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1. James' MD3 Cards > GP (CAH) > Flashcards

GP (CAH) Flashcards

1
Q

When does a congenital haemangioma require treatment?

A
  • Pressure on eyes/nose/trachea
  • Blocking field of vision OR large facial lesion
  • Ulcerating/painful lesion
  • Child has negative social stigma at school age
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2
Q

List 4 common causes of Fever in a child

A
  • Viral infection (URTI, tonsillitis, chickenpox)
  • UTI
  • Otitis media
  • Gastro
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3
Q

Not to be missed Dx of Fever in a child

A
  • Kawasaki’s (high fever, rash, strawberry tongue)
  • Appendicitis
  • Sepsis
  • Meningitis
  • Osteomyelitis
  • Pneumonia
  • Malignancy
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4
Q

What are the pertinent Hx points for a fever in a child?

A

-Immunisation Hx
-Sick contacts
-Recent travel
-Localising signs
-Signs of dehydration
(*inconsolable child is a bad sign)

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5
Q

What is the GP management of suspected meningiococcal sepsis/meningitis?

A

IM Benzylpenicillin and immediate transfer to hospital

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6
Q

Differential for bilious vomiting in a neonate

A

(* Bilious vomiting suggest obstruction = surgery!)

  • malrotation/volvulus (within 1st week of life)
  • duodenal atresia (very soon after birth)
  • necrotising enterocolitis
  • intussusception
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7
Q

How do you define “failure to thrive”?

A

Child is less than 3rd centile for weight
OR
Child crosses 2 centile lines in a short period of time

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8
Q

Outline the management of a febrile convulsion. When do you refer?

A
  • Febrile convulsion occurs in context of fever, lasts less than 15 mins, and usually self resolving
  • It is BENIGN: REASSURE PARENTS, treat underlying cause, panadol for pain and fever (not curative)
  • REFER with febrile status epilepticus, evolving neurology, recurrence in same febrile episode, or incomplete recovery within an hour.
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9
Q

What are the components of a 6 week baby check?

A
  • Observations (Trisomy 21, other phenotypic syndromes, interaction, eye movements, skin perfusion/jaundice, coarctation of aorta, descended testes, etc.)
  • Height/weight/head circumference (charts)
  • Developmental Hip dysplasia (Barlow and Ortolani tests)
  • Organomegaly (liver usually 3-4 cm below right costal margin)
  • Congenital heart disease (VSD)
  • Limb movement (predominant ‘hand-ness’ is abnormal before 18 months-may be muscle weakness)
  • GENITALS: Testes should descend by 3 months, check hypospadia
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10
Q

When is Enuresis abnormal?

A
  • Child is over 6
  • Daytime incontinence (of faeces too)
  • parent or child is troubled by bedwetting
  • child is punished for bedwetting
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11
Q

What is the management of enuresis?

A
  • motivation/avoid punishment/supportive parents & siblings
  • Chart wet and dry nights
  • avoid caffinated drinks and nappies
  • mattress protection
  • bedwetting alarms (80% effective in 6-8 weeks)
  • Meds(short term e.g. school camp) DDAVP/Minirin(ADH)
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12
Q

Outline management principles in the acute swollen scrotum.

A
  • First exclude torsion (high-riding testis, absent cremasteric reflex, tender +++) and hernia with surgical consult
    • If present - surgical exploration
  • If trauma, refer for surg unless testis is palpable as normal w/o pain.
  • Once excluded, use Doppler U/S sound to assess vascularity and anatomy (rule out torsion)
  • ABx for epididymoorchitis,
  • Outpatient referral for varico/hydrocoele.
  • If HSP, prednisolone 1mg/kg after surgical consult excludes torsion
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13
Q

Mx of Balanitis

A
  • Good hygiene
  • If candida suspected (satellite lesions) use topical antifungal
  • Topical hydrocortisone 1% if necessary
  • Topical ABx if required (unproven efficacy)
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14
Q

Mx of Impetigo

A
  • Warm wash of blisters
  • Topical mupirocin (Bactroban)
  • If extensive/unresponsive treat as cellulitis
  • Water-tight dressings (Tegederm)
  • Exclude from school (HIGHLY CONTAGIOUS)
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15
Q

Mx VZV

A
  • Symptom management with cool compress, calamine lotion
  • HIGHLY CONTAGIOUS! EXCLUDE FROM SCHOOL
  • IF
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16
Q

What is hand foot and mouth disease?

How is it managed?

A

Viral infection (coxsackie A 16)

Conservative management (HIGHLY INFECTIOUS)

  • Fluids, pain relief, not sharing cutlery, exclude from school
  • Refer to hospital w features of meningism
17
Q

Mx of vulvovaginitis

A

Conservative

  • Keep area dry, loose clothing
  • Weight loss if overweight
  • Avoid bubble bath/antiseptics and rinse area
  • Nappy rash cream/parraffin
  • consider referral if bleeding, pain
18
Q

Signs and Symptoms of Croup

A
  • Barking cough
  • inspiratory stridor
  • may have fever
  • increased work of breathing

(SEVERE SIGNS- lethargy, stridor at rest, tracheal tug, nasal flaring, chest wall retraction)

19
Q

Management of Croup

A

AVOID DISTRESSING CHILD FURTHER! (No Ix/Ex)

  • Cough only: No Rx required
  • Mild-mod: Prednisolone 1mg/kg
  • Severe: Nebulised Adrenaline 1% and 0.6mg/kg dexamethasone

If no improvement consider DDx or obstruction

20
Q

Common causes of Acute otitis media

A

Strep. pneumoniae (35%)
H. influenzae non-typable (25%)
Viral (25%)
Moraxella catarrhalis (15%)

Parental smoking and dummies are risk factors

21
Q

Management of Acute Otitis Media

A 
ANALGESIA ONLY
ABx only indicated when:
-child less than 12/12
-immunocompromised
-severly unwell
-no improvement in 48 hours

Rx amoxycillin or Augmentin if not responding

22
Q

Describe the Sx of Strep throat

A
  • B/w 3-14 y/o
  • High Fever
  • Tonsilar exudate
  • Cervical lymphadenopathy
  • absent cough/coryzal Sx
23
Q

Management of Strep throat

A
  • Penicillin V (Phenoxymethyl penicillin)
  • 2nd line: cephalexin
  • If intolerant/poor PO intake use Pen G

(if pen. sensitive use roxithromycin)

24
Q

Complications of Strep throat

A
  • Rheumatic fever
  • Post strep GN
  • Retropharyngeal abscess
  • Acute Otitis Media
25
Q

Typical Hx of Croup

A

-Non-specific viral prodrome
-develop barking cough 1-2 days
+/- stridor

26
Q

Management of Croup

A
  • reassurance
  • symptomatic relief
  • avoid overexamining and distress to child
  • prednisolone
  • T/F to hospital consider early intubation if severe
27
Q

DDx of stridor

A
  • Croup (barking cough)
  • Epiglotitis (septic, drooling ++ w open mouth)
  • Foreign body
  • Infective tracheitis
  • Retropharyngeal abscess
  • Quinzy/peritonsilar abscess
  • Diphtheria
28
Q

What are the side effects of ventolin?

A

tachycardia/tachypnoea
tremor
headache
nausea/vomiting

29
Q

Name some common Asthma triggers in children

A
  • irritants (PARENTAL SMOKING and pollution)
  • allergens
  • cold
  • exercise
30
Q

Name the 4 main management strategies of childhood asthma

A
  • Relievers (SABA)
  • Preventer (ICS+LABA)
  • Asthma Action Plan
  • Info pamphlets

1. James' MD3 Cards (9 decks)

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