General Flashcards
Management for eczema
topical steroids - follow plan
eczema baths - bath oil, soap free wash, clean towel
cool compress
oil based moisturiser - keep clean/uncontaminated
anti-histamine
avoid skin infections? i.e. preventative care
wet dressing
prevent overheating
dry skin and then moisturise - don’t leave water on the skin
AB choice for cellulitits
mild = cefalexin oral
moderate = cefalexin oral or cefazolin IV
severe = flucloxacillin IV
necrotising fasciitis = vancomycin & meropenem AND clindamycin
most common pathogen of cellulitis?
group A strep, followed by staph aureus
Jaundice - compare physiological vs pathological
Physiological:
- appears after 24 hr
- resolves within 2 weeks
- serum bilirubin levels are less than 250umol/L
- max intensity by 4-5th day (term) or 7th day (prefterm)
Pathological:
- within 24hrs
- persists longer than 14 days
- serum bilirubin reaches 250umol/L
- stool colour is pale, dark urine
Causes of jaundice within 24hrs
Hemolysis:
isoimmunisation - ABO or Rh incompatibility
G6PD deficiency
haemorrhage
bruising - instrumental delivery
Sepsis
spherocytosis
Causes of jaundice after 24hrs
Physiological
sepsis
hemolysis
breastmilk jaundice (causes conjugated - increases enterohepatic circulation)
hypothyroidism (causes conjugated - increases enterohepatic circulation)
dehydration/insufficient feeding (breastfeeding jaundice)
bruising/birth trauma
Causes of conjugated bilirubin jaundice (conjugated fraction >10% of total bilirubin) AT ANY POINT
neonatal hepatitis
extrahepatic obstruction -> biliary atresia
metabolic causes - a1 antitrypsin deficiency, galactosaemia
hepatotoxins - paracetamol
hypothyroidism (increases enterohepatic circulation)
Most common organisms of meningitis in:
- 1-2months
- 2mth - 2yrs
PLUS most common viral cause
1-2mths: E.coli, GBS, listeria
2mth-12yrs: S.pneumoniae (pneumococcus(, neiserria meningitis (meningococcus)
Viral causes: enteroviruses and HSV
Kernig’s vs brudzinski’s sign
Kernig’s - raise leg up straight
Brudzinski’s - flex chin to chest (get flexion of lower extremities)
Meningitis diagnosis
LP
Also perform FBC, UEC’s, LFTs, coags, culture
What to order on LP
Glucose, protein, WCC (neutrophilic (viral) or lymphocytic (bacterial)), culture
Contraindications for LP
Skin infection at the sight of LP
Raised ICP - risk of cerebral herniation
Cardiovascular compromise
Suspected spinal epidural abscess
Treatment for meningitis
Empiric IV ABs, await for cultures
Supportive therapy: fluids
Give Acyclovir is HSV is suspected
Viral causes are usually self limiting
Complications of meningitis
Early:
Septic chock
DIC
cerebral herniation
Late:
CVA
sensory-neural losses
seizures
cognitive impairment
meningococcal can result in necrosis of limbs requiring amputation.
Kawasaki disease key clinical manifestations
Fever present for ~ 5days or more plus 4/5 of the following:
- strawberry tongue
- purpuric rash
- cervical lymphadenopathy > 1.5cm
- bilateral non-purulant conjunctival injection.
- peripheral extremity changes -> erythema, oedema, or skin desquamation
Treatment kawasaki
steroids
immunoglobulins
aspirin -> due to complication of coronary artery aneurysm
first sign of CF in a baby?
meconium ileus
What leukemia is most common in young children?
acute lymphoblastic leukemia
What is subacute sclerosing panencephalitis related to?
Measles if let untreated. However otitis media is the most common complication of measles.
CPR breath to compression rate in paeds?
15 compressions to 2 breaths
Treatment of croup?
oral steroids (prednisolone)
ABx do not work with croup as it is usually a viral cause
What is the CPR rate in a neonate?
3 compression to 1 breath
What investigation for suspected hirshprung disease?
rectal suction biopsy
Outline causes of neonatal jaundice at:
<24 hrs
Always pathological and requires further investigation
Should have a FBC and Coombs test performed.
Causes include:
- sepsis
- ABO or Rh alloantibodies
- hereditary conditions: G6DP deficiency, spherocytosis
- haemorrhage: cerebral, intra-abdominal