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Paeds ILA > ILA 1 > Flashcards

ILA 1 Flashcards

1
Q

Septic screen

A

FBC, CRP, urine culture, blood culture

CXR, LP, U&Es, blood gas

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2
Q

Common sites for sepsis to come from

A

Lungs - pneumonia
Bladder - UTI
Abdomen - Appendicitis

Pelvic - abscesses
Skin - cellulitis/burns
Nervous System - meningitis

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3
Q

Types of bacteria: Group B strep

A

Gram +ve cocci - often in chains

B-haemolytic, catalase -ve

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4
Q

Listeria

A

Gram +ve bacilli

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5
Q

E. coli

A

Gram -ve bacilli

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6
Q

H. influenzae

A

Gram -ve coccobacilli (choc agar)

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7
Q

N. meningitidis

A

Gram -ve cocci

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8
Q

S. pneumoniae

A

Gram + cocci

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9
Q

What causes purpura?

A

Extravasation of the blood into the skin/mucous membranes

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10
Q

Causes of purpura rash

A

DIC, bacteraemia can cause widespread thrombosis, HSP, ITP, leukaemia

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11
Q

Management of patients with meningococcal septicaemia

A 
A - Airway
B - high flow O2 (10L/min)
C - IV access, fluids, abx
D - AVPU (pupillary reaction)
E - body temp, glucose, urine output
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12
Q

How is men septicaemia transmitted?

A

Droplets from the upper resp tract

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13
Q

What prophylaxis would you give to a pregnant women who has been in contact with a child with men septicaemia?

A

Ceftriaxone IM single dose

ciprofloxacin also CI in epilepsy

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14
Q

What defines a close contact?

A

anyone who repeatedly and regularly shares the living space of someone with the infectious disease
anyone who has an intimate relationship with the infected case
anyone who has had transient close contact e.g. during intubation

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15
Q

JIA investigations

A

Limb examination
Bloods - FBC, U&Es, LFTs, CRP/ESR, HLA B27
Urine dip
Imaging - Xray

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16
Q

Diseases associated with HLA B27

A 
PAIR
Psoriasis
Ankylosing Spondylitis
IBD
Reative Arthritis
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17
Q

What are the baseline bloods for JIA usually like

A

Often normal

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18
Q

Differentials for JIA

A

Conn tissue disorder, malignancy, infection (sepsis)

19
Q

Who is part of the MDT for a child with JIA

A 
Paed Rheumatologists
Nurses
Physios
Paeds Opthalmologists
Dieticians
GP
20
Q

DD of Kawasaki’s

A 
Scalded skin syndrome
Juvenile rheumatoid arthritis
Scarlet fever
Toxic shock syndrome
Measles
Rheumatic fever
21
Q

What sized arteries does Kawasakis affect

A

medium-sized

22
Q

Investigations for Kawasaki’s

A

Increased CRP/ESP/Plts/WCC
May be anaemia
Echo

23
Q

Other than fever, what are the signs of Kawasaki’s

A

MY HEART
M(y) - Mucosal membrane involvement (lips) - red/dry, STRAWBERRY tongue
H - Hands/feet - red + oedematous, desquamation
E - Eyes, bilateral non-purulent conjunctivitis
A - Adenopathy - cervical lymphadenopathy
R - Rash - widespread erythematous
T - Temp, fever for >5days

24
Q

Tx Kawasaki’s

A

Aspirin, IV Ig, supportive, Echo (immed, + at 4-6weeks)

25
Q

Causes of diabetes insidious + what is it

A

High volume of dilute urine d/t impaired water resorption by kidneys
Cranial - decreased secretion of ADH from PP
Nephrogenic - resistance to ADH in the kidneys

26
Q

What investigations would you do in suspected DKA

A

ABCDE
Blood - glucose, ketones, E&Es, creatinine
Blood gas
Blood + urine cultures
ECG - T wave depression (d/t hypokalaemia)
Weight

27
Q

Treatment of DKA

A

(1) Rehydration (SLOWLY over 48hrs) - fluid bolus + maintenance fluids
(2) Insulin - following IV fluids for 1hr. Change fluids to +5% glucose when glucose <14mmol/L
(3) Potassium - this will fall with Tx, give replacement with fluids

28
Q

RFs for T1 DM

A

FH, genetics, 4-7yrs or 10-4yrs, enteroviral infections, low vit D

29
Q

What is the most common cause worldwide of cong hypothyroidism

A

Iodine deficiency

30
Q

What is the most common cause in the UK of cong hypothyroidism

A

Maldescent of the thyroid + athyrosis

31
Q

What are the DD for a collapsed neonate

A 
THE MISFITS!
T - Trauma
H - Heart disease
E - Electrolyte disturbances
M - Metabolic
I - Inborn errors of metabolism
S - Sepsis
F - Formula Mishaps
I - Intestinal catastrophes
T - Toxins
S - Seizures/CNS abnormalities
32
Q

What is a stridor?

A

Usually inspiratory, vibrating sounds of varying pitches caused by air flow through a partially obstructed airway

33
Q

DD of bronchiolitis

A

LRTI
Heart failure
GOR

34
Q

Risk factors for bronchiolitis

A 
Older children
Nursery attendance
Smoking in the home
Prematurity
IC
35
Q

How would bronchiolitis differ in a CF pt to a normal one?

A

More likely to be bacterial, give abx for causative infection (will also prevent secondary bact inf if viral)

36
Q

Causes of heart failure in neonates + infants

A 
Cardiac arrhythmias
Volume overload
Pressure overload
Systolic vent dysfunction
Diastolic vent dysfunction
37
Q

What is failure to thrive

A

Insufficient weight gain or inappropriate weight loss

38
Q

Causes of FtT

A 
Inadequate calories:
-Poor breastfeeding technique
-Persistent vomiting
-Chronic disease
Inadequate absorption:
-Coeliac disease
-Liver disease
-CF
-Diarrhoea – lactose intolerance, cow’s milk protein intolerance etc
Excessive calorie use:
-Chronic disease
-Diabetes
-Hyperthyroidism
Psychosocial
39
Q

Investigations for FtT

A

Bloods - FBC, U&Es, LFTs TFTs, ESR

Urine culture

40
Q

Causative agents of urine infection

A

E.coli, Klebsiella, Proteus, Enterococcus

41
Q

Investigations for nephrotic syndrome

A

Urine dip, U&Es, LFTs, FBC, Ig, complement levels, varicella titres, BP
May be more..

42
Q

Prognosis of nephrotic syndrome

A

1/3 resolve directly
1/3 infrequent relapses
1/3 frequent relapses - steroid dependent

43
Q

Management of nephrotic syndrome

A 
Fluid balance
Prednisolone
Penicillin prophylaxis
Pneumoccocal vaccination
Consider albumin infusion

Paeds ILA (1 decks)

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