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3a > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What is redcurrant jelly like stool associated with?

A

Intussusception

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2
Q

What is the gold standard diagnostic test for Intussusception and what would you see in a positive test?

A

Abdominal USS - should show target-like mass.

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3
Q

What is the key diagnostic investigation in pyloric stenosis?

A

Abdominal ultrasound scan

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4
Q

What is hand foot and mouth disease (Coxsackie A16) characterised by?

A

mild systemic upset, oral ulcers followed by vesicles on the palms and soles

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5
Q

Low calcium, low phosphate , high ALP and high PTH are signs of what?

A

Rickets - can present as widening of wrist joints and prominent forehead (frontal bossing)

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6
Q

Compression:Ventilation ratio in Paediatric life support?

A

30:2 if solo
15:2 if 2 or more responders present

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7
Q

Most common form of visual impairment in babies delivered under 32 weeks gestation?

A

Retinopathy of prematurity

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8
Q

Features of ITP in children?

A

-Bruising
-Petechial or purpuric rash
-Bleeding is less common (Gums or nose)

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9
Q

Investigations for ITP?

A

FBC - should show isolated thrombocytopenia
Blood film
Bone marrow exams if there is atypical features e.g. lymph nodes, splenomegaly, failure to resolve

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10
Q

Hypochloraemia, hypokalaemia and alkalosis are classic of what condition?

A

Pyloric stenosis

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11
Q

Neonatal hypotonia is associated with?

A

Prader-Willi syndrome

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12
Q

First-line treatment for eczema?

A

Topical emollients

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13
Q

Treatment for viral-induced wheeze?

A

First-line - SABA e.g. salbutamol
Next step is oral montelukast or inhaled corticosteroids

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14
Q

Features of CMPA?

A

Regurgitation/Vomiting
Diarrhoea
Urticaria/atopic eczema
Colic - irritable, crying
Wheeze/cough

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15
Q

Management of CMPA if formula fed?

A

extensive hydrolysed formula (eHF), amino acid formula (AAF) in severe cases

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16
Q

Management of CMPA if breastfed?

A

Continue breastfeeding
Eliminate cows milk protein from mothers diet
Use eHF from when breastfeeding stops to 12 months of age

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17
Q

Management of rickets?

A

Oral vitamin D

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18
Q

Severe asthma attack criteria?

A

Sats < 92%
PEF 33-55% best/predicted
Too breathless to talk/feed
HR of over 125 in older than 5, over 140 in 1-5
Resp rate more than 30 in older than 5, over 40 in 1-5
Use of accessory neck muscles

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19
Q

Life-threatening asthma attack criteria?

A

Sats < 92%
PEF < 33% best/predicted
Silent chest
Poor resp effort
Agitation
Altered consciousness
Cyanosis

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20
Q

Signs of intestinal malrotation/volvulus?

A

Distended abdomen
Bilious vomiting
Slow to establish on feeds

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21
Q

Investigation for malrotation/volvulus?

A

Upper GI contrast study
Ultrasound

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22
Q

When should referral be made for unilateral undescended testis?

A

After 3 months of age

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23
Q

Tetralogy of Fallot?

A

Right ventricular hypertrophy
Pulmonary stenosis (Ejection systolic murmur, left sternal edge)
Overriding aorta
VSD
(Cyanosis or collapse in first month of life, hypercyanotic spells)

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24
Q

High risk factors in feverish child?

A

Pale/mottled/blue skin
Weak, high pitched cry, no response to social cues
Grunting, RR> 60, chest indrawing
Reduced skin turgor
Age < 3 months with temp over 38
Non-blanching rash

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25
Q

Medium risk factors in feverish child?

A

Pallor
No smile, decreased activity
Nasal flaring, RR>50, Sats < 95%, chest crackles
Tachycardia, CRT > 3 seconds, dry mucous membranes
Fever more than 5 days, rigors, swelling of limb or joint

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26
Q

Late complication of trisomy 21?

A

Alzheimer’s disease

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27
Q

Main causative organism of croup?

A

Parainfluenza virus

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28
Q

First line treatment of threadworm?

A

Single dose of mebendazole for whole household and hygiene advice

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29
Q

Associations of hirschsprung’s disease?

A

3x more common in males
Down’s syndrome

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30
Q

Presentation of Hirschsprung’s disease?

A

Neonatal - failure or delay to pass meconium
Older - constipation, abdo distension

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31
Q

Investigations for hirschsprung’s?

A

Abdo X-ray
Gold standard is rectal biopsy which would show absence of ganglion cells in submucosa

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32
Q

Management for Hirschsprung’s?

A

Rectal washouts/ bowel irrigation initially, followed by surgery to affected segment of colon for definitive management.

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33
Q

What season is bronchiolitis most common?

A

Winter

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34
Q

Most common cause of bronchiolitis?

A

RSV

35
Q

Management of CF?

A

Regular chest physio and postural drainage
High calorie diet with high fat intake
Minimise contact with other CF patients
Vitamins
Pancreatic enzyme taken with meals
CFTR modulators e.g. Lumacaftor can be used in patients who are homozygous for delta F508 mutation

36
Q

Investigation in suspected SUFE?

A

Plain X-ray both hips with AP and frog-leg views

37
Q

Apgar score meaning?

A

7-9 normal ( 10 unusual as normally lose a point for blue extremities)
4-6 moderately low
0-3 - very low

38
Q

What is Ladd’s procedure for?

A

Surgical treatment of intestinal malrotation with volvulus

39
Q

Treatment for pyloric stenosis?

A

Pyloromyotomy - usually laparoscopic

40
Q

Treatment for scarlet fever?

A

Oral penicillin V for 10 days

41
Q

When can a child safely return to school after scarlet fever?

A

24 hours after starting antibiotics

42
Q

Elevation of the testicle relieves pain in?

A

Epididymitis

43
Q

Short stature + primary amenorrhoea = ?

A

Turners syndrome

44
Q

What should you not use in children under 3 months in treating bacterial meningitis?

A

Corticosteroids

45
Q

What virus causes Roseola infantum?

A

Herpes virus 6

46
Q

Meconium should be passed by?

A

48 hours of birth - red flag if more (CF, Hirschsprung’s)

47
Q

Most common cause of painless massive GI bleed requiring transfusion in children aged 1-2?

A

Meckel’s diverticulum

48
Q

How to correct age for prematurity?

A

Age minus number of weeks born early from 40 weeks

49
Q

What oral antibiotic should be used to treat mycoplasma pneumonia in children?

A

macrolides e.g. erythromycin.

50
Q

Features of oligoarticular JIA?

A

Pain and swelling in joints (Knees, ankles, elbows)
Worse in mornings
Limp
ANA may be +ve

51
Q

First line treatment in PDA?

A

Indomethacin or ibuprofen - to promote duct closure

52
Q

NSAIDs increase the risk of what in chickenpox?

A

Necrotising fasciitis

53
Q

Management of croup?

A

Single dose oral dexamethasone at 0.15mg/kg
In emergency/severe - high flow O2 and nebulised adrenaline

54
Q

Features in child with maternal Syphillis infection?

A

-Snotty (rhinitis)
-Saddle shaped nose
-Sensorineural hearing loss,
-Small and spaced teeth
-Swollen liver/spleen
-Swollen lymph nodes

55
Q

What conditions are commonly associated with Down’s syndrome?

A

Heart defects - usually repairable
Visual problems - cataracts
Hearing loss
Hypothyroidism
Hypotonia - developmental motor delay
Leukaemia
Easily disclocated neck - especially in those that do certain sports

56
Q

Features of Noonan syndrome?

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis - mid-systolic high pitched crescendo-decrescendo heard at upper left sternal edge

56
Q

Features of edward’s syndrome (trisomy 18)?

A

Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers

57
Q

Features of Patau syndrome (trisomy 13)?

A

Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

58
Q

Features of fragile X syndrome?

A

Learning difficulties
Macrocepaly
Long face
Large ears
Macro-orchidism

59
Q

Severity of alpha-thalassaemia?

A

1 - 2 globulin chains affected - hypochromic and microcytic but Hb level normal
3 chains - + anaemia and splenomegaly (Hb H disease)
4 chains - death in-utero (Hydrops fetalis)

60
Q

Classic triad of shaken baby syndrome?

A

Retinal haemorrhages
Subdural haematoma
Encephalopathy

61
Q

Features of PDA?

A

Left subclavicular thrill
Continuous ‘machinery’ murmur
Large volume, bounding, collapsing pulse
Wide pulse pressure
Heaving apex beat

62
Q

Paediatric maintenance fluid requirements?

A

100ml for first 10kg
50ml for next 10kg
20ml for each kg above 20
Divide by 24 to calculate infusion rate per hour

63
Q

What should be given before surgery in transposition of the great arteries?

A

Alprostadil (prostaglandin E1) - maintains PDA in cyanotic congenital heart diseases

64
Q

Benign cause of stridor/noisy breathing?

A

Laryngomalacia - usually self resolves by 2 years of age`

65
Q

Signs of congenital Rubella syndrome?

A

Sensorineural deafness
Congenital cataracts - absent fundal/red reflexes bilaterally

66
Q

Signs of congenital CMV?

A

Hearing loss
Low birth weight
Petechial rash
Microcephaly
Seizures

67
Q

First-line investigation for Duchenne?

A

Genetic testing

68
Q

Most common cause of early onset neonatal sepsis (within first 72 hours)

A

Group B Strep (Agalactiae)

69
Q

What cardiac abnormality can be caused by lithium use in pregnancy?

A

Ebstein’s anomaly (tricuspic regurgitation and stenosis)

70
Q

First-line laxative for constipation in children?

A

Movicol ( Osmotic - Real name is macrogol)

71
Q

What is the medical term for growing pains?

A

Benign idiopathic nocturnal limb pains of childhood

72
Q

Features of benign rolandic epilepsy?

A

Partial seizures at night

73
Q

What is gas in the intestines a sign of ?

A

Necrotising enterocolitis

74
Q

Initial management for transposition of great arteries?

A

Prostaglandins

75
Q

Edward’s syndrome quadruple test result?

A

Lowered AFP, Oestriol ,hCG
Normal Inhibin A

76
Q

First line investigation for meckel’s diverticulum?

A

Technetium scan

77
Q

Whooping Cough Treatment?

A

Azithrommycin/Clarithromycin if within 21 days of onset of cough

78
Q

What are undescended testicles associated with?

A

Testicular torsion
Testicular cancer
Infertility

79
Q

What heart defects are associated with Turners syndrome?

A

Ejection systolic murmur most common - bicuspid aortic valve
Coarctation of the aorta

80
Q

Triad of shaken baby syndrome?

A

Retinal haemorrhages
Subdural haematoma
Encephalopathy

81
Q

What treatment should be given in suspected Nec?

A

Broad spectrum antibiotics

82
Q

Peak incidence of ALL?

A

2-5 years

3a (9 decks)

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