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MSRA > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What are the steps of asthma management in children <5 years old?

A

STEP 1 - SABA

STEP 2 (not controlled on prev. step, or new Dx of asthma with >/= symptoms 3x/wk or night-time waking - SABA + 8/52 trail of Mod ICS. If Sx reoccur within 4/52 of stopping Mod ICS, restart at low dose. If Sx resolved but then reoccur beyond 4/52 of trial, re-start trial at mod dose

STEP 3 - SABA + low dose ICS + LTRA

STEP 4 - stop LTRA and refer to paediatric asthma specialist

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2
Q

What is paediatric low dose ICS?

A

<= 200 micrograms budesonide or equivalent

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3
Q

What is paediatric moderate dose ICS?

A

200 micrograms - 400 micrograms budesonide or equivalent

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4
Q

What is paediatric high dose ICS?

A

> 400 micrograms budesonide or equivalent

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5
Q

By when do umbilical hernias usually resolve?

A

3 years old

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6
Q

When are meningitis B vaccination doses given?

A

2 months
4 months
12-13 months

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7
Q

What conditions are exomphalos associated with?

A

Cardiac and renal problems, Down’s syndrome, Beckwith-Wiedemann syndrome

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8
Q

How is retinoblastoma inherited?

A

Autosomal dominant

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9
Q

On what chromosome is the defect associated with retinoblastoma found?

A

Chromosome 13

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10
Q

In whooping cough, within what time frame may antibiotics be given?

A

Within 21 days of the onset of the cough

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11
Q

What antibiotic is given for whooping cough in children <1 month old?

A

Clarithromycin

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12
Q

What antibiotic is given for whooping cough in children aged >1 month and non-pregnant adults?

A

Azithromycin

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13
Q

What antibiotics is given for whooping cough in pregnant women?

A

Erythromycin

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14
Q

When are pregnant women offered the pertussis vaccination?

A

16-32 weeks

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15
Q

When are infants given the pertussis vaccination?

A

2 months
3 months
4 months
3-5 years

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16
Q

What are the diagnostic criteria for whooping cough?

A

Acute cough for 14 days, without another apparent cause, and has one or more of the following criteria:

  1. Paroxysmal cough
  2. Inspiratory whoop
  3. Post-tussive vomiting
  4. Undiagnosed apnoeic attacks in young infants
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17
Q

What is the special consideration, with regard to vaccination, mad for infants born prematurely at or before 28 weeks?

A

First set of immunisations should be given in hospital due to the risk of apnoea

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18
Q

At what age do you perform infant, paediatric and adult basic life support?

A 
Infant = <1 y/o
Paediatric = 1 y/o-puberty
Adult = puberty+
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19
Q

What is the most common complication of measles?

A

Otitis media

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20
Q

What is the most common cause of death in measles?

A

Pneumonia

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21
Q

When is subacute sclerosing panencephalitis seen following a measles infection?

A

5-10 years later

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22
Q

What is the measles incubation period?

A

10-14 days

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23
Q

Up until when is a pt with measles still infective?

A

From prodrome until 4 days after the rash has started

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24
Q

What is the classical CXR sign seen in croup?

A

A PA view will show subglottic narrowing, commonly called the ‘steeple sign’

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25
Q

What is the classical CXR sign in acute epiglottitis?

A

A lateral view will show ‘thumb sign’, a swelling of the epiglottis

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26
Q

How is croup managed?

A

Signal dose of dexamethasone (0.15mg/kg) to all children regardless of severity
If an emergency: high-flow oxygen; nebulised adrenaline

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27
Q

Which test attempts to dislocate an articulated femoral head?

A

Barlow’s

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28
Q

Which test attempts to relocate a dislocated femoral head?

A

Ortolani’s

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29
Q

What type of conditions are autosomal recessively inherited?

A

‘Metabolic’ - exceptions: inherited ataxias

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30
Q

What type of conditions are autosomal dominantly inherited?

A

‘Structural’ - exceptions: Gilbert’s, hyperlipidaemia type II

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31
Q

Patent ductus arteriosis is kept patent using what?

A

Prostaglandins

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32
Q

Patent ductus arteriosis is closed using what?

A

Indomethacin

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33
Q

What are the four characteristic features of TOF?

A
  1. VSD
  2. Right ventricular hypertrophy
  3. Right ventricular outflow tract obstruction, pulmonary stenosis
  4. Overriding aorta
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34
Q

When does TOF tend to present?

A

1-2 months

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35
Q

What is a cephalohaematoma?

A

Swelling that usually appears 2-3 days following delivery and does not cross suture lines. It gradually resolves over a number of weeks. Associated with ventouse delivery

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36
Q

What is a caput succadeneum?

A

It occurs due to generalised superficial scalp oedema, which crosses suture lines. It is associated with prolonged labour and will rapidly resolve over a couple of days

37
Q

How does otitis media with effusion present?

A

Sensation of fullness in the ear and retracted tympanic membrane (not bulging)

38
Q

What are the features of Kawasaki disease?

A

= a rare vasculitis seen in children. Features include:High Fever lasting >5 days
Red palms with desquamation and strawberry tongue

39
Q

What is acrocyanosis?

A

Peripheral cyanosis around the mouth and extremities that is common in neonates and may persist between 24-48 hours

40
Q

Which organism is responsible for scarlet fever?

A

Group A haemolytic streptococci (usually Streptococcus pyogenes)

41
Q

What presentation causes an EEG with slow waves in the temporal lobe?

A

Herpes simplex encephalitis

42
Q

What is a cause of stridor in infants that gets worse on crying/laughing, and causes an oblique filling defect in the mid-thoracic region?

A

Vascular ring

43
Q

Which features in children increase the risk of dehydration (and thus necessitate the use of ORS)?

A
  1. <1 year old
  2. LBW
  3. > 5 episodes diarrhoea, >2 vomits in 24 hrs
  4. Unable to tolerate fluids/breastfeeding
  5. Signs of malnutrition
44
Q

When would you USS the hips of a baby born in breech?

A

Before 6 weeks

45
Q

What is the most common cause of croup?

A

Parainfluneza virus

46
Q

What is Osgood-Schlatter disease?

A

Thought to be caused by small avulsion fractures at the insertion of the quadriceps tendon into the proximal tibial apophysis. More common in sporty children - gradual onset of pain with swelling at the tibial tuberosity, exacerbated by activity, relieved by rest

47
Q

What infection causes strawberry tongue?

A

Scarlet fever or Kawasaki’s disease

48
Q

How does iron poisoning present in children?

A

Abdominal pain/vomiting/GI bleeding. Metabolic acidosis –> drowsiness. Dilated blood vessels can cause hypovolaemic shock

49
Q

What does jaundice <24 hours after birth mean?

A

Pathological - usually due to haemolytic disease = most commonly due to ABO incompatability

50
Q

What does conjugated hyperbillirubinaemia jaundice at any point in an infant mean?

A

Pathological - may be neonatal hepatitis; extra-hepatic obstruction (e.g. biliary atresia - dark urine and pale stool imply and obstruction); drug or metabolic e.g. alpha-1-antitripsin

51
Q

How do you diagnose bronchiolitis?

A

Coryzal Sx for 1-3 days followed by a) persistent cough; b) tachypneoa/chest recession; c) wheeze/creps on auscultation

52
Q

What are the possible genotypes of Klinefelter’s syndrome?

A

47XXY or 48XXXY

53
Q

What are the signs of congenital dislocation of the hip on XR?

A
  1. Broken Shenton’s line
  2. Shallow acetabulum
  3. Hypoplastic femoral head
54
Q

What can delay surgery for aortic stenosis in children?

A

Balloon valvotomy

55
Q

Which prophylactic meds are given to children with ALL?

A

Co-trimoxazole, ofloxacin, fluconazole, aciclovir

56
Q

What are the 3 features you would expect to find on biopsy for coeliac disease?

A
  1. Villous atrophy
  2. Crypt hyperplasia
  3. Increase in lymphocytes in the epithelium
57
Q

What are the first-line disease-modifying drugs in JIA (to be used after physio)?

A

Methotrexate and sulfasalazine

58
Q

What age ranges might distinguish between avascular necrosis (Perthes disease) and SUFE?

A

Perthes disease = 4-10 years old

SUFE = usually in adolescence

59
Q

How can an asthma attack be graded according to PEFR?

A

PEFR<33% = life-threatening
PEFR 33-50% = acute severe
PEFR>/=50% = moderate

60
Q

How is PDA managed?

A

In prematurity - NSAIDs/indomethacin

At term - percutaneous catheter device

61
Q

What is the most common causative organism of otitis media?

A

Rhinovirus

62
Q

What prophylaxis might be given to household contacts of epiglottis?

A

Rifampicin

63
Q

What imaging might be done with suspected NAI?

A

Skeletal survey

64
Q

What condition may aplastic anaemia progress to if untreated?

A

Paroxysmal nocturnal haemoglobinuria

65
Q

Which illness causes a ‘barking’ cough?

66
Q

In what condition can nebulised adrenaline be given?

A

Moderate and ++ croup

67
Q

What sign might be seen on CXR if a CXR were done (not recommended) on a child with croup?

A

Steeple sign

68
Q

What is the blood profile in ALL?

A

Low Hb/low neutrophils/low plts

High lymphocytes

69
Q

What is haemorrhagic disease of the newborn also called?

A

Vitamin K deficiency bleeding (VKDB) - it is almost exclusively a problem in breast-fed infants because formulas are supplemented with vitamin K

70
Q

What is hand-foot-and-mouth disease caused by?

A

The coxsackie virus

71
Q

How is non-bullous impetigo managed?

A

1st line = hydrogen peroxide 1%

2nd line = topical abx, e.g. fuscidic acid 2% or mupirocin 2%

72
Q

Which are the live vaccines?

A 
BCG
MMR
Oral polio
Yellow fever
Oral typhoid
LAIV
73
Q

What is the definition of SGA?

A

<10th centile

74
Q

In a baby with symmetrical growth delay, and an umbilical hernia - what might this indicate?

A

Congenital hypothyroidism

75
Q

What is the most common cause of failure to thrive in the UK?

A

Non-organic issues - e.g. social problems

76
Q

What is screened for at newborn blood spot screening - that takes place between days 5 and 8 post-birth?

A
  1. PKU
  2. Congenital hypothyroidism
  3. Sickle cell disease
  4. CF
  5. MCADD
  6. Maple syrup urine disease
  7. Homocystinuria
  8. Glutaric acidaemia type 1
  9. Isovaleric acidaemia
77
Q

The thumbprint sign on lateral neck XR is characteristic of what?

A

Epiglossitis

78
Q

What is a double-bubble a sign of?

A

Duodenal atresia

79
Q

What is roseola caused by?

80
Q

What is erythema toxicum neonatorum?

A

A harmless red rash that occurs on the face of newborns

81
Q

What is HSP?

A

A systemic vasculitis, characterised by the deposition of IgA-containing immune complexes in the skin and kidney

82
Q

Raised titres of antistreptolysin O are associated with what?

83
Q

What is more common - Hodgkin’s or Non-Hodgkin’s lymphoma?

84
Q

Deficiency in what part of the immune system might cause recurrent meningococcal infection?

A

Complement

85
Q

What is the most common type of motor sensory neuropathy?

A

Charcot-Marie Tooth disease

86
Q

Which syndrome link progressive hearing loss (sensoneural) with a goitre (hypothyroidism)?

A

Pendred syndrome

87
Q

Which cause of neonatal jaundice is associated withHeinz bodies?

A

G6PD deficiency

88
Q

How should children <6/12 be treated in relation to UTIs?

A

Atypical UTI - USS whilst has infection

UTI responding to Abx - USS within 6 weeks

MSRA (18 decks)

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