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402- Paediatrics > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

Neonate age range

A

First 28 days of life

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2
Q

Infant age range

A

Up to 1 year

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3
Q

Features of a mild-moderate allergic reaction (4)

A
  • Facial swelling
  • Urticaria
  • Itchy/ tingling in mouth/ throat
  • Gastro: vomiting, diarrhoea, abdominal discomfort
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4
Q

Features of anaphylaxis ABCDE

A

Airway

  • Angioedema of airway
  • Tongue swelling
  • Stridor
  • Hoarse voice

Breathing

  • Tachypnoea
  • Hypoxia
  • Wheeze

Circulation

  • Shock/ hypotension
  • Weak pulse
  • Pale/ cold extremities

Disability

  • Reduced consciousness/ drowsiness
  • Eyes: swelling, conjunctivitis

Exposure
- Urticaria

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5
Q

Management of mild-moderate allergic reaction

A

If symptoms have resolved

  • Observation for a few hours
  • Discharge with antihistamines (chlorphrenamine)
  • Consider allergy clinic review

If symptoms still present

  • Oral antihistamines +/- oral steroids
  • Observe for few hours
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6
Q

Initial management of anaphylaxis

A

ABCDE management

  • Establish airway
  • Maintain O2 >92%
  • Fluid resuscitation
  • IM adrenaline every 5 mins, max 3
  • IV adrenaline if IM fails
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7
Q

Post-resus management of anaphylaxis

A

IM or slow IV Antihistamine (chlorphrenamine) or hydrocortisone

Oral anti-histamine/ prednisolone follow up

Adrenaline autoinjector for future events

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8
Q

Kawasaki’s disease epidemiology

A

Typically affects children < 5

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9
Q

Feature of Kawasaki’s disease (ARDIO)

A

LymphAdenopathy
- Anterior cervical

Polymorphus Rash
- Due to light sensitivity

Distal changes of the extremities
- Erythema of hands and feet

Conjunctival injection
- Causing eye discomfort/ photophobia

Oral mucosa and lip changes

  • Strawberry tongue
  • Injected lips/ pharynx
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10
Q

Investigations for kawasaki’s disease

A

FBC

  • Neutrophilia
  • Leucocytosis
  • Increased platelets (in second week)

U+Es
- Hyponatraemia

CRP (>50) and ESR (>80)

ECG

Urine MCS
- Pyuria

Throat swab

Echocardiogram

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11
Q

Which children with Kawasaki’s disease are at the most risk of coronary artery aneurysm?

A

Age < 6 months and >5

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12
Q

Management of Kawasaki’s disease + follow up

A

> 10 days from onset

  • Low dose aspirin
  • 3-5mg/kg/day for 6-8 weeks

<10 days / high risk of complications
- High dose IV IG 2g/Kg + high dose aspirin

Follow up echo with 7 days

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13
Q

Which vaccinations are required after treatment of Kawasaki’s disease?

A

Most likely to cause Reye syndrome with aspirin

  • Varicella
  • Influenza
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14
Q

Definition of juvenile idiopathic arthritis

A

Arthritis in age < 16 for > 6 weeks, with other causes excluded

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15
Q

Subtypes of JIA

A

Oligoarticular (most common)

Polyarticular RF positive and negative

Enthesitis-related

Juvenile Psoriatic

Systemic onset

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16
Q

Feature of systemic onset JIA

A

Daily fevers for at least 2 weeks that quickly becomes normal

Salmon pink rash

Lymphadenopathy

Enlarged spleen and liver

Serositis

Arthritis

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17
Q

Causes of primary noctrual enuresis

A 
Primary nocturnal (never been dry at night)
- Normal in <5

Has family history

Causes

  • Overactive bladder
  • High fluid intake
  • Failure to wake
  • Psychological distress
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18
Q

Causes of secondary enuresis

A

Wetting bed after at least 6 months of being dry at night

Causes

  • UTI
  • Constipation
  • DM
  • Psychosocial
  • Abuse
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19
Q

Diurnal enuresis

- Causes

A

Daytime incontinence

Causes

  • Learning disability
  • Overactive bladder/ stress incontience
  • Constipation
  • Psychosocial
  • Recurrent UTI
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20
Q

Management of enueresis

A

Non-pharmacological
- Enuresis alarm

Pharmacological
- Has to be started by specialist

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21
Q

_____ is the first line pharmacological treatment for nocturnal enuresis

A

Desmopressin

- Taken at bedtime

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22
Q

______ is the first line medication for an overactive bladder

A

Oxybutinin

23
Q

________ is a tricyclic antidepressant that can be used for nocturnal enuresis

A

Imipramine

24
Q

Transient synovitis is associated with _______

A

Recent Hx of a Viral URTI

25
Transient synvoitis typically presents in ages ____ and is more common in ______
Age 3-10 Boys > girls
26
Presentation of transient synovitis
Typically, generally well - Mild/ no fever Limp + difficulty weight-bearing Mild-moderate hip pain Normal/ mild hip restriction
27
________ must be ruled out before diagnosing transient synovitis
Septic arthritis
28
Transient synovitis typically improves significantly in ______ and fully resolves in __________
48 hours 1-2 weeks
29
Perthes disease arises from _______ of the ________
Avascular necrosis of the femoral epiphysis
30
Complications of perthes disease
Chronic pain Hip osteoarthritis
31
Perthes disease typically presents in ages ____ and is more common in ______
4-12 Boys
32
Osgood-Schlatter disease is caused by inflammation at the _______
Tibial tuberosity
33
Osgood-Schlatter disease typically presents in age _______ and presents primarily with ______
Age 10-15 Anterior knee pain
34
Pathophysiology of Osgood-Schlatter disease
Inflammation of the tibial epiphyseal plate - Arises from stresses like running/ jumping Small avulsion fractures arising from patella tendon pulling small bone pieces.
35
Presentation of Osgood-Schlatter diease
Anterior knee pain - Worsens with movement Swelling at tibial tuberosity - Tender during active inflammation
36
_______ and ______ of the knee worsen pain in Osgood-Schlatter disease
Kneeling and extension
37
Management of Osgood Schlatter disease
Avoiding stressing activity Icing NSAID After active inflammation - Stretching - Physiotherapy to strengthen tendon
38
Slipped upper femoral epiphysis commonly presents in ages ______ and in _____ children
Ages 8-15 (boys) Obese children
39
Risk factors for a slipper upper femoral epiphysis
History of trauma Obesity Rapid growth spurt Hypothyroidism
40
Features of slipped upper femoral epiphysis
ACUTE Hip pain - Radiating to groin/ knee/ thigh - Prefer hip at external rotation Restricted hip movement - Especially internal rotation Painful limp Shortened affected limb
41
Initial investigation for slipped upper femoral epiphysis (SUFE)
Pelvic X Ray
42
Management of slipped upper femoral epiphysis (SUFE)
Surgery
43
Brittle bone syndrome is known as ________
Osteogenesis imperfecta
44
Osteogenesis imperfecta is caused by...
Group of genetic disorders | - Typically leads to abnormal Type 1 collagen formation
45
Osteogenesis imperfecta is inherited in _______ fashion but mutations may be ______
Autosomal dominant De novo
46
The least severe form of osteogenesis imperfecta is ______ and the perinatally lethal type is _______
46
The least severe form of osteogenesis imperfecta is ______ and the perinatally lethal type is _______
Least severe= type 1 Lethal type= Type 2
47
Presentation of osteogenesis imperfecta
Physical features - Blue/ grey sclera - triangular face - Short stature MSK features - Dental problems - Bone deformities: bow legs, scoliosis - Joint/ bone pain Functional - Hypermobility - Deafness from early adulthood.
47
Presentation of osteogenesis imperfecta
Physical features - Blue/ grey sclera - triangular face - Short stature MSK features - Dental problems - Bone deformities: bow legs, scoliosis - Joint/ bone pain Functional - Hypermobility - Deafness from early adulthood.
48
Children are more likely to have _____ and _______fractures compared to adults
Greenstick and buckle/torus fractures | - As they have more cancellous, spongy bone,
49
A salter harris fracture occurs at ______
The growth plate
50
Salter-Harris growth plate fracture classification | - Type 1-5
SALTR Type 1 - Straight through physis Type 2 - Above the physis (metaphysis) Type 3 - Below the physis (epiphysis) Type 4 - Through the physis, metaphysis and epiphysis Type 5 - Crush
51
Gaucher's disease is particularly prevalent in which population?
Ashkenazi jews

402- Paediatrics (15 decks)

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