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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
What is the classical CXR sign in acute epiglottitis?
A lateral view will show 'thumb sign', a swelling of the epiglottis
26
How is croup managed?
Signal dose of dexamethasone (0.15mg/kg) to all children regardless of severity If an emergency: high-flow oxygen; nebulised adrenaline
27
Which test attempts to dislocate an articulated femoral head?
Barlow's
28
Which test attempts to relocate a dislocated femoral head?
Ortolani's
29
What type of conditions are autosomal recessively inherited?
'Metabolic' - exceptions: inherited ataxias
30
What type of conditions are autosomal dominantly inherited?
'Structural' - exceptions: Gilbert's, hyperlipidaemia type II
31
Patent ductus arteriosis is kept patent using what?
Prostaglandins
32
Patent ductus arteriosis is closed using what?
Indomethacin
33
What are the four characteristic features of TOF?
1. VSD 2. Right ventricular hypertrophy 3. Right ventricular outflow tract obstruction, pulmonary stenosis 4. Overriding aorta
34
When does TOF tend to present?
1-2 months
35
What is a cephalohaematoma?
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
36
What is a caput succadeneum?
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
How does otitis media with effusion present?
Sensation of fullness in the ear and retracted tympanic membrane (not bulging)
38
What are the features of Kawasaki disease?
= a rare vasculitis seen in children. Features include:High Fever lasting >5 days Red palms with desquamation and strawberry tongue
39
What is acrocyanosis?
Peripheral cyanosis around the mouth and extremities that is common in neonates and may persist between 24-48 hours
40
Which organism is responsible for scarlet fever?
Group A haemolytic streptococci (usually Streptococcus pyogenes)
41
What presentation causes an EEG with slow waves in the temporal lobe?
Herpes simplex encephalitis
42
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?
Vascular ring
43
Which features in children increase the risk of dehydration (and thus necessitate the use of ORS)?
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
When would you USS the hips of a baby born in breech?
Before 6 weeks
45
What is the most common cause of croup?
Parainfluneza virus
46
What is Osgood-Schlatter disease?
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
What infection causes strawberry tongue?
Scarlet fever or Kawasaki's disease
48
How does iron poisoning present in children?
Abdominal pain/vomiting/GI bleeding. Metabolic acidosis --> drowsiness. Dilated blood vessels can cause hypovolaemic shock
49
What does jaundice <24 hours after birth mean?
Pathological - usually due to haemolytic disease = most commonly due to ABO incompatability
50
What does conjugated hyperbillirubinaemia jaundice at any point in an infant mean?
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
How do you diagnose bronchiolitis?
Coryzal Sx for 1-3 days followed by a) persistent cough; b) tachypneoa/chest recession; c) wheeze/creps on auscultation
52
What are the possible genotypes of Klinefelter's syndrome?
47XXY or 48XXXY
53
What are the signs of congenital dislocation of the hip on XR?
1. Broken Shenton's line 2. Shallow acetabulum 3. Hypoplastic femoral head
54
What can delay surgery for aortic stenosis in children?
Balloon valvotomy
55
Which prophylactic meds are given to children with ALL?
Co-trimoxazole, ofloxacin, fluconazole, aciclovir
56
What are the 3 features you would expect to find on biopsy for coeliac disease?
1. Villous atrophy 2. Crypt hyperplasia 3. Increase in lymphocytes in the epithelium
57
What are the first-line disease-modifying drugs in JIA (to be used after physio)?
Methotrexate and sulfasalazine
58
What age ranges might distinguish between avascular necrosis (Perthes disease) and SUFE?
Perthes disease = 4-10 years old | SUFE = usually in adolescence
59
How can an asthma attack be graded according to PEFR?
PEFR<33% = life-threatening PEFR 33-50% = acute severe PEFR>/=50% = moderate
60
How is PDA managed?
In prematurity - NSAIDs/indomethacin | At term - percutaneous catheter device
61
What is the most common causative organism of otitis media?
Rhinovirus
62
What prophylaxis might be given to household contacts of epiglottis?
Rifampicin
63
What imaging might be done with suspected NAI?
Skeletal survey
64
What condition may aplastic anaemia progress to if untreated?
Paroxysmal nocturnal haemoglobinuria
65
Which illness causes a 'barking' cough?
Croup
66
In what condition can nebulised adrenaline be given?
Moderate and ++ croup
67
What sign might be seen on CXR if a CXR were done (not recommended) on a child with croup?
Steeple sign
68
What is the blood profile in ALL?
Low Hb/low neutrophils/low plts | High lymphocytes
69
What is haemorrhagic disease of the newborn also called?
Vitamin K deficiency bleeding (VKDB) - it is almost exclusively a problem in breast-fed infants because formulas are supplemented with vitamin K
70
What is hand-foot-and-mouth disease caused by?
The coxsackie virus
71
How is non-bullous impetigo managed?
1st line = hydrogen peroxide 1% | 2nd line = topical abx, e.g. fuscidic acid 2% or mupirocin 2%
72
Which are the live vaccines?
``` BCG MMR Oral polio Yellow fever Oral typhoid LAIV ```
73
What is the definition of SGA?
<10th centile
74
In a baby with symmetrical growth delay, and an umbilical hernia - what might this indicate?
Congenital hypothyroidism
75
What is the most common cause of failure to thrive in the UK?
Non-organic issues - e.g. social problems
76
What is screened for at newborn blood spot screening - that takes place between days 5 and 8 post-birth?
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
The thumbprint sign on lateral neck XR is characteristic of what?
Epiglossitis
78
What is a double-bubble a sign of?
Duodenal atresia
79
What is roseola caused by?
HHV-6
80
What is erythema toxicum neonatorum?
A harmless red rash that occurs on the face of newborns
81
What is HSP?
A systemic vasculitis, characterised by the deposition of IgA-containing immune complexes in the skin and kidney
82
Raised titres of antistreptolysin O are associated with what?
HSP
83
What is more common - Hodgkin's or Non-Hodgkin's lymphoma?
NHL
84
Deficiency in what part of the immune system might cause recurrent meningococcal infection?
Complement
85
What is the most common type of motor sensory neuropathy?
Charcot-Marie Tooth disease
86
Which syndrome link progressive hearing loss (sensoneural) with a goitre (hypothyroidism)?
Pendred syndrome
87
Which cause of neonatal jaundice is associated withHeinz bodies?
G6PD deficiency
88
How should children <6/12 be treated in relation to UTIs?
Atypical UTI - USS whilst has infection | UTI responding to Abx - USS within 6 weeks

MSRA (18 decks)

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