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Paediatrics > Febrile/irritable infant or child > Flashcards

Febrile/irritable infant or child Flashcards

1
Q

What can be the causes of an acute fever for an infant?

A

Viral Illness:

  • non-specific viral infection
  • URTI
  • influenza
  • Gastro
  • tonsillitis

Bacterial Illness

  • Septicaemia
  • Meningitis
  • Arthritis, osteomyelitis
  • Pneumonia
  • Urinary tract infection
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2
Q

What should you ask in a history of a child with an acute fever

A
  • duration and pattern
  • pain? earache, difficulty swallowing, dysuria or frequency
  • Associated features
  • Contact with other infections
  • Vaccinations
  • Drinking adequate fluid?
  • Antipyretics and cooling measures tried?
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3
Q

What investigations should be done for a febrile child

A
  • Full blood count
  • throat swab
  • blood culture
  • Lumbar Puncture
  • Urine analysis
  • CXR
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4
Q

What are the commonest causative organisms of otitis media?

A
  1. Strep pneumoniae
  2. Haem. Influenzae
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5
Q

Is tonsillitis usually viral or bacterial in nature

A

Viral

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6
Q

What are the signposts of a serious bacterial infection vs an intercurrent viral one?

A
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7
Q

What should you be thinking of if the fever persists for >5days, and what concurrent symtpoms will you likely see?

A

Kawasaki Disease

  • rash, conjunctivis, lymphadenopathy, red lips*
  • Also rule out inf endocarditis, osteromyolitis*
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8
Q

What is the purpose of the 3-minute toolkit

A
  • as children can be hard to pick up signs and can appear relatively normal even when decompensating, the toolkit allows for rapid assessment of the child
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9
Q

How does irritability usually present in infants and for what common reasons?

When shold you consider more serious reasons?

A

Usuually periodic and due to discomfort or stress?

If it starts suddenly and is associated with a change of behaviour

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10
Q

What is infantile Colic

A

Periodic crying affecting infants in the first 3 months of life.

Crying associated with hunger/swallowed air or discomfort, is paroxysmal and often occurs in the evening.

Can last hours, with a distended tense abdo and lifted legs.

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11
Q

What are some of the more serious causes of sudden crying?

A
  • any acute illness
  • otitis media
  • intusseception
  • Strangulated inguinal hernia
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12
Q

passage of the classical ‘red currant jelly’ suggests?

A

Severe vascular compromise due to intersusception of the bowel

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13
Q

What is Transient tachypnea of the newborn (TTNB)

A
  • most common cause of respiratory distress in term infants
  • Caused by delay in the absorption of lung liquid especially following elective caesarian.
  • Usually settles in 1-2 days
  • May need O2
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14
Q

Risk factors for pneumonia in newborn babies

A

PROM

maternal fever

chorioamnionitis

preterm

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15
Q

How should infants with respiratory distress be investigated?

A
  • Blood culture then start on broad spec AB
  • CRP
  • CBC
  • Lumbar puncture
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16
Q

What’s the concern surrounding meconium aspirate and whats the risk factor surrounding which babies

A
  • asphyixiated infants may start gasping and aspirate meconium before delivery, which is thick and causes mechanical obstruction, chemical pneumonitis and inactivation of surfactant.
17
Q

Dysmorphic features of Trisomy 21

A
  • flattened nasal bridge
  • Low set ears
  • epicanthal folds
  • brachydactyly
  • single palmar crease
  • HYPOtonia
  • sandle gap toes
18
Q

Associated problems with Trisomy 21

A
  • Duodenal atresia
  • cardiac abnormalities
  • otitis media
  • hypothyroidism
  • coeliac
19
Q

Clubbing in children, three most common causes!

A
  1. Cystic Fibrosis
  2. Congenital Heart Disease
  3. Bronchiectasis
20
Q

What ages do we get immunisations

A
  • 6 weeks
  • 3 months
  • 5 months
  • 15 months
  • 4 years
  • 11-12 years
21
Q

Increased and decreased tone in children, the two most likely reasons are….

A
  • Increased: Cerebral palsy
  • Decreased: down syndrome, prada willi
22
Q

TORCH stands for what?

A

Types of Congenital infections

  • Toxoplasmosis
  • Others: syphillis, varicella, paravirus B19
  • Rubella
  • CMV
  • HSV/ HIV

also Hep B, STIs and genital flora (group B strep)

23
Q

what has changed the incidence of spina bifida dramatically and what are the three types?

A

FOlic acid supplementation during pregnancy

  • Meningocele
  • myelomeningocele
  • Spinabifida oculta
24
Q

What causes the whoop from pertussis?

A

The whoop occurs following the paroxysms of coughs with a sudden inspiratory effort against a narrowed glottis due to an infection from bordetella pertussis

25
Q

Can you do anything for whooping cough/pertussis?

A

Erythromycin given early can shorten the illness duration but a child is infective by the time the whoop is heard.

26
Q

Short stature and delayed puberty in girls can often be due to ____

A

Turners Syndrome: An absence of one X chromosome.

  • short stature
  • webbing of neck
  • wide spaced nipples
  • IVF can sometimes be successful
27
Q

The most common congenital heart defect is?

A

Ventricular septal defect

Can be membranous (smaller) or muscular

  • Can be asymptomatic
  • harsh pansystolic murmur against lower sternal edge
28
Q

What consists of tetralogy of fallot?

A
  • Overriding aorta
  • VSD
  • right ventricular hypertrophy
  • pulmonary stenosis
    *
29
Q

What is the clinical presentation of VSD and why?

A

Can be asymptomatic, but large shunts can cause breathlessness of feeding and crying, poor growth and recurrant chest infections.

Harsh rasping pansystolic murmur can be heard at the lower left sternal border.

There may be signs of heart filure

30
Q

If a child has congenital heart disease, what do you need to think about prophylactically

A

These children are at an increased risk for infective endocarditis.

Maintaining healthy teeth and gums is reccommended ( antibiotics before dental surgery is not)

31
Q

Two main pathogens of otitis media?

A

Haemophilus influenza and strep pneumoniae

32
Q

Bulging red tympanic membran and loss of the light reflex could indicate?

A

bacterial otitis media

33
Q

Where does interssusception usually occur?

A

Usually from the ileum into the caecum

** episodic screaming and pallor

34
Q

Why should bile stained vomiting be taken seriously?

A

It is indicative of a bowel obstruction

  • Duodenal atresia (downs syndrome)
  • Hirshprungs
  • meconium ileus (CF)
35
Q

how should you investigate bile stained vomiting?

A

Nasogastric tube to aspirate the stomach, stop feeds whilst investigation (upper GI contrast study) pends

36
Q
A

Paediatrics (4 decks)

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