Paediatric Flashcards

1
Q

Eczema herpeticum
Sx

A

Seen > in atopic/asthma
Monomorphic widespread VIRAL infection commonly herpes

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2
Q

Nephrotic syndrome

A

Hypoalbuminemia
Hypercholesterolemia
Oedema

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3
Q

General approach for hematuria

A

Dipstick»Urinalysis»urine culture»rft»asotcomplement»USG

All based on initial result, mngt differ according to the scenario

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4
Q

Transient Tachypnea of Newborn

A

•Early onset, delayed fluid clearance from lung,lasts 4-6hrs
Features of resp distress, grunting, nasal flaring, ICR,SCR
•Improvement with O2 support

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5
Q

TTN vs RDS

A

RDS worsen after 48-72hrs
Due to surfactant deficiency

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6
Q

Bed wetting
Age

A

Daytime Continence acquired by 3 yrs old
Night time Continence by 6 yrs old

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7
Q

SVT (narrow complex) with stable hemodynamic status
Age wise

A

<6mth: face immersion in cold water
>6 mth : icepack applied on the face
School aged: blow the thumb 10-15sec/ syringe after full inspiration ( child must look strained)
Valsalva fails: IV adenosine

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8
Q

SVT in shock

A

Synchronised DC cardioversion

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9
Q

Wide complex tachycardia
Aka SVT with aberrancy

A

IV amiodarone

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10
Q

Acute mastoiditis

A

•Complication of acute otitis media
•post auricular swelling and redness
• initial step: culture swab
• commence abx : flucloxacillin + 3rd gen cephalosporin

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11
Q

Next step after abx in acute mastoiditis

A

CT scan
Hearing assessment during convalescent period

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12
Q

Cut-off for overweight and obesity
WHO

A

85th-96th centile
>97th centile

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13
Q

Neck mass approach (if lymphadenopathy)

A

Watchful waiting 6 weeks if reactive lymph node
+ red flags need prompt action
If no red flags : FNAC

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14
Q

Painful limbs , bilateral,> at night, but gait is normal and no tenderness elicited by movement

A

Growing pains

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15
Q

Acute epiglottitis

A

Acute,sudden onset sore throat, dysphagia,drooling of saliva, tripod posture, expiratory stridor

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16
Q

Acute epiglottitis airway mngt

A

Severe:Bag mask ventilation 100% O2
Endotracheal intubation (smaller tube)
If fail: surgical cricothyroidotomy
For child < 8 yrs: needle cricothyrotomy

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17
Q

Lymphadenopathy
Anterior vs posterior ∆

A

Anterior: USG
Posterior: FNAC
Look into other associated factors as well

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18
Q

Perthes disease

A

Idiopathic AVN femoral head
4-10 yrs old
Hip pain radiating to knee, painless limp
Limited IR & Abduction
Xray serial
Scottish Rite brace initial Rx
If fails—- osteotomy

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19
Q

Acute rheumatic fever

2 major / 1 major+ 2 minor
+
Presence of GAS
SPECS
FEP

A

Major: Polyarthritis, Erythema marginatum, Sydenham chorea, Subcutaneous nodule,Carditis
Minor: fever, ESR>30, PR interval prolonged

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20
Q

Recurrent ARF criteria

A

2 major or 1 major + 2 minor or 3 minor
+
GAS infection

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21
Q

Vulvovaginitis in child

A

FB (MCC) : blood with foul smelling
Threadworm: a/w itchiness
Sexual abuse

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22
Q

Thyroglossal duct cyst
Most common complications

A

By order:
1. Infection
2. Malignancy

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23
Q

Enuresis ( after age of 6)

A

Initial test: urinalysis and USG
Enuresis alarm
Vasopressin
TCA

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24
Q

Most common AGE virus

A

Norovirus
Self limiting
PCR if needed but not necessary

25
Q

Overweight centile child with normal height centile

A

TSH
Prior to that, diet, parents obesity all taken into consideration

26
Q

MCC of Acute mastoiditis and acute otitis media

A

Streptococcus pneumoniae

27
Q

Language delay

A

> 24 months is a concern

28
Q

1° encopresis
Vs
2° encopresis

A

1°: never been continent
2° : previous continent
MCC: constipation with overflow incontinence, attitude issues: conduct disorder/oppositional defiant disorder

29
Q

Regression
SX?
Cause?

A

SX:Baby talk, thumb sucking, enuresis
Cause? Sexual abuse, parental separation

30
Q

Patient with arrested Tanner 2 stage

A

•Bone age determination 1st
•Xray of Left Wrist and Left Hand done
•Bone age can differentiate actual age vs Turner syndrome

31
Q

MCC of pubertal delay

A

Constitutional delay

32
Q

Anaphylactic reaction
Adrenaline dose

A

O2 1st
0.2ml adrenaline 1:1000 deep IM

33
Q

Vertigo in child

A

•Always suspect CNS tumor or epilepsy, needs specialist opinion
•EEG or CT scan

34
Q

Hypertrophic pyloric stenosis

A

•Non bilious vomiting, within 30 mins after feeding
•2mth-6mth age
•Epigastric mass
•Hypochloraemic metabolic alkalosis

35
Q

Marfan Syndrome
Murmur findings?

A

AR : 3 different murmurs
Decresendo murmur
Austin Flint
Functional systolic murmur

36
Q

Marfan Syndrome
Organs involved?
Autosomal?
Best ix?

A

Heart ❤️, skeleton 🦴, eyes 👀
Autosomal dominant
Cardiac Echo

37
Q

Wheezing in child
Algorithm ?
Rx:

A

Determine HX
Sudden or insidious
Unilateral or bilateral
Family HX
Rx: if sudden, suspect FB or aspiration.. admit and O2 therapy
Insidious: neb salbutamol to see wheeze or early asthmatic or other causes

38
Q

Neuroblastoma

A

Common in early age < 2 yrs old
Extra cranial: non tender mass palpable

39
Q

Wilms tumor

A

Median age: 3.5 yrs
Large smooth mass does not ❌ cross midline, non tender
Hematuria+ hypertension
MCC

40
Q

UPJ obstruction

A

√ Intermittent flank pain
√ Nausea and vomiting
√ Hydronephrosis+/-
√ USG during painful episodes diagnostic if Urinalysis and culture are normal
*Intermittent kinking causes pain due to obstruction

41
Q

Duration of school exclusion for Measles

A

Patients with established measles should be excluded until 4 days after the onset of rash.

42
Q

ITP

A

Diagnosis by exclusion
NO specific test
Mild , asymptomatic: rest
Mild bleeding: steroid
Mod : ivIg
Severe: splenectomy

43
Q

ITP platelet transfusion

A

If platelet<10,000

44
Q

Painless rectal bleeding in child btw 2-8 yrs old

A

Juvenile colonic polyps

45
Q

Retinoblastoma
Ix ? Initial?
Best?

A

Initial: USG: intraocular calcification
Best : MRI

46
Q

Croup
SX + signs
Rx

A

1-3 yrs ;Tachypnea,brassy cough, inspiratory or biphasic stridor
Mild/Mod/Severe
Mild: early r/v
Mod: neb Budesonide or oral steroids
Severe: neb Adrenaline+ steroids

47
Q

Pertussis
Phase?
Ix?
Rx?

A
  1. Catarrhal/paroxysmal/convalescent
    Infectivity upto 21 days
  2. Nasopharyngeal aspirate
    Serology igA
48
Q

Contact of pertussis mngt

A

Vaccine within 21 days of contact

49
Q

Question 42-50

A

Pertussis must do

50
Q

Language delay MCC

A

Hearing impairment

51
Q

Orofacial MCC

A

Genetic : sporadic/familial
Others:
Drugs
Smoking
Alcohol
Folic acid
Maternal DM and obese

52
Q

Noonan Syndrome

A

Hypertelorism, amblyopia
Downslanting lateral eye
Ptosis
Low set ear
Webbed neck
Heart

53
Q

DDH

A

Barlow’s: telescopic
Otolani: palpable clunk/jerk
Not 🚫 click

54
Q

VUR
Long term abx

A

Low dose 1/4 or 1/3 abx dosage continuous!!!

55
Q

Transposition of Great Arteries

A

MCC cyanosis heart disease
Classical cyanosis happens as the ductus arteriosus begins to shut after the 1st cry.
No murmur
Immediate surgery

56
Q

Failure to thrive (FTT)

A

The most common cause of failure to thrive is inadequate caloric intake.

57
Q

Asymptomatic microscopic hematuria with fever

A

• Repeat UA once fever settles
• repeat urine analysis over next 2 weeks( 2 out of 3 + ) needs detail evaluation

58
Q

SIADH in children causes

A