General paeds - HB

Question 1

What are the signs of respiratory distress in an infant?

Answer 1

• Tachypnoea -more than 60bpm
• Expiratory grunt - helps to maintain functional residual capactiy and increase PEP
• Recession
  
  • Intercostal spaces and sterum sucked in during inspiration
  • Indrawing of the lower costal margin - due to contration of the diaphragm
• Nasal flare - decreases airway ressitance
• Central cyanosis

WOB is generally a better indicator that RR

Question 2

What is the average neonatal weight gain per week?

Answer 2

• 0-3months - 30g/day except on Sundays
• 3-6 months - 20g/day except on Sundays
• 6-9months - 15g/day except on Sundays
• 9-12months - 10 g/day except on Sundays

Question 3

What features must be present for someone to have the arthritis of Juvenile idiopathic arthritis?

Answer 3

• Age of onset less than 16 years
• The presence of arthritis defined as articular swelling and effusion, of the presence of two of the following findings in joints
  
  • Warmth
  • Limitation of movement
  • Tenderness or pain on motion
• Duration of arthritis of at least 6 weeks
• Exclusion of other causes of arthritis
  *

Question 4

How do most children with ITP present?

Answer 4

• Most present with bruising and petechiae alone
• Commonly following a viral infection
• In some instances there is oral bleeding, epistaxis, rectal bleeding or haematuria

Question 5

What is the management for most children with ITP?

Answer 5

Conservative

Educate the parents about when to present to the ED

Advise to avoid contact sports but school attendance is ok

Question 6

What are indications for managing ITP with steroids?

Answer 6

Any patient who has active bleeding (oral, aural, nasal, rectal) even if resolved should be admitted and considered for oral prednisolone.

Question 7

When is ITP considered chronic?

Answer 7

Ongoing thrombocytopenia after a 6 month period