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PA- FCM > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

At what week are surfactants produced in the lungs

A

17-26 weeks
so babies worn before this will require ventilation support

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2
Q

Name some difference on resp tract in child vs adult

A

Tongue: Childs is larger in proportion to mouth
Epiglottis: it is floppier, u-shaped in child and shorter in adults
Vocal cords: it is upwardly slanted in child whereas it is horizontal in adults
The larynx is more anterior and superior in child
less lung capcity in a child

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3
Q

Treatment for surfactant deficiency

A

CPAP + steroids +diuretics +RSV monoclonal antibody

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4
Q

What is laryngomalacia

A

congenital abnormality of the larynx cartilage causes supraglottic collapse during the inspiratory phase of respiration

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5
Q

How does laryngomalacia present

A

harsh cough
stridor
breathing/ feeding/ sleeping difficulties

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6
Q

What is meckel’s diverticulum

A

formation of a small pouch consisting of tissue found elsewhere in the body like pancreatic or gastric tissue
it is clinically indistinguishable from appendicitis

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7
Q

what are the rules of 2 in meckel’s diverticulum

A

Occurs in 2% of population
2cm long
2 feet from ileocaecal valve
Presents under 2 years of age
2 x more common in males

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8
Q

in meckels diverticulum if gastric cells are present then how would the patient present

A

bloody stools as the gastric cells will cause ulceration

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9
Q

what is volvulus

A

occurs when the bowel twists so the blood supply to that part of the bowel is cut off
life threatening

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10
Q

symptoms of volvulus

A

bilious vomiting
severe abdominal pain
irritability
poor feeding
diarrhoea
fever

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11
Q

examination findings on volvulus

A

distended abdomen
very tender
dehydrated
tachycardia

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12
Q

Investigation for volvulus

A

AXR
Bloods- FBC, CRP, U&E
Barium swallow- if child stable

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13
Q

Management for volvulus

A

Resuscitate- iv fluids, analgesia, abx
NG tube insertion to decompress the abdo distension
Emergency laparotomy for ;adds procedure +/- stoma formation

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14
Q

what are the 2 types of stomas and what do they contain

A

colostomy- contents more solid
ileostomy - contents more liquid

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15
Q

what is wilms tumour

A

unilateral renal tumour

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16
Q

2 common finding in wilms tumour

A

palpable abdo mass and abdominal distention

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17
Q

treatment for wilms tumour

A

chemo and surgical resection

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18
Q

what is neuroblastoma

A

a form of cancer that develops from specialised nerve cells (neuroblasts) left behind from a baby’s development in the womb

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19
Q

where does neuroblastoma most commonly originate from

A

adrenal or paraspinal sites

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20
Q

what does a neuroblastoma present with

A

abdominal distension or mass +anorexia

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21
Q

what in urine is suggestive of neuroblastoma

A

catecholamines

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22
Q

Treatment for neuroblastoma

A

chemotherapy, surgery and radiotherapy

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23
Q

what is rhabdomyosarcoma

A

soft tissue sarcoma in children , occurs around muscular structures

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24
Q

what syndrome is rhabdomyosarcoma associated with

A

Li-Fraumeni syndrome

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25
Q

what is gastroschisis

A

defect in the abdominal wall, gut exposed

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26
Q

what is omphalocele

A

failure of viscera to return into abdo cavity

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27
Q

How can a button battery indigestion present as

A

increased drooling
poor oral intake
distress when feeding

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28
Q

what is hypospadias

A

meatus on underside of penis

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29
Q

if hypospadias is noted earlier on then what must you avoid doing

A

do not circumcise, because foreskin used in repair

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30
Q

what age is a hypospadias usually repaired at

A

6-9 months

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31
Q

most common symptoms of an UTI in infants younger than 3 months

A

Fever
vomiting
lethargy
irritability

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32
Q

Treatment for UTI in children under 3 months

A

send urine sample for urgent microscopy and culture
refer to paeds specialist care for further investigation
also think safeguarding

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33
Q

Treatment for UTI in children over 3 months

A

if leukocyte or nitrate or both positive then start antibiotics and send for culture

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34
Q

what ages are neonate

A

new-born to 4 weeks of age

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35
Q

What is SCBU

A

Low dependency unit (Special care), if babies >32 weeks that only require some extra support before going home

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36
Q

What is NICU

A

neonatal intensive care- different levels

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37
Q

What is PICU

A

Babies aged 28 days and over (also if babies have previously been discharged home)

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38
Q

What week is term

A

40 weeks

39
Q

preterm meaning

A

Preterm is defined as babies born alive before 37 weeks of pregnancy are completed
extremely preterm (less than 28 weeks)
very preterm (28 to 32 weeks)
moderate to late preterm (32 to 37 weeks).

40
Q

what is the leading cause of bacterial sepsis in neonates

A

group b strep infection

41
Q

risk factors for group b strep infection in neonates

A

Previous sibling: GBS+ in pregnancy or GBS+ infection
Maternal colonization
Prolonged rupture of membranes (PROM) ≥ 18 hrs prior
to delivery
Intrapartum maternal fever
Pre-term

42
Q

name of complication of neonatal jaundice

A

bilirubin encephalopathy = brain damage

43
Q

what time range does physiological jaundice occur and when odes it peak

A

more than 24 hrs of life up to 2 weeks
levels peal around 3-5 days of life and start to resolve slowly over 2 weeks

44
Q

Treatment for normal physiological jaundice

A

require reassurance
hydration and adequate feeding +stooling

45
Q

Management for jaundice

A

plot on bilirubin threshold graph
ways to treat: exchange transfusion or phototherapy

46
Q

what gender is muscular dystrophy more common in

A

male

47
Q

what are the 3 main types of muscular dystrophy

A

duchenne (most common)
becker
limb-girdle dystrophies

48
Q

ix for muscular dystrophy

A

serum CK
cardiac -ECG, echo
muscle biopsy and genetic testing

49
Q

appearance of rash caused by neissereria meningitidis

A

non blanching purpuric or petechial rash

50
Q

appearance of stevens - Johnson’s syndrome

A

widespread blisters/ bullae
over erythematous
/macular/haemorrhagic skin

51
Q

symptoms of stevens-Johnson’s syndrome

A

fever
arthralgia
myalgia
conjunctivitis
pneumonitis

52
Q

what is the cause of eczema herpeticum

A

type 1 HSV co-infection with active atopic eczema

53
Q

appearance of molluscum contagiosum(viral)

A

flesh-coloured
dome shaped papules on skin

54
Q

Management for molluscum contagiosum

A

self resolves after approximately 18 months

55
Q

appearance of slapped cheek/parvovirus b19

A

malar rash with circumoral pallor
then a lace like rash on trunk and extremities follows

56
Q

Management for parvovirus b19

A

supportive , self limiting

57
Q

appearance of chickenpox

A

starts on head and trunk then spreads throughout the body
red macules-> papules ->pustules ->crusting

58
Q

symptoms of chickenpox

A

headache
anorexia
URTI
fever
itching

59
Q

Management for chickenpox

A

Antihistamines
paracetamol
acyclovir
VZIG for prophylaxis for contact at risk individual

60
Q

appearance of roseola

A

after 3-5 days -fine maculopapular rash lasting 2 days

61
Q

symptoms of roseola

A

high fever
runny nose
tiredness

62
Q

appearance of rubella

A

maculopapular exanthem
pink and pinpoint starting on
face first then spreading
caudally to trunk and
extremities. Generalised over
24 hours

63
Q

symptoms of rubella

A

Fever, arthritis, arthralgias.
Can lead to a rubella
panencephalitis.(after a week)

64
Q

appearance of measles

A

Maculopapular rash lasts 6-8
days

65
Q

symptoms of measles

A

Fever, coryza, cough, non-
purulent conjunctivitis, Koplik
spots

66
Q

cause of impetigo

A

Staphylococcal aureus or
streptococcal skin infection

67
Q

appearance of impetigo

A

Erythematous macules (may
progress to be
vesicular/bullous) on face,
neck or hands

68
Q

symptoms of impetigo

A

The rash presents as oozing
or crusted blisters which can
be present anywhere on the
body but are usually found
around the mouth and nose

69
Q

Management for impetigo

A

Topical (fusidic acid,
mupirocin) or systemic
(flucloxacillin or clarithromycin)

70
Q

cause of scarlet fever

A

group a strep

71
Q

appearance of scarlet fever

A

The rash has a rough
(sandpaper-like) texture, and
is usually worse in the skin
folds (Pastia’s lines)

72
Q

symptoms of scarlet fever

A

Fever, sore throat, general
fatigue/headache/nausea. 24-
48 hours later, a rash appears
on the abdomen and spreads
to the neck and extremities

73
Q

appearance of tinea capitis (head),
tinea corporis (body)

A

fungal
Pruritic, circular, erythematous
scaly patch spreading
centrifugally. Central clearing
is seen

74
Q

Management for tinea capitis (head),
tinea corporis (body)

A

Daily application of topical
antifungals for 3 weeks.
Systemic therapy indicated in
patients with failed topical
therapy (terbinafine,
fluconazole or itraconazole).

75
Q

diff between pityriasis alba and versicolor

A

alba (eczema) vs
versicolor (fungal)

76
Q

appearance of pityriasis alba and versicolor

A

Small, scaly patches of skin
became hypopigmented (or
sometimes hyperpgimented).
Often the smaller patches join
together over time

77
Q

treatment for pityriasis alba and versicolor

A

The treatment is with topic
antifungal cream or shampoo
(e.g. ketoconazole) if practical
– usually for up to two weeks.
Or if this fails, oral antifungals
(ketoconazole or fluconazole)
can be considered. The colour
can take a few months to
return to normal.

78
Q

appearance of nappy rash

A

An erythematous macular,
papular rash located around
the nappy area that can
spread to the lower abdomen
or upper thighs

79
Q

physiological response of poor pulmonary drainage in LVF

A

pulmonary oedema causes RR to increase, SOB and recession

80
Q

physiological response of low systemic output in LVF

A

SNS activation and adrenaline causes tachycardia, vasoconstriction, pallor and long CRT and sweatiness

81
Q

3 physiological response of RVF

A

peripheral oedema
Hepatomegaly
Ascites

82
Q

examples of acyanotic heart disease

A

L side problem
-L to R shunt
- L ventricle outflow obstruction
- pulmonary stenosis- don’t cause much problem other than murmurs

83
Q

examples of L-R shunts

A

( ventricular septal defect, PDA, ASD,AVSD)

84
Q

examples of left ventricle outflow obstruction

A

AS
Coarctation of aorta
PS

85
Q

causes of cyanotic heart disease

A

R sided obstruction
Right to left shunt

86
Q

3 cyanotic heart disease

A

TOF - tetralogy of fallots
TGA - transposition of the great arteries
PA - pulmonary atresia

87
Q

4 characteristic of fallots tetralogy

A

pulmonary stenosis
overriding aorta
VSD
Right ventricular hypertrophy

88
Q

what type of murmur is heard in tetralogy of fallot

A

Aortic regurge- diastolic decrescendo murmur

89
Q

what is transposition of the great arteries

A

the Pulmonary artery and aorta switches place meaning RV pumps blood into the aorta and LV pumps blood into the Pulmonary artery

90
Q

if the heart in a featus is duct dependant what must you avoid when it comes to treatment and why

A

Oxygen as the duct will close if excess oxygen is present

91
Q

6 differences between an innocent and significant murmur

A

INNCOENT :
1.soft
2.no radiation
3.Praecordial only
4.systolic and short
5.varies with posture
6.well

SIGNIFICANT:
1.harsh
2.radiates
3.audible elsewhere
4.not!
5.doesnt
6.other signs (failure, blue)

92
Q

how does varicella spread

A

respiratory route

93
Q

incubation period for varicella

A

12-14 days

94
Q

description of varicella rash

A

macular-papular- vesicular
dew drop on a
rose petalrose petal”” (vesicle surrounded by halo(vesicle surrounded by halo
erythema) - initially clear then cloudy 2-3 D.erythema) - initially clear then cloudy 2-3 D.
Superficial lesions. Superficial lesions

PA- FCM (10 decks)

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