Overview Flashcards
When do girls and boys on average enter puberty?
Girls - 11 years old
Boys - 6 months later
Name two gonadotrophins
LH
FSH
What does LH do?
Stimulates testosterone secretion from Leydig cells
What does FSH do?
Stimulates spermatogenesis by acting on sertoli cells
What is the function of dihydrotestosterone?
Enlargement of male sex organs
Secondary sexual characteristics
Anabolism
Describe true precocious puberty
<8 years old in girls
<9 years old in boys
Define puberty delay
Absence of secondary sexual development in a girl aged 13 or boy aged 14
What scoring system measures sexual characteristic?
Tanner
What are the symptoms of diabetes in children?
Polyuria, nocturnal enuresis, polydipsia, weight loss, fatigue
What is a risk of fluid resus in kids with diabetes?
Cerebral oedema
Describe congenital adrenal hyperplasia
21 OH enzyme deficiency
- Absent cortisol and aldosterone
- increased androgens
How does CAH present?
Addison Crisis
Virilisation
Describe an addison crisis how is it managed?
Hyponatraemia
Hyperkalaemia
Hypotension
Urgent salt and cortisol
How does increased testosterone present?
Female - ambiguous genitalia
Male - precocious puberty
What are the key anatomical differences between kids and adults?
Large head, prominent occiput Large surface area compared to volume High anterior larynx/floppy epiglottis More flexible ribs Blood volume 80mls/kg HbF
Name the signs of respiratory distress in kids
Prominent inspiratory and expiratory stridor Marked intercostal recession Significant distress/agitation Lethargy Restlessness
What causes bronchiolitis?
Viral - RSV, parvovirus, adenovirus
How does bronchiolitis present?
Cough, wheeze, fever
LRTI
How is bronchiolitis treated?
Supportive
Bronchodilators don’t work
What causes croup?
Parainfluenza virues
Where does croup affect?
Larygotrachobronchitis
Epiglottis
How does croup present?
URTI
Barking ‘seal’ cough
How is croup treated?
Steroids - dexamethasone
What is the classic X-ray sign of croup?
Steeple/wine bottle - tapering of the upper trachea
What should be given to kids with viral meningitis?
Steroids - prevent hearing loss
What is a classic sign of measles?
Koplik spots - white specs found in the mouth
6 week old baby with visible peristalsis, non -bilous vomiting
Pyloric stenosis
How is pyloric stenosis treated?
Incision into the sphincter
6 month old with green vomit, sausage mass on stomach with red current stool
Intussusception
How does intussusception look on US?
Target lesion - coiling of bowel folding in on itself
How is intussectpion treated?
Tube up back passage and inflation - air reduction
Bile like mossy green vomit
Malrotation with volvulus
Describe malrotation with volvulus
SMA obstruction and ischaemia as gut twists on itself
What disease is associated with meconium ileus?
CF
What is the most common cause of an acute scrotum?
Hydatid of Morgagni
What causes hydatid of morgagni?
Persistent mullein duct
Describe hydatid of morgagni
Blue dot on testicle - firm bead that can become necrotic
How long do you have to save a testicle that has torted?
4 hours
Describe idiopathic scrotal oedema
Itchy red scrotum treated with analgesia and anti-histamines
What is BXO?
Lichen sclerosis in boys aged 9/10
How can phimosis be managed?
Dab urine, stretch under bath, steroid cream - if it looks scarred surgery can be done
What is paraphimosis?
Retracted irreplaceable foreskin
How do you treat paraphimosis?
Ice
Squeeze
Surgery - circumcision
What is hypospadias?
Urethra on underside of penis
What causes hydrocele?
Patent tunica vaginalis
Describe hydrocele
Transiluminates, oedema comes and goes tend to drain at night and then fill up
What are the key risks of undescended testes?
Testicular cancer
Infertility
Bag of worms
Varicocele
Which side is varicocele most common on?
Left - obstruction of renal vein
Describe febrile seizures
Fever induced tonic clonic
>5 mins - buccal midazolam
Small increased risk of epilepsy
What are the components of APGAR?
Activity Pulse Grimace Appearance Respiration
What are the three symptoms of ADHD?
Impulsivity
Hyperactivity
Inattentive
Name three main chromosome abnormalities screened for antenatally
Downs - 21
Patau - 13
Edward - 18
What is the autism triad?
Language
Repetitive behaviour
Communication
What is small/large for gestational age?
SGA <10th centile
LGA >90th centile
How can low birthweight be described?
LBW - <2.5kg
VLBW <1.5kg
ELBW <1kg
Describe TTN
Transient tachypnoea of the newborn
Often seen with C section due to left over amniotic fluid
Self-limiting but observe in NICU
Describe RDS
Preterm babies <28 weeks in particular
Surfactant deficiency produced by type 2 alveolar epithelial cells
Treat with maternal steroids
What is a serious neonatal infection?
Necrotising enterocolitis
Describe NEC
GI tract - bile in vomit, bloating and bloody stools can lead to necrosis and perforation
Rest bowels and antibiotics
Name the features of a innocent paeds murmur
Soft systolic
Left sternal edge
No radiation
Name six congenital heart diseases
Coarction of aorta Atrial septal defect Ventricular septal defect AVSD Transposition of great arteries Tetralogy of Fallot
What is Tetralogy of Fallot?
Pulmonary stenosis
VSD
RVH
Overriding aorta
Describe androgen insensitivity syndrome
XY
X linked recessive condition in androgen receptor causing testosterone insensitivity in end organs
Female phenotype no uterus
Describe 5 alpha reductase deficiency
46 XY autosomal recessive condition leading to inability to covert testosterone to DHT
Ambiguous
What are red flags for developmental delay?
Asymmetry of movement Loss of skills No speech by 18 months Not walking by 18 months Parental concerns of hearing/vision
How does cerebral palsy present?
Increased spasticity
Hemiplegic, paraplegic, quadriplegic
Often global delay
How is CF inherited?
Autosomal recessive - CFTR gene in epithelial cells leading to sticky, thick mucus
How does Klienfelters present?
XXY
Weak muscles, less body hair, small genitals, breast growth, less sex interest
What is the genotype of turners?
45X - missing X chromosome
What causes whooping cough?
Bordetella Pertussis
What is reactive attachment disorder?
Difficulty forming lasting relationships
- inhibited
- disinhibited
Describe inhibited RAD
Continually fail to initiate and respond to social interactions - met with resistance and avoidance
Describe disinhibited RAD
Inability to display appropriate selective attachments - overfamiliar child
Describe conduct disorder
Repetitive, persistent violation of rules
Aggression, destruction of property, deceitful