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AMK > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

itchy rash over face, golden crust, fever
Mx

A

Impetigo
Hydrogen peroxide 1% cream, fusidic acid cream

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2
Q

rough maculopapular rash on face, periorbital sparing, red tongue

A

scarlet fever

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3
Q

Mx of scarlet fever

A

phenoxymethylpenicillin

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4
Q

red rash all over body, white Koplik spots inside buccal cavity

A

Measles

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5
Q

red rash on both cheeks, fever

A

Parvovirus B19

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6
Q

drooling, soft inspiratory stridor, unwell child

A

acute epiglottis
cause: haemophilus influenza B

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7
Q

widespread polymorphic rash across her torso, and she has oedematous feet. Examination of the mouth shows widespread mucosal erythema and a strawberry tongue.

A

Kawasaki disease

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8
Q

criteria to treat tonsillitis

A

CENTOR: no cough, has fever, has cervical lymphadenopathy, has exudate
give phenoxymethylpenicillin for 5 days

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9
Q

measles Px

A

conjunctivitis
raised red rash
high fever
white koplik spots in oral mucosa

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10
Q

hand foot and mouth MX

A

supportive

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11
Q

croup cause

A

parainfluenza

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12
Q

fever >5 days
conjunctivitis
swollen neck glands
red tongue
rash

A

Kawasaki

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13
Q

Kawasaki Mx

A

IV Ig + aspirin
echo to assess cardiac effect

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14
Q

ADHD not responding to conservative measures. Med:

A

methylophenidate

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15
Q

similar symptoms to SUFE but child under 10

A

perthes disease

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16
Q

failure to pass meconium
distended abdomen
explosive diarrhoea after removing finger during rectal examination

what is it, Ix, Mx

A

hirshsprungs disease
Ix: rectal suction biopsy
Mx: remove unhealthy bowel

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17
Q

machine whirring murmur

A

patent ductus arteriosus

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18
Q

use of prostaglandin E in ASD/VSD

A

allows the ductus to remain patent
blood will continue to flow into the heart

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19
Q

immediate/premature Mx of PDA

A

indomethacin (NSAID) to inhibit prostaglandin and therefore keep the ductus closed

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20
Q

Eisenmenger syndrome

A

the left -> right shunt reverses to become right -> left.
This happens when the pulmonary pressure > systemic pressure

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21
Q

coarctation of the aorta

A

narrowing of the aorta

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22
Q

systolic murmur loudest in the back. radio-femoral delay
wide neck, low set ears

A

coarctation of the aorta in a pt with turners syndrome

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23
Q

teratology of fallot

A
  1. right ventricular hypertrophy
  2. pulmonary stenosis
  3. overriding aorta
  4. ventricular septal defect
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24
Q

boot shaped heart on CXR

A

ToF

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25
Q

transposition of the great arteries

A

the aorta and pulmonary arteries are switched in position. creates two parallel circuits. incompatible with life in theory but there are many shunts which allow blood to still flow

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26
Q

feverish child, trouble swallowing, drooling, sitting forward (tripod position)

A

epiglottitis

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27
Q

cause of epiglottitis

A

haemophilia influenza B (there is a vaccine)

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28
Q

Dx and Mx of epiglottitis

A

lateral x ray of the neck = thumbprint sign
secure airway (may need intubation), IV antibiotics, dexamethson

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29
Q

what to prescribe in constipated child first line

A

movicol disimpaction regimen, then senna/lactulose etc

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30
Q

biliary atresia

A

congenital issue where the final part of the bile duct is not formed
bile cannot leave the gallbladder
raised conjugated bilirubin
jaundice!

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31
Q

born preterm, bloody stool, abdominal distension, bilious vomiting
Mx

A

necrotising enterocolitis
broad spectrum ABs and parenteral feeding

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32
Q

intussuception

A

the bowel telescopes into itself
sausage shaped mass, red currant stool, intermittent abdominal pain

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33
Q

Ix and Mx for intussuception

A

contrast enema, reduction for Mx

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34
Q

hirschsprungs disease

A

dysfunctional myenteric plexus; lack of parasympathetic ganglionic cells
no peristalsis, so faeces gets backed up, constipation
abdominal pain, doesn’t pass meconium, explosive excretion after digital rectal exam

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35
Q

intestinal obstruction Px

A

abdominal distention, bilious vomiting, failure to pass stool or wind
dilated loops of bowel proximal to the obstruction
abnormal bowel sounds (tinkling, then absent later in the obstruction)

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36
Q

olive shaped mass

A

pyloric stenosis

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37
Q

Mx for pyloric stenosis

A

pylomyotomy

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38
Q

Px of pyloric stenosis

A

olive shaped mass, projectile vomiting

39
Q

Px of appendicitis

A

pain in central abdo that then travels to RIF
Rovsings sign: palpated on LIF, pain on RIF

40
Q

x ray of duodenal atresia

A

double bubble

41
Q

x ray of jejunal atresia

A

triple bubble

42
Q

joint pain, fever, salmon-pink rash

A

Juvenile idiopathic arthritis / stills disease

43
Q

how to differentiate roseola infantum vs slapped cheek

A

roseola infantum has a higher fever

44
Q

lethargy, slurred speech, hepatomegaly, fever after taking aspirin
what has happened>

A

reyes syndrome
liver failure and subsequent encephalopathy

45
Q

Presentation of phenylketonuria

A

Hypopigmentation
Musty odour
Eczema
Microcephaly

46
Q

Two conditions which cause abdominal contents to protrude from the foetus’ abdomen and how to diffferentiate

A

Gastroschisis vs omphalocele
Omphalocele has organs covered in the peritoneum

47
Q

Baby immediately vomiting uncurdled milk when breastfeeding

A

Tracheo oesophageal fistula
Milk is uncurdled as it hasn’t reached the stomach

48
Q

Signs of clinical dehydration in children

A

Dry mucus membranes
Sunken eyes
Irritability
Normal crt

49
Q

Signs of clinical shock in children

A

Mottled pale skin
Altered consciousness
Low bp
Prolonged cap refill time

50
Q

Legg calve perthes disease

A

Comprised blood flow to the femoral head
Usually presents age 4 to 9 with limp and pain upon walking, better when sitting
Self limiting

51
Q

how many inhaler puffs is equal to 1 nebule

A

6 (childs dose)

52
Q

what is burst therapy in asthma attack Mx

A

100mcgs of salbutamol 10 puffs with spacer
every 20 mins for 1 hour

53
Q

bilateral palpable flank masses
renal cysts, hepatic fibrosis

A

autosomal recessive pckd

54
Q

potter syndrome

A

pulmonary hypoplasia
oligohydramnios
due to ARPKD / bilateral renal agenesis

55
Q

appearance of a kid with potters sydnrome

A

low set ears
beaked nose
limb deformities

56
Q

bilateral renal agenesis

A

both kidneys fail to develop
can cause potters sydnrome

57
Q

Px of haemolytic uraemic syndrome

A

bloody diarrhoea
vomiting
hypertensive
pallor
seizures

58
Q

haemorrhage disease of newborn is caused by..

A

vitamin k deficiency

59
Q

unilateral wheeze, no signs of infection

A

foreign body inhalation

60
Q

murmur in ASD

A

ejection systolic murmur heard in the pulmonary region
fixed split s2 (pulmonary valve closes later than the aortic valve)

61
Q

murmur in VSD

A

systolic murmur at the left sternal edge
diastolic murmur at heart apex

62
Q

most significant risk factor for developmental dysplasia of the hip

A

breech position in 3rd trimester

63
Q

tests for DDH

A

barlow and ortolani

64
Q

what type of heart sound is heart in ASD?
and why

A

fixed split second heart sound.

ASD = left to right shunt causes an increased pressure in the Right Atrium. This means the pulmonary valve closes later than the aortic valve. “fixed” means that it happens irrespective of inspiration and expiration.

65
Q

most common cerebellar neoplasm in childhood

A

astrocytoma

66
Q

blood gas reading on pyloric stenosis

A

hypochloraemic hypokalaemia metabolic alkalosis

67
Q

murmur and heart sounds heard in VSD

A

holosystolic murmur
loud s2

68
Q

maternal diabetes is assoc with what congenital heart abnormality

A

VSD

69
Q

maternal rubella is assoc with what congenital heart abnormailty

A

PDA

70
Q

turners syndrome karyotype and association

A

45XO
coarctation of the aorta

71
Q

what abnormalities are seen in ToF
pathophis

A
  1. VSD
  2. RV hypertrophy
  3. pulmonic stenosis
  4. overriding aorta

deoxygenated blood cannot leave the pulmonary artery due to stenosis
shunts through the VSD instead
cyanotic

72
Q

murmur heard in ToF

A

ejection systolic in left upper sternal border

73
Q

short term and long term Mx of TGA

A

short term: prostaglandin e2 to maintain PDA. balloon atrial septostomy
Long term: arterial switch opereation

74
Q

cyanotic heart disease presenting in the first week of life

A

transposition of the great arteries

75
Q

cyanotic heart anomaly presenting after the first week of life

A

ToF

76
Q

4 examples of acyanotic heart disease

A

VSD
ASD
PDA
CoA

77
Q

signs of unwell child (A/B,C,D)

A

A/B: increased work of breathing, tachypnea, poor air entry
C: blue, long cap refill time, cool peripheries, tachycardia
D: AVPU, irritability

78
Q

cephalohaematoma
what is it, px, associations, Mx

A

subperiosteal haemorrhage

caused by birth trauma
assoc with prolonged 2nd stage of labour, instrumental delivery,

does not cross suture lines
well-circumscribed fluctuant mass, parietal bone
appears in first week of life, disappears by few months

79
Q

caput succedaneum
px, mx

A

diffuse swelling of the scalp that is above the periosteum, so it crosses suture lines

resolves within first few days of life

80
Q

subgaleal haemorrhage

associations Px Mx

A

assoc with instrumental delivery
rupture of emissary veins, leading to bleeding between the periosteum and the gala aponeurosis.

fluctuant mass, overlying bruising
crosses over suture lines

Mx: monitor for haemorrhagic shock

81
Q

Moro reflex

A

Arms flayed out
Then pulled back in tight to chest
Crying

82
Q

Asymmetrical Moro reflex shows

A

Brachial plexus / isolated nerve injury

83
Q

Waiters tip deformity …

A

Erbs palsy

84
Q

son had a runny nose and sore throat for the past few days but then developed bright red rashes on both cheeks. He now has a raised itchy rash on his chest that looks lace-like in appearance

A

Parvovirus b19

85
Q

Mx of bordetella

A

Azithromycin

86
Q

Mx of bordetella

A

Azithromycin

87
Q

congenital adrenal hyperplasia pathophis

A

defect in hydroxylase 21 gene

hydroxylase 21 is required to convert progesterone into aldosterone and cortisol
so it can’t happen in CAH]

however hydroxylase 21 isn’t required to convert progesterone into testosterone.
so all free progesterone is converted to testosterone

88
Q

Px of Congenital adrenal hyperplasia in females

A

tall, virilised genitals, large clitoris, absent periods

89
Q

Px of congenital adrenal hyperplasia in males

A

tall, large penis, small testicles, deep voice

90
Q

general Px of CAH and why

A

poor feeding, vomtiing, diarrhoea, bronzed skin

due to the production of ACTH (due to lack or cortisol and aldosterone)

91
Q

Ix findings in CAH

A

unequivocally elevated serum conc of 17-hydroxyprogesterone

92
Q

pathophis of phenylketonuria

A

defect in phenylalanine hydroxylase gene
buildup of phenylalaine

93
Q

inheritance pattern of phenylketonuria

A

autosomal recessive

AMK (29 decks)

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