Management

Question 1

Mild Croup Mx

Answer 1

Home Care
Prednisolone 1mg/kg, Single Dose
Paracetamol 15 mg/kg Q4-6 hrs
Good Hydration

Question 2

Severe Croup Mx

Answer 2

Adrenaline Nebulized
Refer ED via ambulance
At hospital
- Continue Adrenaline
- Steroid

Question 3

Severe Bronchiolitis Mx

Answer 3

Transfer to ED - Supportive Care
Oxygen
Fluids
Paracetamol

Question 4

Asthma Step Wise Management

Answer 4

Step 1 – SABA PRN Ventolin
Step 2 – ICS Fluticasone, BD + Ventolin PRN
Step 3 – ICS + Monteleukast + Ventolin PRN
Step 4 – ICS/LABA Combi +/- Monteleukas + Ventolin PRN
(if <5 y/o - Do not give Step 4. Just refer them)

Question 5

Scarlet Fever Mx

Answer 5

Antibiotics - Penicillin 15mg/kg
Paracetamol
Hydration - ORS
Exclude from school 1st 24hours

Question 6

Kawasaki Mx

Answer 6

Medication - IVIG, Aspirin, Corticosteroids
Meds for Fever
2D Echo - Coronary Artery and Blood Tubes in the heart

Question 7

Febrile Neutropenia Mx

Answer 7

Refer to ED ASAP
Do Septic Workup - FBE, Blood C, UA, CXR, CT Scan, Lumbar Puncture
Antibiotics within 30-60 mins
Fluids and Fever Meds

Question 8

General Head Trauma Mx

Answer 8

Mild – Home
Mild w/RF - Observe 4 Hours
Mod-Sever – Imaging
Painkillers, Anti-Nausea Medications

Question 9

Seizure Mx

Answer 9

Refer Seizure Clinic
Investigations
- Blood – UEC, LFT, BSL, TFT, FBE
- ECG
- EEG and Brain Imaging

Question 10

Simple Febrile Convulsion Mx

Answer 10

Observe him for 1hr and check recovery
Usually benign and do not require investigations
Find the source of the fever and treat it
Paracetamol for the fever

Question 11

General Seizure Advice to Parent

Answer 11

Stay calm
Don’t try putting anything in his mouth
Protect the child from injury and move harmful objects away
Time the seizure
Do not try to stop it by holding them
When the seizure finishes just roll the child onto their side
Seizure >5 mins (Five) call the ambulance

Question 12

Full Septic Work up

Answer 12

FBE, ESR, CRP
Blood culture
Urine test
CXR
Lumbar Puncture

Question 13

Infantile Colic - PURPLE Mneumonic

Answer 13

P – Peaks around 2m age
U – Unprovoked, unexpected
R – Resists soothing
P – Pain like facial expression
L – Long and can last >3h
E – Worse in the evening

Question 14

Soothing Maneuvers

Answer 14

Swadling
Side/Stomach Postion
Shushing
Swinging
Sucking

Question 15

Down Syndrome Complication - Mx

Answer 15

(1) Vision and Hearing Problem - Ophthalmologist
(2) Thyroid - Regular Thyroid Screening
(3) Heart - Heart Screening and Scans
(4) Bowels - Celiac workup
(5) Speech Problem - Speech Pathologist,
(6) Learning Difficulties - Special Schools
(7) Shorter Lifespan - Work up Complications = Longer Lifespan

Need to Confirm First = Karyotype
Managed as MDT
Support Group - Down Sx Federation, NDIS

Question 16

Respiratory Distress Syndrome Mx

Answer 16

Refer to Tertiary Care for Intensive Care via Ambulance and PIPER Team
Inv. - CXR, ABG
Oxygen
IV Fluids
IV Antibiotics
Worsen - CPAP -> Intubate
Refer to Pediatrician - Might give Surfactant Directly

Question 17

SIDS Management

Answer 17

Safe Sleeping Environment
- Sleep the baby on his back
- Face should be uncovered
- Own Sleeping Place but can put crib in your room
- Standard mattress
- No Pillows, No Stuff Toys
- Do not sleep on the same bed
- Not too cold or Not to warm

Good Pregnancy Care - Reg F/u and Test
Avoid Smoking
Breast Feeding
Pacifiers maybe protective
Home Apnea Monitors - Not Effective