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YEAR 4 > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What procedure is performed for intestinal malrotation?

A

Ladd’s procedure

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2
Q

What are two conditions that are associated with malrotation?

A

Exomphalos
Diaphragmatic hernia

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3
Q

Hip pain is a common symptom of Perthes disease, name 3 more.

A

Knee pain (referred)
Limp
Restricted hip movements

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4
Q

What investigations are carried out for Perthe’s disease?

A

X-ray
Blood tests - inflammatory markers to rule out other causes.
Technetium bone scan
MRI scan

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5
Q

What is the management of Perthes disease?

A

Bed rest
Traction
Crutches
Analgesia
Physiotherapy
Regular x-rays
Surgery = older children where it is not healing

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6
Q

Growth retardation, microcephaly and senorineural deafness are 3 features of congenital cytomegalovirus, name 9 more.

A

Pinpoint petechial skin lesions
Encephalitis
Hepatosplenomegaly
Visual impairment
Learning disability
Pneumonitis
Anaemia
Jaundice
Cerebral palsy

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7
Q

What is the characteristic feature of Slipped Upper Femoral Epiphyses?

A

Restricted internal rotation.

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8
Q

What is the definitive mx of slipped upper femoral epiphyses?

A

Internal fixation (across the growth plate)
Cannulated screw

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9
Q

Which investigation is the choice for SUFE?

A

X-ray

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10
Q

What is the management for SUFE?

A

Surgery

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11
Q

Which typically childhood infection can precipitate necrotising fascitis? What medication can increase this risk?

A

Chickenpox - secondary bacterial infection with invasive group A streptococcal soft tissue infection.
NSAIDs increase this risk

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12
Q

Encephalitis is a rare complication of chickenpox, name 5 more.

A

Pneumonitis
Disseminated haemorrhagic chickenpox
Arthritis
Nephritis
Pancreatitis

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13
Q

What is the progression of the chickenpox rash?

A

Macular -> Papular -> Vesicular

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14
Q

What congential heart problem is assoicated with episodes of cyanosis when the child is upset or distressed? And what are these termed?

A

ToF
Tet Spells

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15
Q

What is the most common cause of ambiguous genitalia in a neonate?

A

Congential adrenal hyperplasia.

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16
Q

What is the most common presenting sx of neonatal sepsis?

A

Respiratory distress (grunting, subcostal recessions etc)

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17
Q

What age group does intussusception normally affect?

A

6-18 months

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18
Q

Viral illness is commonly associated with intussusception, name 4 other associated conditions.

A

Henoch-Schonlein Purpura
Meckel’s diverticulum
Cystic fibrosis
Intestinal polyps

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19
Q

What are 4 complications of intussusception if not treated?

A

Obstruction
Gangrenous bowel
Perforation
Death

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20
Q

What is the other name for Roseola infantum? What virus causes it?

A

Sixth disease
Herpes virus 6

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21
Q

What is the age group usually affected by roseola infantum?

A

6 months - 2 years

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22
Q

How does roseola infantum present?

A

Fever for a few days then development of a maculopapular rash.

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23
Q

Other than a resistant high grade fever (for 5 or more days) and a strawberry tongue, state 4 more features of Kawasaki disease.

A

Cervical lymphadenopathy
Red soles and palms - later desquamation
Bright red, cracked lips
Conjunctival injection

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24
Q

What investigation must be performed in children with Kawasaki disease to screen for complication?

A

Echocardiogram
Coronary artery aneurysms

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25
Q

Female sex and breech presentation are two risk factors for developmental dysplasia of the hip, name 4 more.

A

Positive fhx
Firstborn children
Oligohydramnios
Birth weight over 5kg

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26
Q

What are the criteria for screening USS examination for DDH?

A

First-degree fhx of hip problems in early life
Breech presentation at or after 36 weeks
Multiple pregnancy

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27
Q

What screening for DDH is done for all infants at the newborn baby check and 6 month baby check?

A

Ortolani and Barlow tests
Ortolani = attempts to relocate a dislocated femoral head
Barlow = attemps to dislocate an articulate femoral head

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28
Q

What is the firstline investigation for DDH in a child over 4.5 months?

A

X-ray

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29
Q

Prematurity is the main risk factor for necrotising enterocolitis, name 4 more.

A

Formula feeds
Respiratory distress and assisted ventilation
Sepsis
PDA and other congenital heart defects

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30
Q

Vomiting is one of the presenting features of necrotising enterocolitis, name 5 more.

A

Intolerance to feeds
Generally unwell
Distended abdomen that is tender
Absent bowel sounds
Blood in the stools

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31
Q

What are the characteristic x-ray findings for neonates with necrotising enterocolitis?

A

Dilated loops of bowel
Bowel wall oedema
Pneumoatosis intestinalis
Penumoperitoeum
Gas in the portal vein

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32
Q

What is the mx of necrotising enterocolitis?

A

Nil by mouth
IV fluids
NG tube
TPN
Antibiotics
Surgical emergency -> removal of necrotic bowel tissue

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33
Q

Perforation and peritonitis are complications of necrotising enterocolitis, name 7 more.

A

Sepsis
Death
Strictures
Abscess formation
Recurrence
Long term stoma
Short bowel syndrome

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34
Q

What is another name for the red eye reflex that is checked on the NIPE?

A

Fundal reflex.

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35
Q

What are the four characteristic features of congenital rubella syndrome?

A

Sensorineural hearing loss
Congenitial cataracts
Congenital heart disease
Glaucoma

36
Q

What does the use of lithium in pregnancy cause?

A

Ebstein’s anamoly

37
Q

What is the most common causative agent for bacterial pneumonia in children?

A

Streptococcus pneumoniae.

38
Q

What empirical antibiotics should be given to children over and under 3 months with suspected sepsis?

A

< 3 months: IV amoxicillin (or ampicillin) + IV cefotaxime
> 3 months: IV cefotaxime (or ceftriaxone)

39
Q

How is whooping cough (pertussis) diagnosed?

A

Nasal swab

40
Q

What are the features of viral pneumonia in children?

A

Rhinorrhoea
Absence of localised pain
Wheeze
Age under 2
Low grade fever

41
Q

When can you not do an LP in meningitis?

A

Raised ICP
Meningiococcal
DIC

42
Q

When is the Men B vaccine given?

A

2, 4 and 12 months

43
Q

How does eczema present in infants?

A

Facial and Extensor surfaces

44
Q

What is the treatment of whooping cough, if the child presents within 21 days of the onset of the cough?

A

Macrolide (Azithromycin or Erythromcyin)

45
Q

What is the school protocol for whooping cough?

A

48 hours off after initiation of antibiotics
21 days after onset of cough.

46
Q

How to differentiate between colic and infantile spasms?

A

Colic distress during the spasms.
Infantile spasms distress in between the spasms.

47
Q

What is the average age for West syndrome?

A

4-8 months

48
Q

What kind of murmur is heard in ToF? Why?

A

Ejection systolic murmur
Pulmonary stenosis

49
Q

At what age do the majority of cow’s milk protein intolerances resolve by?

A

5 years

50
Q

What is the most common complication of measles?

A

Otitis media

51
Q

When should umbilical hernias be repaired?

A

Symptomatic or large - 2-3 years
Asymptomatic - 5 years

52
Q

What are the characteristic features on auscultation of an ASD?

A

Ejection systolic murmur and fixed splitting of the second heart sound.

53
Q

What signs would suggest the patient is in clinical shock (compensated) rather than just clinical dehydration?

A

prolonged cap refill
cold and pale peripheries

54
Q

Under what age should a child with a suspected UTI be referred immediately to hospital?

A

<3months

55
Q

How may an older child present with DDH?

A

Leg length discrepancy and trendelenburg gait

56
Q

Name 2 conditions associated with hypospadias.

A

Cryptorchidism
Inguinal hernia

57
Q

When is the operation for hypospadias usually performed? What is a key piece of information to tell the parents?

A

Around 12 months
Ensure he is not circumscised as the foreskin is used to repair the defect.

58
Q

What does hand preference in a child under 12 months suggest? What is the immediate action?

A

Cerebral palsy
Urgent referral to child development service for multidisciplinary assessement.

59
Q

Which medication is given to maintain a PDA?

A

Prostaglandin E1

60
Q

Which medication is given to close a PDA?

A

Indomethacin

61
Q

What type of murmur and pulse are associated with PDA?

A

Continuous murmur loudest at the left sternal edge.
Collapsing pulse.

62
Q

How long does caput succedaneum take to resolve?

A

Few days

63
Q

How long does a cephalohaematoma take to resolve?

A

Few months

64
Q

What age group is transient synovitis most commonly seen in?

A

3-8 years old

65
Q

What are the two main defects in the heart of a child with Turner’s syndrome?

A

Biscupid aortic valve
Aortic coarctation

66
Q

When raised what type of bilirubin is indicative of biliary atresia in a child.

A

Conjugated (processed by the liver but cannot be excreted into the biliary system).f

67
Q

What is the peak incidence of bronchiolitis?

A

3-6 years

68
Q

What is the most likely cause a of a massive haemorrhage in a 1-2 year old, requiring transfusion?

A

Meckels Diverticulum.

69
Q

What is the most appropriate mx to try and reduce the effects of hypoxia in a neonate?

A

Therapeutic cooling (35-33)

70
Q

What is the age group for croup?

A

6 months to 3 years

71
Q

What is the medical term for gas in the bowel wall and with what conditions do you see it?

A

Pneumatosis intestinalis
Necrotising

72
Q

What is the firstline for ADHD in children? What needs to be monitored every 6 months?

A

Methylphenidate
Weight and height

73
Q

What organsim is most often the cause of croup?

A

Parainfluenza virus.

74
Q

All newborn babies should have their hearing checked by the health visitor as part of the ‘Newborn Hearing Screening Programme’. If this is abnormal they go on to have which hearing test?

A

Auditory brainstem response test is carried out as a newborn/infant.

75
Q

Rocker bottom feet are a feature of Edward’s syndrome, name 3 more features.

A

Choroid plexus cysts, clenched hands, and small placenta.

76
Q

Other than grunting and subcostal recessions what are 7 more signs of respiratory distress in a child?

A

Raised respiratory rate
Use of accessory muscles of breathing, such as the sternocleidomastoid, abdominal and intercostal muscles
Nasal flaring
Head bobbing
Tracheal tugging
Cyanosis (due to low oxygen saturation)
Abnormal airway noises

77
Q

What age does pyloric stenosis present?

A

2-8 weeks up to 6 months

78
Q

What age does meckel’s diverticulum present?

A

Under 2s

79
Q

What is the investigation of choice for Meckels Diverticulum in stable children?

A

Technetium scan

80
Q

What is cerebral palsy?

A

Movement and posture disorder due to a non-progressive lesion in the motor pathway of the brain.

81
Q

What are the four types of cerebral palsy? What are the key elements of each?

A

Spastic - UMN lesion causing increased tone
Dyskinetic - lesion in the basal ganglia and substantia nigra causing athetoid movements and oromotor problems
Ataxia - lesion in the cerebellum causing cerebellar signs (DANISH).
Mixed

82
Q

What is the kocher criteria for septic athritis?

A

Temp over 38.5
Non-weight bearing
WCC over 12
ESR over 40

83
Q

What are 4 differentials for septic arthritis?

A

Transient synovitis
Perthes disease
SUFE
Juvenile idopathic arthritis

84
Q

What is the guthrie test?

A

Heel prick test

85
Q

What to screen for in Turners?

A

Thyroid
Diabetes
Coeliac

86
Q
A

YEAR 4 (11 decks)

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