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Year 3- Primary Care Tutorial Notes > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

When does “Weaning” start?

A

At 6mths usually

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2
Q

When breastfeeding some children may not open bowels often (one or a few days).

List 9 other breastfeeding problems

A
  • Sore/ cracked nipples (position)
  • Thrush (Candida enters)
  • Tongue-tie
  • Baby not getting enough milk
  • Making too much milk
  • Breast engorgment
  • Blocked milk duct
  • Mastitis
  • Breast abscess
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3
Q

Describe Infantile Colic

A
  • When baby cries a lot but no obvious cause. Common, should improve on its own
  • Cry >3hrs a day/ 3days a week for 1 week
  • Can start when a few weeks old, usually stops by 6 months
  • Curl up/ arch back due to pain
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4
Q

List some key aspects of gait in children

A
  • Asian children tend to walk later
  • Normal gait doesn’t represent that of an adult until 3yrs old
  • Adult gait and posture occur around 8yrs
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5
Q

List Normal gait variations in kids

A
  • Toe walking, Knock Knees & In-toeing, Internal Tibial Torsion
  • Metatarsus Adductus, Bow Legs, Flat Feet, Crooked Toes
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6
Q

List Abnormal gait variations in kids

A
  • Antalgic, Circumduction, Spastic, Stepping, Clumsy

* Ataxic, Trendelenburg, Toe walking with absent heel contact

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7
Q

List Newborn Skin conditions

A
  • Jaundice (Call GP if not eating, making wet diapers often or difficult to wake up)
  • Erythrema Toxicum (red spots/ rash, 2/3 days after birth, not warm)
  • Milia (White spots or bumps)
  • Cradle Cap (Scales)
  • Baby acne, Heat rash, Eczema, Mongolian spots, Newborn dry skin
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8
Q

List and compare Paediatric Skin conditions

A
  • Measles: Partially confluent, spreads from behind ears, Koplik’s spots, Conjuctivitis
  • Rubella: Non-confluent maculopapular, Spreads from ears
  • Scarlet fever: Maculopapular, Partially confluent, Spreads from neck, Groin+Axilla, Perioral sparing, Strawberry tongue
  • 5th disease/ Erythrema Infectiosum: Not always rash. Lace pattern trunk+limbs, slapped cheek
  • Roseola infantum: Patchy, More on torso, 3 days high fever, sudden temp. drop before rash
  • Varicella: Whole body, small red bumps-> Blisters/pustules-> Scabs, “Starry sky” appearance
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9
Q

Describe Transient Synovitis

A

Synovial inflammation after minor trauma/ vaccination.

Presents with limp, Hip pain

Usually at age of 3-10yrs

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10
Q

What is the normal lifespan of Threadworms?

A

6wks

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11
Q

Describe Pyloric Stenosis on examination

A

Pylorus can sometimes feel tight, especially just before about to vomit

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12
Q

List 2 key aspects of a Newborn exam

A
  • Ideally done within first 24hrs of life, then repeated at 6-8 weeks by GP.
  • Adjunct to examination is the Guthrie/ PKU Test to look for Phenylketonuria
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13
Q

Outline the Pre-examination of a Newborn Exam

A
  1. Examine Notes (Antenatal-USS/ Bloods, Birthing-APGARS, Birth history & complications)
  2. PMHx, FHx, Social Hx
  3. Ask parents: Any concerns? Feeding (Formula/ Breast, Quantity)?, Passed Urine and Meconium in 1st 24hrs?
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14
Q

List 10 steps of a Newborn Exam

A

1,2: Prepare, Inspect

  1. Head + Eyes
  2. Mouth
  3. Ears
  4. Chest
  5. Abdomen + Groin
  6. Hips, Limbs, Back
  7. Tone + Reflexes (Moro’s, Stepping etc)
  8. Conclude exam and Plot Weight, Length, OF Circumference on WHO growth chart
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15
Q

In a Newborn Exam, describe the Inspection

A

General, Posture, Movements, Colour, Skin marks, Dysmorhpic features

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16
Q

In a Newborn Exam, describe the Head+Eyes stage

A
  • Shape: Occipito-Frontal circumference, Palpate suture lines + Fontanelles
  • Eyes: Red reflex to exclude Cataracts and Retinoblastoma
17
Q

In a Newborn Exam, describe the Mouth and Ears stages

A

Mouth: Suck reflex, Cleft lip/palate

Ears: Mobile Pinna, Patent EAM

18
Q

In a Newborn Exam, describe the Chest stage

A

Palpate Clavicle, Shape+Movement, Heart sounds/ murmur, Air entry, HR, RR, Sats

19
Q

In a Newborn Exam, describe the Abdomen + Groin stage

A
  • Shape, Distension, Respiration use
  • Palpate for masses/ hernia, Auscultate for Bowel sounds, Femoral pulses
  • External Genitalia (2 testes, Patent Anus and correct position?)
20
Q

In a Newborn Exam, describe the Hips, Limbs, back stage

A
  • Symmetry
  • Hands: Digits, Palmar crease, Grasp reflex
  • Legs: Posture, Digits
  • Hips: Barlow’s THEN Ortoleni’s tests to exclude Developmental Dysplasia (“Click”-> USS)
  • Spine: Curvature particular Sacrum to exclude Spina Bifida, Palpate SPs, Neuro exam
21
Q

List the usual order of shapes a child can draw

A

Line, Circle, Cross, Square, Triangle

22
Q

Outline relationship of Honey and Wheat to Weaning in a child of 7mths

A

Honey should be avoided before 12mths due to risk of infant botulism. Wheat is safe to try after 6mths

23
Q

At what age should a child be referred to paediatrician if not begun to walk?

A
  • 18mths.
  • Usually begin to cruise furniture around 10-12mths
  • Can walk alone by 15mths
24
Q

Describe Functional Constipation

Can get from switching from Breast->Formula milk or Cow’s-> Actimel

A
  • H2O pulled out of bowel= Hard stool

- Liquid stool leaks out as overflow ‘diarrhoea’

25
Q

Outline the treatment of Functional Constipation

List some causes of pain at rest

A

Movicol/ Lactulose sachets in incremental amounts

Causes of pain at rest;

  • Anal fissure
  • Thrombocytosed haemorrhoid (Straining, Pregnancy)
26
Q

Outline the treatment for Atopic Eczema

A
  • Sedating antihistamine such as Piriton (x1 a night)
  • Non-sedating antihistamine (Loratidine, Cetirizine)
  • Oral steroid (Prednisolone)
27
Q

Compare the use of the Antihistamine Fexofenadine 120mg and 180mg

A

Fexofenadine 120mg- Hayfever/ Allergic Rhinitis

Fexofenadine 180mg- Urticaria

28
Q

When should Grazax tablets be considered?

Name one contra-I

A
  • Hayfever not responding to anti-allergic drugs
  • Wasp or bee hypersensitivity
  • Don’t use in pregnancy
29
Q

Outline the Grazax tablet dosing regimen

A
  • Take tablets daily for 2-3yrs

- Dose 1: Taken under medial supervision, monitor for 20-30mins

Year 3- Primary Care Tutorial Notes (15 decks)

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