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PAEDIATRICS > General paeds + WRAP UP > Flashcards

General paeds + WRAP UP Flashcards

1
Q

At what ages to children receive vaccinations?

A

Birth, 6 wks, 4 months, 6 months, 12 months, 18 months, 4 years, 12 years

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2
Q

What vaccinations are given at each age?

A 
Birth - Hep B
6 weeks - Hep B, DPT (diptheria, pertussis, tetanus), Haemophilus influenzae type B, polio, pneumococcus, rotavirus
4 months - same as 6wks
6 months - same but without rotavirus
12 months - Haemophilus influenzae type B, meningococcal C, MMR
18 months - MMR, varicella, DPT
4 years - DPT, polio
12 years - DPT, HPV
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3
Q

What is the contagious period of viral illnesses?

A

From 1 daysbefore onset of fever/rash until 24hours after fever has finished

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4
Q

What should parents do if they suspect child’s spots are chicken pox?

A

Draw a circle around the spots, if they turn into blisters within 24 hours then probably chicken pox

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5
Q

What rashes are associated with a high fever?

A 
Meningococcal
Kawasaki disease
Stevens Johnson
Cocksackie/hand-foot-mouth disease 
Glandular fever
HSP
Measles, Mumps
Scarlet fever
Roseola
5th disease
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6
Q

What rash conditions are medical emergencies? How do the rashes appear?

A

Diptheria: membrane forming on throat/tonsils, swollen lymph glands, dysphagia
Meningococcal disease: non-blanching, purpuric papular rash, signs of meningism

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7
Q

What is the difference between petechiae and purpura?

A 
Petechiae = pin-point non-blanching lesions
Purpura = larger non-blanching lesions >2mm
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8
Q

What rashes are reportable to the public health unit?

A

Diptheria, Measles, Meningococcal

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9
Q

What are some neurocutaneous lesions that are important to look for on developmental examination?

A

Cafe-au-lait spots
Shagreen patch
Cutaneous angiofibromas
Axillary/inguinal freckling

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10
Q

What are some common causes of leukaemia?

A

Radiation exposure
Chemicals and drugs
Genetics
Viruses

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11
Q

What are some common symptoms/signs of leukaemia in children?

A

Symptoms related to infiltration or decreased production of other cells
FEVER in absence of infx
Increased risk of infection, anaemia, bruising
Bone pain, splenomegaly, lymphadenopathy

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12
Q

Compare and contrast AML and ALL

A

Table from toronto notes

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13
Q

What is a complications of a very high WCC?

A

Leukostasis

- Increased WCC causing aggregation and clumping - most commonly affects lungs and brain - local hypoxaemia

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14
Q

Explain the pathophysiology of leukaemia

A

Flow chart from notes
Malignant transformation of lymphoid progenitor cells –> uncontrolled proliferation of these progenitor cells in the bone marrow –> lymphoblasts replace normal cells in the BM –> pancytopaenia
- Anaemia (lethargy, pale)
- Thrombocytopaenia (bruising, petechiae)
- Neutropaenia (infection)
+ bone pain, joint pain

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15
Q

What defines the neonatal period?

A

First 28 days of life

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16
Q

Describe the APGAR scoring system

A

Total score out of 10, each thing worth 0-2 points
Poor (0-4), Fair (5-7), Good (8-10)
Appearance (blue/pale, body pink and extremeties blue, all pink)
Pulse (0, <100, >100)
Grimace (reflex) - no response, grimace, cough
Activity (tone) - limp, some flexion, active
Respiration - absent, slow/irregular, good

17
Q

What are some of the nutritional challenges of a premature baby?

A
  • Difficult coordinating sucking/swallowing/breathing because this develops at 34-36weeks
  • Immature gag reflex - risk of aspiration
  • Immature GIT and enzymes (limits absorption)
  • Immature liver/metabolism - hypoglycaemia and jaundice
18
Q

What are some findings on newborn check that are cause for urgent investigation?

A

General: respiratory distress, jaundice >24hours, poor tone, cyanosis, seizures, altered LOC
Head/neck: bulging fontanelles, subgaleal haemorrhage, non-patent nares
Chest: apnoeic episodes, weak/absent pulses, poor pulse oximetry
Abdo: bilious vomiting, non-patent anus
GU: non-descended testes, testicular torsion, ambiguous genitalia, no poop in 24hrs

19
Q

What are reflex anoxic seizures?

A

Reflex anoxic seizures are paroxysmal, spontaneously-reversing brief episodes of asystole triggered by pain, fear or anxiety. Anoxic seizures are non-epileptic events caused by a reflex asystole due to increased vagal responsiveness.

20
Q

What are the differentials for a seizure in a child?

A 
Epilepsy
Febrile seizure
Meningitis
Head injury
Breath holding attack
Reflex anoxic seizures 
Infantile spasm
21
Q

Explain the APGAR score

A 
Appearance (colour)
Pulse rate
Grimace (reflexes)
Activity (tone)
Respiratory rate
22
Q

How do you define failure to thrive?

A

Failure to achieve the growth potential expected for a child

The term is usually applied when the growth crosses two or more centile lines downwards on a standard growth chart

23
Q

What examinations will you do for a child with a seizure?

A

ABCDEFG

  • Full set of obs especially temperature
  • Cranial nerve - focal symptoms
  • Look for any dysmporphia
  • Look for any neurocutaneous symptoms
  • Assess development
24
Q

What investigations will you do for a child with a seizure?

A
  • Full obs
  • BSL
  • UA
  • FBC and differentiated WCC
  • EUC
  • If concerned, EEG, MRI
25
Q

What is the definition of status epilepticus and how will you manage it?

A

Seizing for >5 minutes or multiple without recovery in between

  • Call for help
  • ABCDEFG
  • Ensure safety
  • Put on monitoring, put on oxygen, think about IV access
  • IM medazolam or IV
  • Give another dose at 5 minutes if still seizing
  • Still seizing at 20 mins give IV/IO phenytoin
26
Q

What is the definition of prematurity?

A

<37 weeks gestation

27
Q

What are some complications of prematurity?

A 
Temperature instability
Hypoglycaemia
Jaundice
Respiratory distress syndrome
Feeding
28
Q

What are some complications of extreme prematurity?

A 
Retinopathy of prematurity
Hearing loss
Respiratory distress
PDA
Necrotising enterocolitis
Anaemia
29
Q

What are some risk factors for neonatal hypoglycaemia?

A 
Prematurity
GDM
Hypothermia
Macrosomia or small baby
Poor feeding
Unwell
30
Q

What are the clinical findings of a baby with hypoglycaemia?

A

CNS excitation: high pitched cry, irritable, seizures, jitteriness
CNS depression: poor feeding, lethargy, apnoea, coma
Catecholamine response: pale, sweaty, tachy

31
Q

How do you manage a baby with hypoglycaemia?

A

Oral/NG formula or dextrose

32
Q

What are you looking for with the red eye reflex in a newborn examination?

A

White - retinoblastoma

Absent or white - congenital cataracts

33
Q

What are the ‘do not miss’ things on newborn examination?

A

Jaundice <24 hours, bulging fontanelles, central cyanosis, poor tone, bilious vomiting, non-patent nares, non-patent anus, resp distress, weak pulses, organomegaly, testicular torsion, ambiguous genitalia, no meconuim after 24hours

PAEDIATRICS (9 decks)

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