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MD 3 - Paeds > Misc > Flashcards

Misc Flashcards

1
Q

empirical AB therapy for suspected sepsis in an infant with and without a LP result yet

A

unknown LP = flucloxacillin + ceftriaxone

-ve LP = gentamycin

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2
Q

definition of celluitis

A

infection of deeper dermis and subcutaneous fat

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3
Q

chronic complications of rheumatic fever

A

rheumatic valvular heart disease

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4
Q

criteria for admission for burns

A
  • > 10% TBSA
  • specific locations (perineum, face, hands, circumferential)
  • co-morbidities
  • circumferential burns
  • all full thickness burns
  • all chemical, electrical and inhalation burns
  • those
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5
Q

clinical features of post strep glomerulonephritis

A

ranges from asymptomatic to nephritic syndrome

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6
Q

describe the difference between mid-dermal and deep dermal burns

A

mid dermal - sensation intact, capillary refill varies, heals without grafting
deep dermal - sensation dulled, capillary refill absent, may require grafting

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7
Q

treatment of impetigo

A

topical - mupirocin

systemic - flucloxacillin

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8
Q

most common age for poisoning

A

1-3 years

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9
Q

clinical features of necrotising fasciitis

A
  • fever
  • pain
  • constitutional unwellness out of proportion to cutaneous signs
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10
Q

what are the endocrine effects of pain

A

increased cortisol, glucagon, adrenaline and BSL

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11
Q

definition of ALTE

A

an episode that is frightening to the observer and is characterised by some combination of:

  • apnoea
  • colour change
  • change in muscle tone
  • choking or gagging
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12
Q

3 specific complications of group A streptococcal infection

A

scarlett fever
rheumatic fever
acute post-strep glomerulonephritis

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13
Q

at what total body surface area burn do you put in a naso-gastric tube

A

> 10% TBSA

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14
Q

pathogenesis of post-strep glomerulonephritis

A

antigen-antibody mediated complement activation causing diffuse proliferative glomerulonephritis

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15
Q

when should a baby have the capacity to sleep through the night without a feed

A

6 months

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16
Q

HEADSSS

A 
H - home
E - education/eating/exercise/employment
A - activities/peer relationships
D - drugs/alcohol/smoking
S - sexuality
S - suicide
S - safety
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17
Q

treatment of post strep glomerulonephritis

A

fluid and sodium restriction

frusemide

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18
Q

timing of Rheumatic fever

A

2-4 weeks after GAS pharyngitis

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19
Q

3 ways to investigate for food allergy

A

skin prick test
serum specific IgE
food challenge

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20
Q

treatment of rheumatic fever

A
  • penicillin - eradicate GAS -carriage

- prednisone if severe carditis

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21
Q

what are the 8 major food groups causing allergy

A 
peanuts
tree nut allergy
shellfish
milk
soy
fish
wheat
eggs
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22
Q

which AB has an increased risk of causing Pseudomembranous colitis

A

Clindamycin

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23
Q

role of dextrose in maintenance fluids

A
  • helps distribute water throughout all compartments of the body (free water)
  • prevents hypotonic solutions causing haemolysis
  • prevents hypoglycaemia and ketosis
  • minimal nutritional value
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24
Q

name the 4 pain rating scales for children

A
  • Wong-Baker faces
  • numeric (0-10)
  • behavioural (face, legs, activity, cry, consolability - 10)
  • behavioural/physiological changes
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25
Q

describe the appearance of a full thickness burn

A

waxy colour

leathery and charred

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26
Q

difference between SUDI and SIDS

A

SUDI - describes an unexpected and sudden death in an infant
SIDS - describes a sudden unexpected death in an infant where you are unable to determine the cause of death after vigorous investigation

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27
Q

what are the primitive reflexes you should test for in an infant

A 
rooting
suck
moro
parachute
grasp
\+/- stepping
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28
Q

clinical features of scarlett fever

A
  • high fever
  • sandpaper rash, desquamates
  • acute pharyngitis - either a few days before the rash or concurrently
29
Q

empirical AB therapy for suspected sepsis in a child (not infant)

A

ceftriaxone + flucloxacillin

30
Q

describe the distribution of scarlett fever rash

A

starts on the head and neck with perioral sparing and then moves to trunk and then extremities

  • marked in skin folds and pressure points
  • palms and soles spared
31
Q

average sleep requirements at 1 year

A

13.5h/day

32
Q

management of scalded skin syndrome

A

IV flucloxacillin + clindamycin
fluids
supportive skin care

33
Q

management of cellulitis

A

flucloxacillin or cephalexin

34
Q

pharmacological treatment for iron overdose

A

desferrioxamine

35
Q

initial hospital care of burns (10)

A
  • incident details, and time of burn
  • assess TBSA% and depth
  • ABCDE, secondary survey
  • analgesia
  • tubes - IDC, NG
  • tetanus
  • documentation and transfer
  • wound care
  • dressings
36
Q

difference between night terrors and nightmares

A

night terrors = child is still asleep, begins with a scream

nightmares = wake the child up from sleep

37
Q

what are some non-pharmacological pain relief techniques

A 
diversion
controlled breathing 
comforting touch
imagination
giving information
relaxation
38
Q

most common age group to get post strep glomerulonephritis

A

4-8

39
Q

how do you work out the volume of maintenance fluid for children

A

2/3 of 4,2,1 rule (max 100ml/hour)

40
Q

what causes torticollis

A

shortened SCM muscle

41
Q

4 types of child abuse/neglect

A

physical
emotional
neglect
sexual

42
Q

what is the recommended dose of nebulised adrenaline for anaphylaxis in children

A

5mg (5mls of 1:1000)

43
Q

At what time of the night do sleep walking/night terrors occur

A

First ⅓ (usually during transition from NREM3/4 to another sleep stage)

44
Q

when do you put in an IDC in a patient with burns- if perineal burns

A
  • if resus fluids required (>10% TBSA)

- if perineal burns

45
Q

average sleep requirements at 2-3 months

A

15 hours

46
Q

At what total body surface area burn do you commence fluid resuscitation

A

> 10-15%

47
Q

pathogenesis of scarlett fever

A

delayed type skin reactivity to exotoxin from the plasmid of GAS bacteraemia causing widespread T cell activation

48
Q

definition of excessive crying in an infant/colic

A

> 3 hours/day for >3 days

49
Q

complications of torticollis

A

hemihypoplasia

50
Q

presumed pathogenesis of ALTEs

A

exaggerated physiological airway protection reflexes

51
Q

how do you work out the volume of fluid to give a child to replace fluid deficit

A

estimate the volume from weight loss and hydration status

52
Q

common age for sleep walking

A

8-12

53
Q

describe the sensation, capillary refill and healing of a full thickness burn

A

sensation absent
absent capillary refill
requires grafting for healing

54
Q

diagnosis of post strep glomerulonephritis

A
  • elevated serum antibody titres against streptococcal antigens
  • low serum complement
55
Q

what is the peak age for SIDS

A

3 months

56
Q

what causes scalded skin syndrome

A

exfoliative toxin of staphylococcus aureus

57
Q

at what age does crying usually peak

A

6-8 weeks

58
Q

what is the triple hypothesis of SIDS

A

SIDS may be the coming together of:

  • intrinsic vulnerability
  • potentially vulnerable development stage
  • final insult that would not on its own be fatal
59
Q

how do you work out the volume of resuscitation fluid for children

A

10-20ml/kg

60
Q

first aid for burns (7)

A
  • remove heat source
  • apply cool running water for >20 minutes
  • cover person to guard against hypothermia
  • cover the burn in cling film
  • chemical/eye burns should be irrigated with copious volumes of cold water
  • leave blisters intact
  • call ambulance
61
Q

diagnosis of rheumatic fever

A

evidence of previous GAS infection and either 2 major criteria or 1 major and 2 minor criteria

62
Q

what is the special extra things you do for a circumferential burn

A

elevate!
frequent vascular obs
?escharotomy
referral!

63
Q

common age for night terrors

A

4-8

64
Q

what is the recommended dose of IM adrenaline given for acute anaphylaxis

A

0.01mg/kg (max dose 0.5mg)

65
Q

clinical features of orbital cellulitis

A

opthalmoplegia
proptosis
decreased acuity
headache

66
Q

what are the body %s in a child for burns

A 
front - 18%
back - 18%
arms front and back - 9% each arm
legs front and back - 14% each leg
head - 18%
67
Q

average sleep requirements at birth

A

16 hours

68
Q

definition of necrotising fasciitis

A

rapidly spreading infection of deep layer of superficial fascia

MD 3 - Paeds (18 decks)

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