Paediatrics Flashcards by Georgina Jolliffe

Sx Kawasaki disease

Rash
Fever
Swollen cervical LNs
Strawberry tongue

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Tx kawasaki disease

Aspirin

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What is Kawasaki disease?

Medium vasculitis predominantly in children under 5

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Infectious mononucleosis

Glandular fever caused by Epstein Barr virus

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Glandular fever sx

Sore throat
Lymphadenopathy
Pyrexia

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Treatment infectious mononucleosis

Rest, fluids, no contact sport (splenomegaly)

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Sx chickenpox

Itchy macropapular rash which becomes vesicular
Rash starts on head/trunk and spreads

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When are children infectious with chickenpox

4 days pre rash and 5 days after first appearance

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What is scarlet fever?

Reactions to toxins made by group a haemolytic streptococci

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Incubation period scarlet fever

2-4 days

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Sx scarlet fever

fever
malaise
strawberry tongue
erythematous rash sparing palms and soles

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Tx scarlet fever

penicillin

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complications of scarlet fever

otitis media, rheumatic fever

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Cause of hand foot and mouth

Coxsackie a16 and enterovirus 71

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Sx hand foot and mouth

sore throat, oral ulcers, vesicles on palms and soles

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What is fifth disease

Slapped cheek

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Cause of fifth disease

parvovirus b19

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sx fifth disease

slapped cheek appearance, triggered by sunlight and heat

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cause of measles

RNA paramyxovirus

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sx measles

irritable, conjunctivitis, koplik spots, rash starts behind ears and spreads to body

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mx measles

notifiable disease, mostly supportive

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cause of rubella

togavirus

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Infectious period rubella

7 days before sx to 4 days after rash onset

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sx rubella

low grade fever, macropapular rash spreads from face to body

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Cause of pertussis

bortedella pertussis

sx whooping cough

paroxysmal cough >2 weeks

Tx whooping cough

Azithromycin

Pathophys whooping cough

Mortadella releases exotoxins that increase cAMP= reduced phagocytosis

Tx rubella

Supportive

When is the rash itchy in rubella infection

Itchy in adults but not kids

Congenital rubella syndrome

First 8-10 weeks are most dangerous Sensorineural deafness, cataracts, heart disease, IUGR etc

What is rheumatic fever?

Whole body reaction following strep progenies infection

What type of hypersensitivity is rheumatic fever

Sx rheumatic fever

fever arthritis Chorea erythema marginatum

What is erythema marginatum

Face is spared

What are Aschoff bodies and when are they found?

Rheumatic fever granulomas found in heart

Diagnosing rheumatic fever

recent strep infection plus either 2 major or 1 major and two minor Major = arthritis, carditis, chorea, erythema marginatum Minor = fever, raised CRP, long QR

Should you notify PHE for mumps case?

Yes

Sx mumps

Parotitis, fever, malaise, orchitis, raised amylase

Tx mumps

Supportive

Most common site of undescended testes

Superficial inguinal ring

patent processus vaginalis leads to .....

hydrocele

What is a Wilm's tumour?

Malignant kidney tumour caused by mutation of tumour suppressor Wt1

Sx wilm's tumour

HTN, unilateral flank mass, haematuria

Diagnosis Wilm's tumour

Unexplained unilateral flank mass needs pads review 48h

Tx Wilm's tumour

nephrectomy and chemo

trident hands, frontal bossing

achondroplasia

Causative organism epiglottitis

haemophilus influenza B

Sx epiglottitis

temperature, drooling, no coughing, tripod position

X-ray epiglottitis

thumb/steeple signs on x-ray

management epiglottis

urgent ENT

tx asthma

salbutamol and prednisolone

what is ADHD?

Inattentiveness, impulsivity and hyperactivity

Mx ADHD

- CAMHS referral - If >5, methylphenidate 6w is an option

What is ASD?

Impairment in social interaction and communication, repeated behaviours

SX ASD

- Impaired social communication - children play alone, can’t maintain friendships appropriately - Repetitive behaviours - repetitive motor mannerisms, inflexible adherence to routines that aren’t their own - Intellectual impairment/language impairment

Mx ASD

- Educational and behavioural management - SSRIs, methylphenidate if needed

what is bronchiolitis?

RSV LRTI

Sx bronchiolitis

- Cough - Coryzal sx - Breathlessness - Wheezing

Tx bronchiolitis

supportive

causative organism epiglottitis

haemophilus influenzae B

what should you never do with epiglottitis?

inspect airway

management epiglottitis

intubate o2 and ABx cefuroxime

what is a wheeze?

expiratory noise - narrowed lower airway

what is stridor?

inspiration, upper airway obstruction

conditions causing wheeze

asthma, URTI, bronchiolitis, allergy, GORD, foreign body aspiration

conditions causing stridor

epiglottitis, croup, anaphylaxis, laryngomalacia, foreign body aspiration

bronchiolitis causative organism

RSV

sx neonatal sepsis

respiratory distress, tachycardia, apnoea, jaundice, seizures