Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paeds > MedEd revision lecture > Flashcards

MedEd revision lecture Flashcards

1
Q

6wk baby throwing up small vomumes after feeds, arching back, well and thriving

A

GORD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

baby recently started on formula feeds, diarrhoea, colicky pain

A

cows milk protein allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

differentials for vomiting baby

A

pyloric stenosis
GORD
posseting
Gastroenteritis (D+V)
bowel obstruction
raised ICP
ingesting toxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

GORD counselling

A

very common ~50% babies
poor tone in sphincter and overfeeding
will get better as baby gets better

avoid overfeeding
formula + thickeners
avoidance of cows milk protein (rule out)
consider gaviscon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pyloric stenosis

A

male 4:1

features:
projectile vomiting
palpable olive
visible peristalsis
weight loss
dehydration

Ix:
AUSS- antral nipple sign
blood gas- hypokalaemic hypochloraemic metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

differentials for diarrhoea

A

Toddlers diarrhoea (1-5yrs frequent, explosive stool containing undigested food)
gastroenteritis
coeliac (>6months)
IBD (older)
CMPI
cystic fibrosis (steatorrhoea)
constipation with overflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Investigations for coeliac

A

anti TTA abs
+ baseline IgA levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

different cows milk protein intolerance

A

IgE mediated –> anaphylaxis type picture

non IgE –> vomiting diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is hydrolysed formula

A

partially digested milk so prevents allergy in CMPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

neonatal jaundice investigations <24hrs

A

conjugated and unconjugated bilirubin

DAT test

Sepsis screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why does breastfeeding increase jaundice

A

beta-glucoronidase enzyme increases bilirubin reabsorption in the gut brush boarder

inhibits UDP glucuronosyltransferase which conjugates bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is haemolytic disease of the newborn?

A

mainly RhD incompatibility (also anti C, E, kell and duffy)

sensitisation of Rh-ve mother in previous baby

anti Rh Abs cross placenta in next pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

features of ABO incompatibility

A

can be first pregnancy
mother blood group O, baby A or B

weakly positive DAT

jaundice in neonate <24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

biliary atresia associations

A

associations:
T21 and 18
intestinal malrotation
cardiac abnormalitis
pancreatic abnormalities
splenic malformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

biliary atresia management

A

urgen surgical referral
Kasai procedure
time critical 80%–> liver transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

coca cola coloured urine
bad throat infection 3 weeks prior

A

post streptococcal glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

features of obstructive uropathy and examples

A

hydronephrosis or oligohydramnios on antenatal scans
not passed urine within 24hrs after birth

Eg.
posterior urethral valves
Pelviureteric junction obstruction (usually unilateral so may have passed some urine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the features of atypical UTI

A

seriously ill
poor urine flow
abdominal mass
renal dysfunction
not responding to Rx after 48hrs
non E.coli organism (eg. Klebsiella)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

most common paeds solid tumor

A

Wilms tumour
nephroblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

large abdo mass found during bath time, asymptomatic

A

wilms tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

facial swelling, abdo distension, protein in urine, hypotension

A

nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

triad in nephrotic syndrome

A

proteinuria
oedema
hypoalbuminaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

causes of nephrotic syndrome

A

congenital
minimal change disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

management of nephrotic syndrome

A

daily urine dip
pred 60mg BD for 4-6 weeks then wean
low salt diet
diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when to refer for nephrotic syndrome

A

haematurea
low C3
signs of renal impairment/ HPTN
steroid resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

complications of nephrotic syndrome

A

inc risk of thrombosis
infection- strep pneumonea
hypovolaemia
drug toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

features of post strep glomerulonephritis

A

previous strep infection ~2weeks prior
coca cola urine
low C3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

features of IgA nephropathy

A

days after URTI
IgA deposition in glomerulus
C3 usually normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

features of HSP

A

70% will have renal involvement eg. haematurea, protein uria

GI symptoms

purpuric rash on buttocks and back of legs

arthralgia

previous URTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Haemolytic uraemic syndrome

A

Hx of recent bloody diarrhoea (E.coli 0157)

triad: MAHA, thrombocytopenia (petechiae), AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Dialysis criteria for HUS

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

erythema toxicum counselling

A

nothing to worry about
babies reaction to being outside of uterus

moves around
well child
no management required
may last for 1 month but will get better in weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is port wine stain associated with?

A

sturge weber syndrome

–> epilepsy, hemiplesia, learning difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Causes of erythema multiforme

A

infection: EBV, HSV, mycoplasma, chlamydia
Abx: penicillins, sulphonamides
SLE
malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

features of scarlet fever

A

widespread sandpaper like rash
fever
strawberry tongue
sore throat

36
Q

complications of scarlet fever

A

mastoiditis
meningitis
pleural effusion
post strep glomerulonephritis
rheumatic fever

37
Q

erthyema marginatum

A

immune response to GAS infection

38
Q

Erythema migrans

A

single target lesion- lymes disease

39
Q

Features of measles

A

rash starting on head then moving down - spares hands and feet
koplik spots
2-3 prodrome followed by rash
high fever

self limiting but risk of complications

40
Q

causes ofCafe au lait spots

A

neurofibromatosis type 1
ataxic telagectasia
fanconis anaemia
mccune albright syndrome (fibrous dysplasia of bone, CAL spots and precocious anaemia)
russel silver syndrome
gauchters disease

41
Q

features of neurofibromatosis type 1

A

autosomal dominant
chrom 17
over 6 cafe au lait
> neurofibromas
axilliary/ inguinal frecklys
optic glioma
Lisch nodules
osseous lesions
1st degree relative

42
Q

Tubero sclerosis features

A

aut dom on chrom 9
epilepsy
intellectual impairment
retinal haematomas

43
Q

neonatal sepsis RFs

A

prolonged rupture
prematurity
maternal fever
Hx of GBS
neonatal resuscitation

44
Q

specific buzz for the following infections
CMV
Rubella
Parvovirus
toxoplasmosis

A

CMV- jaundice and thrombocytopenia

Rubella- heart disease, cataracts and deafness

parvovirus

toxoplasmosis- hydrocephalus

45
Q

encephalitis

A

inflammation of the brain
infective or autoimmune

major: altered GCS, lethergy, personality changes

minor: fever, seizures, focal neurology, CSF WCC >5

causes: HSV, toxo, enteroviruses

46
Q

toxic shock syndrome

A

exaggerated immune response to toxins in infection usually GAS, staph aureus, psuedo, klebsiella

fever, rash, vomiting, diarrhoea, lymphopenia

common after recent surgery or burn- high risk of infection

47
Q

Diagnosis of T1DM

A

fasting glucose >7.9
random >11.1
2hr post prandial >11.1

2 of the above on separate occasions

48
Q

Mx and counselling of newly diagnosed T1DM

A
  1. same day MDT referral to paeds DM team
    -for diagnosis

education:
-lifestyle
-education on insulin therapy
- risks of diabetes
- risks of DKA and hypos

secondary care:
- 4 clinics a year with HbA1c Mx

screening
- micro and macrovascular complications from age of 12
- screening for autoimmune diseases
- diabetic foot checks

psychosocial support

daily basal bolus rapid release insulin injections before meals + long acting glucose

continuous BM measurements

49
Q

glucose targets in T1DM

A

fasting 4-7
random 4-7
post prandial 5-9

50
Q

symptoms and PC of T1DM

A

polyuria
polydipsia
weight loss

51
Q

what counts as a hypo episode

A

glucose <4mmol/L

52
Q

symptoms of hypogylcaemic episode

A
53
Q

management of hypo

A
54
Q

sick day rules for T1DM

A

Blood glucose monitoring: every 2 hours
Ketone testing (urine/blood) if ill or hyperglycaemia: every 2 hours
Increase insulin (10-20% total daily dose)
Adequate fluid intake (sugar-free): 100mls/hour
If vomiting continuously >4h or ketone levels not reducing: hospital

55
Q

RFs for T2DM in paeds

A

Family history
Obesity
Ethnicity
After puberty

56
Q

where anatomically is the obstruction in stridor

A

larynx to carina

57
Q

what noise is made in obstruction above the larynx

A

stertor- snoring noise
eg. tonsillitis, retropharyngeal abscess, decreased conciousness

58
Q

causes of stridor

A

anaphylaxis
croup
epiglottitis
bacterial tracheitis
foreign body
diptheria
laryngomalacia
subglottic stenosis (ex prem requiring intubation)

59
Q

principles of mananagement of upper airway obstruction

A
  1. keep child calm
  2. oxygen if needed
  3. call senior paediatrician, ENT, anaesthetics
  4. extreme -> adrenaline neb first
  5. then dex 0.15mg/kg (max 0.6mg/kg)- takes about 4hrs
  6. budesonide nebuliser
  7. treat underlying cause eg. anaphylaxis fluids, epiglottis abx
60
Q

what is the mechanism of grunting

A

forcing air out of a closed glottis

61
Q

when is the peak age of laryngomalacia and how is it managed

A

6-8weeks
doesnt usually require intervention UNLESS failing to gain weight
afebrile

if not gaining weight -> referral to ENT for laryngoscope potentially surgery, anti reflux eg. omeprazole

62
Q

why have you got to be cautious with fluids in trauma?

A

because you clot first with your best clotting factors and if you give too many fluids you risk bursting the clots and you’re left with less good clotting factors and risk of bleeding

63
Q

signs of salbutamol toxication

A

shivering / tremor
vomiting
high lactate
hypokalaemia and arrhythmias

64
Q

steps of acute asthma management

A
  1. burst step
    3x10 puffs salbutamol every 4 hrs
    2x atrovent
    prednisolone orally (atopy history)
  2. IV bolus step
    MgSO4
    salbutamol
    aminophylline
  3. infusion step
    aminophylline
    salbutamol
  4. panic step
    intubate and ventilate

ward management
1hrly salbutamol -> 2 hourly sal –> 3hrly sal –> 4hrly salbutamol –> home

65
Q

what is a worrying sign on ABG in asthma

A

normal or high C02 as retaining and sign of tiring

66
Q

collapsed baby main diagnoses

A

sepsis
sepsis
SEPSIS
congenital heart disease
inborn errors of metabolism (low glucose, high lactate)
Non accidental injury

67
Q

Right-sided heart problem

A

cyanotic heart disease

68
Q

left sided heart problem

A

acyanotic
shock
pulmonary overload/ oedema

69
Q

cyanotic heart diseases

A

Tricuspid atresia
Transposition of the great arteries
Tetralogy of fallot (VSD, overriding aorta, right outflow obstruction, right ventricle hypertrophy
Pulmonary stenosis/ atresia
Eienmengers (long time shunting to the right, lungs become overloaded and high pressure causing blood direction to reverse and shunt to the left hence becoming cyanotic)
Ebsteins anomaly?

70
Q

when does the PDA classically close?

A

day 4-5 of life

71
Q

Acyanotic congenital heard disease

A

AVSD (T21)/ VSD
mitral stenosis/ atresia
co-arctation
aortic stenosis
ebsteins?

72
Q

timing of CHD

A

first few hours
atresia/ critical stenosis
hypoplastic heart

first few days
Transposition, tetralogy, large PDA
coarctation

weeks
aortic stenosis

months
right heart problems

73
Q

duct dependent CHD

A

critical aortic stenosis
HLHS
transposition
Ebsteins
tricuspid atresia
pulmonary atresia

74
Q

How do distinguish causative organism in bronchiolitis (generalised creps and wheeze)

A

naso-pharyngeal aspirate - looking for host of viruses eg. RSV, rhinovirus, adenovirus, parainfluenza, covid

75
Q

describe the course of illness in bronch

A

starts with coryzal
development of resp distress over 3-4days
peaks day 5
lasts 10-14 days

76
Q

bronchitis podium

A

breathing:
1. no support
2. oxygen if <90-92%
3. CPAP/ vasotherm
4. Intubate and ventilate

feeding
1. little and often feeds
2. NG feeds
3. IV fluids

SUPPORTIVE MANAGEMENT

77
Q

overview of wheeze in terms of age and diagnosis

A

under 1 year –> broncholitis
1-5yrs –> viral induced wheeze
5ish –> multi trigger wheeze
over 5 –> asthma

78
Q

under 4 weeks antibiotics for sepsis

A

cefotaxime (less risk of cholestasis than ceftriaxone)
amoxicillin to cover listeria

79
Q

antibiotics in sepsis for >4weeks

A

cefriaxone

80
Q

papular rash - discrete raised lesions

A

think hand foot and mouth

81
Q

macular rash- flat to the skin cant feel when stroke

A

maculAr -MMR

82
Q

maculopapular rash

A

any normal viral rash

83
Q

vesicular rash

A

varicella zoster, herpes

84
Q

pustular rash

A

staph/ impetigo

85
Q

petechial (<2mm) purpuric (>2mm)

A

think meningococcal sepsis/ DIC
ITP
HSP
leukaemia

86
Q

most important things to do when pt having a seizure

A

oxygen
check BM
start a timer
call for help

Paeds (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions