paediatrics 👶🏻 Flashcards
classic tetrad for severely infected infants with congenital toxoplasmosis
hydrocephalus
chorioretinits
convulsions
cerebral calcifications
what causes toxoplasmosis
toxoplasma gondii
eating uncooked meat/exposure to cat faeces
What kind of history will a patient present with who has functional abdominal pain
Vague, persistent, central abdo pain
Acute,chronic or cyclic
Girls 8-12
Nausea and vomiting
Fx of functional disorders
What history would a patient with constipation present with
Vague abdo pain
Painful defecation
Poor diet and fluid intake
Obesity
Faecal incontinence
On clinical examination of a patient with constipation what would you find
Minimal-mild abdo tenderness
Stool in rectum
Abdo distension
Faecal mass palpable
Mx of constipation
Stool softening laxatives
Improving water, food and fibre intake
What history would a patient with gastroenteritis present with
Vague abdo pain with nausea and vomiting
Diarrhoea +/- mucus
Recent travel, contact with sick person or ingestion of suspicious food/drink
With gastroenteritis, if it last more than 10 days what does that suggest
Parasitic or non-infectious cause
On clinical examination of patient with gastroenteritis what would you see
Diffuse abdo pain
Abdo distension
Hyperactive bowel sounds
Signs of volume depletion
Low grade fever
What history would a patient with coeliac disease present with
Recurrent abdo pain, cramping or distension
Bloating and diarrhoea
Dermatitis herpetiformis
Family history of coeliac disease
On clinical examination of a patients with coeliac disease what would you see
Generalised abdo pain or bloating
Underweight or failing to thrive
What history would a patient with TB present with
Night fever
Sweating
Cough
Haemoptysis
Poor appetite
Weight loss
Recent travel abroad
Treatment for TB
isoniazid
Rifampicin
Ethambutol
Pyrazinamide
History of patient with scarlet fever
Under 10
Sore throat
Malaise
GI upset
Clinical examination of pt with scarlet fever will reveal ?
Strawberry tongue
Sandpaper-like generalised rash
Fever
Tender cervical lymphadenopathy
Dx scarlet fever
Rapid throat swab but abx should be started immediately
Mx scarlet fever
Oral phenoxymethylpenicillin 10 days
If PA azithromycin
Children can return to school 24 hours after commencing abx
CREAM
Conjunctivitis
Rash
Erthyema of hands and feet
Adenopathy (cervical)
Mucosal involvement (strawberry tongue, oral fissures)
high grade fevers for >5 days
kawasaki disease
Mx of Kawasaki disease
High dose aspirin - due to risk of Reye’s syndrome aspirin is usually contraindicated in children
IV immunoglobulin
Sx of staphylococcus toxic shock syndrome
High grade fever
Malaise
Erthymematous rash
Syncope
Hypotension
Progression of toxic shock syndrome
Initially non specific flu like symptoms possibly with nausea, vomiting and diarrhoea
Then rapid progression to high fever and eruption of widespread rash that covers >90% body surface
Ix toxic shock syndrome
CK elevated
Low platelets
Blood, throat or CSF culture: no growth of pathogen
Mx toxic shock syndrome
Antibiotics
Fluid resuscitation
Vasopressors
Surgical debridement
Signs and symptoms you would see with coeliac disease paediatric
Failure to grow/thrive
buttocks wasting
Foul smelling faeces
Conjunctival pallor
Abdominal distension
Presentation of measles
Fever >40
Coryzal sx
Conjunctivitis followed by a rash 2-5 days after onset of sx
Koplik spots
Lasts about 5 days
Other names for fifth disease
Parvovirus B19
Slapped cheek syndrome
Erythema infectiosum
Presentation of fifth disease
Prodrome of fever, Coryza and diarrhoea
Bright red rash on cheeks followed by lacy rash on extremities
What is roseola
Aka sixth disease
Common disease of infancy caused by human herpes virus 6
Complications of roseola
Febrile convulsions
Presentation of roseola
Febrile and lethargic for up to 5 days
Blanching, rose pink macular rash erupts and covers trunk typically
Can spread to face and limbs
Cervical lymphadenopathy
Mx of roseola
Supportive
What history would a patient with asthma present with
Family history
Wheezing triggered by change in Weather, Environmental tobacco smoke, exercise, emotion
Tachypnoea
Dry night time cough
What history would a patient with bronchiolitis present with
Under 1 year
Seasonal - common in winter
Passive tobacco exposure
Cough increased in severity over time
Features of bronchiolitis
Coryzal symptoms
cough
Increasing breathlessness
Wheezing
Feeding difficulties
In what cases is bronchiolitis more severe
Bronchopulmonary dysplasia e.g premature
Congenital heart disease
Cystic fibrosis
Causes of bronchiolitis
Most cases = respiratory syncytial virus RSV
What is a common complication seen in bronchiolitis caused by RSV
Hyponatraemia
What history would a typical patient with croup present with
Male
Between 6 months and 6 years
Seal like barking cough worse at night
Stridor
Incidence in autumn/winter
Mild fever
Mx of croup
Dexamethasone
Supportive
Adrenaline nebuliser in emergency
What causes croup
Upper airway infection
Vast majority of cases caused by parainfluenza virus
Other viruses include adenovirus, RSV and influenza