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Toni's Paeds > Diagnosis > Flashcards

Diagnosis Flashcards

1
Q 
4 hr term infant
no antenatal complications or issues during delivery
incr work of breathing
RR:55 SpO2: 86%
hyperexpanded
reduced breath sounds on L
A

pneumothorax

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2
Q

18hr old neonate
hypotensive
desaturated
drowsy

A

infection: likely organism =
Gp Bstrep
start benpen + gentamycin
covers all causes of perinatal infection: GpB strep, listeria, G-ve

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3
Q 
floppy term baby
post emergency c section
apnoeic
HR: 50
APGAR: 1
A 
Action:
dry (can lose 0.5 degrees C/min)
assess APGAR
rescue breaths
CPR
much later consider:
intubate
atropine
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4
Q

neonate born at 28 weeks

A

90% chance of survival

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5
Q 
6 day old 
central cyanosis
no murmur
SpO2: 85%
otherwise well
A

e. hyperoxic test
prostaglandin E2 infusion started
cardiac centr -> echo
surgery

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6
Q 
5 month old girl
prev well
1/7 hx fever, reduced feeding,
drowsy, irritable
T: 39, RR: 33, HR: 150
fontanelle not bulging
A 
urine dip mc+s
FBC CRP blood cultures
LP
no CT given incr ICP unlikely,
radiation exposure and sedation needed

ceftriaxone!
HiB, strep pneumnoiae, neisseria meningitidis

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7
Q

ruling out meningitis

A

e. none

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8
Q

10 wk baby

vomiting after feeding

A 
gastro oesophageal reflux
pyloric stenosis (if projectile)
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9
Q 
4 yo known asthmatic
RR: 45 SpO2: 93% high flow 02
sub + inter costal recession at rest
despite:
1 salbutamol neb
oral pred
A 
2nd salbutamol neb
later if needed:
atrovent neb
salbutamol infuson
amnophylline
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10
Q

large VSD

6 wk old

A

pansystolic murmur
acyanotic heart defect
L->R shunt inc pulm blood flow -> pulm htn + oedema
=resp distress

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11
Q 
10 yo
distended abdomen
periorbital swelling
prev well
no GI sx
A

nephrotic synd

proteinuria 3g/24hr
albuminaemia

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12
Q 
8 month baby
barking cough
mod stridor 
intercostal recession on exertion
well perfused
T:37.8
A

croup

nebulised steroids

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13
Q 
2 yo 
sudden onset cough + DIB
prev well
incr work of breathing
reduced breath sound on R
tachypnoea
A

?binhaled foreign body

?crule out pneumothorax

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14
Q

10 yo
3 yr hx constipation
prev normal
no medication

A 
osmotic laxative initially
dietary advice:
increase fibre and fluid intake
later possibly add stimulant laxative
manual evacuation = last resort
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15
Q 
8 hour old neonate
oligo hydramnios
c section
L ankle deformity
int deviated
A

low liquor vol = cause

physical compression = talipes

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16
Q 
4 yo
4x diarrhoea with blood + mucus
2x vomit
tachycardic
T:39.2
A

salmonella
rotavirus: unlikely to cause bloody stools
UC: unlikely given age
coeliac: chronic steatorrhoea no vomiting

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17
Q

12 wk s

cousin had child w spina bifida

A 
failure of neural tube to close
top- anencephaly/encephalocoele
generally fatal as brain exposed
mid/bottom- spina bifida
hydrocephalus can develop due to assoc Arnold-Chiari malformation
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18
Q

14 yo
4 wk limp
no trauma

A

int rotated + short limb with slipped fem epiph

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19
Q

signs of sinister seizure

A

focal features e.g. eye deviation
prolonged >10 mins
change in conscious level before or after
developmental delay

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20
Q

9 month baby

97th centile head circumference

A

splaying of cranial sutures suggests incr CSF vol

sun setting eyes occur in severe hydrocephalus

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21
Q

5 yo epileptic

still fitting after 5 mins

A

pr diazepam
iv lorazepam
iv phenytoin

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22
Q

widely spaced nipples

A

Turners

23
Q

low set ears

A

Trisomies

24
Q

hairy pigmented patch on spine

A

spina bifida occulta

25
Q

Goldenhar’s syndrome

A

unilateral facial defects, affecting jaw + ear

26
Q

physical signs and obs of 6 wk baby

A

HR 110-160
RR: 30-40
upgoing plantar reflexes until walking around 12 months
atonic primitive neck reflex should disappear by 3 months
2cm liver margin normal

27
Q

18 months
pale
Hb 65
sperocytes

A

sperocytosis

28
Q

5 yo boy

13cm on tender mass L side abdomen

A 
Wilm's  tumour
20% of paeds malignancy
unilateral L kidney in males
nephroblastoma
nephrectomy + chemo
29
Q 
8yo
unwell 4 wks
severe anaemia
low platelets
raised white cells
A

ALL

30
Q

newborn fails to pass meconium
abdo distension
bile stained vomit
abdo xray:

A

Hirschsprung’s disease
presents in infancy
rectal suction biopsy

31
Q 
18 months
pale
Hb 65
hypochromic microcytic
pencil cells
target cells
A

Fe deficiency anaemia

32
Q 
4yo
1/52 coryza, fever
incr drowsiness over past day
reduced feeding
HR:80
BP: 120/80
A

Neisseria meningitidis

33
Q 
8 month old
20 min L sided seizure -> unconscious
1/7 hx lethargy
sister has cold sores
no rash
A

HSV

34
Q 
3 month old
febrile 38.7
2 x clear fluid vomits
otherwise well
urine dip +++ve leucocytes
A

E.coli

35
Q

9 month old
2/7 vomiting with bile
1 x bloody stool
abdo distension

A

intussusception

36
Q

14 month old
4/7 watery diarrhoea & vomiting with 37.5 fever
no blood in stool
dehydrated but stable

A

rotavirus

37
Q

4yo
4/7 fever + vomiting
multiple episodes watery diarrhoea

A

rotavirus

38
Q

3 wk term baby
apnoeic episodes, coryza + cough
afebrile
brother has cough + cold

A

RSV

39
Q

2 yr old
4/7 fever + bloody diarrhoea
haemolytic anaemia
raised urea

A

E.coli 0157

40
Q

3 yo
prev viral gastritis
diarrhoea
symptoms worse following joghurt snacks

A

lactose intolerance

41
Q

6yo
numerous episodes diarrhoea
sometimes bloody
prev on PICU

A

pseudomembranous colitis

42
Q

3 yo
3/52 hx increasing irritability,
1/7 hx visual disturbance, vomiting
now unresponsive

A

intracranial tumour

43
Q 
5 day old
poor feeding
unresponsive, floppy
a febrile
otherwise normal
consanguinity
A

hyperammonaemia

44
Q 
5 wk
stopped breathing at home -> A+E
unresponsive
irregular breathing
nappy rash
torn frenulum
A

NAI

45
Q

2 wk old bronchiolitis
IVF: 10% dextrose/0.18%NaCl full maintenance 3/7
now unresponsive

A

hyponatraemic

46
Q

2 month old
2/7 hx drowsiness and fever
no rash
unresponsive

A

meningitis

47
Q

How do you asses dehydration clinically?

A 
Capillary refill time: prolonged
Skin turgor: reduced
Pulse: weak, tachycardic 
Resp: abnormal pattern
Extremities: cool, poorly perfuse
48
Q

4 month old
Vomiting, poor feeding, excessive crying 8 hrs
Normal growth + dev
Appears unwell, tender in lower R quadrant, mass felt

A

Inguinal hernia

49
Q

15 yr old male
Vomiting
Pain in abdomen
Red swollen right testicle

A

Testicular torsion

50
Q 
8 yr old male 
Swollen red right scrotum
Upper region of testicle is tender
Cremasteric reflex present
No nausea or vomiting
A

Torsion of hydatid of Morgagni

51
Q

3 month old
Resp arrest
Frenulum torn
Bruising around chest wall

A

Intracranial haemorrhage secondary to NAI

Vigorous shaking -> subdural haemorrhage

52
Q

2 yr old
Fever
Resp rate >50

A

Pneumonia
Viral or bacterial
Crepitations won’t be heard

53
Q

6 month old
Cough, fever, coryza
Crepitations throughout lungfields

A

Bronchiolitis
Caused by RSV
Resp distress + wheezing due to small airway obstruction

Toni's Paeds (16 decks)

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