Paediatrics Flashcards
Criteria for admission with croup?
Any features of moderate or severe croup:
- Frequent barking cough
- Easily audible stridor
- Significant sternal wall retractions
- Agitated, lethargic
**<6 months of age
What are the clinical features of hand, foot and mouth disease?
- Usually affects <10 year olds
- Systemic sx: fever, cough, abdo pain
- Mouth ulcers followed by rash affecting hands, feet, face, buttocks
What are the features of measles?
- Initial prodrome: fever, conjunctivitis
- Koplik spots - white spots on buccal mucosa
- Rash, beginning behind the ears before spreading around whole body
What are the features of scarlet fever?
- Fever
- Malaise, headache, nausea/vomiting
- Strawberry tongue
- Rash: fine punctate erythema (sandpaper texture)
Management of scarlet fever…
Throat swab taken, followed by antibiotics without delay:
1st line = Pen V for 10 d
2nd line = Azithromycin
What are the x-ray findings of necrotising enterocolitis?
- Dilated bowel loops
- Bowel wall oedema
- Pneumoperitoneum resulting from perforation
- Air both inside and outside the bowel wall
What is the management of threadworms?
Mebendazole antifungal = 1st line –> given to all household members
What are the clinical features of Kawasaki disease?
- High grade fever (resistant to antipyretics)
- Conjuctival injection
- Bright, red cracked lips
- Strawberry tongue
- Red palms and soles - desquamation
What is the management of Kawasaki disease?
- High dose aspirin - risk of coronoary anuerysm
- IV Ig
- Echo rather than coronary angiography
What is the definition of precocious puberty?
Development of secondary sexual characteristics at under 9 in males and under 8 in females.
What is the management of childhood asthma?
1= SABA
2= SABA + low-dose ICS
3= SABA + low dose ICS + LTRA
4= SABA + low dose ICS + LABA
5 = SABA + maintenance and reliever therapy (MART)
With under 5s:
1= SABA
2 = SABA +low dose ICS
3= SABA + low dose ICS +LTRA
When is pneumonia suspected in bronchiolitis patients?
High grade fever (>39C)
What are the feartures of transient synovitis?
- Limp
- Groin/ hip pain
- Usually preceded by viral infection
Risk factors for development dysplasia of hips?
- Female gender
- Breech presentation
- Positive family history
- Large baby weight
What clinical tests are used to test for development dysplasia of hips?
Barlow = dislocation of hip
Ortalani = relocaton of hip
Immunisation schedule UK :
Birth = BCG if risk factors
2 months = 6 in 1 vaccine (diphtheria, polio, whooping cough, tetanus, Hib, Hep B), oral rotavirus, Men B
3 months = 6 in 1 vaccine (diphtheria, polio, whooping cough, tetanus, Hib, Hep B), oral rotavirus, PCV
4 months = 6 in 1 vaccine (diphtheria, polio, whooping cough, tetanus, Hib, Hep B), Men B
12-13 months = MMR, PCV, Men B, Hib/Men C
3-4 years = 4 in 1 vaccine (diphtheria, polio, whooping cough, tetanus), MMR
12-13 years = HPV for girls and boys
13-18 years = Men ACWY
What hearing test is carried out at birth?
Otoacoustic emission test - part of newborn hearing screening programme
Auditory brainstem repsonse test is carried out if otoacoustic emission test is abnormal
What hearing test is carried out at school entry?
Pure tone audiometry
What is the antibiotic treatment for meningitis?
<3 months = IV amoxicillin + IV cefotaxime
>3 months = IV cefotaxime or ceftriaxone
What antibitoic prophylaxis is used for meningitis?
Ciprofloxacin for all contacts
Why is vitamin K offered to all newborn babies?
Babies tend to be deficient of Vitamin K which can impact clotting factors therefore more at risk of haemorrhagic disease
What warrants immediate hospital referral for bronchiolitis?
- Apnoea
- Severe respiratory distress e.g. grunting, significant chest recessions, RR>70
- Central cyanosis
- Persistent SpO2 <92%
When should children be referred urgently for delay in developmental milestones?
- Not sitting upright at 12 months
- Not walking at 18 months
- Hand preference before 12 months
What neurological signs are seen in Down’s syndrome?
- Hyporeflexia
- Hypotonia
