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Paediatrics > General paeds > Flashcards

General paeds Flashcards

1
Q

Which phase of growth has the fastest rate of growth?

A

Prenatal/intrauterine

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2
Q

What is infantile growth heavily dependent on?

A

Nutrition and thyroxine

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3
Q

What is childhood growth heavily dependent on?

A

Thyroxine and growth stimulating hormone

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4
Q

What is pubertal growth heavily dependent on?

A

Sex hormones

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5
Q

What is the normal milk requirement for a baby up to 6 months?

A

150 mls/kg/day

~5 oz/kg/day

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6
Q

When should babies begin to be weaned from?

A

6 months

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7
Q

What are the maintenance fluid requirements for a child for the 1st 10kg, 2nd 10 kg and 3rd & subsequent kg?

A

1st 10 kg = 100 mls/kg/day
2nd 10 kg = 50 mls/kg/day
3rd and subsequent kg = 20 mls/kg/day

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8
Q

How is obesity and being overweight defined in childhood?

A

Obesity: Above 98th centile on age+sex matched growth chart
Overweight: Above 91st centile on age+sex matched growth chart

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9
Q

What screening procedures will a child attend and when?

A

Birth: neonatal exam (eyes, heart, hips, automated hearing screen)
5-7 days: Guthrie heel-prick test (PKU, hypothyroid, CF, haemoglobinopathies, acylcarnitine)
8 weeks: General exam usually done by GP
4-5 years: Orthoptist

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10
Q

When is soiling deemed abnormal?

A

> 4 years

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11
Q

At what age do night terrors, nightmares and sleepwalking tend to occur?

A

Night terrors: 4-7 years
Nightmares: 8-10 years
Sleepwalking: 5-10 years

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12
Q

How much fluid should be given to a child in a fluid resuscitation bolus?

A

20 mls/kg of 0.9% sodium chloride

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13
Q

What temperature is a red flag in infants under 3 months old?

A

> 38 degrees

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14
Q

What are some features of an atypical febrile convulsion?

A

Last longer than 15 minutes
Focal features
2 within 24 hours, or within same febrile illness

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15
Q

What are some risk factors for a child developing epilepsy?

A

Atypical febrile seizure
Abnormal neurology/neurodevelopment prior to event
Family history in 1st degree relative of epilepsy

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16
Q

What is the risk of a child who has had a simple febrile convulsion developing epilepsy?

A

Simple febrile convulsion (i.e. no risk factors) = 1% risk of developing epilepsy - same as background risk

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17
Q

What is the risk of a child who has had a febrile convulsion with 1 risk factor developing epilepsy?

A

2%

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18
Q

What is the risk of a child who has had a febrile convulsion with 2+ risk factor developing epilepsy?

A

10%

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19
Q

What is the recurrence rate of a simple febrile convulsion?

A

~30%

20
Q

Between what ages do febrile convulsions tend to occur and what percentage of children get them?

A

Commonly between 6 months and 6 years

Around 3% of kids get them

21
Q

What criteria must be fulfilled to diagnose Kawasaki’s disease?

A

Fever lasting >= 5days AND 4+ of:

  1. Changes in extremities (desquamation/erythema/oedema)
  2. Bilateral conjunctivitis (non-purulent)
  3. Rash
  4. Cervical lymphadenopathy
  5. Changes in oropharynx (cracked lips/red tongue)
22
Q

What is the causative organism of meningococcal septicaemia?

A

Neisseria meningitides

23
Q

What are the most common causative organisms for meningitis in neonates?

A

E Coli
Group B strep
Listeria

24
Q

What are the most common causative organisms for meningitis in children?

A

Viral
Meningococcal
Pneumococcal
Haemophilus

25
Q

How can the glucose CSF:blood ratio help differentiate between bacterial and viral meningitis?

A

In bacterial, Glucose CSF:blood ratio is usually < 0.4 whereas it usually normal in viral meningitis

26
Q

What is the possible sequelae of meningitis?

A

Cerebral palsy in <2yr
Deafness
Epilepsy
Coning and death

27
Q

What staging system is used to stage puberty?

A

The Tanner scale

28
Q

What is the first sign of puberty in girls and boys?

A

Girls: breast enlargement
Boys: testicular enlargement (when testes reach 4 mls, puberty has started)

29
Q

What is the cut off for precocious puberty in girls and boys?

A

Girls: onset of secondary sexual characteristics before 8
Boys: onset of secondary sexual characteristics before 9

30
Q

What is the cut off for delayed puberty in girls and boys?

A

Girls: no sign of puberty by 13 or menarche after 15
Boys: no sign of puberty by 14

31
Q

In clinical genetics, what is penetrance?

A

How symptomatic and syndromic an individual with the affected gene is

32
Q

In clinical genetics, what is anticipation?

A

Apparent earlier age of onset and increased severity of a disease in successive generations, eg, Huntington’s disease.

33
Q

What is aneuploidy?

A

Abnormal number of chromosomes in a cell e.g. 45 or 47

34
Q

Which syndrome is a baby with the following features (Small ears, Upslanting palpebral fissures, Epicanthic folds, Flat facial profile, Short nose, Brachycephaly (flat head), Single palmar crease, Sandal gap between hallux and 2nd toe, hypotonia) likely to have?

A

Down’s syndrome (Trisomy 21)

35
Q

Which syndrome is a girl with features of wide neck, shield-shaped chest, short stature, wide carrying angle, feeding problems likely to have?

A

Turner’s syndrome (45 XO)

36
Q

Where is the chromosomal deletion in DiGeorge syndrome?

A

22q11.2

37
Q

Which condition is a child with large forehead, small proximal limbs, low bridge of nose, midface hyperplasia, trident hands and frontal bossing likely to have and which gene is implicated in this condition?

A

Achrondroplasia/dwarfism

Gene: FGFR3

38
Q

Which syndrome is a child with wide-spaced eyes, ptosis, thick eyelids, coarse facial features, chest wall deformities and short neck with low posterior hairline likely to have?

A

Noonan syndrome

39
Q

Which antibiotics are used for meningitis?

A

In community, IM benzylpenicillin.

In hospital, a 3rd gen cephalosporin that can cross the blood-brain barrier e.g. IV cefotaxime

40
Q

Which antibiotic is given as prophylaxis for meningitis for ‘kissing contacts’?

A

Ciprofloxacin or rifampicin

41
Q

Which antibiotics are used for whooping cough (bordatella pertussis)?

A

A macrolide e.g. erythromycin or clarithromycin for 7 days or azithromycin for 5 days. Exclude from nursery for 3 weeks after start of cough stage or 5 days after starting the antibiotic.
Prevention with DTaP vaccine

42
Q

Which bacteria is associated with heamolytic-uraemic syndrome?

A

E.coli 0157

43
Q

What is the characteristic sign of respiratory distress syndrome seen on CXR?

A

Ground-glass sign

44
Q

What is the management of hypoxic ischaemic encephalopathy?

A

Cool to 33-34 degrees for up to 72 hours. This slows down cerebral metabolism to limit glutamine and free radical release. Long-term risk of HIE is cerebral palsy

45
Q

When should a newborn have passed meconium by?

A

Within first 24 hours of life

Paediatrics (16 decks)

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