Knowledge revision - Paeds

Question 1

What are the key aspects of a paediatric history?

Answer 1

• PC, HPC, PMH
• Birth history – method of delivery, gestation, complications etc
• Developmental history
• Immunisations
• FH
• SH – school, home life, friendships etc

Question 2

What are the major red flags for children with pyrexia?

Answer 2

• Pale/mottled
• Appears ill to HCP
• Weak, high-pitched cry
• Grunting
• RR > 60
• Reduced skin turgor
• Age < 3 months
• Non-blanching rash
• Seizures/ neck stiffness

Question 3

What are the main causes of respiratory distress in infants?

Answer 3

Choking
Croup
Bronchiolitis
Pertussis
Congenital HD

Question 4

‘Barking cough’ suggests…

Answer 4

Croup

Question 5

How is croup treated?

Answer 5

Dexamethasone – 150 mcg/kg

Question 6

When is the peak age for bronchiolitis?

Answer 6

3-6 months

Question 7

What is the Mx of bronchiolitis?

Answer 7

Supportive

Question 8

‘Whooping cough’ is also known as…

Answer 8

Pertussis

Question 9

What are the symptoms of epiglottitis?

Answer 9

Pyrexia, sore throat, drooling, stridor (late sign)

Question 10

How is epiglottitis managed?

Answer 10

IV Ceftriaxone + Consult anaesthetics/senior

Question 11

When is neonatal jaundice abnormal?

Answer 11

< 24 hours = pathological
> 2 weeks or > 3 weeks in pre-term = Prolonged

Question 12

When does physiological jaundice tend to occur?

Answer 12

3-7 days

Question 13

What are the most common causes of pathological jaundice?

Answer 13

ABO haemolytic disease, Rh incompatibility or sepsis

Question 14

Give some causes of prolonged neonatal jaundice.

Answer 14

Exclusive breastfeeding, sepsis, Hepatitis, biliary atresia, inherited Hb-opathies

Question 15

How is neonatal jaundice managed?

Answer 15

Investigate for cause
Guided by bilirubin level - usually phototherapy - plasma exchange in severe cases

Question 16

Which differential must be considered in febrile convulsions?

Answer 16

CNS infection

Question 17

What advice can be given to parents whose child has had a febrile convulsion?

Answer 17

1/3 of these children will have another febrile convulsion
Small increased risk of epilepsy (2%)