MLA Child health Flashcards
Which inherited diseases cause anaemia?
Sickle cell
Fanconi anaemia (bone marrow failure)
Thalassemia (haemoglobin deficiency)
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
How does IM Adrenaline resolve anaphylaxis?
It improves circulation, reduces swelling, and improves general symptoms through the fight or flight response
What is the management of ADHD in children?
Combination of meds and talking therapy
1st line: methylphenidate
2nd line: Lisdexamfetamine
What are some side effects of medications for ADHD?
Low mood
Low BP
Nausea/vomiting
Decreased appetite
Headaches
What are the symptoms of ADHD?
Inattention, hyperactivity. and impulsivity
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
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
What are some complications of biliary atresia?
Liver damage (cirrhosis) then failure
Portal hypertension
Ascites
Malnutrition
Sepsis
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
What is bronchiolitis?
Inflammation of the bronchi
<2, most commonly RSV
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
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
What is the management of cerebral palsy?
MDT approach
- Physiotherapy
- SALT
- Dieticians
- Drug treatment for symptoms
- Surgical correction of hip displacement
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
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
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
What is the definitions of hypertonia?
Increased resistance in muscles
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)
