Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 PassMed Incorrect Qs > Paediatrics 1 > Flashcards

Paediatrics 1 Flashcards

1
Q

Neonate NEWBORN BLS

5 steps

A
  1. Dry baby and maintain temperature
  2. Assess tone, respiratory rate, heart rate
  3. If gasping or not breathing give 5 inflation breaths*
  4. Reassess (chest movements)
  5. If the heart rate is not improving and <60bpm start compressions and ventilation breaths at a rate of 3:1

*Inflation breaths are different from ventilation breaths. The aim is to sustain pressure to open the lungs.

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

8-year-old boy presented with:
- progressive gait disturbance and falls, unsteady gait and toe walking at the age of 4 years.
- Tremors in the hands were noted sometime prior to this visit.
- Gait was wide-based and unsteady
- pes cavus
- mild scoliosis
- absence of cardiac murmur.

diagnosis and genetic pattern?

A

Friedreich’s ataxia is autosomal recessive

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

Perthes disease- Avascular necrosis of head femoral head

More common in boys or girls?

Caterall Staging
Stage 1
Stage 2
Stage 3
Stage 4

A

5 times more common in boys

Caterall Staging

Stage 1 Clinical and histological features only
Stage 2 Sclerosis with or without cystic changes and preservation of the articular surface
Stage 3 Loss of structural integrity of the femoral head
Stage 4 Loss of acetabular integrity

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

Perthes Disease Management
1. Supportive:
2. < 6yo
3. Older
4.

A
  1. To keep the femoral head within the acetabulum: cast, braces
  2. If less than 6 years: observation
  3. Older: surgical management with moderate results
    4 .Operate on severe deformities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ITP Management

Usually…

BUT
1
2
3

A
  • usually, no treatment is required. Advice about preventing trauma for bleeding

BUT if platelets <10 * 109/L) or there is significant bleeding:
- oral/IV corticosteroid
- IV immunoglobulins
- platelet transfusions can be used in an emergency (e.g. active bleeding) but are only a temporary measure as they are soon destroyed by the circulating antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Going back to school rules:
- Rubella
- Scarlet fever
- Hand foot and mouth
- Whooping cough
- Measles
- Chickenpox
- Mumps
- Infectious gastroenteritis
- Impetigo

A
  • Rubella- 5 days from rash onset
  • Scarlet fever- 24 hours from when abx started
  • Hand foot and mouth- none

Whooping cough- 2 days after commencing abx (or 21 days from onset of symp if no abx)

  • Measles- 4 days from rash onset
  • Chickenpox- until all lesions have crusted over
  • Mumps- 5 days from swollen glands
  • Infectious gastroenteritis- 48 hours from when symptoms have settled
  • Impetigo- Until lesions are crusted and healed, or 48 hours after commencing antibiotic treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fragile X syn.

genetic pattern

features 6

A

X-linked dominant

Features in males
- learning difficulties
- large low set ears, long thin face, high arched palate
- macroorchidism
- hypotonia
- autism is more common
- mitral valve prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Is conjugated or unconjugated bilirubin elevated in biliary atresia?

A

Conjugated bilirubin is elevated in biliary atresia

Unconjugated -> conjugated in the liver

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

Before starting anti-TNF med, what investigation would you do and why?

A

CXR- to rule out latent TB which can be reactivated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Seborrhoeic dermatitis in children

aka

Site? (4)
Describe the rash basically

Management:
1.
2.
3. If severe/ persistent

A

aka- ‘Cradle cap’

site- scalp, nappy area, face, limb flexures

erythematous rash with coarse yellow scales

Management
1. Reassurance that it doesn’t affect the baby, usually resolves within a few weeks
2. Massage a topical emollient onto the scalp to loosen scales, brush gently with a soft brush and wash off with shampoo.
3. If severe/persistent a topical imidazole cream may be tried

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Knee pain children and young adult STEMS

  1. Chondromalacia patellae -
  2. Osgood-Schlatter disease
    (tibial apophysitis)
  3. Osteochondritis dissecans
  4. Patellar subluxation
  5. Patellar tendonitis
A

Chondromalacia patellae - teenage girls, anterior knee pain on walking up + down stairs, rising from prolonged sitting

  1. Osgood-Schlatter- sporty teenagers, Pain, tenderness + swelling over the tibial tubercle, Pain on bending down
  2. Osteochondritis dissecans- Pain after exercise
    Intermittent swelling and locking
  3. Patellar subluxation- Medial knee pain due to lateral subluxation of the patella
    Knee may give way
  4. Patellar tendonitis- athletic teenage boys, Chronic anterior knee pain that worsens after running
    Tender below the patella on examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Risk factors for noonatal hypoglycaemia

A
  1. preterm birth (< 37 weeks)
  2. maternal diabetes mellitus
  3. IUGR
  4. hypothermia
  5. neonatal sepsis
  6. inborn errors of metabolism
  7. nesidioblastosis
  8. Beckwith-Wiedemann syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Managment of threadworm

A

Single dose of oral Mebendazole and for the entire household + hygeine advice

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

Down syndromes are at in crease of what with regards to contact sport STEM!

A

atlanto-axial instability- If participate in specific sports, they may carry an increased risk of neck dislocation (e.g. trampolining, gymnastics, boxing, diving, rugby and horse riding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pataus is what chromsome?

Features? (4)

A

13

Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

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

Diet advice for children with ADHD

A

Normal balanced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If its a young teen with hip pain, how can you differenciate between Perthes and SUFE? (2)

A

SUFE-
Age 10-15yo
key examination finding being the loss of internal rotation of the leg in flexion.

Perthes
3-10yo
NO LIMIT IN MOVEMENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Congenital heart defect

Cyanotic presenting in the first days of life =

Cyanotic presenting in the first 1-2 months =

A

Days = Transposition of great vessels

Months = TOF

19
Q

What vaccines do you recive between the ages of 12-13 and then 13-18yo?

A

12-13yo = HPV vaccination
13-18 years = ‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)
Men ACWY

20
Q

When should you routinely assess APGAR score?

A

1 and 5 minutes of age

21
Q

Whooping cough going back to school rules?

Also what abx is used?

A

48 hours following commencement of antibiotics (or 21 days from onset of symp if no abx)

clarithromycin

22
Q

Briefly explain the pathology and what you’d see on a hormonal panel in these conditions causing delayed puberty in females?

Turners-

Consitutional delay of puberty

Congenital adrenal hyperplasia

Functional hypothalamic amenorrhoea

Premature ovarian insufficiency

A

Turners- Due to ‘streak’ ovaries- Ovaries dont produce oestrogen but increase in LH and FSH. Also low anti-mullarian hormone (low reserve)

Consitutional delay of puberty- Normal hormonal panel, LH and FSH will not be elvated in pre-pubertal girls

Congenital adrenal hyperplasia-

Functional hypothalamic amenorrhoea- usually a result of stress, eating disorder or intense exercise resulting in depression of GnRH. Might expect to see a low BMI, which causes a low level of LH and FSH to be released into the bloodstream

Premature ovarian insufficiency- ovaries entering a menopausal state early, usually before a patient’s 40s. The oestrogen level decreases resulting in a high LH and FSH level

23
Q

What is hypospadias and what condition is assoc. with it?

3 management points for hypospadias

A

hypospadias- congenital abnormality of the penis. Urethra comes out on the ventral side.

Assoc. with Cryptorchidism (undestended testes) 1/10 with hypospadias have cryptorchidism therefore examine groin.

Management:
- Make sure they pass urine in first 24 hours
- Don’t get circumcised because foreskin can be used in surgery
- Surgery at 12 months

24
Q

Major risk factors for SIDS ( sudden infant death syndrome) are: (5)

A
  • prone sleeping
  • parental smoking
  • bed sharing
  • hyperthermia and head covering
  • prematurity
25
Q

What is alpha thalassaemia?

What chromo?

There are two seperate alpha-globulin genes located on each chromosome….

Severity depends on the number of alpha globulin alleles affected:

1 or 2 alpha globulin alleles affected =

If are 3 alpha globulin alleles are affected =

If all 4 alpha globulin alleles are affected (i.e. homozygote) =

A
  • Due to a deficiency of alpha chains in haemoglobin

chromosome 16

1 or 2 alpha globulin alleles affected = hypochromic and microcytic, but Hb levels would be typically normal

3 = hypochromic microcytic anaemia with splenomegaly. This is known as Hb H disease

All 4 = death in utero (hydrops fetalis, Bart’s hydrops)

26
Q

Kochers criteria for septic arthritis

A
  1. Non-weight bearing - 1 point
  2. Fever >38.5ºC - 1 point
  3. WCC >12 * 109/L - 1 point
  4. ESR >40mm/hr
    5.
27
Q

Receiving the MMR as a child later in life. When do you give second dose?

Max response =

A

Max response = 3 months between doses to maximise the response rate

1 month is considered adequate if the child is > 10 years of age.
In an urgent situation (e.g. an outbreak at the child’s school) then a shorter period of 1 month can be used in younger children.

28
Q

If you have a VSD what are you at an increase of getting later in life?

A

endocarditis

29
Q

Management steps for cows milk protein allergy

If formula fed
1. First-line =
2.

If breast fed
1.
2.
3. When breast feeding stops-

A

If formula fed
1. extensive hydrolysed formula (eHF) milk is the first-line with mod symp
2. Amino acid-based formula (AAF) in infants with severe CMPA or if no response to eHF

10% of infants are also intolerant to soya milk

If breast fed
1. continue breastfeeding
2. eliminate cow’s milk protein from maternal diet. Can have calcium supplements for mum
3. When breast feeding stops- eHF milk when breastfeeding stops, until 12 months of age and at least for 6 months

30
Q

ADHD med methylphenidate side effect 5 but 1 main 1

A

stunted growth
insomnia, weight loss, anxiety, nausea and pain.

31
Q

What is the number one cause of painless massive GI bleeding requiring a transfusion in children between the ages of 1 and 2 years.

A

Meckels diverticulum

results from the failure of the vitelline duct to obliterate during the fifth week of fetal development

32
Q

Mitochondrial diseases are inherited following 3 principles:

A
  • Affected males cannot pass it onto their children
  • Affected females will pass it onto all of their children
  • All individuals who inherit the affected mitochondria, will have the disease
33
Q

Complete androgen insensitivity- - classic presentation (STEM 2)

what is it?

A
  • primary amenorrhoea
  • You get bilateral inguinal hernias which are actually undescended testes
  • Small breast bud development and spare public hair due to aromatase androgens

phenotypically female genitalia in a genetic male, caused by failure of androgen masculinisation of genitalia in-utero

34
Q

Route and how many times do you give Vit K to a neonate?

why is it given?

Who is at risk of this? (2)

A

Once- off dose IM injection

can also be given orally but IM is preferred if compliance is an issue with parents

Why? Given to prevent hemorrhagic disease

  • breast fed babaies
  • mums on anti-epileptics
35
Q

What exam findings would you ding with neonate Congenital diaphragmatic hernia (2 and 1 STEM)

A
  • dyspnoea and tachypnoea at birth
    STEM - classical concave abdominal appearance
  • Reduced breath sound bilaterally
36
Q

Genetic inheritance pattern of Sickle cell?

A

Autosomal recessive

37
Q

DDH

Indication for 2 week hip USS

Indication for 6 week USS

A

2 weeks- abnormal birth check with ortolini and barlow

6 weeks
- Breech at birth
- Breech at 36 weeks
- 1st degree relatives with Hx of Hip problems
- Twin/Multiple pregnancy

38
Q

Management of thread worm

a rogue fact which is very frustrating…

A

One off Mebendazole for patient and all family members + hygeine

Cannot be given to < 6 months!)

39
Q

Febrile convulsions

Simple criteria (4)

Complex criteria (3)

Febrile status

A

Simple criteria (4)
- < 15 minutes
- generalised
- don’t reoccur in 24 hours
- complete recovery within 1 hour

Complex criteria (3)
- 15- 30 mins
- focal seizure
- may repeat within 24hrs/ same illness

Febrile status
- > 30 mins

40
Q

Orofacial cleft lip causes

what maternal drugs in preg? (2)

Maternal factor in preg -

Infection in preg

syndromic disorders (3)

A

what maternal drugs in preg? - Benzos
- Anti-epileptics (phenytoin)

Maternal factor in preg
- smoking

Infection in preg
- rubella

syndromic disorders
- **18- edwards
- 13 pataus
- 15 - Prader-Willi syndrome?

41
Q

Genetic pattern of inheritance Haemophilia A?

A

X-linked recessive

Therefore only mother to son passing

42
Q

Features which may be present in a sexually abused child (8)

A
  • pregnancy
  • sexually transmitted infections, recurrent UTIs
  • sexually precocious behaviour
  • anal fissure, bruising
  • reflex anal dilatation
  • enuresis and encopresis
    -behavioural problems, self-harm
  • recurrent symptoms e.g. headaches, abdominal pain
43
Q

undescended unilateral testicle

what surgery is done?

Bilateral undescedended testes management?

A

Reassure and Referral if at 3 months of age hasn’t descended

child should be referred to a paediatric surgeon and seen before 6 months of age

Orchidopexy- this should occur at around 1yo

BILATERAL- Review by senior paed within 24 hours as the child may need urgent endocrine or genetic investigation

Year 4 PassMed Incorrect Qs (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions