Module 4 Paediatrics Flashcards
Measles signs
CCCK
Cough, Conjunctivitis, Coryza, Kolpik’s spots
Slapped cheek
Eythema infectiosum
Parvovirus
worse in adults with heamoglobinopathies
Coxsackie
hand-Foot and mouth disease
Primary herpes simplex
aka Herpes stomatitis
Cold sore
Eczema herpeticum around eyes
Scalded Skin Syndrome
Staph toxin mediated erythroderma
H.Influenza and staph cause peri-orbital cellulitis
Beta-hemolytic strep
significant redness and scaling
Erysipelas - scalded looking
Strep throat
Strawberry tongue
Red spots except around mouth and nose
This is scarlet fever
Streptococcus treated using penicillins
Make sure rash isn’t mistaken for antibiotic allergy.
Fungal skin infections
• Tinea capitis • Tinea (ringworm) • Corporis • Unguium • Cruris • Pedis Ammoniacal Nappy rash – differentiate by crease sparing and lack of satellite lesions – They indicate Candida. Also in mouth and mother’s nipples
Congenital toxoplasmosis
Low birth weight Retinal lesions Microcephaly Lesions Nerve deafness
Urticaria
Looks like nettle stings Causes by heat/cold – 2-5mm If IgE mediated response more concerning Can be caused by a virus/Bacteria Papular/cholinergic – exercising child
Strawberry mark
Cavernous haemangioma
Port-wine stain
Capillary haemangioma
Most common childhood RTI
RSV (Respiratory syncytial virus) (90% in first winter)
Normal baby fluid volume
150ml/kg/day
Causes of underfeeding
Malabsorption
underfeeding
Separating CMPT to CMPA
CMPA involves vomiting and blood in vomit/faeces
When is early weening?
4 - 6 months
Normal neonatal jaundice
1 day - 2 weeks, unless preterm in which case2 weeks can result from fluid loss.
Investigations in suspicious fracture
Skeletal survey
CT head
blood screen
Ophthalmoscopy
Sign of silent reflux
Back arching
infantile spasms are caused by…
Steroids
vigabatrin
Types of Left to Right shunt in CHD
ASD
VSD
AVSD
PDA
ASD signs and symptoms
Asymptomatic when younger
Fixed and widely split S2
Systolic murmur in pulmonary area
What causes the symptoms in ASD?
Right heart failure due to overload
PDA presentation
Preterm Poor feeding FTT Tachypnoea Active precordium, thrill, galloping rhythm easily palpable femoral pulse
Classical Continuous machinery murmur in pulmonary area
Hepatomegaly and oedema
Classic PDA sign
Continuous machinery murmur in pulmonary area
VSD signs and symptoms
May be asymptomatic until pulmonary vascular resistance has fallen
poor feeding
FTT
Tachypnoea
Active precordium, thrill, galloping pulse
pan-systolic murmur heard in LLSE - transmits to upper sternal edge and axillae
Hepatomegaly and oedema
AVSD Signs and symptoms
If large, no murmur
Can rapidly lead to pulmonary vascular disease
Poor feeding, FTT, tachypnoea
Active precordium, thrill, gallop rhythm
Hepatomegaly, pulmonary oedema
Murmur arises from valvular regurg, rather than septal defect itself
Common CHD in trisomy 21
AVSD
management of L-R shunt conditions
Increase calorie intake
NG feeds, Diuretics, ACE-i
occlusion, either surgical or catheter
Types of stenotic CHD
Coarctation of the Aorta
Pulmonary stenosis
Aorta stenosis
Signs and symptoms of coarctation of the Aorta
Weak femoral pulses - especially compared to brachials
Difference in pre- and -post ductal saturations
Older children have a murmur across the back if collaterals develop
If ductus arteriosus closes/is closing, baby collapses/is acidotic
Aortic stenosis signs
Weak pulses
Palpable thrill in suprasternal region and carotid area
Ejection systolic murmur in aortic area
If critical - acidotic and collapsed
Pulmonary stenosis signs
ES murmur in LUSE
If pulmonary branch stenosed, radiates to the back
Right ventricular heave if severe
Cyanotic heart conditions
Transposition of the great arteries
Tetralogy of Fallot
Signs of Transposition of great arteries
Cyanosis
Acidosis
collapse/death as FO closes
Transposition of great arteries management
atrial septostomy at birth. followed by correction of arteries within 1 week to prevent right heart overload
Tetralogy of Fallot Comprises of…
Pulmonary artery muscular thickening
VSD
RV Hypertrophy (deoxygenated blood into left ventricle and aorta)
Over-riding of the Aorta ( shifted right)
Tetralogy of Fallot features
Cyanosis
collapse
acidosis
possible 22 q deletion
Tetralogy of Fallot management
When hyper cyanotic - propanol, BT shunt
surgical repair - 6-9 months
