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Y3 GP > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

If you suspect a child is being abused in primary care, what are the next steps?

A
  1. Document
  2. Internal referral to safe guarding team within the practice
  3. GPs should make a referral to the Local Authority Children’s Social Care Services. This is typically done through the Local Safeguarding Children Board (LSCB) or its equivalent in the region. This may involve contacting the local authority’s social services department.
  4. If there is immediate risk or suspicion of criminal activity, the police should be informed. In some cases, the police may already be involved in collaboration with social services.
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2
Q

What are some risk factors for plantar fasciitis?

A

Repetitive impact activities (running, jumping)
Prolonged standing
Flat feet or high-arched feet
Tight Achilles tendon or calf muscles
Obesity

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3
Q

What percentage of cartilage is lost in stage 4 osteoarthritis?

A

60%

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4
Q

What percentage of cartilage is lost in stage 1 osteoarthritis?

A

10%

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5
Q

What length of time do you have to have symptoms to be diagnosed with long covid?

A

12 weeks

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6
Q

Why can’t steroids be given before colonoscopy?

A

Because they mask the inflammation

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7
Q

What two conditions should you think of in a man with back pain?

A

Multiple myeloma and prostate cancer

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8
Q

How does codeine cause constipation?

A

Activation of mu-opioid receptors inhibits the release of acetylcholine, a neurotransmitter that stimulates muscle contractions in the GI tract.

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9
Q

What are some risk factors for GORD in children?

A

Premature birth
Family history
Obesity
Hiatus hernia
History of repaired congenital diaphragmatic hernia/oesophageal atresia
Neurodisability (cerebral palsy)

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10
Q

With GORD in children, what would indicate same-day admission?

A

Haematemesis
Melaena
Dysphagia

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11
Q

What is the treatment for children aged 1-2 with suspected GORD?

A

4 week trial of omeprazole or H2RA

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12
Q

What is Positing?

A

When babies vomit out a bit of milk (normal)

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13
Q

With GORD what treatment works?

A
  • Burp
  • Put child at 30 after eating
  • Not overfeeding, little and often
  • Thickening the formula (cornstarch, rice starch)
  • Gaviscon (mix in the milk)
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14
Q

What symptoms indicate specialist assessment?

A
  • Bild-stained vomit, abdominal distension, blood in stool
  • Persistent faltering growth
  • Feeding aversion
  • Unexplained iron deficiency anaemia
  • Suspected complications (aspiration, otitis media, dental erosions)
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15
Q

What is mesenteric adenitis?

A

Mesenteric adenitis describes inflamed abdominal lymph nodes. This presents with abdominal pain, usually in younger children. This is often associated with tonsillitis or an upper respiratory tract infection. No specific treatment is required.

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16
Q

What is an abdominal migraine?

A

Abdominal migraine:
Presents with recurrent moderate to severe abdominal pain, nausea, vomiting, and paleness.
Primarily affects children but can occur in adults.
Believed to share mechanisms with traditional migraines.
Diagnosis:
Based on clinical presentation and exclusion of other causes.
Management:
Avoiding triggers and maintaining regular lifestyle habits.
Medications for prevention and acute treatment, including prophylactic drugs and pain relievers.
Psychological interventions like cognitive-behavioral therapy.

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17
Q

Why do children get a wheeze with a viral infection?

A

Airway inflammation, damaged by the virus- leaky endothelium, fluid in the airway, airways get tighter.

Turbulent air, vibrates against the walls- give the wheeze.

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18
Q

In children, what are the characteristics of asthma?

A

Wheeze is recurrent and episodic. Present even without infection (long history of a wheeze, SOB)
Wheeze in response to triggers
No fever
Dry cough
History of atopy

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19
Q

What are the characteristics of an inhaled foreign body?

A

Sudden onset wheeze (unilateral)
Initial choking episode
No fever
Dry cough
History/collateral is important

Patients need to go straight to A&E- CXR and remove the foreign body

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20
Q

What is a radiographic feature of an aspirated foreign body?

A

A lung volume that does not change during the respiratory cycle

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21
Q

What are some complications of an inhaled foreign body?

A

Pneumonia
Bronchitis
Bronchospasm
Pneumothorax
Bronchiectasis

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22
Q

What is Osgood-Schlatter Disease?

A

Is a type of osteochondrosis characterized by inflammation at the tibial tuberosity

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23
Q

How do you diagnose Osgood-schlatter’s?

A

Diagnosis is primarily clinical, based on the characteristic signs and symptoms
Imaging studies (x-ray, ultrasound, or MRI) may be used to confirm the diagnosis

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24
Q

How do you manage Osgood-schlatter’s?

A

Initial management focuses on pain control with analgesics and modification of physical activities.
Non-steroidal anti-inflammatory drugs (NSAIDs) can be used for short-term symptom relief.
Encouragement of stretching and strengthening exercises, particularly for the quadriceps and hamstring muscles.
In severe cases, temporary immobilization with a knee brace or cast may be necessary.

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25
Q

What is infantile colic?

A

Infantile colic is a term used to describe severe, often fluctuating, and uncontrollable crying or fussiness in an otherwise healthy and well-fed infant. Colic is a common condition that usually begins within the first few weeks of life and typically resolves on its own by the time the baby is three to four months old.

26
Q

What are characteristics of intussusception in kids?

A

Severe abdo pain, vomiting and change in stool consistency- currant jelly stool.

27
Q

What are the characteristics of pyloric stenosis?

A

Projectile vomiting after feeds, weight loss and feeding difficulties.

28
Q

What is the treatment of threadworm for children over 6 months?

A

Mebendazole combined with hygiene measures.

Bend- worms are bendy

29
Q

What is threadworm?

A

Itchy bum, despite washes, worse at night.
Wetting the bed
Extreme itching around the anus, particularly at night-young girls may also complain of severe itching around the vulva and vagina, during the night or soon after going to bed
Irritability and waking up during the night

30
Q

What personal hygeine measures do you take with threadworm?

A

Hot washes for clothes, bedding because they lay their eggs. Kids can re-infect themselves easily.

31
Q

Who can you ask for help from with regards to child safeguarding?

A
  • School staff
  • Early years practitioners
  • Child minders
  • GPs
  • The police
32
Q

Who should you refer onto with regards to a child’s safety

A

Local authority children’s social care

33
Q

What happens after you make a referral to social care?

A

Social Worker Response: After you report a concern, a social worker should reply within one working day, informing you of the actions they plan to take.

Possible Further Assessment: You might be asked to help assess the child further, either through an early help assessment or a child in need assessment, led by a social worker.

Strategy Discussion: If the social worker suspects the child is at risk of significant harm, a strategy discussion is held by the local authority. You may contribute by providing information and agreeing on necessary actions.

Child Protection Conference: If concerns are confirmed, an initial child protection conference is organized to decide on the child’s safety, health, and development. If you’re involved with the child (e.g., a teacher or health worker), you’ll be invited.

Core Group Formation: The conference decides on a core group of practitioners and family members to develop and implement the child protection plan. This group meets within 10 working days.

Child Protection Plan: The core group, including you if you’re a member, works on developing and implementing the child protection plan.

Detailed Process: The entire process is detailed in the “Working Together to Safeguard Children (2015)” statutory guidance for further reference.

34
Q

What is the red book?

A

The “red book” is a special book given to parents when a baby is born in the UK. It has a red cover, and in it, you can keep important information about your child’s health and development. It includes details about vaccinations, how your child is growing, and advice for parents on things like feeding and safety. Doctors and nurses also use the red book to write down important information during check-ups. It’s a helpful guide for parents to keep track of their child’s health as they grow up.

35
Q

What is the ages and stages questionnaire?

A

Your health visiting team will send you a questionnaire, known as the “Ages and Stages Questionnaire” or ASQ-3, to fill in before your child’s 9 to 12-month and 2-year development reviews

Assesses communication, fine and gross motor function.

36
Q

When do babies have their heel prick test and what is tested?

A

Between 5 and 8 days old.

PKU
Hypothyroidism
Cystic fibrosis
Sickle cell disorders
Maple syrup urine disease (A rare metabolic disorder that affects the breakdown of certain amino acids)

37
Q

When do health visitors go to your home?

A

10th and 14th day

38
Q

When are vaccinations offered for children?

A

8 weeks
12 weeks
16 weeks
12 months

39
Q

What are the gross motor development stages for newborns, 6-8 weeks, 12 months and 2-2.5 years?

A

Newborn
- Limbs flexed, symmetrical pattern
- Marked head lag on pulling up

6-8 weeks
- Raises head to 45 degress in prone

12 months
- Walks unsteadily- a broad gait with hands apart
- Limit age is 18 months

2-2.5 years
- Runs and jumps

40
Q

What are the vision and fine motor development stages for 6 weeks, 10 months and 2-5 years?

A

6 weeks
- Follows moving object or face by turning the head
- Limit age 3 months

10 months
- Mature pincer grip
- Limit age is 12 months

2-5 years
- Line 2 years
- Circle- 3 years
- Cross- 3.5 years
- Square 4 years
- Triangle- 5 years

41
Q

What is the rooting reflex in babies?

A

This reflex starts when the corner of the baby’s mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and root in the direction of the stroking. This helps the baby find the breast or bottle to start feeding. This reflex lasts about 4 months.

42
Q

When is constipation most common in children?

A

Toilet training times
Moving school, house

43
Q

What is the first line treatment for constipation in children?

A

Movicol- can add to fruit squash

44
Q

What is maintenance laxative treatment?

A

Movicol for at least several weeks after regular bowel movements are established.

Should remain on laxatives until toilet training well established.

45
Q

What safety-netting advice is appropriate?

A
  • Very distressed, soiling their pants
  • Has blood or mucus
  • Is losing weight
  • Is unusually tired
46
Q

What are some emollients you can use for eczema?

A

E45 and double base cream

47
Q

What are skin complications of eczema?

A

Acute exacerbations bacterial and viral.
Oozing skin, blisters, sores, shivery, malaise.

48
Q

What would you do if hydrocortisone is not working in eczema?

A

Use Betnoate (stronger but for a shorter duration of time)

Hydrocortisone is basically nothing. Can be used under the eyes or the pubic area. Will not thin the skin.

2 weeks management- should be working then referral under Dermatology.

49
Q

Management of hayfever

A
  • Wear sunglasses
  • Nasal barriers- vaseline
  • Met office- monitor pollen and weather
  • Keep windows shit
  • Avoid triggers
  • OTC antihistamines (certrizine/loratadine)
50
Q

What symptoms should you safety net for in allergeis?

A

Anaphylactic shock

  • Difficulty breathing
  • Severe swelling
  • Chest pain/tightness

Or could be underlying asthma

51
Q

Are there systemic symptoms for steroid nasal inhalers?

A

Locally absorbed, no systemic symptoms

Even pregnant women can use it

52
Q

What are the four functional areas of development in children?

A

Gross motor
Vision and fine motor
Hearing, speech and language
Social, emotional and behavioural

53
Q

What age should a child be walking?

A

12 months

Walks unsteadily- a broad gait with hands apart
Limit age- 18 months

Walks steadily by 15 months

54
Q

How old should a child be when they start using the words ‘Dada or Mama’?

A

7-10 months

55
Q

What age should a child have bowel control?

A

2 years

56
Q

When should a child be dry by night?

A

4 years

57
Q

What is discussed at the 6 week check up?

A
  • Key components of the 6-week baby check include:
    Full physical examination of the baby, including:
    Checking for congenital abnormalities (e.g., heart murmurs, hip dysplasia, undescended testes).
    Monitoring growth parameters (weight, length, head circumference).
    Assessing neurodevelopmental progress (e.g., reflexes, tone).
    Review of feeding and sleeping patterns.
    Discussion of immunisation schedule and upcoming vaccinations.
    Screening for postnatal depression in the mother.
    Addressing any parental concerns or questions regarding the baby’s health and development.
58
Q

What does a health visitor do?

A

Feeding Support: Provide guidance on breastfeeding, formula feeding, and weaning.
Growth Monitoring: Track baby’s growth and developmental milestones.
Parental Advice: Offer advice on sleeping, crying, and general baby care.
Maternal Health: Screen for postnatal depression and support maternal mental health.
Safety and Immunisation: Advise on home safety, accident prevention, and the immunisation schedule.

59
Q

What is the monoclonal antibody drug used to prevent RSV?

A

Palivizumab is a monoclonal antibody which is used to prevent respiratory syncytial virus (RSV) in children who are at increased risk of severe disease.

60
Q

How often would a health visitor visit you after the 10th day?

A

Summary of Regular Health Visitor Visits After the 10th Day
6-8 Weeks: Developmental review.
3-4 Months: Developmental review and support.
9-12 Months: Comprehensive health and development review.
2-2.5 Years: Focused developmental review.

61
Q

When can most babies sit without support?

A

7-8 months

Y3 GP (13 decks)

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