Paediatric Diseases Flashcards
Describe the vital signs table for children
insert table
When is a child classes an infant?
Up to 18 months/2years
In what ways are infants anatomy different to adults?
- large heart with a big surface area to volume ratio
- high anterior larynx and floppy epiglottis
- more flexible ribs
- low blood volume
What is the relevance of infants having a different larynx and epiglottis?
Requires a different intubation technique - in children <1 year old the airway must be kept more neutral in an emergency to prevent it from closing up
At birth what is the average blood volume of a baby?
80mls/kg - blood loss can occur easily
How does physiological jaundice occur?
Foetal haemoglobin is broken down by the babies liver but it is still maturing and does not have all the appropriate enzymes so therefore results in excess unconjugated bilirubin
What is the most common respiratory pathology in infants?
Bronchiolitis
Describe bronchiolitis
Acute inflammatory injury of the bronchioles presents with coryza, distinct cough, lots of secretions, fever, wheeze, intercostal recession, apnoea, poor feeding
What virus commonly causes bronchiolitis?
RSV
How is bronchiolitis treated?
Supportive - CPAP can be used for apnoea
Describe Croup
Acute laryngotracheobronchitis - causes subglottic oedema, inflammation and exudate. Presents with a barking cough and stridor (usually worse at night)
What causes croup?
Usually paraflu
How can croup be treated?
Steroids
Name the ENT emergency that is more common in children
Epiglottitis
Describe epiglottitis
Presents with sudden onset continuous stridor, dribbling, septic but no prominent cough
What causes epiglottitis?
Usually haemophilus influenza
How is epiglottitis treated?
Steroids and antibiotics
Other than croup and epiglottitis name another pathology that presents with stridor in infants
Bacterial tracheitis
Describe bacterial tracheitis
Commonly due to staph aureus presents with a productive cough, stridor and an acutely unwell child
What signs can be seen on CXR of croup?
- hypopharynx distension
- narrowing of air column (steeple sign)
How does pneumonia present in infants?
Fever, cough, crackles in lungs, grunting, nasal flaring, intercostal recession
Bronchopneumonia or focal
What is another name for whooping cough?
Pertussis
How does pertussis present?
Apnoea, vomiting, ‘whoop’ occurs due to inspiration against closed glottis
What is the treatment for pertussis?
Mainly supportive (vaccine for prevention)
Describe meningitis
Acute inflammation of the meninges due to infection (bacterial or viral). Presents with stiff neck, photophobia, fever, purpuric rash (non-blanching), arthritis, bulging fontanelles
How is meningitis investigated?
Lumbar puncture and imaging but depends on history
What is encephalitis ?
Inflammation of the brain, can present with focal seizures, weakness or personality changes
What is given to patients with suspected encephalitis?
Aciclovir in case it is due to herpes
How is gastroenteritis treated?
Oral rehydration (dioralyte)
What is the differential diagnosis for a ‘funny turn’?
- febrile seizures
- reflex anoxic attack
- breath holding attack
- epilepsy
- arrhythmias
- heart abnormality
What investigation must always be done in an infant with ‘funny turns’?
Heart tracing to rule out long QT
Describe febrile seizures
A single tonic -clonic symmetrical seizure usually lasting <5 mins happen as a result of an increase in temperature due to infection. Important to find and treat the underlying cause.
What is a reflex anoxic attack?
Self limiting brief systole triggered by pain/fear/anxiety. Benign and a child will grow out of it.
How does congenital heart disease usually present?
Cyanosis and heart failure
What is the most common arrhythmia in infants?
Supra ventricular tachycardia
How is an SVT in children managed?
With drugs until a pacemaker can be inserted when they are older
