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REVISION > PAEDIATRICS > Flashcards

PAEDIATRICS Flashcards

1
Q

What organism causes hand, foot and mouth?

A

Cossackie A16

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2
Q

Whats the most common childhood leukaemia?

A

ALL

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3
Q

Murmur associated with Turner’s syndrome?

A

Ejection systolic murmur loudest over aortic valve - due to bicuspid aortic valve

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4
Q

Slipped capital femoral epiphysis symptoms?

A

Hip, groin, medial thigh or knee pain
Loss of internal rotation of leg in flexion
Often in higher percentiles for weight

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5
Q

Which infants require routine USS for DDH of hip at 6 weeks?

A

first-degree family history of hip problems in early life
breech presentation at or after 36 weeks gestation, irrespective of presentation at birth or mode of delivery
multiple pregnancy

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6
Q

Which TORCH infection is most commonly associated with chorioretinitis in a newborn?

A

Toxoplasmosis

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7
Q

A pregnant woman develops a rash that begins on her face and spreads to her body, accompanied by a low-grade fever and lymphadenopathy. What TORCH infection is she likely experiencing?

A

Rubella

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8
Q

Which TORCH infection is the most common congenital infection?

A

Cytomegalovirus

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9
Q

Which TORCH infection can cause hearing loss, vision impairment, LBW and microcephaly?

A

Cytomegalovirus

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10
Q

How can toxoplasmosis be caught?

A

By eating undercooked meat or contact with cat faeces containing the parasite toxoplasma gondii

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11
Q

In which TORCH infection might you find blueberry muffin spots in a newborn?

A

Rubella
These are congenital dermal haematopoeisis

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12
Q

Which TORCH infection is most likely responsible for intracranial calcifications, hydrocephalus and chorioretinitis?

A

Toxoplasmosis

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13
Q

Which TORCH infection is most likely responsible for congenital heart defects, deafness, cataracts?

A

Rubella

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14
Q

What is in the 6-in-1 vaccine?

A

Diphtheria
Pertussis
Polio
Hep B
HiB
Tetanus

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15
Q

What is in the 4-in-1 vaccine?

A

Diphtheria
Polio
Tetanus
Pertussis

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16
Q

What is in the 3-in-1 vaccine?

A

Polio
Tetanus
Diphtheria

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17
Q

What vaccines are given at 8 weeks?

A

6 in 1
Men B
Rotavirus

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18
Q

What vaccines are given at 12 weeks?

A

6 in 1
Rotavirus
PCV

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19
Q

What vaccines are given at 16 weeks?

A

6 in 1
Men B

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20
Q

What vaccines are given at 1 year?

A

PCV
MMR
Men B
HiB/Men C

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21
Q

What vaccines are given at 3 years and 4 months?

A

4 in 1 booster
MMR

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22
Q

What vaccines are given at 12-13 years?

A

HPV

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23
Q

What vaccines are given at 14 years?

A

Men ACWY
3 in 1 booster

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24
Q

What vaccines are given at 65 years?

A

Annual flu
Pneumococcal
Shingles (used to be 70 but now can be given at 65! At 50 if immunocompromised)

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25
Q

What type of vaccine is diphtheria?

A

Toxoid

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26
Q

What type of vaccine is pertussis?

A

Toxoid

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27
Q

What type of vaccine is oral polio?

A

Live attenuated

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28
Q

What type of vaccine is hepatitis B?

A

A subunit vaccine

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29
Q

What type of vaccine is HiB?

A

A conjugate vaccine

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30
Q

What type of vaccine is tetanus?

A

A toxoid

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31
Q

What type of vaccine is oral rotavirus?

A

A live attenuated vaccine

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32
Q

What type of vaccine is Men B?

A

A conjugate vaccine

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33
Q

What type of vaccine is PCV?

A

A conjugate vaccine

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34
Q

What type of vaccine is MMR?

A

A live attenuated vaccine

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35
Q

What type of vaccine is Men C?

A

A conjugate vaccine

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36
Q

What type of vaccine is HPV?

A

A subunit vaccine

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37
Q

What type of vaccine is Men ACWY?

A

A conjugate vaccine

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38
Q

What type of vaccine is influenza?

A

A live attenuated vaccine

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39
Q

For which hepatitis are there vaccines?

A

A
B

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40
Q

Which types of vaccines often require booster doses to maintain immunity?

A

Inactivated preparations
Toxoid
Subunit and conjugate

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41
Q

Examples of live attenuated vaccines?

A

BCG
MMR
Influenza intranasl
Oral rotavirus
Oral polio
Yellow fever
Oral typhoid

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42
Q

Examples of inactivated vaccines?

A

Rabies
Hep A
Influenza IM

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43
Q

Examples of toxoid vaccines?

A

Tetanus
Diphtheria
Pertussis

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44
Q

Examples of subunit and conjugate vaccines?

A

Pneumococcus
Haemophilus
Meningococcus
Hep B
HPV

45
Q

Characteristics of innocent murmurs?

A

Soft blowing in pulmonary area or short buzzing in aortic area
Systolic - no diastolic component!
Symptomless - no thrill, added sounds, other abnormalities
Situation dependent - varies with posture

46
Q

Types of innocent heart murmurs?

A

Venous hums
Stills murmur

47
Q

What do venous hums sound like?

A

Continuous blowing murmurs heard just below the clavicles

48
Q

What causes venous hums?

A

Turbulent blood flow in the great veins returning blood to the heart

49
Q

What does a stills murmur sound like?

A

Low-pitched sound heard at the lower left sternal edge

50
Q

Differentials of a pan systolic murmur?

A

MR
TR
VSD

51
Q

Differentials of an ejection systolic murmur?

A

AS
Pulmonary stenosis
HOCM

52
Q

What does VSD sound like? How does it present?

A

Pan systolic murmur heard at the left lower sternal border
Can present with failure to thrive or features of HF

53
Q

What causes VSDs?

A

Congenital are associated with chromosomal disorders - downs, edwards, pataus, cri-du-chat. OR congenital infections

Can also be acquired e.g. post MI

54
Q

What is the most likely congenital heart defect to be found in adulthood?

A

Atrial septal defects

55
Q

Mortality of ASD?

A

50% by age 50

56
Q

2 types of ASD and which is more common?

A

Ostium primum
Ostium secundum - more common 70%

57
Q

Whats the murmur of ASDs?

A

Ejection systolic murmur with fixed splitting of S2

58
Q

What is a fixed split second heart sound?

A

Splitting of the heart sound does not change with inspiration and expiration

This occurs in ASD as blood is flowing from L atrium into R atrium increasing the volume of blood the R ventricle has to empty before the pulmonary valve can close

59
Q

Risk factors for PDA?

A

Prematurity
Being born at high altitude
Maternal rubella infection in first trimester

60
Q

Features of PDA?

A

Left subclavicular thrill
Continuous machinery murmur
Large volume bounding collapsing pulse
Wide pulse pressure
Heaving apex beat

HF symptoms : SOB
Failure to thrive
Multiple respiratory infections

61
Q

What is the most common type of cyanotic congenital heart disease?

A

Tetralogy of fallot

62
Q

What are the 4 features of tetralogy of fallot?

A

ventricular septal defect (VSD)
right ventricular hypertrophy
right ventricular outflow tract obstruction = pulmonary stenosis
overriding aorta

63
Q

What determines the degree of clinical severity in tetralogy of falloy?

A

The severity pf the right ventricular outflow tract obstruction

64
Q

What murmur does tetralogy of fallot cause?

A

Ejection systolic loudest in pulmonary area due to pulmonary stenosis

65
Q

CXR findings in tetralogy of fallot?

A

Boot-shaped heart

66
Q

What are causes of cyanotic heart disease?

A

Tetralogy of Fallot
Transposition of the great arteries
Truncus arteriosus
Total anomalous pulmonary venous return
Tricuspid atresia
Ebsteins anomaly

67
Q

What is acrocyanosis?q

A

Cyanosis around the mouth and extremities
Seen in healthy babies
Occurs immediately after birth and may persist for up to 48 hours

68
Q

What causes transposition of the great arteries?

A

Caused by failure of the aorticopulmonary septum to spiral during septation which means the aorta leaves the R ventricle and pulmonary trunk leaves the L ventricle q

69
Q

Who is at greater risk of transposition of the great arteries?

A

Children of diabetic mothers

70
Q

What is eisenmengers syndrome?

A

Reversal of a L to R shunt in a congenital heart defect due to pulmonary hypertension (VSD, ASD, PDA)

71
Q

What is Ebstein’s anomaly?

A

Congenital heart defect characterised by low insertion of the tricuspid valve resulting in a large atrium and small ventricle

72
Q

What can cause Ebstein’s anomaly?

A

Exposure to lithium in utero

73
Q

What do 80% of pts with Ebstein’s anomaly also have?

A

A patent foramen ovale or ASD

74
Q

What can cause persistent or severe neonatal hypoglycaemia?

A

Preterm birth
Maternal DM
IUGR
Hypothermia
Neonatal sepsis
In born errors of metabolism
Beckwith-wiedemann syndrome
Nesidioblastosis

75
Q

Why is transient neonatal hypoglycaemia normal?

A

Transition from placental nutrition to- may be issues with milk supply etc
Increased metabolism e.g. for maintaining body temp
Liver glycogen stores may take a while to activate

76
Q

Organisms causing meningitis in children <3 months?

A

GBS
E. coli
Listeria monocytogenes

77
Q

Organisms causing meningitis in children 1 month-6 years?

A

N. Meningitidis
Strep pneumoniae
H. Influenzas

78
Q

Organisms causing meningitis in children >6 years?

A

N. Meningitidis
Strep pneumoniae

79
Q

2 inherited causes of unconjugated hyperbilirubinaemia?

A

Gilberts syndrome
Crigler-najjar syndrome

80
Q

2 inherited causes of conjugated hyperbilirubinaemia?

A

Dubin-Johnson syndrome
Rotor syndrome

81
Q

When is jaundice in the newborn period considered pathological?

A

First 24 hours
Prolonged i.e. after 14 days (21 days if premature)

82
Q

Causes of neonatal jaundice in the first 24 hours?

A

Rhesus haemolytic disease
ABO haemolytic disease
Hereditary spherocytosis
G6PD deficiency

83
Q

Causes of prolonged neonatal jaundice?

A

Biliary atresia
Hypothyroidism
Galactosaemia
UTI
Breast milk jaundice
Prematurity i.e. immature liver function
Congenital infections e.g. CMV

84
Q

Why is jaundice more common in breastfed babies?

A

Thought to be due to high concentrations of beta-glucuronidase = increased intestinal absorption of unconjugated bilirubin

85
Q

Features of cystic fibrosis?

A

In the neonatal period there may be meconium ileus or prolonged jaundice
Recurrent chest infections
Malabsorption - steatorrhoea, FTT
Short stature
Delayed puberty
Infertility males, subfertility in females
Nasal polyps
Rectal prolapse due to bulky stools

86
Q

What is a specific contraindication to lung transplantation in CF?

A

Chronic infection with burkholderia cepacia

87
Q

Which organisms may colonise CF patients?

A

Staphylococcus aureus
Pseudomonas aeruginosa
Burkholderia cepacia*
Aspergillus

88
Q

What is plagiocephaly?

A

Parallelogram shaped head often due to baby sleeping in the same position each night

89
Q

What is bronchopulmonary dysplasia?

A

chronic lung disease of prematurity

90
Q

Symptoms of cows milk protein intolerance?

A

regurgitation and vomiting
diarrhoea
urticaria, atopic eczema
‘colic’ symptoms: irritability, crying
wheeze, chronic cough
rarely angioedema and anaphylaxis may occur

91
Q

Symptoms of measles?

A

Prodromal phase of irritability, conjunctivitis and fever
Koplik spots
Maculopapular rash that starts behind ears
Desquamation sparing palms & soles after a week

92
Q

Symptoms of mumps?

A

Fever
Malaise and muscular pain
Parotitis - ear ache or pain on eating

93
Q

Symptoms of rubella?

A

Prodrome of low grade fever
Maculopapualr rash that starts on face and spreads to body
Lymphadenopathy

94
Q

Poor prognostic factors for ALL?

A

Age <2 or >10
WBC >20 at diagnosis
T or B cell surface markers
Non-Caucasian
Male sex

95
Q

What is the prognosis of ALL in children?

A

For those <15, 90% will survive 5 years or more

96
Q

Life-threatening signs of asthma?

A

PEFR <33%
Ox sats <92%
Normal pCO2
Silent chest
Cyanosis
Feeble respiratory effort
Shock
Exhaustion
Confusion
Coma

97
Q

When can a child talk in short sentences of 3-5 words?

A

3 years

98
Q

When can a child combine 2 words?

A

2 years

99
Q

When can a child understand simple commands e.g. give it to mummy?

A

12-15 months

100
Q

When does a child know and respond to their own name?

A

12 months

101
Q

When can a child say mama and dada?

A

9 months

102
Q

What is the triad of shaken baby syndrome?

A

Retinal haemorrhages
Subdural haematoma
Encephalopathy

103
Q

Inheritance pattern of haemophilia?

A

X-linked recessive

104
Q

What causes haemophilia A and B?

A

A - deficiency in factor 8
B - deficiency in factor 9

105
Q

Investigation for slipped capital femoral epiphysis?

A

AP and lateral XR of both hips (as bilateral in 20%!)

106
Q

What is diagnostic for SUFE on an XR of the hip?

A

Line of klein (lune drawn up the lateral edge of the femoral neck) fails to intersect the epiphysis

107
Q

Where is the most commonly affected location for eczema in infants

A

Face and trunk

108
Q

Where is the most commonly affected location for eczema in young children?

A

Extensor surfaces

109
Q

Where is the most commonly affected location for eczema in older children?

A

Flexor surfaces and creases of face and neck

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