MLA Child health Flashcards by Malgorzata Szymaniak

Which inherited diseases cause anaemia?

Sickle cell
Fanconi anaemia (bone marrow failure)
Thalassemia (haemoglobin deficiency)

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What is the dose on adrenaline for anaphylaxis compared to cardiac arrest?

Anaphylaxis (IM)
- 1:1000 solution
- If persistent, can be given as IV infusion

Cardiac arrest (IV)
- 1mg of 1:10,000 solution dose every 3-5 minutes

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How does IM Adrenaline resolve anaphylaxis?

It improves circulation, reduces swelling, and improves general symptoms through the fight or flight response

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What is the management of ADHD in children?

Combination of meds and talking therapy

1st line: methylphenidate
2nd line: Lisdexamfetamine

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What are some side effects of medications for ADHD?

Low mood
Low BP
Nausea/vomiting
Decreased appetite
Headaches

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What are the symptoms of ADHD?

Inattention, hyperactivity. and impulsivity

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What is biliary atresia?

Blockage in the bile ducts because they didn’t form properly during pregnancy

Presents as jaundice and pale stool in the first 4-8 weeks of life

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What is the management of biliary atresia?

1st line: Kasai procedure which restores bile flow. Done before 8 weeks old

May need liver transplant if there is cirrhosis

Cannot be managed conservatively

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What are some complications of biliary atresia?

Liver damage (cirrhosis) then failure
Portal hypertension
Ascites
Malnutrition
Sepsis

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What is bronchiectasis?

Chronic lung disease that causes lungs to be widened and damaged causing mucus build up and increased risk of infection

Symptoms: chronic cough, recurrent chest infections, fatigue

Caused by infections, allergies, autoimmune diseases, cystic fibrosis

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What is bronchiolitis?

Inflammation of the bronchi

<2, most commonly RSV

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What are the different types of cerebral palsy?

4 types:
- spastic (most common). Causes awkward movements due to increased muscle tone
- Dyskinetic. Difficulty controlling movements
- Ataxic (least common). Loss of balance and coordination
- Mixed cerebral palsy

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What is cerebral palsy?

Non-progressive, permanent difficulty controlling muscles due to abnormal brain development or brain damage

Causes: prematurity, infections, lack of oxygen, injury, haemorrhage, toxins

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What is the management of cerebral palsy?

MDT approach
- Physiotherapy
- SALT
- Dieticians
- Drug treatment for symptoms
- Surgical correction of hip displacement

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Which medications are used to manage symptoms of cerebral palsy?

Hyoscine hydrobromide or glyclopyrronium bromide for drooling
Diazepam for pain
Baclofen for hypertonia
Botox for spasticity

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What are the clinical features of cerebral palsy?

Delayed motor mile stones
Floppiness or stiffness
Abnormal movements
Feeding issues
Persistent toe walking

Doesn’t progress so consider alterative diagnosis of symptoms are getting worse

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Which scoring systems are used to classify cerebral palsy?

Gross motor function classification system (GMFCS) and bimanual fine motor function (BFMF) test for upper limbs

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What is the definitions of hypertonia?

Increased resistance in muscles

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What is the definition of spasticity?

Stiffness that is velocity dependent

The faster you move the limb, the more stiff it will become

What is the definition of dystonia?

Abnormal postures that are worse with intention. It can be observed

What are some complications of cerebral palsy?

It’s non-progressive but some will become more apparent with age

Feeding and aspiration issues
Drooling
Constipation
Visual/hearing impairment
Epilepsy
Learning disability
Speech problems
Osteopenia and osteoporosis especially if non-mobile
Sleep disturbance

What is hypoxic-ischaemic encephalopathy?

When the babies brain is not receiving enough oxygen or blood flow at the time of birth
- Common cause of cerebral palsy

What causes chronic kidney disease in children?

Congenital urological abnormalities
Haemolytic uremic syndrome (HUS)
Glomerular disease
Sepsis
Autoimmune diseases

What is the clinical presentation of cystic fibrosis?

Resp: chronic cough, wheezing, SOB, frequent lung infections

Digestive: chronic diarrhoea, constipation, intestinal blockage, greasy stool, inability to gain weight

Skin: salty skin and sweat

Growth: slow growth, short stature

Other: clubbing, delayed puberty, fertility problems, muscle and joint pain

How does Kawasaki's vasculitis present?

CRASH Conjunctivitis Rash Aneurysms Strawberry tongue Hand and feet erythema

What is Kawasaki's vasculitis?

An acute, self-limiting vasculitis affecting children <5years mostly in east Asia (Japan)

How is Kawasaki's vasculitis managed?

- Hospital admission - Oral aspirin (high dose until fevers resolve, then low dose) - IV immunoglobulin - Possibly corticosteroids or infliximab Would resolve naturally over 8 weeks, but has a risk of coronary artery aneurysm so best treated

Which pathogen is the most common cause of epiglottitis?

Haemophilus influenza (HIB) Streptococcus pneumonia (2nd most common)

What are some complications of acute otitis media?

- Mastoiditis - Otitis media with effusion leading to conductive hearing loss - Labyrinthitis - Tympanic membrane perforation

What is Pott's puffy tumour?

Osteomyelitis of the frontal bone caused by an untreated sinus infection from otitis media It's rare

What is an auricular haematoma?

AKA cauliflower ear Caused by trauma to the pinna

What causes scarlet fever?

Streptococcus pyogenes (group A strep) Give antibiotics and go back to school 24 hours after beginning treatment

Which pathogen is most likely to cause meningitis in children 0-2 months?

Group B streptococcus then strep pneumoniae

What is the management of otitis media with effusion?

Should resolve by itself so observe only if there are no signs of infections Can be treated with a tympanostomy if persistent

What is Osgood-Schlatter disease?

Pain and swelling in the knee in children because they're growing Managed conservatively with analgesia and maybe physiotherapy but it will resolve once the child stops growing

What is dacryoadenitis?

Infection of the lacrimal gland of the eye Presents as a unilateral swelling often preceded by a viral infections. Doesn't cause any systemic symptoms and can be managed conservatively

What is a Hordeolum (stye)?

Bacterial infection of the eyelash follicle of to meibomian gland Presents as tender with swelling and discharge

What is a chalazion?

Chronic inflammation and blockage of a meibomian gland in the eye Presents as a chronic lump gradually increasing in size. Not associated with pain or inflammation

What does reticulocytosis on a blood film mean?

Elevated level of reticulocytes (immature red blood cells) Occurs due to overproduction to compensate for rapid destruction or loos of blood cells Eg. haemolytic anaemia, spherocytosis, sickle cell

How does G6PD deficiency present?

Jaundice, haemolytic anaemia, and gallstones X-linked so mostly affects males

Which condition causes Heinz bodies on a blood film?

G6PD deficiency

What is G6PD deficiency?

Genetic, x-linked disorder causing haemolytic anaemia because their red blood cells are unstable

What is the difference between an incarcerated and strangulated hernia?

Incarcerated: irreducible but has blood supply Strangulated: no blood supply

What is Hirschsprung's disease?

Nerves in areas of the bowel are missing so there is no peristalsis there leading to severe constipation and enterocolitis Presents as delay to pass meconium when born

What are the effects of smoking on a pregnancy?

Intrauterine growth restriction and a small for gestational age baby

What are the 4 abnormalities in tetralogy of fallot?

Overriding aorta Ventricular septal defect Pulmonary outflow tract obstruction Right ventricular hypertrophy Causes a pansystolic murmur

What is Epstein's anomaly?

Displacement of the posterior and septal leaflets of the tricuspid valve causing tricuspid regurgitation Caused by lithium use during pregnancy (background of bipolar disorder)