Paediatrics Flashcards
Nocturnal Enuresis Management?
- General
- Enuresis alarm
- Desmopressin
- Others (Imipramine, Oxybutynin)
Nocturnal Enuresis General Management?
- Fluid intake
- Toileting patterns
- Lifting and waking
- Reward systems e.g. star charts
Nocturnal Enuresis underlying causes?
- Constipation
- Diabetes
- UTI if recent onset
Desmopressin MOA?
Vasopressin analogue
Desmopressin side effect?
Hyponatraemia
‘Other’ Nocturnal Enuresis management?
- Imipramine
- Oxybutynin
Imipramine MOA?
TCA
Oxybutynin MOA?
Anticholinergic
Nocturnal Enuresis Classification?
- Primary = never achieved continence
- Secondary = dry for at least 6m before
Desmopressin for NE preferable?
Short term control e.g. sleepovers
Child development referral points?
- Doesnt smile at 10 weeks
- Cannot sit unsupported at 12 months
- Cannot walk at 18 months
Hand preference before 12 monthsa?
Abnormal, ?Cerebral Palsy
Probability of septic arthritis in children criteria?
Kocher’s criteria
Kocher’s criteria (1 point each)?
- Non weight bearing
- Fever > 38.5
- WCC > 12
- ESR > 40
Kocher’s criteria score interpretation?
- Very low risk
- 3% probability
- 40% probability
- 93% probability
- 99% probability
Septic arthritis children epidemiology?
- 4-5/100,000 children
- 2M:1F
Septic arthritis most commonly affected joints?
Hip, knee, ankle
Septic arthritis symptoms x4?
- Joint pain
- Limp
- Fever
- Systemically unwell: lethargy
Septic arthritis signs x3?
- Swollen
- Red joint
- Minimal movement of affected joint
Septic Arthritis Ix?
- Joint aspiration (for culture, WCCs)
- Bloods (raised inflammatory markers)
- Blood cultures
Kawasaki disease diagnosis?
Fever for >5 days + 4/5 of:
1. Bilateral conjunctivitis
2. Cervical lymphadenopathy
3. Cracked lips/strawberry tongue
4. Oedema/desquamation of hands/feet
5. Polymorphic rash
Kawasaki disease management?
- High dose aspirin
- IVIG
- Echo
Kawasaki disease complication?
Coronary artery aneurysm
Why is aspirin C/I in children?
Reye’s syndrome