Paediatric differential Diagnoses + safeguarding Flashcards

1
Q

Differentials for increasing sleepiness

A

Hypoglycaemia: poor feeding
Exhausted: WOB/feeding
Encephelopathic: infection/metabolic condition
Neurological: head injury/poor cerebral perfusion
Hypoxia
Hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Differentials for tachycardia

A
Upset/anxiety
pyrexia
pain
fear
cardiac arrythmia/failure
Increase WOB
Sepsis/shock
hypovolaemia 
Iatrogenic: salbutamol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Differentials of seizures

A
  • febrile
  • meningitis
  • encephalopathy
  • epilepsy
  • sepsis
  • brain tumour
  • metabolic disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Differentials of a non-blanching rash

A
  • Meningicoccal septicaemia if with fever MEDICAL EMERGENCY
  • AI/NAI - bruising
  • Henoch-Schonlein purpura
  • Idiopathic thrombocytic pupura
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs of heart failure

A
decrease feeding: SOB
clammy when feeding
Reasonable saturations
Tachycardia
Enlarged liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs of an acutely unwell child

A
Abnormal breathing
Increase HR/RR
Sleepy
pale
Grunting
Unclear heart sounds
Hx of poor feeding
Signs of HF
Cold extremeties
decreased sats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Differentials of difficulty breathing

A
Sepsis
CHD/HF
bronchiolitis
meningoencephalitis
NAI w hypovolaemia
DKA
Acute blood loss
asthma
UA obstruction
Pneumonia
Pneumothorax
Metabolic acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the triad of shaken baby syndrome

A

Retinal haemorrhages
subdural haematoma
encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

RIsk factors for Sudden infant death syndrome

A
prone sleeping
parental smoking
bed sharing
hyperthermia and head covering
prematurity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of enuresis in a child

A
  • Normal
  • Stressors
  • Constipation
  • UTI
  • Diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management of enuresis

A
  • Reward charts for good behaviours like going for a wee before bed
  • Adequate but not excessive intake over the day
  • Restrict fluid intake just before bed
  • Avoid caffeine
  • Desmopressin >7
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Advice for parents with children with enuresis

A
  • NOT the child’s fault

- 99% will become dry over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does bile stained vomit suggest

A

Intestinal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does haematemasis suggest

A
  • Oesophagitis
  • Gastric ulcer
  • Oral/nasal bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does projectile vomiting suggest

A

pyrloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does abdo distention/tenderness suggest

A

Obstruction
strangulated inguinal hernia
surgical abdo

17
Q

What does blood in stool suggest

A

Gastroenteritis
Salmonella
Campylobacter
Intussusception

18
Q

What does a bulging fontanelle suggest

A

Raised ICP: Meningitis/hydrocephalus

19
Q

What should you include in a feeding history

A
  • Bottle or breast: mls vs how long on breast
  • Volume before now
  • Timescale of decline of feeding
  • WHy does the baby stop feeding
  • Any precipitating changes e.g. change formula
  • ALWAYS CALCULATE FEED in mls/kg/day
20
Q

Why may a baby stop feeding

A
  • out of breathe
  • pale
  • clammy
  • sleepiness (worrying)
21
Q

Normal volume of feeds in babe

A
  • <1 monthL 150mls/kg/day
  • > 1 month 100mls/kg day
  • 1-4 hourly 10-40 mins
  • 8 or more feeds in 24 hours