Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3A :0 > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What is the most common cause of epiglossitis

A

H.inflenzae type B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are teh acute asthma numbers

A

resp 30
HR 125
o2 92

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Asthma chronic pathways

A

SABA
iCS low dose
LABA
ICS medium dose
Add LTRA
Higj dose steroid
Add oral theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Well controlled asthma symptoms

A

exercise and sleep sumptomless
No cough or wheeze on most days
Inhaler used less than three time s a week
Normal lung function test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Asthma crisis treatment

A

Oxygen
Salbutamol nebulised
Ipratroprium brimode nebulised
Oral pred
Iv hydrocortisone
Iv magnesium sulphate
Iv salbutamol
Iv aminophyllin
Intubate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are sighs oy an unwell child j resp.

A

raised resp
Use of accessory
subcostal recession ‘cyanosis ‘trachel tugging ‘head bobbing ‘nasal flaring ‘abnorla airway noises- wheezing, grunting stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when to admit a child for bronchiolitis

A

*less than 3
Pre existing conditions - downs, premiturity, cystic fibrosis
* 50-75% less of their noraml milk intake
* Dehydratio
* Reap above 70
* Sats below 92%
* Moderate to severe rep disease
* Aponeas
Paretns unconfidant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how long should chlren wrh scarlet fever take to returnt to school after startng antbotcs

A

24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what do xrays show for necrotsng enterocolts

A

dilated bowel loops (often asymmetrical in distribution)
bowel wall oedema
pneumatosis intestinalis (intramural gas)
portal venous gas
pneumoperitoneum resulting from perforation
air both inside and outside of the bowel wall (Rigler sign)
air outlining the falciform ligament (football sign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

6 week baby check hip dislocation tests?

A

barlo - attempt to dislocate
orlani - relocate the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what causes croup and whats teh treatment

A

paranflenza B vrus

stat dose of oral dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what would an ultrasoud of nturcussepton loo le

A

target sgn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are teh defects of tetralogy of fallout

A

PROV

pulmonaru stenosis
Rv hypertrophy
Overriding aorta
VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is teh criteria for infective endocarditis

A

BE TIMER

Bkood culture positive
Echocardiogram ecg evidence

Temp
Immunoloficak phenomena
Micro evidance
Embolic phenomenon
Risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is teh investigation for puloric stenosis

A

ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What s te treatment for patent ductus arterosus

A

idomenthacn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what s the antbotc for whoopng cough

A

azthromycn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is kallmans syndorme

A

hypogonadotrophic hypogonadism and no smell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is kochers criteria

A

probability fo septic arthritis in children

non weight brearing
fever >38.5
WCC >12
ESR>40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where does neuroblastoma come from

A

neural crest cells in teh sympathetic chain for adrenal medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What blood changes for tne ,ost common type ofnpaed blokd diswse

A

Acute lymphoblastic leuekemia
Pancytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what fracturer scake is used for pediatric

A

salter Harris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Slipped femoral epiphysis definition and epidemiology

A

Head of femur is displaced form growth plate, boys 8-15 obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what s teh treatment of threadworms

A

mebendazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

6 weeks developmental milestones

A

smiles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

4-6 months DMS

A

sits with support
reaches for objects
supports head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

6-9 months

A

palmar grasp
curious and engaged with people

sts unsoported
turns head to name

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

12 months dms

A

cruising
pincer grasp
saying snlgle words
waves goodbye
claps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

15 months DMS

A

tower of 2 bricks
walkng unaded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

2 yeard DMS

A

run and kick ball
tower of brcs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

3 year DMS

A

clmb tars one foot at a tmi
buld a brdge
basc sentances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

pneumonia treatment

A

amoxclln or co amox
clarthromcni

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

cause of broncholosts

A

RSV
respratory syncytal cirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

whoopng cough cuase and treatment

A

bortadella pertussis
macrolides - azithromycin, erethromycin, clarithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what causes cyanotic heart diseae

A

rght to left shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are teh cyanotic heart diseases

A

truncus arterosus
transposton of teh great arterers
trcuspid atresa
tetralogy of fallot
asd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what s eisnmongrs syndrome

A

septal defect allows left to rght shunt cuasing pulmonary hypertention whch then leads to a rght to left shunt blood bypasses the lungs and causes cyanoss

cyanotic heart dsease!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

causes of poor feedng

A

nfecton
teethng
premature - no such and swallow
CHD
down syndomre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

tests and treatment for pylorc stenoss

A
  • On examination after feeding, peristalsis will be visable in the stomach
  • A firm roud mass can be flt that fells like a large olive
  • Blood gas - hypochloric metabolic acidosis as they are vomiting up all the HCL
  • Diagnose using an abdominal ultrasound to visualise the thickend pylorus.
  • Laprospoic pyloromyootmy (ramstedts operation)
  • This is an inscision to widen the canal.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

laxative types

treatment for consipation pharmacutical

A

movicol - stool softner

disimpaction regieme - stimulant laxative such as senna/sodum picobisulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what are teh 3 types of laxative

A

bulk - (fibre) fybogel (ispaghula husk)
osmotic - movicol, lactulose
stimulant - senna, sodium picosulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

hirchsprugs symptoms, diagnosis and treatment

A
  • Delay is passing myconium for 48hours
  • Chroic consipation since birth
  • Abdo aina dn distention
  • Vomiitng
    Poor weigth gain and falire to thrive

abdo xray
rectal bopsy showing abscence of ganglion cells

removel of aganglionic section of bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

inturcusspeion key presentations

A

3 months to 3 years

    • Severe colicky abdominal pain
  • Drawing their legs up
  • Pale lethargic unwell child
  • Recurrtnt jelly stool
  • Right upper quadrant pass on palpation
  • SAUSAGE SHAPPED
  • Comiting
    Intestinal obstrucntion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

intercusseption test

A

ultrasound - target sign
contrast enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

intercusseption treatment

A

theraputic enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

cows milk protien allergy presentation and treatment

A

can pass through milk!!!!

abdo pain
vomiting
cough/sneeze
wartery eyes
eczema
urticarial rash
younger than 1 year

if breastfeeding avoid dairy products
hydroloysed formula, then climb teh milk ladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

mekles diverticulum test

A

technatioum 99 scan
ct
ultrasoud

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

key presintations of billary atresia and treatment

A
  • Jaundice present shortly after birth lasing more than 14 days (21 in premmies)
  • Pale stolls
  • Dark urine
  • 2-6 weeks old
    Faliure to thrive

kasi poroenterostomy (attathcing a seciton of small intestine to the opening if the liver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

nephritic and most common cause in syndroem

A

nephritic - heamaturia, oliguria, mild proinuria

acute post strep glomerulonephritis
IgA nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

nephrotic syndroem and most common cause

A

leaky BM in glomerulus casugin Oedema, protinuria and hypoalbuinaemia

minimal change disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

minimal change disease test snad treatment

A
  • Renal biopsy and standard microscop wth show no abnormality
    Urinanlysis will show small molecular wirght protiens and hyaline casts

Prednisolone - high dose initially
* Low salt diet
* Dieurtics for oedema
Albumin transfusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

acute post strep glomerulonephrtis pathophysiology, test and treatment

A

1-3 weeks after tonsillitis (strep pyonenes (A)). immune complexes get stuck in the glomeruli and cause inflamatio

thraot swab to test for tonsillitits

supportove, antihyoertensives
diuretics for oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

IGa nepropathy path, key presintations

A

IgA deposits in the nephrons ofteh kidneys

  • Purpura
  • Joint pain
  • Abdo pain
  • Renal involvement
  • They can develop arthritis, mainly I knees and ankles
  • Can lead to GI haemorrhage and infarction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

IgA nephrolagy tests and management

A

Biopsy -
“IgA deposits and glomerular mesangial proliferation

Supportive
Steroids sometimes
Cyclophosphamides
Close monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

test for vesicoureteric reflux

A
  • Micuratin cystourethrogram - urinary cathaterisation and contract into eh bladder. Refluc is detected on voiding
    Indirect cystogam radionucletide using scans a
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

path for heamolytic uraemic syndrome

A
  • Antibiotics or antimotility drugs gven during the gastro enteritis make it worse!
  • The formation of blood clots consumes plate,lets leading to thrombocytopenia, and the clots block u the kidneys
    The clots also caus the heamolsis of oterh cells in small vessles as it causes tehm to rupture as ethy pass by
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

heamolytic uraemic syndrome key presentations

A

Classic triad f:
* Microangiopathic heamolytic anemia
* Acute kidney yinjury
* Thrombocytopenia

Previous gastroenteritis!!!
* Diahrrohea which turns bloody in 3 days 
After 1 week the HUS symptoms develop:
* Fever 
* Abdo pain 
* Legarthy 
* Pallor 
* Reduced urine output 
* Heamaturia 
* Hypertention 
* Bruising 
* Jaundice  Confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

heamolytic uraemic syndrome teartment

A
  • Hosptial admission with supportive treatment of:
  • Hypovolemia - (IV FLUId)
  • Hypertension
  • Severe anaemia - blood transfusion
    Severe renal faliure - dialysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what are 4 cuases of fevers for more than 5 days?!?!?/

A

kawasaki, stills, RF and leukemia!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

kawasaki disease diagnostic criteria

A

CRASH and BURN (4/5 mnor symptoms plus fever)

Conjunctvts
Rash
Adenopathy
Strawberry tounge
Hands and feet swelling

BURN (fever >5 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

stepwise management fo croup

A

Oral dexamethasone
Oxygen
Nebulised budesonide
Nebulised adrenalin
Intubation and ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

presintatio of croup

A

Increased work of breathing
“Barking” cough, occurring in clusters of coughing episodes
Hoarse voice
Stridor
Low grade fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

age group of croup

A

6 months to 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what conditions are tesed for on teh newbor screening rogram

A

cystic fibrosis (CF)
sickle cell disease (SCD)
congenital hypothyroidism (CHT)
phenylketonuria (PKU)
medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
maple syrup urine disease (MSUD)
isovaleric acidaemia (IVA)
glutaric aciduria type 1 (GA1)
homocystinuria (HCU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what would the csf look lke in bacterial infection

A

Turbid
hight neutrophills
hgh protiens
high glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what does teh CSF look like in viral infection

A

clear
high lymphocytes
ormal protiens and glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what is teh management for sepses

A

blood clutures
urnie output
fluid
antibiotics
lactate
oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what is stephens - jhonsosn syndrome and ts causes

A

a form of toxc epinermal necrolysis affecting less than 10% of eh body. it is the blisterinf and shedding of the top layer of skin from the body.

it is caused by antibiotis, antiepileptics, allopurinol, NSAIDs and infections such as HIV and herpes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what is the treatemtnet for stephens - jhonsosns syndrome

A

medical emergancy
steriods
immunoglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what is a hemangioma

A

blood vessles forming a raised lump
appers soon after birth but diseaperds by age 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

what are teh causes of a non blanching rash

A

Meningiococcal septicaemia
HSD
leukeaemia
heamolytic uraemic syndrome
idiopathic thrombocytopenic purpura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

scarlett fever cause, presentation and treatment ad isolation time

A

Strep a infection
sandpapaer rash on chest neck and arms , strawberry tounge
penV and go back to school in 24 hours
if no pen v, isolate for 2- 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

rosela infantum cause and presintation

A

snotty and unwell, got better and ONLY THEN developed the rash

starts on torso rhen streads to limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

slapped cheek cause and presintation

A

parovirus B19

once uourve got the rash youre no longer infective

starts on face and mived onto torso and limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

mealses key presintations

A

starts on fac eand soreads t rest of body
KOPLIC SPOTS - white spots in mouth!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

treatment for kawasaki

A

high dose asprin
IV immunoglobulins
Echocardiograms to look for cornary artery anyerisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

rubella preintatoin and managemtn

A

mild rash lasts 3 days
notafiable disease
children must stay ff school 5 dyas after rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what is diptheria

A

toxin mediated bacteria caused by cornybacterium diptheriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

diptheria key presentations

A
  • Sore throat
  • Dysphagia
  • Dysponea
  • Croupy cough
  • Swelling of neck
  • Unvaccinated individual
  • Fever
    Stridor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

treatment of diptheria

A
  • Hospitallsation
  • Potential intubation to prevent obstruction
  • Cardiac monitering - myocarditis and HF can develop
  • Droplet controll and isloation
  • Dose of antitoxin!!!!
    Antibiotic - procaine benzypenecillin or erythromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

commonest causes of meningitis in kids and neonates

A

Children:
* Neissiera meningitidis
* Streptococcus pneumonia

Neonats:
* Group B strep from the birth canal

VIRUS:
* Herpes simplex 
* Enterovirus 
* Varicella zoster   - supportive treatment or aciclovir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

meningitis key presintations in kids and babys

A
  • Fever
  • Neck stiffness
  • Comiging
  • Phptophbia
  • Alerted consioiusness
  • Seizures

Non blanching rash if septceamia.

Nepnetes and babys:
* Non specific
* Hypotonia
* Poor feeding
* Legarthy
* Hypothermia
Bulging fontanelle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

when to lumbar puncture in meningitis suspect

A

umbar puncture in all cildren under 1 month with fever, 1-3 motnsh with fever and unwell under 1year wth fever and signs of seirous illness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

treatmentof meningitis

A

Community:
* If suspected meningitis and non blanching rash, Stat IM benzylpenecillin and imiadtiatl hosptial.
Hospital:
* Lumbar puncture.
* Bloods for meningococcal PCR
* Under 3 months – cefotaxime plus amoxicillin (the amoxicillin is to cover listeria contracted during pregnancy)
* Above 3 months – ceftriaxone
* Add vancomycin if there is risk fo penecillin resistant
* Steroids are used to redce neurologcal da,ge. - dexamethasone 4 times daily for 4 days if over 3 months old

*
85
Q

public health side of minningitis

A

NOTAAFIABLE DISEASE
* People who have had contact 7 dayas before can hve a single dose oral ciprofloxacin given ASAP!!!
Close contacts - prolonged contact in household setting 7 days before onset of the illness or transient close contact but exposed to large droplets at hospital admissions

86
Q

complications of meningitis

A

earing loss
* Seizures and epilepsy
* Cognitie imparement
* Memeory loss
Cerebral palsy

87
Q

causes of encephalitis

A
  • Most common is viral
  • Herpes simplex 1 in children form cold sores
  • Gerpes simplex 2 from genial herpes in neonates 9birth)
  • Varicella zoster
    Epstien barr
88
Q

vaccination schedule to 1 year

A

8 weeks

  • 6/1 -diptheria, tetanus, polio, H influenzea, hep B
  • Menengiococcal B
  • Rotavirus

12 weeks

  • 6/1
  • Pneumoccoal
  • Rotavirus

16 weeks

  • 6/1
  • Meningiococcal B

1 year

  • 2 in 1 HIB and Meningiococcal C
  • Pneumococcla
  • MMR
  • Meningiococcal B
89
Q

vaccination schedule 2-14 years

A

2-8 years

  • Influenza virus

3 year 4 months

  • 4/1 - diphtheria, tetanus, pertussis and polio
  • MMR

12-13 years

HPV (6,1 - genitla warts 16,18 - cervical cancer )

14 years

  • 3/1 - tetanus, diptheria and polio
  • Meningiococcal A,C,W,Y
  • whoopng cough
90
Q

what are complications of not getting teh MMR is you cach teh diseases

A
  • Measules: hospitlalization, death, blindness, pneumonia, seizures,
    • Mumps: deafness, encephalitis, orchitis
    • Rubella: deafness, cateractsm heart defects, brain sdisorders, sliver and spleen damage.
91
Q

what is scalded skin syndrome and its presentation and management

A

Definition

Caused by staphylococcus aurus that produces epiermolytic toxins. Tese protease enzymes break down the protiens that hold the skin together and the skin breaks down

  • Starts with genralised patches of erythema
  • Looks thin and wrinkled
  • Followed by the formation of flid and blisers called bullae leaving sore red skinbelow
  • Looks lie a burn
  • Nikolsky sign - getle rubbign of the skin causes it to peel away

Fever, legarthy, irratibilty, dehydration

Management and monitoring

  • Admission and iV antibiotics
  • Fluid and electolyte balances
  • Ussually make fullr eceovery and don’t scar
92
Q

severe combined immunodeficancy define and cause

A

The moost severe immunodeficancy disease hwhc is a syndreom caused by genetic disorders resultin in absetn or dysfunctioning T cells

  • Over 50% caused by mutation in common gamma chain on the x chromosne
  • X linked recessive inheritance
93
Q

severe combined immuno deficancy presentations and treatment

A

N the fisrt few months of life -
* Persisatant sevre diarrhoea
* Falire to thrive
* Oportunistic infections
* Unwell after live vaccines - BCG, MMR, nasal flu

* Omenn syndrome  - a rare cause of SCID, autosomal recessive and results in mutation of RAG 1/2. the abnormal T cells attack the foetus causing rash, hair loss, diarrhoea lymphadenopathy, hepatosplenomegaly.
  • Speclist cenre
  • Imunoglbulin therapy
  • Sterile enviroment
  • Avoid live vaccines
  • Hematopoietic stem cell transplant.
94
Q

reye syndrome define, causes and presentations and treatment

A

reye of sunSHINE

steatoss
hepatomegally
nfecton (vsV)
not awae
#encephalopahty

    • Acute encephalopathy with hepatic dysfunction stemming from mitochondrial damage.
  • Virla infection
  • Exogenous toxins
  • Drugs
  • ASPRIN
  • Vomiting
  • Risk factors - ercent viral infection
  • Altered mental state
  • Hyperventilation
  • Hepatomegally
  • Diminished pain respinse
  • Seizures

Management and monitoring

  • Supportive care
  • ABCDE
  • Vital dign and urine moniyering
  • Look for signs of raised ICP
95
Q

what are febreil convulsions - everythign

A

Sezures in childrenn aged 6 months to 5 years who also have a high fever.

  • Simple - pmly occur once, last less than 15 mins and are genralised tonic clonic
  • Complex- partial or focal seizure, lst more than 15 mins ot occur multiple times

All other neuology ,must be ruled out:
Epilepsy, meningitis, heamoegae and tumor, syncopeal episodes, electoltye sbnormalaties, trauama,

Simple just treat the underlying cuases.
* Stay with child, put them on a capted floor, recovery position, call an ambulance if it lasts more then 5 mins

Not ususally any long lasting damafe
Can increase chances of developing epilepsy

96
Q

define and manage tonic clonic seizures and focal seizures

A

Genralised tonic clonic:

* Muscle tensing and jerking 
* Tonic (clending) comes first 
* Tounge birint, incontinance and irrecgualr breathing 

* There is a post ictal period where the person is confused irrabtble drowsy or low Manage with sodium valporate  Second line  - lamotrigine or carbamzapine

Focal

  • Start at the temporal lobe
  • Affect hearing speech, memoery and emotions
  • Halluciations, memory flashbacks, déjà vu, straneg things on autopilot
  • Carbamazaptine ot lamotrigine
  • Socium valporate or levetiracetam
97
Q

define and manage abscene (and test) and atonic seizures

A

Absence

  • Trypical in children
  • Pateint becomes blanck, stare into s[ace and abruptly returns to normals
  • To induce the seizue ask the patiet to hyoerventilate (bkow a pin wheel)
  • Last 10-20 seconds
  • Sodium valporate, ethosuximide

Atonic

  • Drop attacks
  • Brief lapses in muscle tone that last less than 3 mins
  • May be ndcatve of lennox gastut syndrome
  • Saodum valporate lamotrgne if it doesn’t work
98
Q

define and manage mycclonic and inflantile spasms

A

Myoclonic

  • Breif suffen contractions
  • Sodium valporate
  • Other: lamotrigine, topirmate

Infantile spasms

  • Also called west syndreom
  • Starts at infancy is is ull body spasms
  • Prednisoloe
99
Q

what are teh side effects fo sodium valporae, carmbamazapine and phenytoin

A
  • Teratogenic
  • Hair loss
  • Tremor
  • Liver damage

Agranulocytossi
Anaplasitc anaemia
Induces P450

  • Folate and vitmain D deficiancy
  • Megaloblasitc anaemia
  • Osteomalacia
100
Q

status epilepticus define and treament

A

Status epilepticus:
* Lasting more than 5 mins or more than 2 without regaining consciousness
* Secure the airway
* High conc oxygen
* Chec blood clugose
* Gain IV acesss
* IV lorazapam, - repeat after 10 mins

* OV phenobarbital or pheytoin or levaracitam

Community emergency meds
* Buccal midazolam
Rectal diazapam

101
Q

what s teh treatment for hypothyrodsm

A

levothyroxne

102
Q

what is hypergonadotrophc hypogonassm and some cuases of t

A

No negative feedback fomr the sex hormones leading to high gonadotrophins and low sex hormones.

* Precious gonad damage  - testicual torsion, cnacer, infections (mumps) 
* Congnital absence 
* Kleinfelters syndrome (XXY) Turners syndrome (XO)
103
Q

what s hypogonadotrophc hypogonadsm and some causes for t

A
  • Deficinacy of LH and FSH
  • Abdnomalt functiong of the hypothalamous pr pituitry
  • Damage - radiotheray or surgery #
  • Hrowth horme deficancy
  • ## hyperprolactineamia
  • serious chronic conditions - cystic fibrosis or IBD
  • Excessive exercise r dieiting

Kallmans syndrome - genetic condition causing hypogonasdotrophic hypogonadism. Associated with reduced or absent sense of smell

104
Q

what s congental adrenal hyperplassa

A

Congenital defiancy of the 21-hydroxylase enzyme which causes unerproduction of cortisol and aldosterone and overproduction of androgens from birth.
Autosomal recessive patterns.

105
Q

what s teh classc sever and less severe presentaton of CAH

A

SEVERE CASES:
Shortly after birgh:
* Hyponatermia, hyperkalemia and hypoglycemia
* This leads to poor feeding
* Vomiting
* Dehydration
* Arrhythmias!
* in females - virulised genetalia (ambigious) due to the high testosterone levsls

LESS SEVERE:

Females:
* Tall for age 
* Facial hair 
* Absent periods 
* Deep voice 
* Early pbity 

Male:
* Tall 
* Deep voicce 
* Large pens 
* Small testicles 
* Early pibity 

HYPERPIGMENTATION!!! - this happens because the anterior pituitry produces lots of ACTH in response ot the low cortidol levels!! 

* Classc prentaton n boys  - salt wasting crisis a few weeks after birth  Classc presintationin girls - undfferentaled genatala at brth
106
Q

what s teh treatment of CAH

A
  • Hydrocortisone
  • Aldosterone replacement - flucortisone
    Female atients may require surgery
107
Q

defne androgen nsensvty and ey presentatons

A

x lned recessve condtons where cells are unabel tot react to androgens

Genetically male with XY characteristics
* Femal phenitype
* Thery have tested in the abdomen or inguinal canal that nerver descnded
* Absence of a uters upper vagina, cervicm fallopina tubes and ovaries
* The internal female organs don’t develop because the teste produce anti-mullarina hprmane whch preventsteh formation of the upper vagina, cervi and fallopian tubes

  • Taller than average
  • Often present with inguinal hernias containg testes at birth
  • Or primay ameh=nhorea at puberty
  • Rasied LH
  • Normal or raised FSH
  • Notmal or raised testosterone for a mle
  • Raised oestrogen for a male
108
Q

presntaton of dabetc etoacdoss

A

Polyuria
Polydipsia
N&V
Acetone smell on breath
Refuced GCS
Symproms of underlying trigger - sepsis

109
Q

treatment of DKA

A
  • Correct dehydration over 48 hours
  • Give a fixed rate of insulin, use https://dka-calculator.co.uk/
  • Add potasisum to the saline soloution!!!
  • Use iv dextrose to help controll the glucose levels
    Mobiter glucose, ketones, pH and
110
Q

pathology of scel cell anaema

A

Heamolytic anamia. The pateints have HbS, which is abnormal sickle cells. It is autosomal recessive where the beta globin gene on chromosone 11 results in the sickle cell trait.

Having one of the genes is beneficial against malaria. Having 2 is bad and leads to sickle cell disease.

111
Q

key presentaton of sckle cell anaema

A
  • Anaemia
  • Increased risk of infection
  • CKD
  • Sickle cell crisis
  • Stroke
  • Avascualr necrosis ]
  • Gallstones
  • Prapism - painfu and persistant erections

Sickle cell crisis:
* Acute exastubation
* Spontaoursy triggerd ot by dehydration, infection, stress, cold weather

  • Vasul-occulative crissis - the most common type, sickle red blood cells block peripheral capilleries causing ischeamia
  • Pain and swellig of hands and feet. Fever
  • Splenic sequestration - blocked blood flow to the spllen leadint o anaemia and shock
  • Emergacy - need blood tranfusion and fluid rescusitation
  • Splenic infarction ca occur - hyposplensm leadint o suseptability to infection - particularly to strp pneumonia and heaophill influenzea
  • Splenecomty
  • Aplastic crisis - tempoary absence of creatin new blood bceks after parovirus B19 leads to anamina needsing blood transfusion normall lasts a week
  • Acute chest syndrome - vessles in lings become cloged. Triggerd by occulsive crisis, fat embolism ot an infection
  • Medical emergancy with high mortality
  • Analesisia
  • iV fluids
    Antibiotcs blood rasfusion, oxygen
112
Q

anagement of scle cell anaema

A

ickle cell crissis:
* Manage supportivly
* Treat infections
* Keep warm
* Good hydration
* Analgesia
* Low threshhld for hospital admission

General manegement:
* Avodi triggers 
* Up to date vaccines 
* Antibiotics prophylaxis  - pen  V

* Hydroxycarbamide - promotes HbF
* Crinanlizumab  - monoclonal antibody targeting p-selction, an adhesion molecule in endothelial cells and platelts. It prevent red blood cells from sticking and casuign a vaso-occlusive crisis. 
* Blood transfusion for severe anaemia  Bone marrow transplant
113
Q

what s facon anaema

A

Definition

Rare autosomal recessive condition leading to progressive bone marrow failure affecting all 3 haematopoietic cell precursors.

114
Q

ITP management and complkicatios

A
  • Monitered untill plateltes return to normal
  • Prednisolone
  • IV immunoglobulins
  • Blood transfusions #
  • Platelet transfusions
  • Most wll self resolve after 3 montsh
  • Chrnoci ITP
  • Anaema
  • Brain heammorage
  • GI bleeding
115
Q

defne and presentatons of ITP

A

Purpuric rash caused by t2hr causing the destructioni of platelets.

Spontenous or trggered by viral infecton

  • Recent viral illness 24-48 ours ago
  • Bleeding
  • Bruising
  • Petechia or purpuric rash
116
Q

5 thngs taht ncrease rs of leuaema

A
  • Radioation exposre - abdo xray during pregnancy is the main enviromenta risk factor
  • Down syndreom
  • Kleinfelters sunfreom
  • Noonan syndreom
    Faconi anaemia
117
Q

presentatons of leukaemia

A

It causes pancytopenia - causing anaemia, leukopenia, thrombocytopenia.

  • Fatigue
  • Fever
  • Falirue to thrive
  • Weight loss
  • Night sweats
  • Pallor
  • Pethecia (thrombocytopenia)
  • Abdo pain
  • Lymphadenopathy
  • Persistant bone pain
  • Hepatosplenomegally
118
Q

tests and treatment for leukemia

A
  • Refer any children with perechia or hepatomegally
  • Urgery full blood cout withtin 48 hours
  • FBC showing anaeia, leukopenia, thombocytope aand high numbers of abnormla WBCs
  • Blood film - blast cells
  • Bonoe marrow biopsy
  • Lmoh node biopsy
  • Chest x ray
  • T scan
  • Lumbar puncurre
  • Umunophenotyping of the abnormal cells
  • Chemo
  • Radiotherapy
  • Bone marrow transplant

Complcations f chemo:
* Flaiure to work
* Stunted growth
* Neurotoxicity
* Infertilty
* Secodary malignancy
* Cardiotoxicity

119
Q

wilms tumour all

A
  • Mass in abdomen
  • Abdo pain
  • Hematuria
  • Legarthy
  • Fever
  • Hypertention
  • Weight loss
  • Ultrasoud
  • CT or MRI to stage eth tuour
  • Biopsy and histology to make a complete diagnosis

Surgical excisions
Chemotherapy and radiotherapy

120
Q

symotoms of neuroblastoma

A
  • Non specific and variable
  • Palpable mass
  • Compression of nerves - can causes urinary incontinance
  • Bone - pain or limp
  • Lymphadenopathy
  • And pancytopenia
  • Sweating, pallor, watery diarrhoea, hypertension
  • Hypertention and tahcy due t excessive calocamine production
  • Scatterd purpura - blueberry muffin rash!
    Thrombocytopenic prupura
121
Q

test and management of neuroblastoma

A
  • Urien catchelocamine to creatien ration
  • The key is to look for the products of carchelochamine break down - raised HVA/VMA in urien.
  • Hva - homovanillic acid
  • VMA - vanillymandelic acid. 90% of patient will ave these raised!
  • Ultrasoudn, MRI
  • MIBG scan - radioactive isotope and 2 scans are taken 24 hours apart.
  • Can regress in youger children
  • In older children, treat moe agressivly.
  • Surgery
  • Chemo and radiotherapy
  • Immunotherapy
  • Antiemetics and parinkillers
122
Q

concetrnng sgns of headaches

A
  • Constant headache
  • Nocturnal
  • Worse on waking
  • Wore on coughing straining and bendng forewards
    Vomtng
123
Q

ey presentatons of bone tumoru

A
  • Persistent bone pain - worse at night
  • Bone swelling
  • Palpable mass
    Restricted joint movements
124
Q

what s ewngs sarcoma

A
  • Tumour occuring in bone and soft tissue
  • Ocalised pain and welling with pathological fracture
  • More common in daiphysis han metaphysis
  • Commoy metastasies to lung and bone #
  • Xrya , biopsy, lactate dehydrogenase
  • MRI CT isotope bone scan
  • Chemotherapy, surgery chemo
125
Q

what s teh blood marer for lver touur

A

AFP - alpha feto proten

126
Q

defne and ey presentatons of klenfelters

A

Males have an additional X chromonsone making them XXY.

  • Part way though pubty they develp hypergonadotrophic hypogonadism
  • Often undiagnosed untill investigation for infertitlity

Appear as nomal males unitll pubity
* Taller heigt
* Wider hips
* Gyneacomastia
* Weaker muscles
* Small tsticles
* Reduced libido
* Shyness
* Injertility
* Subel learing difflcutie - speech and language

127
Q

management and complications of klienfelters

A
  • Testosterone injectiosn
  • Advanced IVF tecnuiqes
  • Breast reduction
  • Speech and lanuae theray
  • Occupational therapy
  • Physiothera
  • Educational suppoort

Slightl increased risk of:
* Breast cancer
* Diabeteris
* Osteoprossis
* Depressiona nd anxiety

128
Q

defne and ey presentatons of turners syndrome and amanagement

A
  • Short stature
  • Webbed neck
  • Broad chest with wirley spaced nipples
  • High arcing palate
  • Downward slopng eyes and ptosis
  • Underdeveloed ovares
  • Late pubity
  • Infertility

cubtal valgus

XO chormonsome

treat eth hrowth hormone therpay

129
Q

ey presntatons of downs syndorme

A
  • Hypotonia
  • Brachychepaly
  • Short neck
  • Short stature
  • Flattened face and nose
  • Prominent epicanthic folds - medical eye and eyelid slin
  • Upward sloping palpebral fissures - gap bewtween lower and upper eyelid
    Single palmar crease
130
Q

complications of down synroem

A
  • Learning difficulties
  • Recurretn otitis media
  • Deafness and eustachian tube abnormalaties
  • Visual problems such as myopia, strabimus and cateracts
  • Hypothyroidms
  • Cardiac defects
  • Atlantoaxial instability
  • Leukaemia
    Dementia
131
Q

what is pataue syndreom

A

trsomy 13, not compoatible wit life

132
Q

what s edwards syndreo

A

trisomy18

  • Rocckerbottom feet
  • Dysmorphic features
    Learning disability
133
Q

what is achondroplasia -

A
  • The gene fibroblast growth factor receptr 3 on chromosone 4
  • It an happen from sporadic mutation or the inheritance of an abnormla copy of a gene
  • Autosoma domminant patter, homyzgenous gene muation is fatal in the neonatal period, therefore tey must have one copy of a normla gene
    It causes abnormla fnction in the epiphysal growth plates
134
Q

key presentaiot and compliations of achondroplasia

A
  • Disproportionate short stature
  • Average height of 4 feet
  • Femur and humers more affected than forearm and lower leg
  • Tunk length and intelligence are average
  • Short digits
  • Bow legs
  • Disproportionate skull
  • Foramen magum stenosis
  • The skull base grows and fuses weirdly leadin to a flattentd midface and nasa bridge and the cranial vaul grows and fuses via membranous ossification
  • Recurrent otitis media
  • Kyphoscoliosis
  • Spinal stenosis
  • Obstructive sleep apnoea
  • Obesity
    Cervival cord compression and hydrocephalus
135
Q

key presentationi of angelmans

A
  • Delayed development
  • Server delay or absence of speech
  • Ataxa
  • Fascnaton with water
  • Happy demeanour
  • inaproprate laughter
  • Hand flapping
  • Abnormal sleep patterns
  • Epilepsy
  • ADHD
  • Dysmorphic features
  • Fair skin, light hair, blue eyes
    Wide mouth and widely spaced teeth
136
Q

key presentation fo prader wlls

A
  • Constant hunger
  • Obesty
  • Hypotoa
  • Mld -moderate learnng dffculty
  • Hypogonadsm
  • Dar soft sn prone t brusng
  • Anxety
  • Dysmorphic featres
  • Narrow forehead
  • Almond eyes
  • Stabsmus
  • Thn upper lp
    Downturned mouth
137
Q

ey presentaton of noonans

A
  • Short stature
  • Broad forehead
  • Downward slopng eyes
  • Ptosis
  • Hypertelorism - wide space between eey
  • Prominent nasolabial folds
  • Low set ears
  • Webbed neck
  • Widely spaced nipples

Associated conditions:
* CHD - pulmonary stenosis hypertrophic cardiomyopathy, ASD
* Cryptorchidism - leading to infertility in men
* Bleeding disorders
* Lymphoedema
Increased risk of leukaemia and neuroblastoma

138
Q

key [resentaiton of willams

A
  • Broad forehead
  • Starburst eyes
  • Flat nasal bridge
  • Long philitrum
  • Wide mouth and widely spaced dteeth
  • Big smile
  • Small cin
  • Very socialble and trusting
    Mild leadning disabilty
139
Q

key presentatons of osteogeness mperfecta

A
  • Recurrent and inapropriate fractures
  • Hyperboblity
  • Blue/grey sclerea
  • Triangular face
  • Short stature
  • Deafnessf rom esarly adulthood
  • Dental issues
  • Bonde deformityr - bowed legs
    Joint and bone pain
140
Q

ey presentatons of rickets

A
  • Legarthy
  • Bone pain
  • Swollen wrists
  • Bne deformity
  • Poor growth
  • Dental problems
  • Muscle weakness
  • Abnormal fratue
  • Bowing of the egs
  • Knowkc kness
  • Rachitic rosar - lums alog the chest
  • Craniotabes - soft skull
    Delayed teeth
141
Q

what s transent synovtis

A

rratible hip caused by transier iritation of the synovial membrain n the joint. Most comon cause of hip pain in kids 3-10. associated woth recent upper resp viral infection.

142
Q

key presentaton of trasent synovitis

A
  • NO FEVER!
  • Few weeks after viral illness
  • Limp
  • Refusal to weight bear
  • Groin or hip pain
  • Mild low grade temp
    Otherwise well
143
Q

management of transent snovts

A
  • Analgesia
  • Exclude septic artheritis!
  • Clear safety net advice to attend A&E if they develp a fever or it gets worse
    Followed up at 48 hours and 1 week
144
Q

septc arthrts bactera

A
  • Staphylococcus aureus
  • Neissiera gonnorhoea
  • Group a strep
  • H influenzie
    E coli
145
Q

ey presentaton of septc arthrts

A
  • Hot, red, swollen painful joint
  • Refusing to weight bear
  • Stiffness and reduced range of motion
  • Fever
  • Legarthy
  • Sepsis
    Affects a single joint - knee or hip
146
Q

what is perthers disaease

A

Disruption of bloodflow to the femoral head leadig t avascualr nerosis. It affects the epiphysis which affects bone distal to the growth plate.

  • Ages 4-12 most commonly 5-8.
  • Boys
  • Idiopathic
147
Q

key presentatio sna tests for perthes

A
  • Pain in hip or groin
  • Limp
  • Resticted movement
  • Reffereed pain to the knee
  • No history of trauma
  • Xray
  • Blood tests - normal
  • Technatioum bone scan
  • MRI scan
148
Q

treatmetn for perthers disease

A
  • Severity varies
  • Conservatve to antain a helathy position and alingent of the joint
  • Bed rest
  • Traction
  • Crutches
  • Analgesia
  • Physiotherapy
  • Regular xrays to asses healing #
    Surgery
149
Q

slpped femoral epiphysis define, risk factors, key presentations

A

The head of the femur is displaced form the grwoth plate.

Boys
Age 8-15 but average age of 12
Obesety

  • Adolescent obese boy undergoing a growth spurt
  • History of minor trauma but pain is disproporitaite
  • Hip, groin, thigh and knee pain
  • Resticted range of hip movement
  • Painful limp
  • Resticted movement in the hip
  • They will have restricted internal rotation

i am very bored

150
Q

define and key presentatons of osgood schlatters

A

Inflamation AT THE TIBIELA TUBEROSITY WHERE THE PATELLA LIGAMENT INSERTS.

Common cause of anterior knee pain

10-15
Boys
Usually unilateral

  • Stress from rubbing jumpin at the same time as the epiphyseal plare results in inflamation. This cause small avulaion fractire where the ligaent pulls away tiny pieces of bone
  • This leads to growth of the tibieal tuberoscity causing a visavble bump below the knee
  • Hard lump below knee
  • Pain at anterior knee
  • Pain exascubate dby physical activity, kneeling and extention
151
Q

developmental displasia of teh hip 3 ris factors

A

Epidemiology and risk factors

  • First degree FH
  • Breech from 36 weeks
  • Multiple pregnancy
152
Q

developmental displasia of the hippresentaton, test and management

A
  • Different leg lengths
  • Restricted hip abduction on one side
  • Significant bilateral restriction in abduction
  • Difference in knee level when flexes
  • Clunking on special tests
  • Ortolanii test - knees and hips flexes, abduct the hp
  • Barlow test - flexed hips and kness, hips adducted
  • Clicking is common, clunking is not and requires ultrasound
  • Ultrasound
  • Xray
  • Pavlik harness if under age of 6 months
  • It keeps the hips stabe and alowsth eacetabulum to devleip to a normal shape
  • Surgery if over 6 months, a hip spica cast immobilises the hip afterwards
153
Q

what are the 5 types of JIP

A
  • Systemic
    • polyarticualr
    • Oligoarticuar
    • Enthetisis related
      Juvanile psoriatic
154
Q

systemeic JIP

A

Systemic

  • Also known as stills disease
  • Subtle salmon pink rash
  • High fevers, lymphadenopathy , weiht loss
  • Joint inflamation and pain
  • Splenomegaly
  • Muscle pain
  • ANA antibodies nd RF negative
  • Raised ESR, CRP, platelets and serum ferratin
  • Key complication of macrophage activation system, where there is DIC< anaemia, thrombocytopenia, bleeding and it is life trheating. There is a low ESR!!!
155
Q

polyarticular JIP

A

Polyarticular

  • Involves 5 or more joints
  • Symetrical affectign small joints and hands and feet, also hips and knees
  • Mild fever, anaemia reduced growt
  • The equiverlent of FA in adults
  • RF negative noramll and
156
Q

oligoarticular JIP

A

Oligoarticualr

  • 4 or less joints
  • Knee or ankle
  • Common in girls under 6
  • Anterior uvitis is common
  • No systemic symptoms
  • Inflamatry marers normal
  • Ana antibodies posative, rf ne
157
Q

enthesis related JIP

A

Ethesitis related arthritis

  • Males over 6
  • Pads seronagatve spondyloarthropathy
  • HLA B27 positive
  • Look for psoriasis and IBD
  • Prone to anterior uveitis
  • Prone to enthersis (inflamation at tendon atatchement sites)
  • Wrist, interphalaneal joints in hands, wrist, greater trochaanter of hip, base of achillies, patella tendon,
158
Q

junaile related arthertitis

A

Juvanile psoriatic artheritis

  • Symetrical polyarthritis afecting smal joints, or asymetrical large joints
  • PSORISIS
  • Placques on skin
  • Nail pitting
  • Onychylosis
  • Dactylisis
  • Enthesis
159
Q

treatments for JIP

A
  • Exercise
  • Phsychological support
  • NSAIDs
  • Steroids
  • DMARDS - methotrexte and sulfasalazine
  • Biloogical therapy - u=tumour necrosis factor inhiibitors sucha as adalinimab
  • Splints to prevent deformity
  • Eye screening for uvitits
160
Q

what is torticollis

A
  • Within the fist few weeks of life a small swelling is noted on the bays neck. It is a small fibrosisin eth sternomastoid muscle.
  • Shortening of the muscle leads to troticollis (neck muscles spasaming and moving to one side)
  • Shrtening of the SM results in the roation and tilting of the head ot the oposite side
  • Passive excerciseded to allow the neck to achieve full movements
  • Hemifacial atrophy and strabismus may develop unless the fell movement is restored
    Physiotherapy!
161
Q

what s the apgar score

A

appearance pulse grmace actvty respraton

all scored out of 2

162
Q

newborn lfe supprt

A

delay cord clampng
dry/ stmulte/ warm up
5 inflaton n air then PEEP
apply O2
sucton laryngeal mask and consider inflation breaths
synchronise 3 chest comprssion to 1 ventilation
consider intubation

163
Q

what s respratory distress syndreom

A

premmies who arent producing wnough surfactant - before 32 weeks

164
Q

management and complication of respiratory distress syndrome

A

antenatal sterods given to mother
intubation and ventialtion
CPAPA
supplementrry oxygen

pneumothrooorax
infection
aponea
intraventricular heamorahe
necrotising enterocolitis

165
Q

bronchopulmaonry dysplasia - define, presenration and prevention

A

chornic lung disase of prematurity

affects babies born befroe 28 weeks, fragile still lungs that arent full ydeveloped

guve dexamethasone antenatally, use CPAP rather than ntubaton
use caffne to stmulate rep effort

166
Q

meconum aspraton - defne path presentatons

A

perstalss due to feotal dstress leadng to partal or total obstructon of teh ar. ths causes feotal hypoxa due to VQ msmathc
ncrease n pulmar ressur eleads to rght to left shuntning

it leads to inhibition of surfactant and causes inflamtion due to teh chemical in there

resp distress soon after birth

167
Q

manageme t of feotal meconum nspraton

A

extrdte mecomiu to prevent further hypoxia
supplamental O2
surfactant
antibiotics
ECMO

168
Q

what s ECMO

A

Extracorporeal membrane oxygenation (ECMO) is a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream of a very ill baby.

169
Q

hypoxc shaema encephalopathy path and causes

A

hypoxa durng btg hleadng to permenrant damage and cerbeaal palsy

causes - maternal shock, intrapartum heammorage, prolapsed cors, nuchal cord

170
Q

what are teh stages of hypoxic ischaemic encephalopathy

A

mild - poor feeding, resloves in 24 hours
moderat - poor feeng letharc hypotona sezures 40% develop cerebal palsy

sevre - reduced consiousness, 50% nortality, 90% decelop cerebal palsy

171
Q

treatment of hypoxic ischeamic encephalopathy

A

supportive care and rescusitation
acid base baance, treatment of seizures

theraputic hypothermia is used in certain situation to protect the nrain. call to 33-34for 72 hours and thn warm up a=over 6 hours

172
Q

what are the torch nfectons and bow are they transmiited

A

toxoplasma gondii
other agents - prepeenama pallidum, varciella zoester, parovirs B19, HIV
rubella
cytomegalovirus
herpes simplx virus

mum to babay - in utero, though teh birth canal or through breast milk

173
Q

ey opresintation so ftorch infections

A
  • Fever
  • Legarthy
  • Cateracts
  • Jaundic e
  • Rebrown spots on skin
  • Hepatosplenomegally
  • CHD
  • Microcephallly
  • Low birth weight
  • Hearing loss
  • Blueberry muffin rash
  • Vision loss
  • Deafness
  • Intellectual disability
    Seizures
174
Q

what is necrotising enterocollitis

A

disorder afectign premmies when part o teh bowel becomes nectoric - leads to perforation, peritonitis, shock and death

175
Q

key presintation of necrotising enterocolitis

A

intolerance to feeds, vomiting green bil, genrally unwell, distended tender abdomen, absent bowel souds, blood in stool

176
Q

tests for necrotsnf enterocolts

A

FBC CPR capllery bloog gass

abdo xray -
Xrya:
* dilated bowel loops (often asymmetrical in distribution)
* bowel wall oedema
* pneumatosis intestinalis (intramural gas)
* portal venous gas
* pneumoperitoneum resulting from perforation
* air both inside and outside of the bowel wall (Rigler sign)
air outlining the falciform ligament (football sign)

177
Q

mangment adn complications of necrotising enterocolitis

A
  • Nil by mouth
  • IV fluids total parentla nutrition
  • Antibiotcs
  • NG tube
  • Surgical emergancy
    Temporary stoma

perforation sepsis death strictures abcess

178
Q

neonatal jaundice normal and abnormla cause

A

normla - mild janidce 2-7 days of age due to HgF breakdown. resolved by day 10

nicreased billirubin production -
heamolytic disease of teh newborn
ABO incompatailoity
heamorrag e
intraventricular heamoraage
polycythemia
sepsis and DIC
GP6D deficaincy

premature clearance -
prematurityy
breast mil
neonatal cholestasis
extrahelapci bilary atresia
hypopituitry
gilbrets syndorme

179
Q

what is teh definitoi of prolonged neonateal jaundice

A

longer tahn 14 days in term and more than 21 in premmies

look for billary atresia, hypothyroidism and G6PD deficiancy

180
Q

tests to doin neonatal juandice when prolonhed

A
  • FBC and blood film
  • Conjugated billirubin levels - hepatobillary cause
  • Blood type testing
  • Direct cooms test for heamolysis
  • Thyroid function
  • Blood and urine cultres
    Glucose phosphare dehydrogenase levels
181
Q

treatment for neonatal juandice

A
  • Total millirubin levels can be monitered on treatment threshold charts
  • T is counted in ours since birth
  • Phototherapy - converts unconjugated billirubin into isomer so it an be excreted in the liver
  • Eye patcehes and blue light is used form a ligh box

Exchange transfusion

182
Q

kernicterus definition

A

Kernicterus:
* Brain damage to the bilirubin levels
* Bilirubin can cross the blood brain barrier and causes damage to the CNS
* Bulds up n the basal gangla and cerabellum
* Floppy, drowsy baby with poor feeding
* They wll get cerebral palsy, learning disability and deafness.

183
Q

what s gastroshss

A

full thickness abdomnal wal defect where teh prgans protude outsde wth no prtectve membrane cuasng exposure to amntotc fludwhch elads to nflamaton

184
Q

rs factros for gastroshsis

A

maternal smong
under 20
envromental expose
use of asprin and ibruprofen

185
Q

treatment for gastroshisis

A
  • Early detetion through scas
  • Women induced at 37 weeks
  • Immidiate fuid rescusitation and maintain adequqte temprature
  • Sterile clean covering over the herniated contect to prevetn exaporation, heat loss and infection
  • Surgery is defeinitive
    Need a nasogastric tube and parenteral feeding whilst the inflamatory peel recovers
186
Q

bowel atresa key presntations

A

bile stained vomit
subbtle bubble sign gas in stomach

187
Q

signs of maternal hyperthyroidism in a neonate

A

small size
preterm
goitre
tachycadria
hepatosplenomeggaly
microcephally

188
Q

bactera for neonatal sepsis

A

groiuo b streo
eli
listeria
klebsitelka
staph aureus

189
Q

symotoms of neonatal spesis

A

fever
resuced tone
resp distress
HR abnormalityd
siezures
vomiting
juandice in teh firt 24 ohrus of life
hypoglycaemia

sepsis in mother
signs of shock
signs of shock

190
Q

management of sepsis in a neonate

A

septic screen -

benzypenicillin and gentamycin
check crp after 24 hours
crp

191
Q

what are teh catogries of teh peads traffic light system

A

colour
respiratory
circulation and hydratio
other

192
Q

a,ber signs

A

pallo r

not responding normally
nasal flaring, >40 RR
<95% resp sats
tacy cardai, reduced mucous, poor feeding

temp >39
fever>5 days
swelling of limb
non weifht bearing limp

193
Q

red signs

A

pale/blue

no response to cues, asleep

grunting, tachyopena .60

reduced skin turgour

<3 months temp >38

bluging fontnelle
non blanching rash
focl seizures
status epilepticsu
neck stiffness

194
Q

fragile X syndrome signs and protien

A

fragile X r=mentl retardation protien (FMR1 gene)

LARGE EARS
long face
high forehead
lareg testes

hypermobile joints
low IQ
autism

195
Q
A
196
Q

what s teh crtera called for rhematc fever and nfectve endocardts

A

rf - jones
E - dukes

197
Q

key presentations of RF

A

cardomegally
artheritis
subcutanous nodules
erythema marginatm
sidenhams chorea

198
Q

what does an ASD murmur soud like

A

crechendo decrechendo murmur with fixed splid second heart soud

loudest ar upper left steral baorder

199
Q

treatment for ASD

A

transvenous catheter closre or open heart surgery

anticoagulents can be used to reduced chances of clots and stroe in adults

200
Q

what genetic conditions aare associated with VSD

A

dowsn syndreom
turners syndrome

201
Q

murmur heard with a VSD

A

pan systolic hear loudest left lower sternal baorder

other causes of pansystolic - mitral and triscuspid regurgitation

202
Q

what isteh creiteria used for IBS

A

rome 2

203
Q

causes of appendicitis

A

feacolish
filieal worms
undigested nuts and seeds

204
Q

further nvestgatons for UT

A

< 6 montsh need ultrasoud in 6 wees
reurrent UTI need ultrasoud n 6 weeks

atypcal UT need uptrasoud n llness

205
Q
A
206
Q
A
207
Q

developmental mlestned form 3-12 months

A

3 months Little or no head lag on being pulled to sit
Lying on abdomen, good head control
Held sitting, lumbar curve

6 months Lying on abdomen, arms extended
Lying on back, lifts and grasps feet
Pulls self to sitting
Held sitting, back straight
Rolls front to back

7-8 months Sits without support (Refer at 12 months)

9 months Pulls to standing
Crawls

12 months Cruises
Walks with one hand held

208
Q

developmental mlestones 13 months to 4 years

A

13-15 months Walks unsupported (Refer at 18 months)
18 months Squats to pick up a toy
2 years Runs
Walks upstairs and downstairs holding on to rail
3 years Rides a tricycle using pedals
Walks up stairs without holding on to rail
4 years Hops on one leg

209
Q
A

3A :0 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions