General and Community Paediatrics Flashcards

1
Q

Three elements of Autism

A

Impaired social interaction, communication and connectedness

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2
Q

Anatomically, where does INspiratory stridor originate?

A
above subglottis (In children), middle airway
- subglotic stenosis, laryngomalasia, FB
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3
Q

Anatomically, where does EXpiratory stridor originate?

A
below subglottis (in children)middle airway
- Tracheomalacia, asthma, FB, vascular ring
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4
Q

Where does stertor originate?

A

Anything above subglottis, upper airway

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5
Q

What does biphasic stridor indicate?

A

Fixed subglottis/ glottis

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6
Q

weak cry, inspiratory stridor, from birth?

A

Laryngeal Web
Failure of recanaliszation of larynx
VCF syndrome / DiGeorge = 65%!
Cri du Chat also associated (loss of part of Chr 5)

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7
Q

Characteristics of laryngomalacia

A

Present in the first few weeks of life
Inspiratory stridor
Omega shaped epiglottis
Feeding difficulties, choking, 50% also have reflux (use losec/gaviscon)
Most grow out of by 12-18 months
Some have blue spells and some have O2 requirement

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8
Q

Characteristics of vocal cord paralysis

A

Idiopathic 80% - birth trauma, neural/mediastinal tumours, prolonged intubation,
Often improve
Some need tracheostomy

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9
Q

Characteristics of subglottic haemangioma

A

Not present at birth
Symptoms of obstruction week 4-16, worsens as the lesion grows
Treat with propranolol x 12 months

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10
Q

Rapidly involuting congenital haemangioma characteristics

A

Red, nodular, peripheral halo, superficial ulceration, regress 1-6 weeks, can have consumptive thrombocytopenia, usually on extremities
- regress on their own in the first year

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11
Q

Non-involuting congential haemangioma characteristics

A

Raised, some grey scale, well circumscribed 5-6cm, coarse telangiectasia, warm to palpation, often on mandibular boarder, later diagnosis
- never regress

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12
Q

Characteristics of infantile haemangioma

A
Not present at birth
Develop and grow to 6-9 months then naturally regress (generally by age 4)
up to 3% of infants, 3:1 F:M
9:1 in PHACE
30% pretem/LBW
GLUT1 POSITIVE

Associated wiht maternal age, pre-eclampsia, placenta previa, fertility drugs, multiples

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13
Q

What is PHACES?

A
P - 
H - 
A - 
C - 
E - 
S -
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14
Q

Differentials of laryngomalacia?

A

Bilateral vocal cord paralysis

Vallecular cyst - improves when nursed prone

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15
Q

What is Mondini Deformity?

A

Structural deformity of INNER ear - starts at 7th week of development
- Only 1.5 turns of the cochlea
- May have acute deterioration in hearing due to increased pressure in cochlear aqueduct with secondary tear in the round window
Diziness related to an oval window fistula
Further deterioration in hearing can be prevented by surgery and may be associated with recurrent meningitis
–> patients generally develop profound hearing loss

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16
Q

Differentials for fluctuant hearing loss?

A

Congenital

Vestibular or cochlear aqueduct problem

17
Q

What is Goldenhar syndrome?

A
18
Q

What is connexin 26 mutation? (GJB2 mutation)

A

Commonest non-syndromic congenital hearing loss

19
Q

What is the maximum conductive hearing loss of otitis media?

A

50 db

20
Q

What is otosclerosis? + most common presentation?

A

Conductive hearing loss
Stapes fixed
*most commonly presents with Otorrhea *
- can present with hearing loss, dizziness, facial palsy, otalgia

21
Q

Frequency of pre-lingual hearing loss?

A

1/500

22
Q

What proportion of pre-lingual hearing loss is acquired / environmental?

A

1/5 (20%)

23
Q

What is the strongest environmental risk factor for acute otitis media in young urban children?

A
  • Day care outside the home *