Next Steps in Child Health Flashcards
1
Q
what micro-organism causes diphtheria?
A
Corynebacterium diphtheriae
2
Q
what type of bacteria is Corynebacterium diphtheriae?
A
aerobic gram-positive
3
Q
is diphtheria an URTI or LRTI?
A
URTI
4
Q
which serotype of meningococcal disease is most serious?
A
serotype B
5
Q
which serotypes of meningococcal disease have vaccines available?
A
A, C, W, Y135
recently B
6
Q
what is the difference between elimination and eradication?
A
elimination: reduction to zero incidences of disease in a defined geographical area, continued measures are required
eradication: permanent reduction to zero of worldwide incidence, intervention measures are no longer needed
7
Q
what diagnosis should you suspect of a 6 week old child who has ‘milky vomit’?
A
pyloric stenosis
8
Q
what is pyloric stenosis?
A
thickening of the pylorus causing narrowing
9
Q
what is shown in ultrasound of pyloric stenosis?
A
pylorus is seen
normally should not be seen
10
Q
what is the treatment of pyloric stenosis (due to thickened pylorus)?
A
surgery to cut open pylorus
11
Q
what diagnosis should you suspect of a 6 months old child who has ‘green vomit’ and ‘red currant jelly’ within their stool?
A
intussusception
12
Q
what do you see on ultrasound of intussusception?
A
target lesions
folds of bowel
13
Q
how do you treat intussusception?
A
air reduction
14
Q
what diagnosis should you suspect of a 6/7/8 year old child with vomiting and peritonitis?
A
appendicitis
15
Q
what is the name of hte point 1/3 of the wasy from the ASIS to the umbilicus that becomes painful in appendicitis?
A
McBurney’s point
16
Q
what can you see on ultrasound of appendicitis?
A
appendix
you can only see it when it is inflamed
17
Q
what is the treatment of appendicitis?
A
appendisectomy
18
Q
what does vomiting bile suggest?
A
high GI obstruction
19
Q
what is malrotation of the gut?
A
when the gut is in the wrong place
20
Q
what is the major complication of malrotation
A
volvulus
bowel obstruction, can lead to ischaemia/necrosis
21
Q
how do you diagnose malrotation with volvulus?
A
upper GI contrast with follow through
22
Q
what is seen in upper GI contrast with follow through in a patient with volvulus following malrotation?
A
twisted bowel is shown
23
Q
what is the treatment of volvulus following malrotation?
A
operation to untwist bowel
24
Q
what is the most common cause of an acute scrotum?
A
torsion of hydatid of Morgani
25
what is a hydatid of Morgani?
remnant mullerian duct structure (left over females bit)
26
is torsion of hydatid of morgani a serious diagnosis?
no
| no consequences
27
what self-resolving condition presents as acute scrotum with large swollen, red, testes that are itchy but not painful?
idiopathic scrotal oedema
28
what is the treatment of idiopathic scrotal oedema?
will settle on it's own
| maybe analgesia or anti-histamines
29
what is phimosis?
congenital narrowing of the foreskin so it becomes tight and can't be retracted
(can be physiological during the period babies where nappies)
30
what is paraphimosis?
a condition where the foreskin can't be returned to it's normal position after being retracted
31
what is hypospadias?
congenital abnormality of urethra in males where the urinary opening is not at the head of the penis
32
what is a hydrocele?
peritoneal fluid around the testical causing swelling
| size can vary as the fluid moves between peritoneum and scrotum
33
why should you wait till after 2 years old to operate on a hydrocele?
many close on their own before the age of 2
34
why are undescended testicles operated on to bring them down?
so they are in a position where they can be examined and changes can be seen
35
as a child ages what happens to the heart rate, systolic BP and resp rate?
HR decreases
SBP increases
RR decreases
36
why anatomically are children more likely to struggle with smaller respiratory infections than adults?
- high anterior larynx
- floppy epiglottis
(if these get inflamed, more likely to cause compromise)
37
what is the commonest reason for acute illness in children?
sepsis
38
why might a child be in respiratory distress due to sepsis from an infection where the source is outwith the lungs?
infection might cause patient to become acidotic
fast breathing to try blow our CO2
39
what is the most common causes of bronchiolitis?
respiratory synctial virus (RSV)
40
what noises are present in croup?
barking cough
| stridor
41
why are steroids sometimes given in croup
to reduce oedema
| -doesn't treat virus
42
what is croup?
(viral) infection around larynx and upper trachea that can cause severe airway obstruction
43
what are febrile seizures?
a seizure that happens when a child has fever
44
what is a reflex anoxic seizures?
syncope caused by reduced oxygenation to the brain due to a brief period of asystole
45
what is a breath holding attack?
when a child holds their breath until they turn blue and pass out
46
compare food allergy to food intolerance?
food allergy- acute allergic reaction (IgE mediated)
| food intolerance- delayed reaction, more varied symptomatology
47
in 2012, 1 in how many children were at risk of obesity? (at or above 95 percentile)
1 in 6
48
what bacteria is the most common cause of uncomplicated urinary tract infections in children?
E. Coli
49
in the UK the median symptom interval for childhood brain tumours is how long?
symptom interval = time between symptom onset and diagnosis
2.5- 3 months
50
what is the commonest kind of heart murmur in childhood?
innocent heart murmur
51
what is a sensitive innocent heart murmur?
an innocent heart murmur which changes with child's position or with respiration
52
what is a short duration innocent heart murmur?
an innocent heart murmur which is not holosystolic
53
what is a single innocent heart murmur?
an innocent heart murmur which has no associated clicks or gallops
54
what is a small innocent heart murmur?
an innocent heart murmur which is limited to a small area and not radiating
55
what is a soft innocent heart murmur?
an innocent heart murmur with low amplitude
56
what is a sweet innocent heart murmur?
an innocent heart murmur which is not harsh-sounding
57
what is a systolic heart murmur?
an innocent heart murmur which is limited to systole
58
in a child which is more likely to cause cardiac arrest- circulatory failure or respiratory failure?
respiratory failure
59
in an adult which is more likely to cause cardiac arrest- circulatory failure or respiratory failure?
circulatory failure
60
what does respiratory failure lead to?
respiratory arrest
61
what does respiratory arrest eventually lead to?
cardiac arrest
62
what does circulatory failure lead to?
cardiac arrest
63
what are the 2 main cause of circulatory failure?
fluid loss
| fluid maldistribution
64
what are the 2 main causes of respiratory failure?
respiratory distress
| respiratory depression
65
if BP is low in a child, how much 0.9% saline should be given initially? (not in trauma)
20mls per kg of child's weight
66
at what percentage of dehydration does shock occur?
over 10% dehydration
67
if a child is in trauma, how much 0.9% saline should be given initially?
10mls per kg of child's weight
68
what is Henloch-Schonlein Purpura?
vaculitis which affects children post-viral
69
what type of murmur is PDA? and where is it heard best?
harsh systolic murmus, best heard at left sternal edge
70
what is the triad of symptoms/signs of nephrotic syndrome?
oedema
proteinuria
hypercholesterolaemia
71
what is the most common diagnosis of a child with projectile vomitting, weight loss and a palpable epigastric mass during feeding?
pyloric stenosis
72
what diagnosis is most common of a child with a webbed neck, broad chest, wide spaced nippled and absent secondary sexual characteristics?
Turners syndrome
73
A child presents with a fever and maculopapular rash and kopik spots (small, white lesions on the oral mucosa), what does this suggest?
measels
74
what infection does drooping saliva suggest?
epiglottitis
75
outsline the management of Perthes disease?
before 6: physio
| after 6 surgery
76
which is more common- viral or bacterial meningitis?
viral
77
which is more severe- viral or bacterial meningitis?
bacterial
78
what is the most common viral infection in children?
enteroviruses eg coxsackie
79
what is the treatment for suspected bacterial meningitis in a child under 3 months?
IV cefotaxime and amoxicillin
80
once the pathogen has been confirmed as gram-neg bacilli, what is the treatment for meningitis in a child under 3 months?
cefotaxime 21 days
81
once the pathogen has been confirmed as group B strep, what is the treatment for meningitis in a child under 3 months?
cefotaxime for 14 days
82
once the pathogen has been confirmed as Listeria monocytogenes, what is the treatment for meningitis for a child under 3 months?
amoxicillin for 21 eays
83
once the pathogen has been confirmed as neisseria meningitidis (meningococcal) what is the treatment for meningitis for a child under 3 months?
ceftriaxone 21 days
84
what is the treatment for viral meningitis?
IV aciclovir
85
what can be given as prophylaxis for close contacts with people with meningitis?
ciprofloxacin
| vaccination booster
86
what virus causes mumps?
rubulavirus
87
which salivary glands are mainly affected by mumps?
parotid glands
88
how is mumps spread?
saliva droplets
89
what is the incubation period of mumps
17 days
90
how does the parotitis typically present in mumps?
begins unilaterally then spreads bilaterally
swollen, red, painful angle of the jaw
may limit movement (eating, swallowing)
91
how long does parotitis in mumps usually last before settling?
3-5 days
92
what is parotitis?
inflammation of the parotid gland
93
what is orchitis?
inflammation of the testes
94
what percentage of patients with mmps get orchitis?
10%
95
when does orchitis usually present in mumps?
4-7 days after parotitis
96
what serious complication can occur from mumps?
viral meningitis
97
when does viral meningitis usually happen in the course of mumps?
a few days after parotitis
98
what is the management of mumps?
supportive care
| notify public health
99
what pathogen causes measles?
morbillivirus
100
how is measles spread?
airborn (coughing, sneezing)
| direct contact with nasal/throat secretions
101
what is the incubationperiod of measles?
10 days
102
what is coryza?
irritation/inflammation of mucous membrane inside the nose
103
what is a prodromal phase?
a period between initial symptoms and rash
104
what is the classic triad of the prodromal phase in measles?
conjuncitivits
cough
coryza
105
what are the pathopneumonic clustered, white lesions in the buccal mucosa in measles called?
koplik spots
106
what kind of rash appears in measles?
morbilliform rash
107
what sites does the morbilliform rash appear on in measles?
first the face/shoulder
then extends down trunk
palms/soles last
108
how do you confirm measles?
salivary swab for measles specific IgM
109
what is the management of measles?
supportive care
| notify public health
110
what is the prophylaxis for people who are in contact with a person with measles?
```
post-exposure vaccination
human IgG (in immunocompromised etc)
```
111
what can measles in pregnancy cause?
miscarriage
prematurity
low birth weight
112
what ages of children are affected by croup?
6 months - 3 years
| peak at 2 years
113
what viruses mainly cause croup?
parainfluenzae viruses
114
what cause of croup is associated with particularly severe disease?
influenza A
115
what is the presentation of mild croup?
occasional barking cough
no audible stridor at rest
minimal intercostal/suprasternal recession
child is happy, interactive and feeding normally
116
what is the presentation of moderate croup?
frequent barking cough
stridor at rest
intercostal/suprasternal retraction at rest
child is alert and undistressed
117
what is the presentation of severe croup?
```
frequent barking cough
prominent stridor at rest
marked intercostal recession
significant distress or lethargy
may have tachycardia
```
118
what is the management of moderate to severe croup?
oral dexamethosone
(severe, unresponsive croup- nebulised adrenaline)
oxygen as required
119
what part of the airways does croup affect?
larynx and trachea (upper airway)
120
what part of the airways does bronchiolitis affect?
bronchioles (lower airway)
121
what age of children are affected by bronchiolitis?
3 months to 1 year
122
in bronchiolitis, what might be heard upon auscultation of the lungs?
fine inspiratory crackles
| expiratory wheeze
123
what part of the gut is most commonly affected by ischaemia in a volvulus due to malrotation?
midgut
| superor mesenteric artery affected
124
what are the symptoms of malrotation?
asymptomatic
125
what are the symptoms of volvulus secondary to malrotation?
irritability, reduced stool frequency, green vomit
126
what is the most common cause of bowel obstruction?
intussesception
127
what are the 3 main risk factors to intusseception?
meckels diverticulum
henoch schonlein purpura
rotavirus (occasionally vaccine)
128
what are the symptoms of intussusception?
intense abdo pain episodically lasting 2-3 minutes
vomiting
red currant jelly stool
sausage shaped abdominal mass
