Paediatrics Flashcards
Give 4 clinical signs of bronchiolitis
Wheeze
Cough
commonest cause of bronchiolitis
respiratory synctial virus
Investigation to confirm bronchiolitis
CXR
Signs of bronchiolitis that would prompt admission
Tracheal tugging
Inspiratory ribs
What would a CXR show in bronchiolitis?
Enlarged bronchi
Consolidation
Except for difficulty breathing, what other symptoms are associated with croup?
Cough
Malaise
Other than croup, give 2 other causes of developing stridor in a 4 year old
Name 2 viruses commonly responsible for causing croup
parvovirus
RSV
Treatment prescribed for croup
dexamethasone
In severe croup, what might be tried before escalation to ICU?
IV hydrocortisone?
What are severe signs associated with croup?
At what age does congenital hypertrophic pyloric stenosis usually present?
2 weeks?
Can bile be present in congential hypertrophic pyloric stenosis?
no - the pylorus is above the sphincter of oddy
How is the vomiting after meals in pyloric stenosis described?
projectile white
Where do you palpate to feel the pylorus in the abdomen during feeds?
centre?
What acid-base disturbance would you expect to find in pyloric stenosis?
metabolic alkalosis - from vomiting
Name the four sections of the stomach
fundus
pylorus
body
c or a?
What 2 electrolyte abnormalities are a/w pyloric stenosis?
hypokalaemia
hyperchloraemia
What gender is more predisposed to SUFE?
boys
What age range is typical for SUFE?
10-12?
Give 2 risk factors other than gender for a SUFE?
Obesity
FHx
What cartilage makes up the epiphyseal plate?
chondreal
What is found on examination in SUFE?
shortened externally rotated leg?
Name 3 differential diagnoses for hip pain in a child
SUFE
Transient synovitis
Hip dislocation
P..?
What is jaundice?
uric acid in the skin (yellow)
Give 2 causes of jaundice within the first 24 hours of life
Biliary atresia
Haemolytic anaemia
Give 2 investigations (other than bilirubin) for jaundice in first 24h
Rhesus status
ultrasound?
Pale stools and raised conjugated bilirubin
Cause of prolonged jaundice in a baby?
obstructive
What complication may occur if raised levels of unconjugated bilirubin remain untreated?
Hepatic encephalopathy?
Give 2 methods of treating neonatal jaundice?
Phototherapy
Ursodeoxycholic acid
What prenatal investigation can be used to detect congenital heart diseases?
In which direction is blood flowing in the heart in acyanotic congenital heart disease?
left to right
Give 2 causes of acyanotic congenital heart disease
Ventricular septal defect
Atrial septal defect
In which direction is blood flowing in cyanotic heart disease?
right to left
Give 2 causes of cyanotic congenital heart disease?
Tetralogy of fallot
Transposition of the great arteries
In decompensated congenital heart disease, give 2 clinical features
What is Eisenmenger’s syndrome?
reversal of left to right shunt
Apart from prematurity, give 2 risk factors for IRDS
maternal drug use
What substance is deficient in the lungs of premature babies, giving rise to IRDS?
surfacant
What cells in the lungs produce this substance?
alveolar
What prenatal medication can be given to prevent respiratory distress syndrome?
dexamethasone
Give 2 signs of IRDS
inspiratory recession
tracheal tugging
What is seen on a chest X-ray in a baby with IRDS?
When breaking bad news, give 2 things a doctor can do to ensure a good consultation
Setting: find a quiet room
Perception: what do you know so far?
Invitation: would you like to know this information?
Knowledge: unfortunately ‘clear information in sizeable chunk then leave silence’
Empathy: this must be really hard
Strategy: support services
In what age range do febrile convulsions typically occur?
3-6
Give 2 features that mean febrile seizures are classified as complex febrile convulsions
lasting > 5 min
2 with no break
Give 3 investigations in febrile convulsions
Give 3 pieces of information to give to parents prior to child being discharged after febrile seizure
Safety net
Paracetamol
Bath?
Define cerebral palsy
brain damage from a hypoxic event
Give 2 of the subtypes of cerebral palsy, using the classification system based on movement disorder
Akynethias
Spastic
Apart from motor complications, give 2 other clinical features that a child with cerebral palsy may have
cognitive
developmental delay
sensory
social
Give 2 professional groups other than doctors that may be involved in the care of a child with cerebral palsy
Physiotherapists
Occupational therapists
SALT
Name 2 medications a child with cerebral palsy may be prescribed to help with muscle spasm
Bisconate
In which gender are intussusceptions more common
boys
Describe the pathogenesis of intussusception
the ileum invaginates into the colon causing obstruction
Give 2 possible findings on abdo x-ray of intussception
mass
trapped gas
What non-surgical management option may be performed in intussusception?
enema
What are 2 indications for laparotomy in intussuception
failed non-surgical
haemodynamically unstable?
