Corrections - 3 Flashcards
Average age for the following milestones:
a) sit without support with a straight back
b) run
c) ride a tricycle
a) 7-8m
b) 16m-2y
c) 3y
Mx of a diaphragmatic hernia?
1) insertion of NG tube (with the aim of keeping air out of the gut)
2) intubate & ventilate in cyanosed patients
3) surgical repair
Is whooping cough a notifiable disease?
Yes
Head size in Fragile X?
Macrocephaly
Testes size in Fragile X?
Large testes (macro-orchidism)
Mx of small umbilical hernias in babies?
tend to resolve by 12 months of age –> reassurance
What heart defect is most commonly associated with Fragile X?
Mitral valve prolapse
Mx of scarlet fever?
oral penicillin V for 10 days
Is scarlet fever a notifiable disease?
Yes
What is HSP?
IgA vasculitis
The most common form of systemic vasculitis in children.
Classic 4 features of HSP?
1) rash
2) abdo pain
3) arthritis/arthralgia
4) glomerulonephritis
What do about 50% of cases of HSP follow?
URTI (mainly strep)
Describe rash in HSP
Typically symmetrically distributed, non-blanching palpable purpura, especially on the lower legs, buttocks, knees and elbows.
What joints are most affected by arthritis/arthralgia in HSP?
The knees and ankles are most often affected.
What is a common GI complication in HSP?
Intussusception
Renal features of HSP?
Vary from mild (i.e., asymptomatic haematuria and/or proteinuria) to severe (i.e., rapidly progressive nephritis, nephrotic syndrome, and renal failure).
Diagnosis of HSP?
Clinical
Whwat monitoring is required in HSP?
Patients should be followed for at least 6 months with periodic urinalysis and BP monitoring.
Average age that a child would pull to stand?
8-10 months
Average age that a child would squat to pick up a ball?
18m
Average age that a child would hop on one leg?
3y-4y
In X-linked recessive conditions, what is the chance of a female child of a heterozygous female carrier being a carrier?
50%
Inheritance of thalassaemia?
Autosomal recessive
What genetic syndrome can cause a small chin, posterior displacement of the tongue and cleft palate?
Pierre-Robin syndrome
1st & 2nd line mx of a viral-induced wheeze?
1st –> SABA
2nd –> LTRA (oral montelukast) or ICS
Role of abx in whooping cough?
Does not alter the course of the illneess, but has been shown to reduce the spread.
Mx of children below the 2nd centile for height?
Should be reviewed by their GP
Mx of children below the 0.4th centile for their height?
Should be reviewed by a paediatrician
Location of eczema in:
a) infants
b) younger children
c) older children
a) face and trunk
b) extensor surfaces
c) flexor surfaces (typical distribution)
1st line investigation in asthma in children aged 5-16 y/o?
FeNO
Diagnose asthma if FeNO ≥35
2nd line investigation in asthma in children aged 5-16 y/o if FeNO is normal?
measure bronchodilator reversibility (BDR) with spirometry
What translocation is Burkitt’s lymphoma often associated with?
c-myc gene translocation
Poor prognostic features of ALL?
- age < 2 years or > 10 years
- WBC > 20 * 109/l at diagnosis
- T or B cell surface markers
- non-Caucasian
- male sex
Mx of otitis media with effusion if symptoms persist following 3m period of active observation?
Refer to ENT for further mx
‘Refer a child with glue ear to ENT if they have persisting significant hearing loss on two separate occasions (usually 6-12 weeks apart)’
Mx of chickenpox?
Supportive & calamine lotion for itch
Only consider aciclovir in immunodeficient children.
Presentation of migraines in paeds vs adults
Migraines in children often present with bilateral pain rather than the unilateral pain more commonly seen in adults.
Mx of pityriasis versicolor?
Ketoconazole 2% shampoo
Descriibe prodrome in measles
irritability, conjunctivitis & fever
Eczema herpeticum is a primary infection of the skin caused by HSV and uncommonly what?
Coxsackie virus
FBC features of ALL?
1) anaemia
2) neutropenia (frequent or severe infections)
3) thrombocytopenia
How is a diagnosis of epiglottitis made?
direct visualisation of inflamed tissue performed by senior, airway trained staff
CPR technique in children <1 y/o & >1y/o?
<1 y/o: two thumb encircling
> 1 y/o: compress the lower half of the sternum
What is the limit age for smiling responsively?
8 weeks
Inheritance of androgen insensitivity syndrome?
X-linked recessive
How long before being able to draw a shape are children able to copy it?
Usually 6 months
What is the most common cause of 1ary amenorrhoea?
Turner’s
What genetic syndrome might you see polydactyly?
Patau (18)
What are the 4 key features of Edward’s syndrome (trisomy 18)?
1) Rocker bottom feet
2) Overlapping fingers
3) Micrognathia
4) Low set ears
How can you distinguish Down’s syndrone and Edwards/Patau syndrome on combined test?
Similar results but lower hCG
Typical feed requirements after first week until weaning?
150 mls/kg/day
Define overweight & obese regarding centiles
Overweight: >91st
Obese: >98th
Key investigations in precocious puberty? (2)
1) MRI brain
2) Scan pelvis & adrenals
Inheritance of Kallman’s?
X-linked recessive
