
  • Appendiceal mass

Management

  • Monitor observations
  • Analgesia
  • Fluid rescusitation and IV antibiotics (if unwell/ concerns of perforation)
  • Appendicectomy
40
Q

What is pyloric stenosis?

When does presentation occur? What is the presentation?

More common in?

A

Hypertrophy of pyloric musclce causing gastric outlet obstruction

presentation

  • projectile vomiting
  • gradually increases in frequency and forcefulness
  • hunger after vomiting
  • weight loss

more common in

  • males
  • first born child
  • those with family history
41
Q

Assessment of pyloric stenosis

A

test feed

  • Gastric peristalsis- wave moving from left to right
  • Pyloric mass- olive shaoed mass in RUQ

Capillary blood gas

  • Hypochloraemic metabolic potassium
  • Low sodium and potassium

Ultrasound scan

42
Q

Management of pyloric stenosis

A
  1. rehydration
  2. correct electrolyte imbalances
  3. Pylomyotomy
43
Q

Pneumonia

presentation

examination

A

Pneumonia

Presentation

  • Fever
  • cough
  • increased work of breathing
  • tachypnoea
  • lethargy
  • poor feeding

Examination

  • Tachypnoea
  • coarse crackles
  • reduced oxygen saturations
  • nasal flaring
  • recessions
44
Q

pneumonia

investigations (3)

management (2)

admit if: (3)

A

investigations

CXR- may confirm diagnosis

NPA aspirate for viral PCR

Bloods generally unhelpful

Management

  • antibiotics- amoxicillin or clarithromycin
  • supportive care- oxygen, fluids

Admit if:

  • Oxygen sats >92%
  • Apnoeas/ grunting
  • Unable to maintain fluid intake
45
Q

Causative agents of pneumonia

  • newborn
  • infantsa nd young children
  • children over 5
A

Newborn causative agents pneumonia:

Bacteria——- (group B strep) + (gram negative enterococci)

Viruses and young children:

Viruses——– (RSV, Adenovirus, Rhinovirus, Influenza)

Bacteria——- (strep pneumoniae, H. Influenzae, chlamydia trochamatis)

Children over 5 years:

Bacteria ——( mycoplasma pneumoniae, strep pneu., chlamydia pneu.)

46
Q

Anaphylaxis what is it

Presentation

A

anaphylaxis is a severe life-threatening systemic hypersensitivity reaction

Presentation

  • Sudden onset and rapidly progressing
  • Angioedema
  • stridor
  • wheeze
  • tachypnoea
  • tachycardia
  • shock
  • vomiting
  • urticaria (hives- red, itchy welts that result from a skin reaction)
  • collapse
47
Q

Anaphylaxis

acute management (7)

A

Acute anaphylaxis management

  • ABCDE approach
  • Adrenaline 1:10000
  • Oxygen
  • Nebulisers
  • fluid bolus
  • hydrocortisone
  • chlorphenamine
48
Q

What is otitis media

which age group is it most frequent in? Why compared to adults?

what usually precedes OM?

A

inflammation of the middle ear

most common in infants. this is becasue the eustachian tube is:

  • shorter
  • horizontal
  • functions poorly

a URTI usually precedes OM

49
Q

presentation of OM

On examination

common causative agents of OM: viral and bacterial

A

Presentation of OM

  • fever
  • ear pain
  • hearing loss
  • loss of appetite
  • generally unwell

On examination

  • erythema
  • bulging tympanic membrane
  • loss of light reflex
  • perforation
  • effusion

Common causative agents of OM:

  • Viral- RSV, Rhinovirus
  • Bacterial- strep pneumonia, haemophilus influenza, moraxella catarrhalis
50
Q

Management of OM (3)

what is glue ear and how is it treated

A

management of OM

  • reassurance usually self resolves in 3-5 days
  • analgesia and fluids
  • antibiotics usually not required- can be given if not resolving

glue ear

-“recurrent ear infections can lead to OM with effusions”

Hearing loss and resultant developmental delay

may be treated with grommets

51
Q

Label which ones are normal, Acute otitis media and OM with effusions

A
52
Q

Urinary tract infections

presentation- infants and children

A

UTI presentations

Infants

  • fever
  • vomiting
  • lethargy
  • poor feeding
  • irritability

Older children

  • fever
  • dysuria
  • increased frequency
  • abdominal pain
  • vomitinng
  • incontinence
53
Q

Initial investigations for a UTI (2)

if there is good clinical evidence and patient is under 3 months what should you do?

A

initial investigatiuons for UTI

  • urinalysis (if nitrites present start abx, if only leukocytes send for culture)
  • urine culture and sensitivity (E.coli and krebsiella)
  • no need for further investigations unless concerns of sepsis

start antibiotics

54
Q

antibiotics for UTI

  • upper UTI, prophylaxis
  • lower uti
  • under months

Further investigationsn for uti (3)

A

upper UTI, prophylaxis- cefalexin ot Co-amoxiclav

lower UTI- trimeythoprim

under 3 months- IV antibiotics

further investigations for UTI-

  • renal USS
  • micturating cystorethrogram (MCUG)
  • DMSA scan
55
Q

wheeze

what is it

inspiratory?

what does it indicate?

what can cause a wheeze?

A

wheeze- high pitched whistling sound, musical like quality

usually heard on expiration

indicates a narrowed airway

what can cause a wheeze?

  • asthma
  • bronchiolitis
  • viruses
  • foreign body aspiration
  • structural abnormalities
  • congenital heart defects
  • GOERD
56
Q

Treatment for wheeze? (3)

age based approach to diagnosing cause of wheeze

what does absence of wheeze suggest in acute asthma?

A

treatment for wheeze

  • 02 as needed
  • SABA
  • if the patient doesnt respond to SABA ask why

age based approach to diagnosing cause of wheeze

impending resp failure

57
Q

Asthma-

diagnosis (4)

acute management

long term management

general management strategies

A

Diagnosis:

  1. Episodic symptoms
  2. Wheeze confirmed by HCA
  3. Diurnal variability
  4. Atopic history
  5. Nothing suggesting alternate diagnosis

Acute management

  1. Oxygen
  2. Salbutamol + ICS
  3. Ipatropium (anticholinergic)
  4. Call for help + cardiac monitoring
  5. Aminphylline + salbutamol + Mg Sulphate

Long term management

SABA reliever “blue” PRN up to 10 puffs per 4 hours

”+ ICS brown preventer- budesonide

”+ LABA (e.g., salmeterol). if this fails stop and increase ICS

”+ LTRA (leukotriene receptor antagonist) like monteleukast (at this stage you have SABA,ICS, LABA, LTRA)

General management strategies

  • assess symptoms, measure lug function, check inhaler technique and adherence
  • adjust dose to find minimum effective
  • update self-management plan
  • move up and down medication ladder as required
58
Q

how do you differentiate between causes of wheeze?

A

Onest of symptoms

a) gradual onset of wheeze in late infancy or early childhood
1ai) regular daily wheeze symptoms?—-
1ai. )improves with salbutamol?

yes- asthma

no- bacterial bronchitis?

1aii) intermittent episodes- interval symptoms (e.g, regular cough/ wheeze at night or after exercise?

yes- improve w salbutamol? (y- asthma n-bacterial bronchitis)

no- recurrent viral induced wheeze

b) sudden onset of coryzal symptoms
1bi) yes- suspect viral lrti like bronchiolitis or viral penumonitis
1bii) no- think inhaled foreign body

59
Q

how can you tell the difference between asthma and viral induced wheeze?

A

children w viral induced wheeze are well between flare ups while children with asthma are not

60
Q

what is viral induced wheeze

when do children usually grow out of it

A

Wheezing due to viral-induced wheeze or acute viral-induced asthma is caused by narrowing of the airways due to mucus production and bronchoconstriction.

grow out of it by 6 when their immunity develops

61
Q

common causative agents of V.I.W. (5)

presentation of VIW

  • severe
  • life threatening
A
  1. RSV
  2. Rhinovirus
  3. coronaviruses
  4. parainfluenza
  5. influenza

Presentation of VIW

  • severe- SpO2 >92%
  • Too breathless to feed or talk
  • HR >125 ( over 5’s) or >140 (under 5’s)
  • Use of accessory muscles

Life threatening

  • silent chest
  • poor respiratory effort
  • altered consciousness
  • agitation/ confusion
  • exhaustion
  • cyanosis
62
Q

difference between bronchiolitis and VIW

A

age

  • bronchiolitis- <12 months old
  • VIW 1-5 years
63
Q

what kind of disease is type 1 diabetes mellitus

what protein is lacking

presentation:

A
  • Autoimmune endocrine disorder
  • insulin lack

presentation:

  • hyperglycaemia (frequent urination, increased thirst, blurred vision, fatigue, headache)
  • Polydipsia (extreme thirst)
  • polyuria (lots of weeing)
  • polyphagia (extreme hunger)
  • weight loss
  • abdo pain (Diabetic ketoacidosis)
64
Q

management of T1DM

What 2 things do you teach to a T1DM patient?

What is a BM range? and what should a normal range be?

A

management

  • lifelong insulin replacement
  • regular blood sugar checks
  • screen for complications and compliance

Teach

  • how to treat hypos
  • sick day rules

Bm range” outdated” but refers to your blood glucose level.

Normal range 4-7

65
Q

HYPOglycaemia symptoms

HYPERglycaemia symptoms

what is of concern in adolescent patients

A

HYPO symptoms

  • Sweating
  • Pallor
  • Irritibility
  • Hunger
  • Lack of co-ordination
  • Sleepiness

HYPER symptoms

  • Dry mouth
  • Increased thirst
  • Weakness
  • headache
  • blurred vision
  • frequent urination

compliance is an issue

66
Q

Diabetic ketoacidosis

presentation

3 changes to blood in DKA

A

presentation

  1. dehydration
  2. shock
  3. abdominal pain
  4. drowsiness
  5. acidotic respirations

3 changes to blood in DKA

  • ketonaemia
  • hyperglycaemia
  • acidaemia
67
Q

diabetic ketoacidosis

treatment

complications of DKA

A

treatment

  • ABCDEFG-appraoch Don’t Ever Forget Glucose
  • Complex and requires 1:1 nursing + senior support
  • combination of fluids, insulin and postassium

Complications

  • hypokalaemia
  • cerebral oedema
  • hypoglycaemia
  • VTE
68
Q

how does insufficient insulin lead to ketoacidosis?

A
  1. insuficient insulin
  2. gluocse can’t enter cells
  3. need for alternative energy source
  • muscle cells broken down to amino acids (gluconeogenesis)
  • fat cell- glycerol (gluconeogenesis) and fatty acids (converted to ketones)
  • increased glucagon converted to ketones
69
Q

gastroenteritis

most common cause in developed countries and during which seasons

presentation

its important to assess

management

A

commonest casuative agent- rotavirus

presentation

  • diarrhoea
  • vomiting
  • fever
  • poor feeding
  • shock

assess hydration

management

  • oral rehydration or IV fluid replacement
70
Q

gastroenteritis

most common viral causes

bacterial

protozoan

Investigations

A

viral

  • rotavirus
  • adenovirus
  • norovirus
  • astrovirus

bacterial

  • Campylobavter
  • shigella
  • salmonella
  • E.coli

Protozoa

  • Giardia
  • crytposporidium

Investigations:

  • stool culture (if septic or blood in stools)
  • U+E’s if IV fluids required
  • Glucose
  • Blood culture (if satrted on antibiotics)
71
Q

Shock presentation

A
  • reduced consciousness
  • decreased Urinary output
  • pale or mottled
  • cool peripheries
  • dry mucous membranes
  • prolonged cap refill
  • sunken eyes
  • tachycardia
  • hypotension
  • tachypneoa
72
Q
  1. what is Henoch- Schlonlein purpura
  2. what is it usually triggered by
  3. What does PPP stand for
A

immune mediated disorder causing inflammation of small blood vessels, IgA mediated vasculitis

usually triggered by a viral URTI

Painful Palpable Purpura

73
Q

presentation of henoch-schonlein purpura

most commonly affects which aged children

A

presentation of henoch-schonlein purpura

  • non-blanching rash (100%) found on the buttocks and extensor surfaces of legs and arms
  • painful swollen joints
  • abdominal pain
  • haematauria

most commonly affects 2-10 year olds

74
Q
  • investigations to rule out other pathologies and measure extent of organ failure (4)*
  • management*
  • 2% Of HSP patients develop:*
A

investigations

  1. FBC
  2. CRP
  3. Blood cultures
  4. U+Es

Management of HSP

  1. Usually self resolves within 6 weeks
  2. simple analgesia
  3. steroids are sometimes used for joint pain

2% of HSP patients develop renal failure

75
Q

4 go to causes of paediatric limp

A
  1. transient synovitis “irritible hip syndrome”
  2. septic arthritis
  3. Perthe’s disease
  4. Slipped capital femiral epiphysis
76
Q

Transient synovitis “irritible hip syndrome”

  • how common of a problem is it
  • associated with what kind of infection
  • sudden onset symptoms (2)
  • pain at rest?
  • affect on ROM?
  • how long does it take to resolve?
  • average age of affect
A

Transient synovitis “irritible hip syndrome”

  • most common cause of hip pain in children
  • associated with viral infection
  • sudden onset hip pain or limp
  • no pain at rest
  • reduced ROM, internal rotation hurts
  • resolves itself within 1 week
  • age of affect- 2-12
77
Q

septic arthritis

presentation

investigations

treatment

most common in what age group

A

presentation

  • red
  • hot
  • painful joint
  • reduced ROM

Investigations

  • FBC, CRP, ESR
  • blood cultures
  • joint aspirate
  • Xray

Treatment

  • Antibiotics +/- surgical washout

Most common in the under 2s

78
Q

Limp

  • What is Perthe’s disease
  • pathophysiology
  • affects which group of people most
  • management
A

Limp

Perthe’s disease-“avascular necrosis of capital femoral epiphysis”

Pathophysiology

  • Occurs due to interruption of blood supply, followed by revascularisation and reossification over 18-36 months

Mainly affects boys + 5-10 year olds

Management- rest, physio, casts and sometimes surgery

79
Q

Limp

  1. What is a slipped capital femoral epiphysis?
  2. most common at which ages
  3. commonly occurs during which process
  4. increased risk with…?
  5. which movements are restricted
  6. management
  7. should be treated promptly to prevent…?
A
  1. Slipped capital femoral epiphysis- “displacement of epiphysis of femoral head postero-inferiorly
  2. 10-15 years
  3. common during adolescent growth spurt
  4. increased risk in obese patients
  5. restricted abduction and internal rotation
  6. surgical management
  7. should be treated promptly to prevent avascular necrosis
80
Q

Leukaemia is a cancer of which cells

how common is leukaemia

presentation (7)

A

white blood cells

most common cancer in children

presentation

  1. lethargy
  2. pallor
  3. generally unwell
  4. non-blanching rash
  5. frequent infections
  6. lymphaednopathy
  7. hepatosplenomegaly
81
Q

leukaemia

investigations

peak age for incidence

80% of leukaemias in children are

A

investigations

  • FBC
  • Blood film
  • bone marrow arpirate/ biopsy
  • lumbar puncture

incidence peaks at age 2-3 years

ALL most common childhood leukaemia

82
Q

inflammatory bowel disease

a quarter of IBD cases present at which stage of life

IBD includes 2 distinct diseases, what are they?

What are the differences between these 2

presentation

A
  • childhood
  • IBD= crohn’s + IBD
  • Crohn’s disease- affects any part of the GI tract from mouth to anus. Diffuse pattern of affect. Transmural. Non-caseating granulomata
  • Ulcerative colitis- confined to the colon. Continuous inflammation. Damage limited to mucosa. Mucosal inflammtaiton and crypt cell damage..

Presentation of IBD:

  • Abdominal pain
  • diarrhoea
  • failure to thrive
  • weight loss
  • delayed puberty
  • extra-intestinal manifestations: oral lesions, uveitis (looks like red eye), arthralgia, erythema nodosum
83
Q

Investigations for IBD

management for Crohn’s

management for Ulcerative colitis

A

Investigations for IBD

  • FBC
  • CRP and ESR
  • foecal elastase
  • biopsy

management for Crohn’s

  • nutritional therapy
  • systemic steroids
  • immunosupressants
  • anti-TNF (infliximab)

management for Ulcerative colitis

  • aminosalicylates
  • topical or systemic steroids
  • immunosupressants
84
Q

Paediatric normal values- <1 year

HR/ min

RR/ min

Systolic BP

A

Paediatric normal values- <1 year

HR/ min- 110-160

RR/ min- 30-40

Systolic BP- 70-90

85
Q

Paediatric normal values- 1-2 years

HR/ min

RR/ min

Systolic BP

A

Paediatric normal values- 1-2 years

HR/ min- 100-150

RR/ min- 25-35

Systolic BP- 80-95

86
Q

Paediatric normal values- 2-5 years

HR/ min

RR/ min

Systolic BP

A

Paediatric normal values- 2-5 years

HR/ min- 95-140

RR/ min- 25-30

Systolic BP- 80-100

87
Q

Paediatric normal values- 5-12 years

HR/ min

RR/ min

Systolic BP

A

Paediatric normal values- 5-12 years

HR/ min- 80-120

RR/ min- 20-25

Systolic BP- 90-110

88
Q

Paediatric normal values- over 12 years

HR/ min

RR/ min

Systolic BP

A

Paediatric normal values- over 12 years

HR/ min- 60-100

RR/ min- 15-20

Systolic BP- 100-120

89
Q

General trends in paediatric vital signs with increasing age

Heart rate

Respiratory rate

Systolic blood pressure

A

as age increases:

HR- decreases

Respiratory rate- decreases

Systolic blood pressure- increases

Year 3 Paeds (4 decks)

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