Other Flashcards by Imogen Smedley

Waiter’s tip posture

Erb’s palsy

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Palsy associated with shoulder dystocia

Erb’s palsy

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Nerve root levels in Erb’s palsy

C5-6

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What signs of base of skull fractures may be seen?

Mastoid eccymosis battle sign
Panda eyes
Haemotympanum
CSF leaf

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Contrast or non-contrast enhanced CT for head injury?

Non-contrast enhanced

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Normal CT scan means can send home in a paediatric head injury - true or false

True

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In head injury, any worrying symptoms should have appeared X hours after the injury

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What is Salter Harris?

Classification growth plate fractures

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What is the growth plate also known as?

Physis

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Accidental injuries often involve bony prominences - true or false

True

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What type of fracture is suspicious for NAI?

Metaphyseal corner fractures

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Posterior or lateral or anterior rib fractures - which is suspicious for NAI?

Posterior and lateral

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Spiral or transverse fractures in long bones is suspicious for NAI?

Spiral fractures in long bones

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What type of brain haemorrhage is seen in shaken baby syndrome?

Subdural haemorrhage

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Name 3 bones (other than posterior ribs) for which fracture to should raise the suspicion of NAI?

Sternal, spinous process, scapular

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Any fracture in a baby too young to crawl/walk is a red flag for NAI - true or false

True

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What HLA type is associated with celiac disease?

HLA DQ2

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Is fecal calprotectin specific to Crohn’s?

Non-specific marker of GI inflam

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Initial blood tests for celiac disease

Total IgA + tTG, FBC, LFTs, U&Es, CRP, ferritin

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Is biopsy always indicated for diagnosis of celiac disease in children?

If classical S+S + tTG >10X upper limit - can diagnose on bloods - then do blood test for EMA antibodies + HLA

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What type of cancer is associated with celiac disease?

T cell lymphoma

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What is toddler’s diarrhoea?

Up to 10 loose stools a day but no other symptoms - thriving
(Still do Ix tho to exclude other causes)
(Improves by age 5-6)

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What is Mittelschmerz?

Unilateral lower abdo pain related to ovulation

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What is the first and second line management for reflux in an infant?

1st Gaviscon

2nd add ranitidine

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What is the first line management of constipation in a child?

Softener eg Laxido

Porphyria cutanea tarda is due to a defect in which enzyme?

Uroporphyinogen decarboxylase

What is the presentation of porphyria cutanea tarda?

Painful blistering skin lesions in response to light

What is the commonest type of porphyria?

Porphyria cutanea tarda PCT

What enzyme is defective in acute intermittent porphyria?

Porphobilinogen deaminase

What is the presentation of acute intermittent porphyria? what age range?

Abdo + neuropsychiatric symptoms 20-40yr

Urine turns red upon standing =

Acute intermittent porphyria

Raised urinary porphobilinogen =

Acute intermittent porphyria

What is seen in the eyes in Down's syndrome?

Brushfield spots

Single palmar crease =

Down's syndrome

What is the phenotypic appearance of Down's syndrome?

Small lot set ears, protruding tongue, upsplanting palpebral fissures, epicanthic folds, flat occiput

What type of cancer is associated with Down's syndrome?

Leukaemia

What gastrointestinal problems are associated with Down's syndrome?

Hirshsprung's

People with Down's syndrome are at increased risk of autoimmune disorders - T or F

True | eg thyroid, celiac

People with Down's syndrome are at increased risk of epilepsy - T or F

True

Are epicanthic folds seen in Down's syndrome or fetal alcohol syndrome?

Both

Is microcephaly seen in Down's syndrome or fetal alcohol syndrome?

FAS

Is thin upper lip seen in Down's or FAS?

FAS

Is a smooth philtrum seen in Down's or FAS?

FAS

What is micrognathia?

Small jaw

What age range gets infantile colic?

0 - 3 months

What is the presentation of infantile colic?

Episodes of crying for >3hr/day, >3/7, for >3wk in otherwise healthy child (Knees drawn up to chest, red face, difficult to console, clenched fists)

What age to children get reflex?

Before 8wk old

What is the presentation of reflux in children?

Vomiting / regurgitation following feeds

Are any investigations required for reflux in infants?

Nope clinical diagnosis

What advice should be given to parents whose children have reflux?

``` Consider over-feeding Trial smaller but more frequent feeds Infants should sleep on their back Feed at position 30 degrees head up Hold upright during feeding and for as long as possible after feeding Trial thickened formula ```

What is the 1st line Mx of infants with reflux other than lifestyle advice?

Gaviscon (alginic acid)

What is the role of PPIs in the Mx of reflux in infants?

Not recommended for simple reflux. If faltering growth or refusing feeds may be trialed.

What are the criteria for a diagnosis of constipation in children >1yr old?

For >1mth - 2 of: - <3 poos/wk - Faecal incontinence (overflow) - Painful/hard movements - Large stools

High or low fibre diet causes constipation?

Low fibre

Overflow soiling can be a sign of fecal impaction in a child?

Yes

If fecal impaction is suspected, should a PR exam be carried out in a child?

No - only by a specialist

What is the 1st line Mx of fecal impaction in a child?

Polyethylene glycol 3350 + electrolytes (Movicol AKA macrogol)

What is the 2nd line Mx of fecal impaction in a child if Movicol doesn't lead to disimpaction after 2wk?

Add a stimulant laxative

Are dietary interventions the 1st line of fecal impaction in children?

No do not use dietary interventions alone

What is the best and most reliable method for diagnosing peanut allergy?

Oral food challenge

Peanuts are a legume - T or F

True

What are the doses of adrenaline for anaphlaxis in age <6yr, 6-12yr and >12yr?

<6yr 150mg 6-12yr 300mg >12yr 500mg

When a patient is in anaphylaxis it is recommended to lie flat and elevate their legs - T or F

True (to ensure blood flow to vital organs)

What is the Mx of anaphylaxis?

IM adrenaline + High flow O2 + Prednisolone + Chlorphenamine antihistamine

How is cow's milk protein allergy diagnosed?

RAST (total IgE and specific IgE for cow's milk protein) | or clinical Dx following exclusion

Breastfeeding is a RF for cow's milk protein allergy - T or F

False breastfeeding is protective

What is the Mx of cow's milk protein allergy in an infant?

Extensively hydrolysed formula (2nd line amino acid based formula) (kids grow out of it, re-introduce milk after 1yr)

If breastfeeding and a child has cow's milk protein allergy - should mum's eliminate cow's milk protein from their diets?

Yes (also give Ca supplements)

When is the newborn baby examination performed?

6 - 24 hours of life

What is the Moro reflex?

Head extension causes abduction followed by adduction of the arms

What age should the Moro reflex disappear?

3-4mth

What is the grasp reflex?

Flexion of fingers when object placed in palm

What is the rooting reflex?

Stroke babies cheek and they turn their head towards | assists in breastfeeding

What age should the grasp reflex disappear?

4-5mth

What age should the rooting reflex disapear?

4mth

Sensorineural deafness + haematuria (renal failure) =

Alport's syndrome

All pregnant and breastfeeding women should take a daily vit D supplement - T or F

True

What genetic syndrome cause friendly extroverted personalities?

William's syndrome

Breasfeeding is protective for SUDI - T or F

True

Lower SES is a RF for SUDI - T or F

True

Room sharing is a RF for SUDI - T or F

False room sharing is protective

Bed sharing is a RF for SUDI - T or F

True

Parenteral smoking is a RF for SUDI - T or F

True

Dummies / pacifiers is a RF for SUDI - T or F

False - protective

Is hypothermia or hypothermia a RF for SUDI?

Hyperthermia eg over-wrapping, head covering

What sleeping position is. major RF for SUDI?

Prone (lying on front)

Is prematurity / low birth weight a RF for SUDI?

Yes

What gender is SUDI more common in?

Male babies

Keeping the cot clear of lots of blankets / teddies is a RF for SUDI?

No you recommend that

Following SUDI, families are offered bereavement services and bereavement counselling - T or F

True (parents also get increased support in next pregnancy eg resuscitation training and movement monitors that alert parents if baby stops breathing)

What is clubfoot also known as?

Talipes equinovarus

What is the 1st line Mx of clubfoot?

Ponseti casts

XR shows onion skin appearance

Ewing's sarcoma

XR shows sunburst pattern

Osteosarcoma

Medical word for bone infection?

Osteomyelitis

Commonest infecting agent in osteomyelitis?

Staph aureus

Imaging modality of choice in osteomyelitis?

MRI

ABx in osteomyelitis?

IV fluclox for 6wk

Neck lump in children derived form remnants of thyroglossal duct

Thyroglossal cyst

Thyroglossal cyst or branchial cyst - which one is located laterally and which is located in the midline?

Thyroglossal cysts in midline | Branchial cysts laterally

Neck lump lymphatic malforomation

Cystic hygroma

Thyroglossal cyst / branchial cyst / cystic hygroma | - which is the huge sized one

Cystic hygroma

What drug class is associated with cleft lip / palate?

Antiepileptics

Choice of antibiotic for tonsillitis if penicillin allergy?

Clarithromycin

Gower's sign + calf pseudohypertrophy

DMD

Caput or cephalohaematoma - which crosses sutures?

Caput

Caput or cephalohaematoma - which goes away in a day which in months?

Caput day | Cephalohaematoma months

Separation of the great toe

Down's syndrome

What are you checking for with the red reflex in newborn examination?

Congenital cataract and retinoblastoma

During the newborn exaination, where do you auscultate for coarctation?

Midscapular area posteriorly