Paediatrics Flashcards
Initial presentation of chickenpox
pyrexia (fever)
headache
malaise
abdo pain
Chicken pox lifecycle presentation
1) papule
2) vesicle
3) pustule
4) crust
Why are NSAIDS avoided with chickenpox
Risk of Strep A and Staph A infections
Order of symptoms of measels
1) prodrome of fever
2)malaise
3) loss of appetite
4) conjunctivitis, cough, coryza
5) Koplik spots (blue-white spots on inside of mouth opp molars)
6) rash develops (face then trunk and extremities)
What is neonatal respiratory distress syndrome (NRDS)
Assoc with preterm neonates
When baby lungs not fully developed,
What does it mean when baby is ‘grunting’
increased breathing, it is a red flag
what are the two most prevalent SBI (serious bacterial infection)
UTI and pneumonia
What is tuberous sclerosis?
Autosomal dominant genetic condition that affects multiple organ systems in the body.
Signs &symptoms:
- seizures
-irregular heart rate
-skin ash leaf spots
-angiofibromas (small red bumps around nose cheeks)
what antibiotics work for p.aeruginosa
ciprofloxacin and gentamicin
What is Henoch Schonlein
A type of vasculitis commonly triggered by URTI or gastroenteritis.
Purpuric non blanching rash on buttocks and limbs
What is Meckels diverticulum
most common congenital anomaly of GI tracts.
-abdo pain, GI bleed, bowel obstruction
What is Perthe’s Disease
Self limiting hip disorder, 4-8 year olds, antalgic gait, all movement of hips are limited.
‘cat eye reflex’
absent red reflex, sign of cataracts or retinoblastoma
what is Duchenne muscular dystrophy
a genetic condition which affects the muscles, causing muscle weakness, starts in early childhood,
4 features which make up tetralogy of fallot
PROVe
P- pulmonary stenosis
R- right ventricular hypertrophy
O- overriding aorta
V- ventricular septal defect
Meningitis in children < 3 months tx
give IV amoxicillin + cefotaxime
Hand, foot and mouth disease caused by
Coxsackie virus
Undescended testicles are associated with an increased risk of ……..(3 answers)
infertility, torsion and testicular cancer
A child with whooping cough should be excluded from school for
48 hours after commencing abx
- Edward’s syndrome
A baby is born with micrognathia, low-set ears, rocker bottom feet and overlapping of fingers
Acute epiglottitis is caused by
Haemophilus influenzae type B
All breech babies at or after ….. weeks gestation require USS for DDH screening at 6 weeks regardless of mode of delivery
36
Marfans syndrome is a …….. genetic disorder
autosomal dominant
what are infantile spasm
episodes of repetitve movements that last a few seconds with symmetrical contractions of neck, trunk, extremeties
score system for newborn
APGAR
red flags
skincolour: blue
resp: grunting, rr>60, chest indrawing
circulation: skin turgor
other:
temp >38 in 0-3months
non blanching rash
bulging fontanelle
neck stiffness
focal seizures
projectile vomiting
pyloric stenosis
pyloric stenosis investigation
serum k+
ultrasound
pyloric stenosis tx
fluid replacement
pyloromyotomy
electrolyte inablances in pyloric stenosis
hypokalaemia (k+)
hypochloraemia (HCl)
double bubble sign on xray
duodenal atresia
or malrotation and volvulus
what is transoesophageal fistula
oesophagus connected with trachea
no gastric bubble on x-ray
oesphageal atresia
single bubblw on xray
gastric atresia
intussusception
telescoping of one segment of bowel into another
intussusception pc
red current jelly stool
palpable sausage shaped mass
abdo distention
bilous vomiting
intussusception ultrasound scan
doughnut sign
intussusception tx
electrolyte and fluid correction
air enema
open surgery
meckel’s diverticulum rules
2 rule:
2-3yrs old
2 inches long
2 feet away from ileo-caecal valve
meckel’s diverticulum pc
mostly asymptomatic
painless rectal bleeding
if obstruction: vomiting and abdo pain
meckel’s diverticulum iv and tx
iv: radioisotop scan , laparotomy
tx: surgical resecction
umbilical herinia tx
asymtomatic <4yrs = reassure
asymptomtic >4yrs = refer to paeds surgeon
symptomicatin heria= urgent referral to paeds surgeon
inguinal hernia tx
refer all to 2ndry care
older children: refer routine
symptomatic: emergency referral
scarlet fever caused by
streptococcus pyogens
scarlet fever tx
penicillin for 10 days
or azithromycin for 10 days
scarlet fever pc
sandpaper rash
strawberry tounge
swollen lymph nodes
sore throat
cystic fibrosis is a
autosomal recessive disease
cystic fibrosis tx
chest physiotherapy
bronchodilators
hypertonic saline to reduce viscosity of mucus
pancreatic enzyme replacement due to pancreatic insufficiency
heel prick test performed at……. and screen for 3 important disease
5 days
3 C’s: sickle cell disease, cystic fibrosis, congential hypothyroidism
NIPE done within
72 hours of birth and again 6-8weeks later
congential hypothyroidism
high TSH
low t4
henoch-schonlein purpura pc
PAAN:
P: Purpura
A: Arthralgia
A: abdominal pain
N: nephropathy
differnece between primary and 2ndry noctunal enuresis
primary: child never achieved consistent nightime dryness
2ndry: child who has been dry for at least 6 months
rapid control for bedwetting
desmopressin oralor sublingual
what is meconium aspiration syndrome
respiratory distress shortly after birth with radiological evidence of aspiration pneumonitis
step by step process for any infant in resp distress
1) take blood gas and o2 sats
2)next most approriat eaction
3) cxr
4) other iv (blood culture)
jaundice present at birth or within 24hrs
pathological and needs further iv
likely haemolytic (rhesus/ABO incompatibility/G6PD) or sepsis
jaundice starting 24hrs to 2 weeks
likely physiological
jaundice beyond 2 weeks
urgent paeds assessment for further iv
Billary atresia pc
normally 3-4 weeks in life
jaundice with pale stools and dark urine
hepatomegaly
splenomegaly
(mostly conjugated bilirubin)
tca overdose causes
hyperkalemia
nephrotic syndrome investigation
urine analysis
most common pc of Hodgkin’s lymhoma
painless, firm lympahdenopathy
neonate with purulent discharge with swelling of eyelid OR injected conjunctiva
Must be referred to secondary care urgently
in consitiutional delay growth what iv should you do
take an x-ray of left wrist to find bone age
scarlet fever caused by
streptococcus pyogens
impetigo caused by
staphylococcus aureus
rubella caused by
rubella virus
roseola caused by
HHV6
chickenpox caused by
varicella zoster virus
measles caused by
morbillivirus (paramyxovirus)
mumps caused by
paramyxovirus
erthema infectiosum
parvovirus B19
Hand foot and mouth caused by
cosackie virus and enetrovirus
what is vesicoureteric reflux (VUR)
the retrograde flow of urine from the bladder to the uterus and kidneys
vesicoureteric reflux (VUR) tx
low dose abx prophylaxis (trimethoprim)
von willebrand disease
prolonged APTT
Platelet = normal
prothrombin time= normal
infantile spasm pc
symmetrical contractions of neck, trunk, and extremeties
extension
6months of age
wolf parkinson white syndrome ECG
delta waves
pre-excitation pattern
prolonged QRS
shortened PR
define simple seizure
<15mins, generalised tonic/clonic
define complex seizure
> 15mins or focal
define febrile status epilepticus
> 30 min without complete recovery
roseola memory tool
3 roses:
- roseloa
- commonly under 3yrs
- fever lasts for 3 days
- rash after fever lasts 3 days
- 3+3= HHV6
rubella rash starts
starts behind the ears
what does buldging fontenelle mean?
raised intercrainal pressure
scarlet fever features
sandpaper rash, strawberry tounge, sore throat fever, swollen
kawasaki disease symptoms
high dose Aspirin, IV immunoglobulins, echocardiogram
