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Finals revision > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What does scaphoid abdomen in a newborn suggest?

A

Congenital diaphragmatic hernia

Also presents with dyspnoea and tachypnoea at birth due to hypoplasia of the lungs

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2
Q

What would be the more accurate way to describe ‘growing pains’ in a child?

A

Benign, idiopathic, nocturnal limb pains of childhood

  • No concerning features (benign)
  • Idiopathic
  • Never present at the start of the day, often wake child up from sleep
  • Worse after a day of exercise
  • No limp or functional limitation
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3
Q

Triad of shaken baby syndrome

A
  1. Retinal haemorrhages
  2. Subdural haematoma (bridging veins ruptured)
  3. Encephalopathy
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4
Q

Management of umbilical hernias?

A

Usually self-resolve
If large/symptomatic ⇒ elective repair at 2-3yrs
If small/asymptomatic ⇒ elective repair at 4-5yrs

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5
Q

Differentiating between infantile spasms and infantile colic?

A

Infantile spasms = child will become distressed BETWEEN spasms (i.e. child crying, then draws chin into chest and throws arms out and stops crying, then repeats) ⇒ EEG for West’s syndrome

Infantile colic = child will become distressed DURING spasms

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6
Q

Rapid onset fever + stridor + drooling ⇒ ?

A

Acute epiglottitis

Other features:

  • very uncomfortable, scared child
  • tripodding
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7
Q

Compare neonatal respiratory distress syndrome (NRDS) and transient tachypnoea of the newborn (TTN) with respect to the following:

  • biggest risk factor
  • prognosis over a few days
  • CXR features
A 
NRDS = prematurity (NRDS = surfactant deficient lung disease, SDLD, so affects premature babies whose mothers don't have steroids antenatally)
TTN = C-section 
NRDS = worsens over the first few days of life
TTN = resolves quickly 
NRDS = ground glass lungs, low volume, bell-shaped thorax
TTN = heart failure pattern (ABCDE)
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8
Q

Triad of symptoms in nephrotic disease

A
  1. Proteinura
  2. Hypoalbuminaemia
  3. Oedema

80% of paediatric cases are caused by minimal change disease, and 90% respond well to high-dose steroids

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9
Q

Invasive skin infection following chicken pox. Most likely causative organism?

A

S.pyogenes (GAS)

2nd most likely is S.aureus

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10
Q

Signs of a life-threatening attack in a child?

A
  1. Sats <92%
  2. PEF <33%
  3. Silent chest
  4. Poor respiratory effort (tiring child)
  5. Agitation
  6. Altered consciousness
  7. Cyanosis
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11
Q

Hypospadias referral?

A

Within 12m of life

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12
Q

How would cystic fibrosis present in a heel prick test?

A

Positive immunoreactive trypsinogen

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13
Q

What are the four features in tetralogy of Fallot?

A
  1. Right ventricular hypertrophy
  2. Overriding aorta
  3. Pulmonary stenosis
  4. Ventricular septal defect
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14
Q

Describe the asthma pathway for children aged 5-16

A
  1. SABA
  2. SABA + ICS
  3. SABA + ICS + LTRA
  4. SABA + ICS + LABA (replace the LTRA)
  5. SABA + low-dose* MART
  6. SABA + moderate-dose* MART
  7. SABA + high-dose* MART/ICS OR + theophylline

*the dose in MART refers to the dose of ICS within the MART (i.e. low-dose MART = low-dose ICS)
MART = combined ICS + LABA

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15
Q

Describe asthma pathway for children <5yrs

A
  1. SABA
  2. SABA + moderate-dose ICS (for 8w, then stop and reassess)
    2a. If sx did not resolve during trial period ⇒ not asthma
    2b. If sx resolved, but reoccured within 4w of stopping ⇒ continue ICS at low-dose
    2c. If sx resolved, but reoccured after 4w of stopping ⇒ repeat step 2 (8 week trial)
  3. SABA + ICS + LTRA
  4. Stop LTRA + refer to specialist
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16
Q

Treatment for bacterial meningitis in a <3month old?

A

IV cefotaxime + IV amoxicillin

Amoxicillin to cover Listeria infection
>3months is just IV cefotaxime (or ceftriaxone)

17
Q

Characteristic features of congenital rubella?

A
  • Sensorineural deafness
  • Congenital cataracts
  • CHD (e.g. PDA)
  • Glaucoma
18
Q

Characteristic features of congenital toxoplasmosis?

A
  • Cerebral calcification
  • Chorioretinitis
  • Hydrocephalus
19
Q

Characteristic features of congenital cytomegalovirus?

A
  • LBW
  • Purpuric skin lesions
  • Sensorineural deafness
  • Microcephaly
20
Q

Causative organism for scarlet fever?

A

Group A strep (e.g. S.pyogenes)

21
Q

Criteria for consideration of hospital admission in a child with bronchiolitis

A
  1. RR >60, or respiratory distress
  2. 25-50% reduction in usual oral intake
  3. Clinical dehydration
  4. Apnoea (observed or reported)
22
Q

Cyanotic heart defects + their memory aids

A
  1. Truncus arteriosus (1 vessel)
  2. Transposition of the great arteries (2 vessels swapped)
  3. Tricuspid atresia (3 valves)
  4. Tetralogy of Fallot (4 defects)
23
Q

Management of TGA

A
  1. Prostaglandin E1 to maintain ductus arteriosus

2. Surgical correction

24
Q

Indication for admission in croup

A

Stridor at rest

25
Q

Memory aid for differentiating between ASD and VSD murmurs

A 
ASD = A Split Double = fixed split S2
VSD = Very Systolic = pan

ASD split S2 is due to ↑ venous return overloading the RV during inspiration ⇒ delaying closure of pulmonary valve

26
Q

Causes of neonatal hypotonia

A
  • Neonatal sepsis
  • Werdnig-Hoffman disease (spinal muscular atrophy T1)
  • Hypothyroidism
  • Prader-Willi
27
Q

Differentiating between necrotising enterocolitis and intussusception

A 
NEC = newborn, bilious vomiting and bloody diarrhoea
Intussusception = 5-12m, bloody diarrhoea
28
Q

Treatment for necrotising enterocolitis?

A

IV cefotaxime + vancomycin

Finals revision (13 decks)

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