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Gastroenterology > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Criteria for admission with croup?

A

Any features of moderate or severe croup:
- Frequent barking cough
- Easily audible stridor
- Significant sternal wall retractions
- Agitated, lethargic
**<6 months of age

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2
Q

What are the clinical features of hand, foot and mouth disease?

A
  • Usually affects <10 year olds
  • Systemic sx: fever, cough, abdo pain
  • Mouth ulcers followed by rash affecting hands, feet, face, buttocks
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3
Q

What are the features of measles?

A
  • Initial prodrome: fever, conjunctivitis
  • Koplik spots - white spots on buccal mucosa
  • Rash, beginning behind the ears before spreading around whole body
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4
Q

What are the features of scarlet fever?

A
  • Fever
  • Malaise, headache, nausea/vomiting
  • Strawberry tongue
  • Rash: fine punctate erythema (sandpaper texture)
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5
Q

Management of scarlet fever…

A

Throat swab taken, followed by antibiotics without delay:
1st line = Pen V for 10 d
2nd line = Azithromycin

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6
Q

What are the x-ray findings of necrotising enterocolitis?

A
  • Dilated bowel loops
  • Bowel wall oedema
  • Pneumoperitoneum resulting from perforation
  • Air both inside and outside the bowel wall
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7
Q

What is the management of threadworms?

A

Mebendazole antifungal = 1st line –> given to all household members

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8
Q

What are the clinical features of Kawasaki disease?

A
  • High grade fever (resistant to antipyretics)
  • Conjuctival injection
  • Bright, red cracked lips
  • Strawberry tongue
  • Red palms and soles - desquamation
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9
Q

What is the management of Kawasaki disease?

A
  • High dose aspirin - risk of coronoary anuerysm
  • IV Ig
  • Echo rather than coronary angiography
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10
Q

What is the definition of precocious puberty?

A

Development of secondary sexual characteristics at under 9 in males and under 8 in females.

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11
Q

What is the management of childhood asthma?

A

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

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12
Q

When is pneumonia suspected in bronchiolitis patients?

A

High grade fever (>39C)

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13
Q

What are the feartures of transient synovitis?

A
  • Limp
  • Groin/ hip pain
  • Usually preceded by viral infection
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14
Q

Risk factors for development dysplasia of hips?

A
  • Female gender
  • Breech presentation
  • Positive family history
  • Large baby weight
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15
Q

What clinical tests are used to test for development dysplasia of hips?

A

Barlow = dislocation of hip
Ortalani = relocaton of hip

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16
Q

Immunisation schedule UK :

A

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

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17
Q

What hearing test is carried out at birth?

A

Otoacoustic emission test - part of newborn hearing screening programme
Auditory brainstem repsonse test is carried out if otoacoustic emission test is abnormal

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18
Q

What hearing test is carried out at school entry?

A

Pure tone audiometry

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19
Q

What is the antibiotic treatment for meningitis?

A

<3 months = IV amoxicillin + IV cefotaxime
>3 months = IV cefotaxime or ceftriaxone

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20
Q

What antibitoic prophylaxis is used for meningitis?

A

Ciprofloxacin for all contacts

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21
Q

Why is vitamin K offered to all newborn babies?

A

Babies tend to be deficient of Vitamin K which can impact clotting factors therefore more at risk of haemorrhagic disease

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22
Q

What warrants immediate hospital referral for bronchiolitis?

A
  • Apnoea
  • Severe respiratory distress e.g. grunting, significant chest recessions, RR>70
  • Central cyanosis
  • Persistent SpO2 <92%
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23
Q

When should children be referred urgently for delay in developmental milestones?

A
  • Not sitting upright at 12 months
  • Not walking at 18 months
  • Hand preference before 12 months
24
Q

What neurological signs are seen in Down’s syndrome?

A
  • Hyporeflexia
  • Hypotonia
25
Q

What is roseola infantum?

A

High fever followed by maculopapular rash across trunk and limbs

26
Q

What is vesicoureteric reflux and how does it present?

A

Abnormal backflow of urine from bladder into the ureter –> causing dilatation and more prone to infections
Usually presents as recurrent UTIs in childhood –> can lead to reflux nephropathy (chronic pyelonephritis secondary to VUR)

27
Q

What is the pattern of eczema in children?

A

Young children = eczema affects the extensor surfaces
Older children = eczema affects the flexor surfaces

28
Q

What are the main risk factors of sudden infant death syndrome?

A
  • Putting the baby to sleep prone
  • Parental smoking
  • Prematurity
  • Sleeping in the same bed as parents
29
Q

What are the features of ITP in children?

A
  • Bruising
  • Petechial rash with no fever present- often after viral illness
  • Bloods show isolated thrombocytopaenia
30
Q

What are the fearures of henoch-schonlein purpura?

A
  • Petechial, non-blanching rash of legs and buttcoks
  • Joint pain
  • Abdominal pain
  • Haematuria
31
Q

What is the management of gastro-oesophageal reflux in children?

A

Conservative = advice about head 30 deg head up during feeding
= Trial of thickened formula for formula feeds
= Ensure not being overfed
Medical = Trial of alginate therapy (gaviscon) after feeds
= PPI used if there is distressed behaviour, faltering growth, unexplained feeding difficulties

32
Q

What are the two forms of precocious puberty?

A

Gonadotrophin dependent:
Premature activation of HPA axis
FSH an LH raised

Gonadotrophin independent:
Due to excess sex hormones
FSH and LH low

33
Q

What is the Kocher criteria for septic arthritis?

A
  1. Fever >38.5 C
  2. Non-weight bearing
  3. Raised ESR
  4. Raised WCC
34
Q

What is the management of whooping cough?

A

< 6 months –> admission
Antibiotics –> Azithromycin or Erythromycin

35
Q

What are the key features of necrotising enterocolitis?

A
  • Feeding intolerance
  • Abdominal distension
  • Bloody stools
36
Q

How does Perthe’s disease present?

A
  • Progressive pain and stiffness in hip
  • Resulting in limping
  • Typically occurs in children aged 4-8
37
Q

What is the management of paediatric headache?

A

Ibuprofen = first line
Nasal sumatriptan if older than 12 years old

38
Q

What are the triad of features in shaken baby syndrome?

A
  • Retinal haemorrhages
  • Encephalopathy
  • Subdural haematoma
39
Q

What is the management of nocturnal enuresis

A

1st line = Night time enuresis alarm
2nd line = Desmopressin (can be used for short term relief)

40
Q

What is the management of constipation in children?

A
  1. Movicol
  2. Lactulose
41
Q

What is the most common cardiac complication seen in Down’s syndrome?

A

Ventricular septal defect

42
Q

What is the main differentiating feature of croup and bronchiolitis?

A

Croup = barking cough and inspiratory stridor
Bronchiolitis = wheeze and tachypnoea

43
Q

What is first line drug for ADHD in children?

A

Methylphenidate

44
Q

What are some key features of Turner’s syndrome?

A
  • Webbed neck
  • Short stature
  • Bicuspid aortic valve
  • Primary amenorrhoea
45
Q

What is acrocyanosis?

A

Peripheral cyanosis that is seen in healthy newborn infants - occurs immediately from birth but will resolve within 24-48 hours

46
Q

What is the first sign of puberty in a girl?

A

Breast development at 11.5 years (between 9-13)

47
Q

What is the first sign of puberty in boys?

A

Testicular growth at around 12 years

48
Q

How does congenital diaphragmatic hernia present?

A
  • Dyspnoea
  • Tachypnoea
    ** Due to lungs being compressed from abdominal contents in thoracic cavity
49
Q

How do you differentiate between caput succedeneum and cephalohaematoma?

A

caput succedeneum = swelling that occurs immediately after birth, crosses suture lines

cephalohaematoma = swelling that appears 2-3 days after birth, usually in parietal region, does not cross suture lines

50
Q

What is the BLS algorithm in children?

A
  1. Unresponsive —> shout for help
  2. Look, listen, feel for breath
  3. 5 rescue breaths
  4. Check for brachial/ femora pulse
  5. Start compressions: ventilations 15:2 ratio (if two trained staff, otherwise 30:2)
51
Q

What are some key risk factors for developing RDS?

A
  • Premature birth
  • Male sex
  • Diabetic mother
  • C section
52
Q

What is the management of RDS?

A

Oxygen
Assisted ventilation
Exogenous surfactant

53
Q

What are the different time periods of neonatal jaundice?

A

Jaundice in first 24 hours after birth –> pathological
Jaundice from 2-14 days –> physiological
Jaundice after 14 days –> prolonged

54
Q

Features of intussusception…

A
  • intermittent, severe crampy abdominal pain
  • Inconsolable crying
  • Drawing knees up when in pain
  • Bloodstained stool –> “red currant jelly”
55
Q

Features of lead poisoning…

A
  • Colicky abdominal pain
  • Anaemia
  • Encephalopathy –> raised ICP

Gastroenterology (2 decks)

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