Brainscape's Knowledge GenomeTM

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


See full index

Finals > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What is the first line management for ADHD in children?

A

Methylphenidate

  • initially on 6 week trial basis
  • CNS stimulant
  • SE: abdominal pain, nausea, dyspepsia, stunted growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Kawasaki’s disease?

A

A type of vasculitis predominantly seen in children.

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

What are the features of Kawasaki’s disease?

A 
High grade fever lasting >5 days 
Conjunctival injection
Bright red, cracked lips
Strawberry tongue
Cervical lymphadenopathy
Red palms of the ands and soles of feet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the diagnosis and management of Kawasaki’s disease?

A

Clinical diagnosis

Management:
High dose aspirin
IV immunoglobulin
Echo to screen for coronary artery aneurysm

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

What is scarlet fever?

A

A reaction to erythrogenic toxins produced by group a haemolytic streptococci.

Common in children aged 2-6 years with peak incidence at 4

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

What are the features of scarlet fever?

A 
Fever: typically lasts 24-48 hours
Malaise, headache, nausea/vomiting 
Sore throat
Strawberry tongue 
Rash: first on torso and spares palms and soles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the diagnosis of scarlet fever?

A

Throat swab taken but antibiotic started before results

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

What is the management of scarlet fever?

A

Oral penicillin V for 10 days (phenoxymethylpenicilin)
Or azithromycin if allergic
Can return to school 24 hours after starting antibiotics

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

What is croup?

A

An acute infective upper respiratory disease causing oedema in the larynx affecting children aged 6 months to 2 years.

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

What causes croup?

A

**Parainfluenza virus

Also: Influenza, adenovirus, RSV

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

describe the presentation of croup

A 
Increased work of breathing
“Barking” cough
Hoarse voice
Stridor
Low grade fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the management of croup?

A

Oral dexamethosone- single dose of 150mcg/kg

Then: oxygen, nebulised budesonide, nebulised Adrenalin and incubation/ventilation

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

What is cystic fibrosis?

A

An autosomal recessive genetic condition affecting chromosome 7 —> mucus glands.

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

What is the initial presentation of cystic fibrosis?

A

Screened for at birth with newborn bloodspot test

Meconium ileus is often first sign. Presents with not passing meconium within 24 hours, abdominal distension and vomiting

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

What are the signs and symptoms of cystic fibrosis?

A 
Symptoms:
Chronic cough
Thick sputum production
Recurrent LRTI
Steatorrhea 
Abdominal pain/bloating
Signs:
Low birth weight
Nasal polyps
Finger clubbing
Crackles and wheezes on auscultation
Abdominal distension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the diagnosis of cystic fibrosis

A

Newborn blood spot testing
Sweat test is gold standard - chloride concentration >60mmol/L
Genetic testing for CFTR gene - amniocentesis or chorionic villus sampling

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

What are the common microbial colonisers of cystic fibrosis

A

Staph aureus and pseudomonas

Staph aureus: people take prophylactic fluclox
Pseudomonas: troublesome to get rid of - treat with nebulised antibiotics such as tobramycin and oral cipro

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

What is the management of cystic fibrosis?

A 
Chest physio
Exercise
High calorie diet
CREON tablets help digestion
Prophylactic fluclox
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do you need to monitor in people with cystic fibrosis?

A

Diabetes
Osteoporosis
Vitamin d deficiency
Liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give an overview of measles

A

RNA paramyxovirus
Spread by droplets
Infective from prodrome until 4 days after rash starts
Incubation period of 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the features of measles?

A

Prodrome: irritable, conjunctivitis, fever
Koplik spots (before rash): white spots on buffalo mucosa
Rash: starts behind ears then to whole body
Diarrhoea occurs in 10% patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the investigation and management of measles?

A

Investigations: IgM antibodies can be detected within a few days of rash onset

Management:
Mainly supportive
Admission may be required for immunosuppressive or pregnant patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the complications of measles?

A

Otitis media: most common
Pneumonia: most common cause of death
Encephalitis typically occurs 1-2 weeks following onset of illness
Febrile convulsions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the features of pyloric stenosis?

A

‘Projectile’ vomiting, typically 30 mins after feed
Constipation and dehydration
A palpable mass in the upper abdomen
Hypochloraemic, hypokalaemic alkalosis due to persistent vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the diagnosis and management of pyloric stenosis?

A

Diagnosis is mostly made by US

Management is with Ramstedt pyloromyotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is whooping cough?

A

Pertussis is an infectious disease caused by gram-negative bacterium bordetella pertussis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When are you immunised against whooping cough?

A

2,3,4 months and 3-5 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the features of whooping cough?

A

Coughing bouts: usually worse at night and after feeds
Inspiratory whoop
Spells of apnoea
Marked lymphocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the diagnostic criteria for whooping cough

A

Suspected if a person has an acute cough that has lasted for 14 days or more without another apparent cause and has one or more of the following:
Paroxysmal cough
Inspiratory whoop
Post-tussive vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the diagnosis of whooping cough?

A

Per nasal swab culture for bordetella pertussis

PCR and serology

31
Q

What is the management of whooping cough?

A

<6 months should be admitted
Notifyable disease
Oral macrolide (e.g. clarithromycin, etc)
Household contacts offered antibiotic prophylaxis
School exclusion: 48 hours after commencing antibiotics

32
Q

What is autism spectrum disorder?

A

It is a neurodevelopmental condition characterised by qualitative impairment in social interaction and communication.

33
Q

What are the clinical features of autism spectrum disorders?

A
  1. Impaired social communication and interaction:
    - children play alone
    - failure of nonverbal cues
    - socially isolated
  2. Repetitive behaviours, interests and activities:
    - inflexible adherence to nonfunctional routines
  3. Intellectual or language impairment
    - Less than 10 words by age 2
34
Q

What is the management of autism spectrum disorders

A

There is no cure but early idetification and treatment can help

Early education and behavioural interventions
Pharmacological interventions:
- SSRIs, Antipsychotics drugs and methylphenidate for ADHD
Family support and counselling.

35
Q

Define intussusception

A

Describes the invagination of one portion of bowel into the lumen of the adjacent bowel, most commonly around the ileo-ceacal region

Usually affects infants between 6-18 months. Boys>girls

36
Q

What are the features of intussusception?

A

Paroxysmal abdominal colic pain during which infant draws knees up to chest, turn pale and vomit.

Vomiting

Bloodstained stool ‘red current jelly’ is a late sign

Sausage-shaped mass in the right upper quadrant

37
Q

What is the investigation for intussusception?

A

USS may show target-like mass

38
Q

What is the management of intussusception?

A

Reduction by air insufflation under radiology control - first line

If this fails, or child has signs of peritonitis = surgery

39
Q

Define bronchiolitis

A

Condition characterised by acute bronchiolar inflammation.

RSV is the pathogen in 75-80% cases.

Most common cause of serious LRTI in <1yr olds

40
Q

What are the features of bronchiolitis?

A 
Coryzal symptoms
Dry cough
Increasing breathlessness
Wheezing, fine inspiratory crackles
Feeding difficulties associated with increasing dyspnoea
41
Q

When should you immediately refer a child with bronchiolitis? (999)

A 
Apnoea
Looks seriously unwell
Severe respiratory distress e.g. grunting, chest recession or RR >70bpm
Central cyanosis
O2 <92%
42
Q

When should you consider referring a child with bronchiolitis to hospital?

A

RR >60
Inadequate oral fluid intake
Clinical dehydration

43
Q

What is the investigation for bronchiolitis?

A

Immunofluorescence of nasopharyngeal secretions may show RSV

44
Q

What is the management of bronchiolitis?

A

Largely supportive:
O2
NG feed
Suction

45
Q

What is muscular dystrophy?

A

It’s an umbrella term for genetic conditions that cause a gradual weakening and wasting of muscles. Most common is duchenne’s muscular dystrophy.

46
Q

What is the gower’s sign?

A

It is the sign for duchennes muscular dystrophy - children use their hands to get up off the floor because they have proximal muscle weakness.

47
Q

Give the aetiology of duchenne’s muscular dystrophy

A

Caused by a defective gene for dystrophin on the X-chromosome. It is an x-linked recessive condition so women who are carriers usually don’t have any symptoms.

48
Q

What is the presentation of duchenne’s muscular dystrophy?

A

Present around 3-5 years with weakness in muscles around pelvis.

Weakness is progressive and eventually all muscles will be affected and they will become wheelchair bound by the time they’re teenagers.

Life expectancy of 25-35 with good control of cardiac and respiratory complications

49
Q

What is the management of duchenne’s muscular dystrophy?

A

Oral steroids have been shown to slow progression of muscle weakness by as much as two years.

Creatine supplementation can give slight improvement in muscle strength

Generally no treatment

50
Q

What is myotonic dystrophy?

A

Genetic disorder that usually presents in adulthood

Progressive muscle weakness
Prolonged muscle contractions. (Unable to release grip after handshake)
Cataracts
Cardiac arrhythmias

51
Q

What are the features of Down syndrome?

A 
Hypotonia
Brachycephaly
Short neck
Short stature
Flattened face and nose
Prominant epicanthic folds
Upward sloping palpable fissures
Single palmer crease
52
Q

What are the complications of down syndrome?

A 
Learning disability
Recurrent otitis media
Deafness
Visual problems
Hypothyroidism
Cardiac defects (ASD, VSD, PDA, TOF)
Atlantoaxial instability
Leukaemia
Dementia
53
Q

What is Fragile X syndrome?

A

Caused by a mutation in the FMR1 gene on the X chromosome.

54
Q

What are the features of fragile X syndrome?

A

Usually presents with delay in speech and language development. Others are:

Intellectual disability
Long, narrow face
Large ears
Large testicles
Hypermobile joints
ADHD
Autism
Seizures
55
Q

What is the management of fragile X syndrome?

A

Supportive

56
Q

What are simple febrile convulsions?

A

Generalised, tonic clonic seizures that last less than 15 minutes and only occur once during an illness.

57
Q

What are complex febrile convulsions?

A

When they consist of partial or focal seizures, last more than 15 minutes or occur multiple times during the same illness.

58
Q

What is the management of febrile convulsions?

A

Identify and manage the underlying source of infection and control the fever with analgesia.

59
Q

What is henoch-schonlein purpura?

A

It is an IgA vasculitis that presents with a purpuric rash affecting the lower limbs and buttocks in children.

Inflammation occurs in the affected organs due to IgA deposits in the blood vessels.

Usually affects: skin, kidneys and GI tract

60
Q

What are the classic features of henoch-schonlein purpura?

A

Purpura
Joint pain
Abdominal pain
Renal involvement

61
Q

What is the investigations in henoch-schonlein purpura?

A

Most important to exclude other pathology such as meningitis.

Investigations:
FBC and blood film
Renal profile
Serum albumin
CRP
Blood cultures
Urine dipstick
Urine protein:creatinine ratio
BP
62
Q

What is the diangnosis of henoch-schonlein purpura?

A

Patient has palpable purpura and at least one of:

  • diffuse abdo pain
  • arthritis or arthralgia
  • IgA deposits on histology
  • proteinuria or haematuria
63
Q

What is the management of henoch-schonlein purpura?

A

Supportive

Steroids is debatable

Monitor with urine dipstick and BP

64
Q

What’s the difference between omphalocele and gastroschisis?

A

Omphalocele: herniated organs are covered by peritoneal sac

Gastroschisis: herniated organs not covered by peritoneum

65
Q

Which heart condition is associated with Marfan’s?

A

Aortic root dilation –> aortic regurgitation

66
Q

What is hirschprung’s disease?

A

Congenital condition where nerve cells of myenteric plexus are absent in the distal bowel and rectum.

Absence of parasympathetic ganglion cells

67
Q

Which conditions are hirschprung’s disease associated with?

A

Down’s syndrome
Neurofibromatosis
Waardenburg syndrome
MEN II

Can occur by itself as well

68
Q

What is the presentation of Hirschprung’s disease?

A 
Delay in passing meconium
Chronic constipation since birth
Abdominal pain and distention
Vomiting
Poor weight gain and failure to thrive
69
Q

What is the initial and diagnostic investigations of Hirsschprung’s disease?

A 
Abdominal xray = initial
Rectal biopsy (full thickness) = diagnostic
70
Q

What is the management of Hirschprung’s disease?

A

Hirschprung’s associated enterocolitis will need fluid resuscitation and management of the intestinal obstruction with abs.

Definitive = surgical removal of the aganglionic section of bowel

71
Q

What is the management of congenital hernias?

A

Inguinal: repair ASAP
Umbilical: conservative management

72
Q

What is the presentation of coarctation of the aorta?

A

acute circulatory collapse at 2 days of age when the duct closes

heart failure & absent femoral pulses

Systolic murmur heard under the left clavicle and over the back

73
Q

When should parents call an ambulance with regards to febrile seizures?

A

If seizure does not stop after 5 minutes

74
Q

What is a child protection plan?

A

Devised for children at risk of significant harm

Finals (20 decks)

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