Gen Paeds Flashcards
Normal amount of sleep for
1) newborn
2) Infants: 4 to 12 months
2) Toddlers: 1 to 2 years
3) Pre-schoolers: 3 to 5 years
4) Grade-schoolers: 6 to 12 years
5) Teens: 13 to 18 years
1) newborn - 16-20hrs (prem 20-22)
2) Infants: 4 to 12 months - 12-16hrs
2) Toddlers: 1 to 2 years - 11-14hrs
3) Pre-schoolers: 3 to 5 years - 10-13hrs
4) Grade-schoolers: 6 to 12 years - 9-11hrs
5) Teens: 13 to 18 years - 8-10hrs
Trigonocephaly
Cause
Clinical features
Trigonocephalyis caused by premature closure of the metopic suture (metopic synostosis)and accounts for approximately 10% of craniosynostosis cases.
Trigonocephaly is characterised by a narrow, triangle-shaped forehead with a prominent midline ridge, resembling a keel, and superior-lateral orbital depression, and hypotelorism. Affected patients also have compensatory occipital-parietal calvarial changes, such as recessed lateral orbits.
Chronic regional pain syndrome - features
CRPS is a musculoskeletal pain syndrome associated with autonomic dysfunction. The lower limbs are commonly affected but it is usually unilateral. On examination, the child will have allodynia and may not be able to tolerate light touch or even clothing. Children will often appear cheerful while reporting a pain score of 10/10. They may have cyanosis, oedema or decreased skin temperature of the affected area with increased sweating.
Benign Nocturnal Pains of Childhood
Benign Nocturnal Pains of Childhood are more commonly known as “Growing Pains”. They can begin from the age of three years but not usually after 12 years old. The lower limbs are predominantly affected but upper limbs can also be affected. Isolated upper limb involvement would be very unusual. The pain is usually bilateral and does not affect the joints. It usually occurs in the evening and can be severe enough to wake children from sleep. Simple analgesia and massage help to relieve the pain. Daytime symptoms are rare and daily activities are not usually limited. In spite of the name, it is not associated with periods of rapid growth and does not occur at growth sites. There is often a family history. The child will have no abnormalities on examination.
Erthromelalgia - features
Erthromelalgia is a rare disorder where patients experience episodes of extreme pain and intense heat of their extremities – often the feet. Patients actively seek to cool the area with fans and ice and may cause skin damage. It may be triggered by increase in environmental temperature or exercise.
Sensitivity and specificity of influenza rapid antigen test
The sensitivity of influenza rapid antigen tests is generally 50-70% and specificities 90-95%
Classical signs of Farber disease
Three classic signs occur inFarber lipogranulomatosis:
a hoarse voice or a weak cry,
small lumps of fat under the skin and in other tissues (lipogranulomas), and
swollen and painful joints.
Affected individuals may also have difficulty breathing, an enlarged liver and spleen (hepatosplenomegaly), and developmental delay.
Farber lipogranulomatosisis a rare inherited condition involving the breakdown and use of fats in the body (lipid metabolism). In affected individuals, lipids accumulate abnormally in cells and tissues throughout the body, particularly around the joints.
Congenital Central hypoventilation syndrome
Gene & inheritance
Characteristics
Associations
PHOX2B, autosomal dominant
Hypoventilation, esp during sleep
Lack of symptomatic response to hypoxia and hypercapnia
Autonomic dysfunction
20% Hirshsprungs
Neural crest tumour -> neuroblastoma (gamgliomas, ganglioneuroblastomas)
Eye - decreased response of pupils to light
Box shaped face - wide and flattened
Intellectual disability criteria
IQ < 70
Average development for 30months
Motor: walks alone, crawls up stairs
Adaptive: makes tower of 3 cubes, makes a line with crayons, inserts raisin in bottle
Language: jargon, follows simple commands, may name a familiar object (eg. Ball)
Social: indicates some desires or needs by pointing, hugs parents
Average development for 2years
Motor: runs well, walks up and down stairs, one step at a time, opens doors, climbs on furniture, jumps
Adaptive: makes tower of 7 cubes, scribbles in circular pattern, imitates horizontal strokes, folds paper once imitatively
Language: puts 3 words together (subject, verb, object)
Social: handles spoon well, often tells of immediate experiences, helps to undress, listens to stories when shown pictures
Average development for 15 months
Motor: walks alone, crawls up stairs
Adaptive: makes tower of 3 cubes, makes a line with crayons, inserts raisin in bottle
Language: jargon, follows simple commands, may name a familiar object (eg. Ball)
Social: indicates some desires or needs by pointing, hugs parents
Characteristics of Blount disease
growth disorder of the tibia with bowing of the legs
Bowing becomes more prominent once waling
Can see lateral thrust of the knees on the stance phase of ambulation
Associated with early walking and obesity
There are two types of Blount disease (early-onset and late-onset), based on whether symptoms begin before or after four years of age
Caloric requirements for
Neonate
6yo
12yo
Kcal in lipids/carb/protein
Neonate 100kcal/kg/day
6yo 75kcal/kg/day
12yo 50kcal/kg/day
Lipid 9kcal/gram
Protein & carb 4 kcal/gram
Recurrence rate of febrile seizures and rain factors
30-40% with Frist febrile seizure will have at least one recurrence. 75% within first year
<12mo = 50%
First degree relative
Low temp
Short duration prior to seizure
All 4 risk factors = 75%
