Paediatrics Flashcards
What is seen in U&Es in pyloric stenosis?
Hypochloraemic, hypokalaemic alkalosis due to persistent vomiting
What is treatment of malrotation?
Ladd’s procedure
What signs are seen in coarctaction of the aorta in kids?
Radio-femoral delay, murmur heard better over the back
What is the gold standard for diagnosis of Hirschsprung’s disease?
Rectal biopsy
Which gender is more at risk of developing DDH?
Female
Pyloric stenosis management
Ramstedt pyloromyotomy
Sign seen on examination / Ix in pyloric stenosis
Olive-sized mass in the right upper quadrant
Symptoms of intussusception
Episodic crying and drawing of the legs towards the chest
USS results of intussusception
Target sign
Management of intussusception
Air insufflation
Which type of congenital cyanotic heart disease presents earliest?
Transposition of the great arteries. Life-threatening condition
What is seen on X-ray in transposition of the great arteries.
Egg on string appearance
What’s seen on X-ray in tetralogy of Fallot?
Boot-shaped heart
Initial drug management of transposition of the great arteries
Continuous IV prostaglandin infusion to keep PDA patent until surgery
Which antibiotics are used in meningococcal disease in < 3 month olds?
Amoxicillin + cefotaxime (amoxicillin for listeria)
Which antibiotics are used in meningococcal disease in > 3 month olds?
Just Cefotaxime/ceftriaxome - no need for amoxicillin
Where do chickenpox rashes start?
Face and torso
Why does cystic fibrosis lead to diabetes?
Thick mucus damaging the pancreas, limiting insulin production
Most common complication and cause of death in measles?
Pneumonia
Complication of mumps
Orchitis (a common trick option in answers for measles questions)
How does measles present?
Fever and a blotchy rash > initially just behind his ears but is now all over his body > clusters of white lesions on the buccal mucosa
What is the weight cut-off for macrosomia?
> 4 kg
Which drugs are contraindicated in chickenpox and why? (2)
NSAIDs can increase the risk of necrotising fasciitis in patients with chicken pox
Aspirin - Reye’s syndrome
Gait in a missed DDH diagnosis
Trendlenberg gait and leg length discrepancy
Which murmur is found in Turner’s?
aortic coarctation (systolic)
Antibiotic used in whooping cough
Azithromycin or clarithromycin if the onset of cough is within the previous 21 days
Analgesia of choice in children
Paracetamol
Initial management of Hirschprung’s
Bowel irrigation/wash-outs
Definitive management of Hirschprung’s
Anal pull through procedure
Follow-up required after 1st seizure in a child
Urgent referral to paediatric neurologist (within 2 weeks)
Most common complication of measles
Acute otitis media
When is the MMR vaccine given
1 year AND 3 years + 4 months
Triad seen in Alport’s syndrome
Renal failure, sensorineural hearing loss and ocular abnormalities in a child
Why do we give allopurinol in acute lymphoblastic leukaemia?
To prevent hyperuricemia => Tumour lysis syndrome
What is the genetic mutation of the Philadelphia chromosome?
Translocation of chromosomes 9 and 22
What condition predisposes you to ALL
Trisomy 21 (Down’s syndrome)
If combined test is suggestive of Down’s syndrome, what further testing would you recommend ?
Chorionic Villus Sampling / Amniocentesis
Define a hernia
Protrusion of part or whole of an organ or tissue through the wall of the cavity that normally contains it
Direct vs indirect inguinal hernia
In direct inguinal hernias, the bowel enters the inguinal canal ‘directly’ through a weakness in the posterior wall of the canal, whereas..
In indirect inguinal hernias, the bowel enters the inguinal canal via the deep inguinal ring
Which type of hernia is more common in infants (direct or indirect) and why?
Indirect inguinal hernia
(Occur because of a) patent processus vaginalis
6 in 1 vaccine
Diphtheria / Hepatitis B / Whooping Cough / Tetanus / Polio / H influenzae B
What vaccines do babies receive at 2 months
6 in 1, MenB, rotavirus
Pathophysiology of pyloric stenosis
Hypertrophy of the pylorus prevents food travelling from the stomach into the duodenum as normal
After feeding, there is powerful peristalsis against the narrow pylorus causing food to be ejected into the oesophagus leading to projectile vomiting
Types of jaundice in neonate and causes
Pathological - ABO incompatibility, Rhesus disease, G6PD deficiency, Spherocytosis
Prolonged - Biliary atresia, Hypothyroidism, Breast milk jaundice, Infection
What happens if jaundice is left untreated in neonate
Kernicterus
Tests for DDH in NIPE exam
Ortolani and Barlow tests
