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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
Female sex and breech presentation are two risk factors for developmental dysplasia of the hip, name 4 more.
Positive fhx Firstborn children Oligohydramnios Birth weight over 5kg
26
What are the criteria for screening USS examination for DDH?
First-degree fhx of hip problems in early life Breech presentation at or after 36 weeks Multiple pregnancy
27
What screening for DDH is done for all infants at the newborn baby check and 6 month baby check?
Ortolani and Barlow tests Ortolani = attempts to relocate a dislocated femoral head Barlow = attemps to dislocate an articulate femoral head
28
What is the firstline investigation for DDH in a child over 4.5 months?
X-ray
29
Prematurity is the main risk factor for necrotising enterocolitis, name 4 more.
Formula feeds Respiratory distress and assisted ventilation Sepsis PDA and other congenital heart defects
30
Vomiting is one of the presenting features of necrotising enterocolitis, name 5 more.
Intolerance to feeds Generally unwell Distended abdomen that is tender Absent bowel sounds Blood in the stools
31
What are the characteristic x-ray findings for neonates with necrotising enterocolitis?
Dilated loops of bowel Bowel wall oedema Pneumoatosis intestinalis Penumoperitoeum Gas in the portal vein
32
What is the mx of necrotising enterocolitis?
Nil by mouth IV fluids NG tube TPN Antibiotics Surgical emergency -> removal of necrotic bowel tissue
33
Perforation and peritonitis are complications of necrotising enterocolitis, name 7 more.
Sepsis Death Strictures Abscess formation Recurrence Long term stoma Short bowel syndrome
34
What is another name for the red eye reflex that is checked on the NIPE?
Fundal reflex.
35
What are the four characteristic features of congenital rubella syndrome?
Sensorineural hearing loss Congenitial cataracts Congenital heart disease Glaucoma
36
What does the use of lithium in pregnancy cause?
Ebstein's anamoly
37
What is the most common causative agent for bacterial pneumonia in children?
Streptococcus pneumoniae.
38
What empirical antibiotics should be given to children over and under 3 months with suspected sepsis?
< 3 months: IV amoxicillin (or ampicillin) + IV cefotaxime > 3 months: IV cefotaxime (or ceftriaxone)
39
How is whooping cough (pertussis) diagnosed?
Nasal swab
40
What are the features of viral pneumonia in children?
Rhinorrhoea Absence of localised pain Wheeze Age under 2 Low grade fever
41
When can you not do an LP in meningitis?
Raised ICP Meningiococcal DIC
42
When is the Men B vaccine given?
2, 4 and 12 months
43
How does eczema present in infants?
Facial and Extensor surfaces
44
What is the treatment of whooping cough, if the child presents within 21 days of the onset of the cough?
Macrolide (Azithromycin or Erythromcyin)
45
What is the school protocol for whooping cough?
48 hours off after initiation of antibiotics 21 days after onset of cough.
46
How to differentiate between colic and infantile spasms?
Colic distress during the spasms. Infantile spasms distress in between the spasms.
47
What is the average age for West syndrome?
4-8 months
48
What kind of murmur is heard in ToF? Why?
Ejection systolic murmur Pulmonary stenosis
49
At what age do the majority of cow's milk protein intolerances resolve by?
5 years
50
What is the most common complication of measles?
Otitis media
51
When should umbilical hernias be repaired?
Symptomatic or large - 2-3 years Asymptomatic - 5 years
52
What are the characteristic features on auscultation of an ASD?
Ejection systolic murmur and fixed splitting of the second heart sound.
53
What signs would suggest the patient is in clinical shock (compensated) rather than just clinical dehydration?
prolonged cap refill cold and pale peripheries
54
Under what age should a child with a suspected UTI be referred immediately to hospital?
<3months
55
How may an older child present with DDH?
Leg length discrepancy and trendelenburg gait
56
Name 2 conditions associated with hypospadias.
Cryptorchidism Inguinal hernia
57
When is the operation for hypospadias usually performed? What is a key piece of information to tell the parents?
Around 12 months Ensure he is not circumscised as the foreskin is used to repair the defect.
58
What does hand preference in a child under 12 months suggest? What is the immediate action?
Cerebral palsy Urgent referral to child development service for multidisciplinary assessement.
59
Which medication is given to maintain a PDA?
Prostaglandin E1
60
Which medication is given to close a PDA?
Indomethacin
61
What type of murmur and pulse are associated with PDA?
Continuous murmur loudest at the left sternal edge. Collapsing pulse.
62
How long does caput succedaneum take to resolve?
Few days
63
How long does a cephalohaematoma take to resolve?
Few months
64
What age group is transient synovitis most commonly seen in?
3-8 years old
65
What are the two main defects in the heart of a child with Turner's syndrome?
Biscupid aortic valve Aortic coarctation
66
When raised what type of bilirubin is indicative of biliary atresia in a child.
Conjugated (processed by the liver but cannot be excreted into the biliary system).f
67
What is the peak incidence of bronchiolitis?
3-6 years
68
What is the most likely cause a of a massive haemorrhage in a 1-2 year old, requiring transfusion?
Meckels Diverticulum.
69
What is the most appropriate mx to try and reduce the effects of hypoxia in a neonate?
Therapeutic cooling (35-33)
70
What is the age group for croup?
6 months to 3 years
71
What is the medical term for gas in the bowel wall and with what conditions do you see it?
Pneumatosis intestinalis Necrotising
72
What is the firstline for ADHD in children? What needs to be monitored every 6 months?
Methylphenidate Weight and height
73
What organsim is most often the cause of croup?
Parainfluenza virus.
74
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?
Auditory brainstem response test is carried out as a newborn/infant.
75
Rocker bottom feet are a feature of Edward's syndrome, name 3 more features.
Choroid plexus cysts, clenched hands, and small placenta.
76
Other than grunting and subcostal recessions what are 7 more signs of respiratory distress in a child?
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
What age does pyloric stenosis present?
2-8 weeks up to 6 months
78
What age does meckel's diverticulum present?
Under 2s
79
What is the investigation of choice for Meckels Diverticulum in stable children?
Technetium scan
80
What is cerebral palsy?
Movement and posture disorder due to a non-progressive lesion in the motor pathway of the brain.
81
What are the four types of cerebral palsy? What are the key elements of each?
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
What is the kocher criteria for septic athritis?
Temp over 38.5 Non-weight bearing WCC over 12 ESR over 40
83
What are 4 differentials for septic arthritis?
Transient synovitis Perthes disease SUFE Juvenile idopathic arthritis
84
What is the guthrie test?
Heel prick test
85
What to screen for in Turners?
Thyroid Diabetes Coeliac
86

YEAR 4 (11 decks)

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