General and Community Paediatrics Flashcards
Three elements of Autism
Impaired social interaction, communication and connectedness
Anatomically, where does INspiratory stridor originate?
above subglottis (In children), middle airway - subglotic stenosis, laryngomalasia, FB
Anatomically, where does EXpiratory stridor originate?
below subglottis (in children)middle airway - Tracheomalacia, asthma, FB, vascular ring
Where does stertor originate?
Anything above subglottis, upper airway
What does biphasic stridor indicate?
Fixed subglottis/ glottis
weak cry, inspiratory stridor, from birth?
Laryngeal Web
Failure of recanaliszation of larynx
VCF syndrome / DiGeorge = 65%!
Cri du Chat also associated (loss of part of Chr 5)
Characteristics of laryngomalacia
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
Characteristics of vocal cord paralysis
Idiopathic 80% - birth trauma, neural/mediastinal tumours, prolonged intubation,
Often improve
Some need tracheostomy
Characteristics of subglottic haemangioma
Not present at birth
Symptoms of obstruction week 4-16, worsens as the lesion grows
Treat with propranolol x 12 months
Rapidly involuting congenital haemangioma characteristics
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
Non-involuting congential haemangioma characteristics
Raised, some grey scale, well circumscribed 5-6cm, coarse telangiectasia, warm to palpation, often on mandibular boarder, later diagnosis
- never regress
Characteristics of infantile haemangioma
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
What is PHACES?
P - H - A - C - E - S -
Differentials of laryngomalacia?
Bilateral vocal cord paralysis
Vallecular cyst - improves when nursed prone
What is Mondini Deformity?
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
