David king tips Flashcards

1
Q

What is persistent pulmonary hypertension of the newborn associated with

A

Meconium aspiration
Birth asphyxia
Septicaemia
Respiratory distress syndrome

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2
Q

Explain the pathology of PPHN

A

High pulmonary resistance which causes a right to left shunt at the aterial and ductal levels
Baby becomes cyanotic very soon after birth

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3
Q

Treatment of PPHN

A

Mechanical ventilation
Circulatory support (Iontropes)
Inhaled nitric oxide
? sildenafil

More severe
Oscillatory ventilation
Extracorpeal membrane oxygenation

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4
Q

Management of asthma ( not acute management)

A
1. B2 agonist 
2+ inhaled corticosteriod 
3. <5yrs add montelukast / >5yrs salmeterol 
4. Increased corticosteroid 
5. Add prednisolone
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5
Q

Assessment of control in an asthmatic child

A
No of oral course of steroids (> 4 in 6mnths)
Hospital admission
Been to ICU
Number of blue inhalers 
Time off school 
Check technique
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6
Q

Symptoms of bronchiolitis

A
Coryza
Cough 
Fever 
Tachypnoea
Wheeze 
Inspiratory crackles 
Intercostal recession 
Cyanosis
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7
Q

Reasons to admit

A

Inadequate feeding
Respiratory distress
Hypoxia

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8
Q

Treatment of bronchiolitis

A

O2

Nasogastric feeds

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9
Q

Confirm the diagnosis of the bronchiolitis

A

Nasopharyngeal aspirate

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10
Q

Symptoms of Kawasaki disease

A
Fever 5/7 days 
Bilateral non purulent conjunctivitis 
Mucous membrane changes (strawberry tongue, red dry cracked lips) 
Cervical lymphadenopathy
Rash (polymorphous)
Oedematous and desquamation of the fingers and the toes 
Reactivation of the BBG site 
Coronary aneurysums
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11
Q

Treatment of Kawasakis disease

A

IV IgG
Aspirin
Echo and a f/up echo in 4-6 weeks

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12
Q

Tests/ Investigations in Kawasakis disease

A
ESR/CRP
WCC
Bilirubin
AST
Alpha 1 antitrypsin 
Platelets
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13
Q

Clinical presentation of ALL

A
Malaise 
Anorexia
Anaemia 
Neutropenia 
Thrombocytopenia 
HSM
Lymphadenopathy
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14
Q

Investiagations

A
FBC 
BM aspirate ( blast cells)
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15
Q

Treatment of ALL

A
Induction 
Consolidation 
Interim maintenance 
Delayed intensification 
Continued maintenance
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16
Q

Types of brain tumours

A

Astrocytoma
Medulooblastoma
Brainstem glioma
Craniopharynioma

17
Q

Pathophysiology of a neuroblastoma

A

Arise from neural crest tissue in the adrenal medulla and the SNS

18
Q

Clinical features

A
Pallor 
Weight loss 
Abdominal mass
Hepatomegaly 
Bone pain 
Limp
19
Q

Investigations for a neuroblastoma

A

Raised urinary catecholamines

20
Q

Pathology of Wilm’s tumour

A

Origanates from embryonal renal tissue

21
Q

Clinical features of a Wilm’s tumour

A

Large abdominal mass
Anaemia
Haematuria
Hypertension

22
Q

Pathology of retinoblastoma

A

Malignant tumour of the retinal cells
Chromosome 13
Autosomal dominant inheritance ( can have incomplete penterance)

23
Q

Clinical features of retinoblastoma

A

Loss of red pupillary reflex

White pupillary reflex

24
Q

Pathology of pyloric stenosis

A

Congeitial hypertrophy of the pyloric muscle causing outflow obstruction

25
Q

Management of pyloric stenosis

A
  1. Correct any fluid or electrolyte disturbances
    Hyponatraemia, hypokalaemia, hypochloraemic alkalosis
  2. Ramsted pyloromyotomy
26
Q

Clinical features of TGA

A

Cyanosis ( Day 2 following closure of the PDA)
Second heart loud and single
~ systolic murmur
Egg on side appearance on CXR

27
Q

Management of TGA

A

Prostaglandin infusion- patency of the duct
Balloon atrial septostomy
Surgery for definitive treatment

28
Q

Clinical features of coarctation of the aorta

A

Circulatory collapse
Absent femoral pulses
Metabolic acidosis

29
Q

Treatment of coarctation of the aorta

A

Surgical repair soon after diagnosis