Misc Flashcards
empirical AB therapy for suspected sepsis in an infant with and without a LP result yet
unknown LP = flucloxacillin + ceftriaxone
-ve LP = gentamycin
definition of celluitis
infection of deeper dermis and subcutaneous fat
chronic complications of rheumatic fever
rheumatic valvular heart disease
criteria for admission for burns
- > 10% TBSA
- specific locations (perineum, face, hands, circumferential)
- co-morbidities
- circumferential burns
- all full thickness burns
- all chemical, electrical and inhalation burns
- those
clinical features of post strep glomerulonephritis
ranges from asymptomatic to nephritic syndrome
describe the difference between mid-dermal and deep dermal burns
mid dermal - sensation intact, capillary refill varies, heals without grafting
deep dermal - sensation dulled, capillary refill absent, may require grafting
treatment of impetigo
topical - mupirocin
systemic - flucloxacillin
most common age for poisoning
1-3 years
clinical features of necrotising fasciitis
- fever
- pain
- constitutional unwellness out of proportion to cutaneous signs
what are the endocrine effects of pain
increased cortisol, glucagon, adrenaline and BSL
definition of ALTE
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
3 specific complications of group A streptococcal infection
scarlett fever
rheumatic fever
acute post-strep glomerulonephritis
at what total body surface area burn do you put in a naso-gastric tube
> 10% TBSA
pathogenesis of post-strep glomerulonephritis
antigen-antibody mediated complement activation causing diffuse proliferative glomerulonephritis
when should a baby have the capacity to sleep through the night without a feed
6 months
HEADSSS
H - home E - education/eating/exercise/employment A - activities/peer relationships D - drugs/alcohol/smoking S - sexuality S - suicide S - safety
treatment of post strep glomerulonephritis
fluid and sodium restriction
frusemide
timing of Rheumatic fever
2-4 weeks after GAS pharyngitis
3 ways to investigate for food allergy
skin prick test
serum specific IgE
food challenge
treatment of rheumatic fever
- penicillin - eradicate GAS -carriage
- prednisone if severe carditis
what are the 8 major food groups causing allergy
peanuts tree nut allergy shellfish milk soy fish wheat eggs
which AB has an increased risk of causing Pseudomembranous colitis
Clindamycin
role of dextrose in maintenance fluids
- helps distribute water throughout all compartments of the body (free water)
- prevents hypotonic solutions causing haemolysis
- prevents hypoglycaemia and ketosis
- minimal nutritional value
name the 4 pain rating scales for children
- Wong-Baker faces
- numeric (0-10)
- behavioural (face, legs, activity, cry, consolability - 10)
- behavioural/physiological changes
describe the appearance of a full thickness burn
waxy colour
leathery and charred
difference between SUDI and SIDS
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
what are the primitive reflexes you should test for in an infant
rooting suck moro parachute grasp \+/- stepping
clinical features of scarlett fever
- high fever
- sandpaper rash, desquamates
- acute pharyngitis - either a few days before the rash or concurrently
empirical AB therapy for suspected sepsis in a child (not infant)
ceftriaxone + flucloxacillin
describe the distribution of scarlett fever rash
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
average sleep requirements at 1 year
13.5h/day
management of scalded skin syndrome
IV flucloxacillin + clindamycin
fluids
supportive skin care
management of cellulitis
flucloxacillin or cephalexin
pharmacological treatment for iron overdose
desferrioxamine
initial hospital care of burns (10)
- incident details, and time of burn
- assess TBSA% and depth
- ABCDE, secondary survey
- analgesia
- tubes - IDC, NG
- tetanus
- documentation and transfer
- wound care
- dressings
difference between night terrors and nightmares
night terrors = child is still asleep, begins with a scream
nightmares = wake the child up from sleep
what are some non-pharmacological pain relief techniques
diversion controlled breathing comforting touch imagination giving information relaxation
most common age group to get post strep glomerulonephritis
4-8
how do you work out the volume of maintenance fluid for children
2/3 of 4,2,1 rule (max 100ml/hour)
what causes torticollis
shortened SCM muscle
4 types of child abuse/neglect
physical
emotional
neglect
sexual
what is the recommended dose of nebulised adrenaline for anaphylaxis in children
5mg (5mls of 1:1000)
At what time of the night do sleep walking/night terrors occur
First ⅓ (usually during transition from NREM3/4 to another sleep stage)
when do you put in an IDC in a patient with burns- if perineal burns
- if resus fluids required (>10% TBSA)
- if perineal burns
average sleep requirements at 2-3 months
15 hours
At what total body surface area burn do you commence fluid resuscitation
> 10-15%
pathogenesis of scarlett fever
delayed type skin reactivity to exotoxin from the plasmid of GAS bacteraemia causing widespread T cell activation
definition of excessive crying in an infant/colic
> 3 hours/day for >3 days
complications of torticollis
hemihypoplasia
presumed pathogenesis of ALTEs
exaggerated physiological airway protection reflexes
how do you work out the volume of fluid to give a child to replace fluid deficit
estimate the volume from weight loss and hydration status
common age for sleep walking
8-12
describe the sensation, capillary refill and healing of a full thickness burn
sensation absent
absent capillary refill
requires grafting for healing
diagnosis of post strep glomerulonephritis
- elevated serum antibody titres against streptococcal antigens
- low serum complement
what is the peak age for SIDS
3 months
what causes scalded skin syndrome
exfoliative toxin of staphylococcus aureus
at what age does crying usually peak
6-8 weeks
what is the triple hypothesis of SIDS
SIDS may be the coming together of:
- intrinsic vulnerability
- potentially vulnerable development stage
- final insult that would not on its own be fatal
how do you work out the volume of resuscitation fluid for children
10-20ml/kg
first aid for burns (7)
- 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
diagnosis of rheumatic fever
evidence of previous GAS infection and either 2 major criteria or 1 major and 2 minor criteria
what is the special extra things you do for a circumferential burn
elevate!
frequent vascular obs
?escharotomy
referral!
common age for night terrors
4-8
what is the recommended dose of IM adrenaline given for acute anaphylaxis
0.01mg/kg (max dose 0.5mg)
clinical features of orbital cellulitis
opthalmoplegia
proptosis
decreased acuity
headache
what are the body %s in a child for burns
front - 18% back - 18% arms front and back - 9% each arm legs front and back - 14% each leg head - 18%
average sleep requirements at birth
16 hours
definition of necrotising fasciitis
rapidly spreading infection of deep layer of superficial fascia
