Knowledge Flashcards
What are the main acyanotic heart murmurs in children and which way does blood flow?
VSD
PDA
ASD
Left to right
What are the signs of an innocent murmur?
Soft
Systolic
Sitting/Standing may vary (variable in position)
Symptomless - otherwise well child
S1/S2 normal - heart sounds normal, no additional sounds
Short
Special tests normal
What are the signs of a pathological murmur?
Harsh Diastolic/Holosysolic Split second heart sound Added sounds present Symptomatic Conducted across the precordium Thrill present
What are the main outflow obstruction murmurs in a child?
Aortic Stenosis
Pulmonary Stenosis
Coarctation of the aorta
What are the main cyanotic murmurs in children?
Right to left shunt
Tetralogy of Fallot
Transposition of the great arteries
What is the Tetralogy of Fallot?
Pulmonary Stenosis Overriding aorta Right ventricular hypertrophy VSD The baby will often become cyanotic on crying - stress - or in the 2nd/3rd day of life
What is the only cyanotic heart disease which can present at birth?
Transposition of the great arteries
Often no murmur
What is Eisenmerger’s Syndrome?
L to R shunt (acyanotic) heart diseases causes pulmonary artery hypertension due to the increased pressure in the pulmonary system. This causes the pressure in the R to be higher than the L, causing a reversal of the shunt. This is acquired cyanotic heart disease. This leads to cyanosis. There is very poor prognosis and heart/lung transplant is the only hope.
What are the murmurs of a VSD?
Reversely proportional to the size of the defect. Pansystolic murmur
What are the murmurs of a PDA?
Continuous machinery murmur
What are the murmurs of an ASD?
Wide, split second heart sound
What are the diagnostic criteria of Kawasaki’s Disease?
Fever present for >5 days Four of the following - Conjunctivits Red mucus membranes Rash Palm changes - desquamation of the superficial skin Cervical lymphadenopathy
What is the rash commonly seen in HSP?
Petechial/purpuric - palpable
On the trunk, buttocks and lower limbs
Symmetrical
What is HSP?
A rare vasculitis resulting in a clinical triad -
Abdominal pain
Joint pain
Rash
It is not usually serious and gets better within a few weeks.
Can lead to complications with the kidneys and bowels (intussusception) - rare
Associated with a previous infection, so there may be associated malaise and fever
May require steroids but usually managed at home with analgesia
Have to have regular checks of urine and BP to check for any kidney problems throughout illness
What are the short, medium and long term treatment plans for someone with anorexia?
Short term - physical stabilisation with vitamins, fluids, slow weight gain
Medium term - MDT package in the community, with child psychiatrist overseeing care and prescribing medications. Diet plan and therapist involvement
Long term - Relapse prevention - particularly at times of transition, e.g moving to university
