Paediatrics Flashcards
X-linked agammaglobulinemia (XLA)
- Inheritance pattern
- Gene affected
- Pathophysiology
- Treatment
X-linked recessive primary immunodeficiency syndrome caused by a mutation in the B-cell tyrosine kinase (BTK) gene, which results in arrested B cell development and agammaglobulinema causing antibody deficiency and recurrent infection.
Also causes hypoplastic tonsils.
Tx: Ig therapy
Contraindications to Rotavirus vaccine?
- Intussusception
- Abdominal disorders
Contraindications to TdaP-IPV?
- Anaphylaxis to streptomycin/neomycin
- Neurological disease
Which allergy is a contraindication to influenza vaccine?
Egg allergy
Developmental red flags (6)
- Not walking by 18mo, rolling too early <3mo
- Hand preference <18mo
- Less than 6 words at 18mo
- Not smiling at 4mo
- Not pointing at 15-18mo
- Regression of previous skills
Oral candidiasis treatment
Nystatin
Infant colic
Unexplained paroxysms of irritability
Management:
1. Reassurance
2. Change feeding technique
3. Eliminate allergens from breastfeeding mother’s diet
Primary dentition
20 teeth
First tooth at 5-9months
Enuresis
Involuntary urinary incontinence >5 years
Primary nocturnal enuresis
Management:
1. Lifestyle modification
2. “wet” alarm
3. Consider desmopressin, imipramine if >7yo
Faecal impaction
Treatment:
1. Complete bowel emptying with laxative - PEG 3350
2. Maintenance treatment
Definition of failure to thrive (FTT)
Growth failure in either height or weight during childhood
Clinical signs of FTT
SMALL KID
Subcutaneous fat loss
Muscle atrophy
Alopecia
Lethargy
Lagging behind normal
Kwashiorkor
Infections (recurrent)
Dermatitis
Prenatal FTT (Growth pattern and causes)
Growth pattern: decreased height, weight and head circumference
Causes:
Placental insufficiency
Intrauterine infections
Genetic
Maternal
Pre-existing conditions (e.g., diabetes, renal disease)
Use of medications, drugs, tobacco, or alcohol
Postnatal FTT (Causes)
Inadequate calorie intake
Inadequate caloric absorption (e.g., gastroesophageal reflux)
Increased caloric requirements (e.g., hyperthyroid, congenital heart disease)
Social determinants (e.g., poverty, societal disorder)
Adverse childhood experience
Caregiver:
Inadequate feeding skills
Inappropriate food for age
Neglect
Insufficient lactation
Disturbed mother and child relationship
Infant:
Sucking or swallowing dysfunction (e.g., cleft palate)
Chronic disease (e.g., infection, metabolic disorders)
Postnatal FTT (Growth Patterns)
- Decreased weight only
- Suggests low PO intake - Decreased height and weight and normal head circumference
- Suggests dystrophies, endocrine disorder, constitutional delay, familial short stature
SIDS Definition
Sudden death of child <12mo
RFs: prematurity, sleeping prone, low birthweight, ETOH (mother in utero), indigenous, smoking in household,
Adolescent History (HEEADSSS)
Home
Education/ Employment
Eating
Activities
Drugs
Sex/sexuality
Suicide and depression
Safety/ violence
What is the age of consent?
16yo
Close age exceptions:
14-15yo can consent if partner is <5 years older
12-13yo can consent if partner is <2 years older
Not consensual if partner is in a position of authority or the young person is dependent on the partner
Child Abuse
Physical abuse
Sexual abuse/exploitation (sex trafficking)
Emotional/mental abuse
Neglect
Child marriage
Forced/exploitative labour (human trafficking)
Criminal activities (e.g., drug trade, theft)
Suspicious injury: (6)
- Bruising - abdomen, buttocks, genitalia, cheek or ears, neck or feet
- Fractures - posterior ribs, metaphyseal, scapular, vertebral, sternal
- Immersion burns
- Frenulum tear
- Retinal haemorrhage
- Bruising in babies not yet cruising
Suspicion of sexual abuse (8)
- Recurrent UTI
- Pregnancy
- STIs
- PV bleeding
- Vaginitis
- Pain
- Genital injury
- Enuresis
Prenatal circulation
Placenta - Umbilical vein - Ductus venosus - IVC - R atrium - Foramen ovale - L atrium - L ventricle - Aorta - Brain/ myocardium - SVC - Ductus arteriosus - Aorta - Systemic circulation - Placenta
What does the ductus arteriosus connect?
Pulmonary arteries to aorta (bypass the lungs)