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Medicine Year 5 > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

mode of inheritance of sickle cell

A

autosomal recessive

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2
Q

mode of inheritance of cystic fibrosis

A

autosomal recessive

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3
Q

mode of inheritance of huntingtons

A

autosomal dominant

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4
Q

mode of inheritance of achondroplasia

A

autosomal dominant

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5
Q

can a male pass on an mitochondrial disease

A

no

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6
Q

give 2 examples of conditions with genetic anticipation

A

huntingtons and myotonic dystrophy

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7
Q

small head and eyes with cleft lip, polydactyly and scalp lesion

A

patau
trisomy 13

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8
Q

small jaw, low set ears, overlapping fingers and rocker bottom feet

A

edwards
trisomy 18

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9
Q

large/long face and ears, large testes, learning difficulties and mitral valve issue

A

fragile x syndrome

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10
Q

short, webbed neck, pectus excavatum, pulmonary stensosis

A

noonan syndrome

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11
Q

small jar, cleft palate, posterior displacement of the tongue

A

pierre-robin syndrome

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12
Q

hypotonia, small tests and constant hunger

A

prader willi

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13
Q

inheritance of prader willi

A

imprinting

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14
Q

short, broad forehead, friendly, learning difficulties, neonatal hyperglycaemia and aortic stenosis

A

williams syndrome

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15
Q

characteristic cry, poor feeding, learning difficulties, small head and jaw with a large gap between the eyes

A

Cri du Chat
chromososmal 5 deletion

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16
Q

short with a shield chest, widely spaced nipples, webbed neck, cystic hygroma, primary amenorrhoea, hypothyroid and lymphoedema

A

turners syndrome

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17
Q

cardiac abnormalities in turners syndrome

A

bicuspid aortic valve, coarctation of the aorta, ejection systolic murmur

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18
Q

What does the APGAR score stand for and how is it calculated

A

Appearance, Pulse, Grimace, Activity, Respiration
0-1-2 in each

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19
Q

compression: ventilation in newborn resuss

A

3 compression to 1 ventilation

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20
Q

compression rate in all infant arrests

A

100-120 bpm

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21
Q

where do you check for a pulse in neonates

A

femoral and brachial

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22
Q

define neonatal death

A

between birth and 28 days

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23
Q

when is the newborn blood spot carried out

A

5-9 days

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24
Q

is it normal for saturations to drop in the first 10 mins of life

A

yes

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25
Q

how does congenital adrenal hyperplasia present

A

ambiguous genitalia

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26
Q

how does cephalohaematoma present

A

several hours after birth
does not cross the suture lines

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27
Q

risk factors for SIDS

A

prone sleeping, smoking, premature, co-sleeping, hyperthermia

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28
Q

risk factors for DDH

A

female, breech, fhx, first born, LWB, oligohydramniosis

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29
Q

when is the DDH USS carried out

A

6w

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30
Q

cause of facial defects in neonate

A

maternal antiepileptic drug use

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31
Q

abnormal newborn hearing test

A

refer for the brainstem one

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32
Q

jittery and hypotonic baby

A

neonatal sepsis

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33
Q

what can maternal labetalol use cause

A

neonatal sepsis

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34
Q

management of symptomatic and non-symptomatic neonatal sepsis

A

no sx: feed and monitor glucose
sx: IV 10% dextrose

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35
Q

LBW, hearing loss, rash, small head and seziures

A

congenital CMV infection

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36
Q

sensioneural deafness and congenital cataracts

A

congenital rubella

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37
Q

management of hypoxic brain injury

A

therapeutic cooling

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38
Q

bowel sounds in NIPE resp exam

A

CDH

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39
Q

PANSYSTOLIC murmur in the left lower sterrnal border

A

VSD

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40
Q

EJECTION SYSTOLIC murmur in the left upper sternal border

A

Pulmonary stenosis

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41
Q

Continuous diastolic machinery murmur in the left upper sternal border with a collapsing pulse and left subclavicular thrill

A

Patent ducts arteriosus

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42
Q

medication to close PDA

A

Indomethacin

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43
Q

crescendo-decrescendo murmur in left upper sternal border

A

coarctation of the aorta

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44
Q

how does coarctation of the aorta present

A

circulatory collapse at 2 days when the duct closes
heart failure
absent femoral pulses

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45
Q

name the 5 cyanotic heart diseases

A

Transposition of the great arteries (loud S2)
Tricuspid atresia
Truncus arteriosus
Total anomalous pulmonary venous return
Tetralogy of fallot

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46
Q

presentation of ToF

A

hypercyanotic tet spells and LOC

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47
Q

management of cyanotic heart diseases

A

prostaglandin to maintain the ductus arteriosis

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48
Q

continuous blowing below clavicle

A

venous hum

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49
Q

low pitched sound in left lower sterrnum

A

stills murmur

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50
Q

murmurs which vary with posture

A

ejection murmers

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51
Q

cause of ebstein anomaly

A

atrialisation of RV due to lithium use

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52
Q

cardiac abnormality in duchennes

A

dilated cardiomyopathy

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53
Q

most common age for croup

A

6-12m

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54
Q

2 treatments for croup

A

dexamathasone and nebulised adrenaline

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55
Q

benign cause of noisy breathing

A

laryngomalacia

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56
Q

CXR in transient tachypinea of the newborn

A

hyperinflation and fluid in the fissure

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57
Q

3 reasons to admit for bronchiolitis

A

RR above 60
Dehydration
50-70% reduction in fluid/oral intake

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58
Q

what are maternal DM, male, prematurity and c-section risk factors for

A

surfactant deficiency

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59
Q

Causes of meningitis in under 3m and over 3m

A

Under 3m: GBS, E.coli, Listeria
Over 3m: N meningitidis, S, pneumonia

(1m-6y also H. influenza)

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60
Q

Investigations in meningococcal septicaemia

A

NO LP
culture and viral PCR

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61
Q

ABx management of meningitis in under 3m and over 3m

A

Under 3m: IV amoxicillin and cefotaxmine
Over 3m: IV cefotaxime/ceftriaxone

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62
Q

Fever then rash with mild systemic upset

A

chicken pox

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63
Q

chicken pox + NSAIDS =

A

necrotising fascitis

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64
Q

prodrome of fever, irritability, conjunctivitis with koplik spots and a rash behind the ears which then spreads

A

measles

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65
Q

2 st and 1 lt complication of measles

A

st: otitis media and pneumonia
lt: encephalitis

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66
Q

fever, malaise, muscular pain and parotitis (pain on eating and earache)

A

mumps

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67
Q

complication of mumps (2)

A

pancreatitis and infertility

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68
Q

pink maculopapular rash on face spreading to body with lympadenopathy

A

rubella

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69
Q

lethargy, fever, headache and slapped cheek rash on face to arms

A

erythema infectiosum

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70
Q

virus causing slapped sheek

A

parvovirus b19

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71
Q

feverr, malaise, tonsillitis and strawberry tongue with fine punctate erythema which spares the mouth

A

scarlet fever

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72
Q

cause of scarlet fver

A

reaction to the toxin from group a strep

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73
Q

mils systemic upset, vesicles on the mouth, palms and soles

A

hand foot and mouth

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74
Q

virus causing hand foot and mouth

A

coksackie A19

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75
Q

fever then maculopapular rash that can cause febrile convulsitons

A

roseola infantum

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76
Q

virus causing roseola infantum

A

herpes 6

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77
Q

age for febrile convulsions

A

6m to 5y

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78
Q

cause of epiglottitis

A

Hib

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79
Q

example of an oral and live vaccine

A

rotavirus

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80
Q

most common cause of pneumonia in children

81
Q

abx treatment if suspected mycoplasma pneumonia

A

erythromycin

82
Q

treatment of threadworm

A

single dose of mebendazole for whole family
no school exlcusion

83
Q

treatment for threadworm

A

single dose of mebendazole for whole family
no school exclusion

84
Q

5 day of fever with conjunctivitis, cracked lips, strawberry tongue, lymphadenopathy and peeling palms and soles

A

kawasaki disease

85
Q

treatment for kawasaki

A

aspirin and IV ig

86
Q

why do you need an ECHO in kawasaki

A

coronary artery aneurysm

87
Q

school exclusion for scarlet fever

A

24 hours after starting abx (penv)

88
Q

school exclusion for whooping cough

A

2 days after starting abx or 21 days from sx

abx = macrolide

89
Q

school exclusion for measles

A

4 days from rash onset

90
Q

school exclusion for rubella

A

5 days from rash onset

91
Q

school exclusion for chicken pox

A

all lesions crusted (usually 5 days)

92
Q

school exclusion for mumps

A

5 days from gland swelling

93
Q

school exclusion for impetigo

A

lesions crusted/48 hours after abx

abx - hydrogen peroxide

94
Q

school exclusion for scabies

A

until treated

95
Q

school exclusion for influenza

A

until recovered

96
Q

school exclusion for roseola infantum

A

no exclusion

97
Q

viral infection followed by joint pain

A

transient synovitis

98
Q

10-15 year old who is obese presenting with hip and groin pain and reduced internal rotation

99
Q

4-8 years with worsening hip pain

A

Perthe’s

100
Q

what is perthes

A

Avascular necrosis of the femoral head

101
Q

treatment of perthes

A

x ray
under 6 observe
over 6 surgerry

102
Q

are bow legs in a child under 3 normal

103
Q

child with an acute limp

A

urgent assessment for septic arthritis

104
Q

what are the kocher criteria

A

to assess if pain is due to septic arthritis
1. non weight bearing
2. fever above 38.5
3. increased WCC
4. ESR

105
Q

widening of the wrist joints with low calcium and phosphate but high ALP and PTH

106
Q

4 classifications of cerebral palsy

A

spastic
dyskinetic
ataxic
mixed

107
Q

damage to UMN causing hemi, di or quadraplegia

A

spastic cerebral palsy

108
Q

damage to the basal ganglia or substantia nigra causing athetoid movements and oro-motor issues

A

dyskinetic cerebral palsy

109
Q

damage to the cerebellum causing cerebellar signs

A

ataxic cerebral palsy

110
Q

medication for spastic cerebral palsy

111
Q

repeated flexion of head/arms/trunk followed by extension of the arms

A

infantile spasms

112
Q

partial seizures at night

A

benign rolandic epilepsy

113
Q

seizures with a rapid recovery

A

reflex anoxic seizures

114
Q

unilateral occipital flattening with protruding ear

A

plagiocephaly
improve by 3-5y

115
Q

fever and RIF pain which can present atypically

A

actute appendicitis

116
Q

urine dip in appendicitis

A

positive protein and leukocytes

117
Q

central abdo pain after a viral URTI

A

MESENTERIC ADENITIS

118
Q

management of mesenteric adenitis

A

self-limiting - conservative

119
Q

abo distention with bilious vomiting and bilious stool with blood at 2w old

A

necrotising enterocilitis

120
Q

RF for nec

A

prematurity and ABx use

121
Q

management of NEC

A

xray showing free air and dilated bowels
total gut rest with TPN and broad spectrum abx

perforation requires laparotomy

122
Q

abdominal distention, delayed meconium and bilious vomiting

A

Hirschsprungs disease

123
Q

management of hirschsprungs

A

RECTAL BIOPSY and wash outs

124
Q

what is hirschsprungs

A

absence of ganglion cells

125
Q

abdo distention and delayed meconium 24-48 hours after birth

A

meconium ileus

126
Q

RF for meconium ileus

A

cystic fibrosis

127
Q

management of meconium ileus

A

PR contrast study which can dislodge the clot
NG N-acetylcysteine
surgical removal

128
Q

bilious vomiting and obstruction with haemodynamic instability at 3-7 days

A

Intestinal malrotation

129
Q

RF for intestinal malrotation

A

exomphalus, congenital diaphragmatic hernia and duodenal atresia

130
Q

USS for intestinal malrotation

A

Whirlpool sign

131
Q

management of intestinal malrotation

A

Ladd’s procedure

132
Q

choking and cyanotic spells associated with polyhydramnios

A

oesophageal atresia

133
Q

jaundice, reduced growth and feeds, pale stool, dark urine at 14 days

A

biliary atresia

134
Q

bilirubin in biliary atresia

A

increased conjugated (cholestatic picture)

135
Q

management of biliary atresia

A

urgent kasai procedure

136
Q

bilious vomiting hours after birth

A

duodenal atresia

137
Q

xray in duodenal atresia

A

double bubble sign

138
Q

when does ilieal atresia present

A

24 hours after birth

139
Q

management of ileal atresia

A

xray shows free air
laparotomy

140
Q

projectile vomiting at 4-6w with a palpable mass

A

pyloric stenosis

141
Q

2 investigations for pyloric stenosis

A

hypochloraemic hypokalaemic metabolic acidosis

USS

142
Q

management of pyloric stenosis

A

ransted and pyloromyotomy

143
Q

2 RF for pyloric stenosis

A

male and FHx

144
Q

colicky pain with D+V, sausage shaped mass and red jelly stool at 6-9m

A

Intusussception

145
Q

what is intussusception

A

telescoping bowel proximal to the ileocaecal valve

146
Q

management of intissusception

A

reduction and air

147
Q

number one cause of a painless massive GI bleed in 1-2 years

A

meckels diverticulum

148
Q

management of meckels diverticulum

A

transfusion and technetium scan if stable

149
Q

management of exomphalos

A

c-section and staged repair

150
Q

RF for gastroscisis

A

socioeconomic deprivation (smoking, alcohol and materal age under 20)

151
Q

difference between exomphalos and gastroscisis

A

gastroscisis is paraumbilical
exomphalos is umbilical

152
Q

presentation and treatment of transient lactose intolerrance

A

common after viral gastroenteritis
remove lactose and slowly re-introduce

153
Q

management of GORD

A

1-2w of alginate then 4w of PPI if reduced feeding and growth

154
Q

management of CMPA

A

extensively hydrolysed formula

155
Q

first line management of constipation

A

osmotic laxative (movicol)
then trial a senna

156
Q

management of inguinal hernia in infants

A

immediate surgery

157
Q

management of umbilical hernia

A

normally self resolve
no resolution then
- small and no sx: repair at 4-5y
- large and sx: repair at 2-3 y

158
Q

red growth of umbilical tissue which is wet and leaking fluid

A

umbilical granuloma

159
Q

jittery baby with increased tone, hyperreflexia, convulsions, drowsiness and coma

A

hypernatremic dehydration

160
Q

feature of achondroplasia

A

trident hands

161
Q

what is phimosis

A

non-retractable foreskin
self-resolve by 2y

162
Q

management of enuresis

A

alarm then desmopressin

163
Q

3 complications of undescended testes

A

infertility, torsion and cancer

164
Q

management of unilateral undescended testicle

A

review at 3m and repair if persistenet

165
Q

ventral urethral meatus and hooded prepuce

A

hypospadias

166
Q

one contraindication to circumcision

A

hypospadias - use the foreskin in the repair

167
Q

painless haematuria with painless palpable mass, reduced appetite and distended abdomen

A

Wilms tumour

168
Q

6 indications of an atypical UTI

A

reduced urine flow, mass, increased creatinine, non E coli, septic or no abx response

169
Q

investigation for reflex nephropathy

A

micturating cystography

170
Q

scan for vesicoureteral reflux

171
Q

UTI in less than 3m

172
Q

management of UTI

173
Q

association with cystic fibrosis

A

diabetes mellitus

174
Q

hepatosplenomegaly with bruising and anaemia

175
Q

age ALL peaks

176
Q

condition associated with ALL

177
Q

poor prognostic indicator in ALL

178
Q

signs of anaemia in ALL

A

soft systolic murmur and SOB

179
Q

presentation of ITP

A

isolated thrombocytopenia preceded by viral illness with fever and pectichae

180
Q

schistocytes on blood film

181
Q

treatment of ITP

A

conservative

182
Q

anaemia in alpha thalassemia

A

hypochromic microcytic anaemia

183
Q

3 types of alpha thalassemia

A

1/2 alleles: anaemia with normal hb
3 alleles: anaemia with splenomegaly
4 alleles: death in utero (hydrops fetalis)

184
Q

what is hydrops fetalis

A

oedema in foetus

185
Q

what is alpha thalassemia

A

reduction in alpha chains

186
Q

normal puberty in males

A

testicular growth at 10-15y
growth spurt at 14y

187
Q

normal puberty in females

A

breast development at 9-13y
growth spurt at 12y
menarche at 11-15y

188
Q

define precocious puberty

A

secondary sexual characteristics before 8y in girls and 9y in boys

189
Q

management of children below the 0.4th centile

190
Q

medication for ADHD

A

methylphenidate - monitor growth

191
Q

consent for sex

A

under 13 no consent

192
Q

triad in shaken baby syndrome

A

retinal haemorrhages
subdural haematoma
encephalopathy

193
Q

3 main fractures in abuse

A

radial
humeral
femoral

194
Q

eczema in 10m

A

face and trunk

195
Q

what is cradle cap and how does it present

A

seborrheic dermatitis
red rash with yellow flakes

196
Q

presentation and treatment of pityriasis rosea

A

pink/red scaly patches on abdomen
self-limiting

197
Q

presentation and treatment of pityriasis versicolour

A

fungal infection from the sub
ketonozole

198
Q

nappy rash candida or dermatitis

A

flexors spared: dermatitis
flexors affected: candida

199
Q

overview the causes of precocious puberty

Medicine Year 5 (27 decks)

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