Paediatrics Flashcards
What is bronchiolitis?
RSV infection with respiratory symptoms.
Common symptoms of bronchiolitis
Cough, breathlessness, wheezing, crackles, feeding difficulties.
How is bronchiolitis managed?
Supportive care
What is hand, foot and mouth disease?
Viral infection causing sore throat, fever, oral ulcers, and vesicles on palms and soles.
What virus causes hand, foot and mouth disease?
Coxsackie virus.
What is the treatment for hand, foot and mouth disease?
Symptomatic treatment only.
Is school exclusion required for hand, foot and mouth disease?
no
What is scarlet fever?
Infection caused by Group A haemolytic streptococci.
What are the symptoms of scarlet fever?
Fever, malaise, headache, sore throat, ‘strawberry’ tongue, rash-sandpaper texture.
What is the treatment for scarlet fever?
Oral penicillin for 10 days.
Is scarlet fever a notifiable disease?
yes
Can a child with scarlet fever return to school after starting antibiotics?
Yes, after 24 hours.
What is slapped cheek (erythema infectiosum/fifth disease)?
Viral infection causing a red rash on cheeks.
What virus causes slapped cheek?
Parvovirus B19.
Is school exclusion necessary for slapped cheek?
No, not infectious once rash appears.
How long can the rash of slapped cheek last?
Intermittently for six weeks, especially when warm.
What is roseola infantum (exanthem subitum/sixth disease)?
Viral infection causing high fever and a maculopapular rash.
What virus causes roseola infantum?
Human Herpes Virus 6.
Are febrile convulsions common in roseola infantum?
Yes, in around 10-15% of cases.
Is school exclusion required for roseola infantum?
No
What is Kawasaki disease?
Systemic vasculitis with fever, conjunctival injection, and other symptoms.
What are the characteristic symptoms of Kawasaki disease?
High-grade fever, conjunctival injection, cracked lips, strawberry tongue, cervical lymphadenopathy, desquamation of hands and feet.
How is Kawasaki disease managed?
High-dose aspirin and echocardiography for coronary artery aneurysms.
What is Mumps?
RNA paramyxovirus causing fever, malaise, myalgia, and parotitis.
What are the initial symptoms of Mumps?
Unilateral parotitis, fever, malaise, myalgia.
What percentage of Mumps cases develop bilateral parotitis?
70%
What is the recommended treatment for high fever in Mumps?
Paracetamol
Is Mumps a notifiable disease?
yes
What is the common complication of Mumps in post-pubertal males?
Orchitis
What is the usual nature of hearing loss in Mumps?
Unilateral and transient.
What is Measles?
RNA paramyxovirus causing irritability, conjunctivitis, and fever.
What are Koplik spots?
Small white spots on the buccal mucosa in Measles.
How does the rash in Measles progress?
Starts behind the ears and spreads, becoming confluent
What is the most common complication of Measles?
Otitis media.
What is the most common cause of mortality in Measles?
Pneumonia
What is Rubella?
German measles causing low-grade fever, maculopapular rash, and lymphadenopathy.
What can Rubella exposure in pregnancy cause?
Congenital rubella syndrome.
Can pregnant women receive the MMR vaccine?
No, as it is a live vaccine
What is Chicken pox?
Varicella zoster virus causing fever and an itchy rash.
How does the rash in Chicken pox progress?
Macular -> papular -> vesicular.
How long should a child with Chicken pox be excluded from school?
Until lesions have crusted over.
What is the recommended management for Chicken pox?
Supportive
What is croup?
Upper respiratory tract infection caused by parainfluenza viruses.
What are the symptoms of croup?
Stridor, barking cough (worse at night), fever, and cold-like symptoms.
How is croup treated?
A single dose of oral dexamethasone (0.1mg/kg) regardless of severity.
What is biliary atresia?
Failure to form or early destruction of extrahepatic biliary tree
What are the symptoms of biliary atresia?
Jaundice > 14 days
Pale stools
Dark urine
Growth impairment
What would be seen on the LFTs for biliary atresia?
Increased conjugated bilirubin
What is the management of biliary atresia?
Urgent Kasai procedure
What is pyloric stenosis?
A condition in which the opening between the stomach and small intestine thickens.
What are the symptoms of pyloric stenosis?
Projectile non-bilious vomiting at 2-4 weeks (up to 4 months) typically after feeding
Olive shaped mass in epigastric region
Hypocholaremic
Hypokalaemic alkalosis
How is pyloric stenosis diagnosed?
abdominal ultrasound
What is the management of pyloric stenosis?
- Ramstad pyloromyotomy
- Before surgery: Correct hypokalaemia, IV rehydration, elevate head
What is Meckel’s diverticulum?
congenital anomaly from persistence of the vitelline (omphalomesenteric) duct.
may mimic pain of appendicitis and in half of the cases, ulceration, inflammation, and GI bleeding due to the presence of an ectopic acid-secreting gastric epithelium can be seen. Pancreatic tissue may also be present in Meckel’s Diverticulum
Rule of twos or threes are often used to describe condition, i.e. condition occurs in 2% of children two feet from ileoccecal valve, contains two types of ectopic mucosa (gastric and pancreatic) in 2yr olds.
What is the management of Meckel’s diverticulum?
surgical resection
What is malrotation?
Incomplete rotation of midgut- usually present 3-7 days after birth
What are the symptoms of malrotation?
Abdominal pain
Blood in stool
Poor appetite
Infrequent bowel movement
Vomiting
How is malrotation diagnosed?
upper GI contrast study and USS
What is intussusception?
telescoping of 1 bowel segment into a distal segment
What is the management of malrotation?
- Laparotomy
- If volvulus present= Ladd’s procedure
What are the symptoms of intussusception?
Paroxysmal colicky abdominal pain, vomiting, bloody stools- red current jelly
Sausage shaped mass in RUQ
During paroxysm, the infant will characteristically draw their knees up and turn pale
How is intussusception diagnosed?
USS
What is the management of intussusception?
Air insufflation
If fails= surgery
What is Hirschsprung’s disease?
Failure of nerve plexuses to form in the distal colon leading to uncoordinated peristalsis and functional obstruction
Associated with Down’s
What are the symptoms of Hirschsprung’s disease?
Failure to pass meconium
Constipation
Abdo distention
How is Hirschsprung’s Disease diagnosed?
rectal biopsy
What is the management of Hirschsprung’s disease?
Initially managed with rectal washouts before surgery
What are the symptoms of Cow’s milk intolerance?
In first 3 months-
regurgitation
Vomiting
Diarrhoea
Urticaria (hives)
Actopic eczema
Colic symptoms; irritability, crying , wheeze, chronic cough, rarely angioedema & anaphylaxis may occur
How is Cow’s milk intolerance diagnosed?
Prick/ patch testing
What is the management of Cow’s milk intolerance?
Extensive hydrolysed milk (first line)
If breastfed then continue and eliminate Cow’s milk protein from diet
What is necrotising enterocolitis?
Inflammation and death of intestinal tissue.
What is the main risk factor for necrotising enterocolitis?
Prematurity
What are the initial symptoms of necrotising enterocolitis?
Feeding intolerance, abdominal distension, and bloody stools.
What are the progressive symptoms of necrotising enterocolitis?
Abdominal discoloration, perforation, and peritonitis.
What may X-rays show in necrotising enterocolitis?
Pneumatosis intestinalis or pneumoperitoneum.
