General Paeds 4 Flashcards
Describe features of toddler’s diarrhoea?
Known as chronic nonspecific diarrhoea.
Defined as 3 or more watery bowel motions per day. Often smellier and paler than usual with bits of undigested food.
If child is fit and well and no examinations or investigations are needed, symptoms often resolve by age 5-6 years.
Causes of chronic diarrhoea in children?
Cow’s milk intolerance,
Toddler’s diarrhoea,
Coeliac disease,
Post-gastroenteritis lactose intolerance
What are predisposing factors to UTIs in children?
Incomplete bladder emptying - infrequent voiding, hurried micturition, obstruction by full rectum due to constipation, vulvulitis, neuropathic bladder.
Vesicouriteric reflux.
Poor hygiene - not wiping front to back in girls.
Explain presentation of UTIs in children?
Infants: poor feeding, vomiting and irritibility.
Younger children: abdominal pain, fever and dysuria,
Older children: Dysuria, frequency and haematuria.
Pyelonephritis is suggested by temp > 38 and loin pain/tenderness
What are the investigations for UTIs in children?
Urinalysis if: Any symptoms of UTI, unexplained fever over 38 degrees or children with alternative site of infection who remain unwell.
Collection method: clean catch is gold standard but if not possible then urine collection pads should be used.
Others: catheter specimen urine or suprapubic aspiration.
What is the management of a UTI in children?
Infants under 3 months should be referred immediately to paeds.
Children over 3 months with LOWER UTI - oral abx for 3 days (usual trimethoprim, nitro, amox)
Children over 3m with UPPER UTI - Consider admission to hospital, if not then give 7-10 days of co-amoxiclav or cephalosporin.
WHat bacteria is commonly isolated from UTIs in children?
E.coli (85%),
Proteus (common in boys),
staphylococcus,
Klebsiela,
Psudomonas
What is the classification of viral induced/pre school wheeze?
Primary:
1. Episodic viral wheeze (wheeze only during viral infections, child is otherwise well)
2. Multi-Trigger Wheeze (Wheeze triggered by lots of things eg, viruses, pollen, animals
Secondary: Due to underlying lung conditions eg, cystic fibrosis, immune deficiency, ciliary dyskinesea, GORD.
What are the risk factors for preschool wheeze?
Postnatal environment,
Host factors,
Immune response,
Allergic inflammation,
Remodeling,
Genetic factor.
Investigations and management for preschool wheeze
Ix - mostly not required.
Tx - Avoid environmental exposure, if recurrent then use ICS or montelukast.
Red flags for viral induced/preschool wheeze?
Symptoms of underlying of serious respiratory pathology,
Severe frequent wheeze with numerous attendances,
No improvement after 8 weeks of ICS.
Symptoms present since birth.
Abnormally severe airway obstruction.
Slow or incomplete recovery.
