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MEDICINE NEW > Minimal Paediatrics > Flashcards

Minimal Paediatrics Flashcards

1
Q

Triad of ADHD:

A
  1. Hyperactive
  2. Impulsive
  3. Inattention
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2
Q

Rx of ADHD

A

Conservative: parenting education + training
CBT for older children

Medical: methylphenidate (ritalin)
Atomoxetine

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3
Q

Features of cerebral palsy:

A 
Acquired CNS injury prior to age 2 may present with:
Delayed motor development
CNS signs- weakness, paralysis
Learning disability
Epilepsy
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4
Q

4 forms of cerebral palsy:

A
  1. Spastic hemiplegia- pyramidal lesion, arms > legs
  2. Spastic diplegia- legs > arms, scissoring gait, internal rotation, adduction, knee extension, plantar flexion
  3. Spastic quadraplegia- most severe, low IQ + seizure associated
  4. Dyskinetic (athetoid)- unwanted involuntary actions de to basal ganglia affected, dysarthria
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5
Q

What is bronchiolitis in children and it’s causes?

A

Bronchiole inflammation- LRTI
Signs: coryza then cough, low fever, wheeze, inspiratory crackles, intercostal recession

Causes: Resp syncitial virus (RSV)
Mycoplasma, parainfluenza (more Croup URTI), adenovirus

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6
Q

Which childhood illness are parainfluenza and respiratory syncitial virus typically associated with?

A

Parainfluenza- croup, URTI (stridor, barking cough)
Dexamethosone

RSV- bronchiolitis, LRTI (wheeze, crackles)
Doesn’t need steroids + bronchodilators routinely

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7
Q

How does the preferred antibody test for coeliac test change if investigating those under 18 months?

A

IgA anti-gliadin
If IgA deficient, measure IgG anti-gliadin

Villous atrophy on duodenal biopsy

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8
Q

What are the signs of a patent ductus arteriosis?

A

General: failure to thrive, pneumonia, CCF
Cardiac: collapsing pulse, loud S2
systolic pulmonary murmur or continuous machinery hum

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9
Q

Rx to close patent ductus arteriosis?

A

NSAIDs: ibuprofen or indomethacin (reduce prostaglandin level)
Steroids prior to labour if pre-term

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10
Q

Causes of congenital cyanotic heart disease?

A 
5T's:
Tetralogy of Fallot
Transposition of great arteries
Tricuspid atresia
Truncus arteriosis
Total anomalous pulmonary venous return
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11
Q

3 key features of autism:

A

Impaired social communication
Impaired imagination
Restricted range of interests

30% coexistent epilepsy

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12
Q

Rx of Croup:

A

4 year old with stridor, barking cough- URTI laryngotracheobronchitis

Mild/moderate: dexamethasone PO or prednisolone PO
Severe: nebulised adrenaline

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13
Q

Differential of Croup to be excluded:

A

Bacterial tracheitis- mucosal sloughing, not cleared by coughing, risks occluding the airway
Continuous or biphasic stridor may be present, barking cough
Moderate high fever- appears toxic

Epiglossitis- avoid examining throat, swollen epiglottis
Haemophilis influenzae, cephalosporin + intubate
Drooling secretions
Softer stridor
Muffled voice, no cough

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14
Q

Tests for cystic fibrosis in newborns?

A

Sweat test >60mmol Na+
DNA test
Immunoreactive trypsin

Screening: newborn blood spot Guthrie test

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15
Q

Features of Cystic Fibrosis treatment:

A

Respiratory: postural draining, chest physiotherapy
Antibiotic prophylaxis, mucolytics
Lung transplant

Gastro: increased calorie intake
Creon, omeprazole (increases duodenal pH for absorption), ADEK vits
Diabetic review

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16
Q

How is developmental dysplasia of the hip diagnosed?

A

Ortolani + Barlow manoeuvres

USS at 2-4 weeks in those high risk:
Older mum or positive FHx
Oligohydramnios, high birth weight
Postmaturity
Breech birth, caesarian for breech
17
Q

Clinical features that may be associated with Down’s syndrome:

A 
Mental + growth retardation
Cardiac malformation- VSD, ASD, AVSD, patent ductus
Duodenal atresia
Reduced lung capacity
Leukaemia
Hearing loss
Alzheimer's
18
Q

What are febrile convulsions?

A

Single tonic clonic symmetrical generalised seizure lasting under 20 minutes, associated with a raised temperature.

Signs it’s something else:
Focal CNS sigs
1+ attack in 24 hours
Seizures last >15 minutes

19
Q

Rx of febrile convulsion:

A

Recovery position if >5minutes
Benzodiazepines
Paracetamol syrup

20
Q

Rx of infant gastro oesophageal reflux?

A

Feed thickening

Antacid
Gaviscon

Extreme cases- fundoplication

21
Q

A child has purpura, how does the child being ill and platelet count affect likely diagnosis?

A

Ill + low platelets: meningococcal septicaemia, leukaemia, DIC, HUS
Ill + normal platelets: virus- measles, vasculitis- kawasaki (high plts)

Well + low platelets: ITP, rarely anaplastic anaemia
Well + normal platelets: Henoch Schönlein

22
Q

How does pyloric stenosis present?

A

At 3-8 weeks: projectile large volume vomits, non-bilious, within minutes of feed
Baby always hungry, anxious

Signs: olive-sized pyloric mass

23
Q

Tests and management of intussecpition?

A

USS

Rx:

  1. Air enema reduction
  2. Laparoscopic reduction- NG tube, cross match
24
Q

Diagnostic criteria for Kawasaki:

A 
Fever for 5 days + 4 of:
Bilateral non-purulent conjunctivitis
Neck lymphadenopathy
Dry fissured lips, strawberry tongue
Polymorphous rash
Extremity changes: desquamation, arthralgia, palmar erythema

Complication: coronary artery aneurysm

25
Q

What aspects of neonatal jaundice are abnormal?

A

Onset before 24 hours of birth: sepsis, ABO incompatibility, Rhesus disease, red cell abnormalities

Prolonged lasting >14 days: breastfeeding, sepsis, CF, hypothyroid

Encephalopathic (kernicterus): lethargy, hypertonic, arched neck

26
Q

Long term sequelae of kernicterus?

A

Acute bilirubin encephalopathy:
Athetoid movements
Deafness
Low IQ

Prevention: phototherapy, plasma exchange transfusion
Phototherapy converts bilirubin into soluble products for excretion

27
Q

What is a neuroblastoma and where do they occur:

A

Primary childhood malignancy from neural crest cells
Occurs in adrenal glands
Along spinal cord, neck, chest, abdo, pelvis- can cause proptosis

MIBG scan
VMA or HVA levels in urine

28
Q

What tests are required to diagnose transient synovitis of the hip?

A

FBC, ESR/CRP
Plain films
USS ± aspiration

Diagnosis of exclusion

29
Q

Features of Turner’s syndrome:

A 
Short stature
Hyperconvex nails
Wide carrying angle
Ptosis, nystagmus
Webbed neck
Broad chest, hypoplastic breasts, inverted nipples
Coarctation of aorta
Lymphoedema, gonad dysgenesis

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