Medical Paediatrics Flashcards
What is the difference between an allergy and an intolerance?
Allergy is immune-mediated reaction while intolerance is direct effect of the protein on you
Which kind of allergic reaction may be difficult to differentiate from a food intolerance?
Delayed (Type 4) hypersensitivity
What investigations may be carried out in suspected immediate food allergy?
Specific IgE
Skin prick tests
Food challenge
Give some treatment options for food allergy.
Avoid allergen
Anti-histamines
Adrenaline
Immunotherapy
Children tend to grow out of egg allergy by age…
3
How are immediate food allergies mediated?
IgE
How are delayed food alleries mediated?
Cell
Give common symptoms of immediate allergy.
Angio-oedema, urticaria
Give common symptoms of delayed food allergy.
GI symptoms, rash
Give an example of a delayed food allergy.
Cow’s Milk Protein allergy
What is the prevalence of Cystic Fibrosis?
1 in 2500 live births
What is the defect in CF?
Faulty CFTR protein
What are the main symptoms experienced by patients with CF?
Recurrent resp infection Pancreatic insufficiency Liver disease Portal hypertension Gallstones
What infection control measures are needed for patients with CF?
Need to stay away from other with CF and be nursed in a side room when in hospital
What is the most common presentation of CF?
Newborn screening
How may CF present in neonates?
Meconium ileus
What is the gold-standard test for CF?
Sweat test
What are children with CF treated with?
Trikafta
Can people with CF have children?
Males cannot but women can
Most likely cause of loss of red reflex in 2 y/o…
Retinoblastoma
What is the next step in asthma treatment for children if SABA + ICS does not control symptoms?
Leukotriene Receptor Antagonist
What are the 3 shunts of foetal circulation?
Ductus venosus
Foramen ovale
Ductus arteriosus
What kinds of shunt do the ductus arteriosus and foramen ovale create?
R –> L
What kind of shunt is found in normal neonatal circulation?
L –> R
What kind of shunt is found in cyanotic congenital heart conditions?
R –> L (bypasses lungs, hence cyanosis)
Give examples of cyanotic congenital heart defects.
5T’s:
- Truncus arteriosus
- Transposition of the great vessels
- Tricuspid atresia
- Tetralogy of Fallot
- Total Anomalous Pulmonary Venous Connection
Cyanosis from birth suggests…
Transposition of the great vessels
Cyanosis from a few months old suggests…
Tetralogy of Fallot
Which abnormalities make up Tetralogy of Fallot?
Pulmonic stenosis, RVH, VSD and over-riding aorta
Acyanotic CHD may present with…
signs of heart failure eg. SOB, poor feeding, failure to thrive
Give examples of acyanotic CHD.
ASD, VSD, PDA, coarctation of the aorta
Petechial rash, no fever after respiratory infection suggests…
ITP
Joint pain and ‘salmon pink rash’ suggests…
Juvenille Idiopathic Arthritis (Still’s Disease)
Young adult with knee pain after exercise with swelling/locking suggests,,,
Osteochondritis dissecans
Microcephaly, cleft lip/palate and polydactyly suggests…
Patau Syndrome (Trisomy 13)
What is the prognosis for Patau Syndrome?
Life-limiting - usually before 5
Micrognathia, Low-set ears, Rocker-bottom feet
and Overlapping of fingers suggests…
Edward’s Syndrome (Trisomy 18)
What is the prognosis for Edward’s Syndrome (Trisomy 18)?
Usually die before or shortly after birth
Upslanting palpebral fissures, single palmar crease
and small, low-set ears suggests…
Down’s Syndrome
LD, long face, macrocephaly, large ears suggests…
Fragile X Syndrome
Webbed neck, pectus excavatum, short stature, pulmonary stenosis suggests…
Noonan Syndrome
Which cardiac complications are associated with Marfan Syndrome?
Mitral valve prolapse and aortic aneurysm/dissection
Karyotype = 45 X suggests…
Turner’s Syndrome
Short stature, premature ovarian failure (in childhood) suggests…
Turner’s Syndrome
Delay/absence of puberty with anosmia suggests…
Kallmann syndrome
Which condition is associated with ambiguous external genitalia in females?
Congenital Adrenal Hyperplasia
Which cardiac abnormality is associated with Turner’s syndrome?
Aortic coarctation
Dyskinetic cerebral palsy occurs due to damage of…
Basal ganglia
What is first-line in children for constipation?
Movicol
Rash with satellite lesions in nappy area suggests…
Candidiasis
What is the cause of HSP?
IgA-mediated vasculitis, usually following viral illness
How long do molluscum typically take to recede?
9 months
‘Trident hand deformity’ suggests…
Achondroplasia
Is school exclusion recommended for children with head lice?
no
Give differentials for unexplained bruising on a child.
NAI
Genuine accident
Coagulopathy eg. Von Willibrand’s, ITP, bone marrow failure
Osteogenesis imperfecta
Which investigations would be indicated for suspected NAI?
Coagulation screen
Skeletal survey
What is the prognosis for a child with febrile convulsions?
2/3 will never have a convulsion again, 1/3 will. Slightly increased risk of epilepsy
