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Year 4 Finals > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Fill in the blank:
Allergic rhinitis is an ____ mediated response to allergens within the environment

A

IgE

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2
Q

Name 4 risk factors for developing epistaxis

A
  • Antiplatelet therapy or anticoagulant therapy
  • Haemophilia or von Willebrand’s
  • NSAIDs
  • Trauma or septal perforation
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3
Q

Anterior epistaxis involves which plexus?

A

Kiesselbach’s plexus
AKA Little’s area

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4
Q

Posterior epistaxis involves branches of which artery?

A

Sphenopalatine

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5
Q

Mild hepatosplenomegaly may be a symptom of which common virus? What should patients experiencing this be advised?

A

Epstein Barr virus
- avoid contact sports until resolved

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6
Q

Which 2 antibiotics should be avoided in cases of EBV?

A

Ampicillin and amoxicillin

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7
Q

If an EBV patient is given amoxicillin, what side effect may occur?

A

Itchy maculopapular rash

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8
Q

Fill in the blank:
Cholesteatoma is an abnormal accumulation of skin and ____ ____ within the middle ear cleft

A

Squamous epithelium

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9
Q

Fill in the blank:
Cholesteatoma often results from chronic ____ ____

A

Otitis media

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10
Q

Name the ENT complaint:
Persistent foul smelling ear discharge + otalgia + headache

A

Cholesteatoma

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11
Q

What is the primary management of symptomatic cholesteatoma?

A

Surgical removal of skin and squamous epithelium accumulation

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12
Q

Name 2 complications of untreated cholesteatoma

A

Any of:
Facial nerve palsy, meningitis, epidural abscess, sigmoid sinus thrombosis

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13
Q

Name 4 red flag symptoms for head and neck

A

Any of:
- hoarseness or change in voice
- refractory mouth ulcers or coloured lesions
- painless mouth or neck lumps
- weight loss
- blood in saliva or phlegm
- unilateral nasal polyp
- unilateral hearing loss
- unilateral persistent node bleeds

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14
Q

Chronic nasal polyps could indicate what disease?

A

Cystic fibrosis

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15
Q

What is the main visual symptom of hereditary haemorrhagic telangiectasia?

A

Small red or purple s[pots on fingertips/lips/nostril lining/ears/face

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16
Q

What 2 organisms most commonly cause otitis externa?

A

Pseudomonas or staph aureus

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17
Q

When should oral antibiotics be considered in otitis externa?

A

Systemic upset, immunosuppression, ear canal occluded by swelling and debris

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18
Q

Which combined antibiotic and steroid ear drops may be given in mild to moderate otitis externa?

A

Gentamix

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19
Q

What type of gauze can be inserted into the ear for deeper penetration of antibiotic preparations in severe otitis externa?

A

Wick gauze

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20
Q

Name 4 circumstances in which we would admit children with otitis media

A
  • under 3 months old
  • temperature 38+
  • systemically unwell
  • suspected meningitis, mastoiditis, facial nerve palsy
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21
Q

Otosclerosis is abnormal growth of what within the ear?

A

Bone growth around the stapes

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22
Q

What is Schwartz sign on otoscopy and what does it suggest?

A

Reddish blue hue seen through tympanic membrane, suggests otosclerosis

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23
Q

Name the ENT complaint:
Progressive hearing loss + family history positive + Schwartz sign on otoscopy

A

Otosclerosis

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24
Q

Name the neck lump:
Soft painless fluctuant mass that transilluminates

A

Cystic hygroma

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25
Q

Name the neck lump:
Palpable painless midline mass that moves up on swallowing and protrusion of tongue

A

Thyroglossal cyst

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26
Q

Name the neck lump:
Painless mass located anterior to the sternocleidomastoid muscle

A

Branchial cyst

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27
Q

What is the definitive treatment for quinsy?

A

Aspiration

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28
Q

What 2 organisms are most commonly causative of quinsy?

A

Group A strep or staph aureus

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29
Q

Name the 4 points of the CENTOR criteria for acute tonsillitis

A
  • fever
  • absence of cough
  • tonsillar exudate
  • tender anterior cervical lymphadenopathy
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30
Q

Fill in the blank:
A CENTOR score of __ or __ indicates a 32-56% likelihood of isolating ____

A
  • 3
  • 4
  • strep
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31
Q

Name 3 circumstances in which we would give antibiotics in suspected tonsillitis

A
  • CENTOR score 3 or 4
  • evidence of systemic upset
  • immunosuppressed patients
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32
Q

What is the first line treatment for suspected acute bacterial tonsillitis without penicillin allergy?

A

500mg penicillin V PO QDS 5-10 days

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33
Q

What is the first line treatment in suspected acute bacterial tonsillitis complicated by penicillin allergy?

A

250-500mg clarithromycin or erythromycin PO BD for 5 days

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34
Q

Lemierre’s syndrome is a complication of which common infection?

A

Tonsillitis
- characterised by internal jugular vein inflammation and septic emboli

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35
Q

Name the ENT complaint:
Significant hearing loss + chalky white patches on tympanic membrane on otoscopy

A

Tympanosclerosis

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36
Q

Which type of vasculitis may cause recurrent epistaxis and chronic sinusitis?

A

Wegener’s (granulomatosis with polyangiitis)

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37
Q

What autoantibody will be positive in cases of Wegener’s?

A

C-ANCA

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38
Q

What is the first line induction therapy for cases of Wegener’s?

A

High dose glucocorticoids e.g. prednisolone, dexamethasone, methylprednisolone, betamethasone

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39
Q

Name 2 agents which can be used for maintenance therapy in Wegener’s patients

A

Azathioprine, methotrexate

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40
Q

Which 2 systems are most commonly affected in Wegener’s?

A

ENT and renal

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41
Q

When is whooping cough vaccinated against in children?

A

8, 12 and 16 weeks, plus 3 years and 4 months

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42
Q

What test should be carried out for confirming pertussis infection?

A

PCR

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43
Q

Name 3 complications of whooping cough

A

Any of:
Bronchiectasis, hernias, secondary pneumonia, hernias, rib fractures

44
Q

Which antibiotic class should be given in cases of whooping cough?

A

Macrolides (azithromycin, clarithromycin, erythromycin)

45
Q

Why are macrolides given in whooping cough?

A

To reduce infectivity
NB does not affect the course of the disease

46
Q

What is the most common nephrotic disorder in children?

A

Minimal change disease

47
Q

Name the presentation:
Child with periorbital oedema + frothy urine + normotensive

A

Minimal change disease

48
Q

What is the first line treatment in children with minimal change disease?

A

Prednisolone

49
Q

What 2 agents may we use in cases of minimal change disease complicated by severe fluid overload?

A

Human albumin + furosemide

50
Q

What are the 5 features of Kawasaki disease aside from a persistent fever?

A

C - conjuctivitis
R - rash
E - erythema - of hands and feet
A - adenopathy
M - mucosal involvement - strawberry tongue, oral fissures

51
Q

How long should a fever have been present for a diagnosis of Kawasaki disease?

52
Q

What complication are Kawasaki disease patients at risk of?

A

Coronary artery aneurysm

53
Q

What is the first line treatment for Kawasaki disease?

A

IV immunoglobulin + high dose aspirin

54
Q

Explain the step wise approach in acute asthma attack management

A

1 - oral prednisolone in ALL patients 1-2mg/kg OD max 40mg, salbutamol (spacer in mild/moderate, nebulised in severe/life threatening), oxygen if sats under 92%
2 - nebulised ipratropium bromide
3 - nebulised magnesium sulfate
4 - IV salbutamol

55
Q

PEFR of below what percentage indicates a life threatening asthma attack?

56
Q

What is the most common causative pathogen of bronchiolitis?

57
Q

What is the mainstay of treatment for bronchiolitis?

A

Supportive

58
Q

Double bubble sign on AXR indicates what?

A

Duodenal atresia

59
Q

Duodenal atresia is associated with what genetic abnormality?

A

Trisomy 21/Downs

60
Q

Failure to pass meconium in the first 48 hours of life may indicate what disease?

A

Hirschsprung’s

61
Q

What is the gold standard for diagnosing Hirschsprung’s disease?

A

Rectal suction biopsy

62
Q

Name the presentation:
Episodic colic + vomiting + red currant jelly stools

A

Intussusception

63
Q

Target sign on USS is indicative of what disorder?

A

Intussusception

64
Q

What is the first line treatment for intussusception?

65
Q

Meconium ileus is associated with what disease?

A

Cystic fibrosis

66
Q

Polyhydramnios may indicate what abnormality in the infant?

A

Gastrointestinal obstruction

67
Q

Volvulus is treated with what procedure?

A

Ladd’s procedure

68
Q

Acidosis on blood gas with features of bowel obstruction indicates what?

A

Necrotising enterocolitis

69
Q

Children with recurrent UTIs and unexplained fevers should be investigated for what?

A

Vesicoureteric reflux

70
Q

Negative Prehn’s test (elevation of testicle) may indicate what?

A

Testicular torsion

71
Q

Positive Prehn’s test (elevation of testicle) may indicate what?

A

Acute or chronic epididymitis

72
Q

A partial thickness fracture with the concave surface intact and convex side breaking is named what?

A

Greenstick fracture

73
Q

Toddler’s fracture is what type of fracture?

74
Q

A fracture extending through the metaphysis, growth plate and epiphysis is what class of Salter-Harris?

75
Q

A fracture involving just the physis is what class of Salter-Harris?

76
Q

A crush injury to the physis is what type of Salter-Harris?

77
Q

Osteogenesis imperfecta is a disorder of what substance?

78
Q

Name 2 non bony manifestations of osteogenesis imperfecta

A

Blue sclera and sensorineural deafness (due to otosclerosis)

79
Q

Deficiency in what is the most common cause of rickets?

80
Q

What class of drugs may lead to an acquired case of rickets?

A

Anticonvulsants
- watch for bone pain in patients with epilepsy

81
Q

Which gastrointestinal disorder may lead to rickets?

A

Coeliac disease
- due to malabsorption

82
Q

Isolated raised ALP is indicative of what disease?

A

Paget’s disease

83
Q

Paget’s disease is characterised by what?

A

Increased but uncontrolled bone turnover

84
Q

Name the complaint:
Bone pain and warmth + sunburst appearance on xray

A

Osteosarcoma

85
Q

Ewing’s sarcoma typically presents on what portion of the bone?

86
Q

Onion skin periosteal reaction is indicative of what?

A

Ewing’s sarcoma

87
Q

Which radiological finding may be found in rickets?

A

Widened growth plate

88
Q

Which imaging modality is most sensitive for detecting osteomyelitis?

89
Q

Which type of medication should ALL children with an acute asthma attack receive?

A

Oral prednisolone

90
Q

Biliary atresia is characterised by high levels of what?

A

Conjugated bilirubin

91
Q

Fill in the blank:
Kernicterus only occurs when bilirubin is __.

A

Unconjugated

92
Q

What is the first line treatment for biliary atresia?

A

Kasai procedure

93
Q

What kind of blood gas abnormality may pyloric stenosis produce?

A

Hypochloraemic hypokalaemic metabolic alkalosis

94
Q

Ulcerative colitis is closely related to what other disease?

A

Primary sclerosing cholangitis

95
Q

Which class of medications is first line in inducing remission in ulcerative colitis?

A

ASAs e.g. mesalazine

96
Q

What is first line treatment in acute exacerbations of ulcerative colitis?

A

IV hydrocortisone

97
Q

Erythema nodosum is an extraintestinal sign of what?

A

Inflammatory bowel disease

98
Q

What is the first line treatment for inducing remission in Crohn’s disease?

A

Oral prednisolone

99
Q

What is the first line therapy for maintaining remission in Crohn’s disease?

A

Azathioprine or mercaptopurine

100
Q

Which endocrinological abnormality may lead to chronic constipation?

A

Hypothyroidism

101
Q

What is the first line treatment in chronic constipation?

102
Q

Dermatitis herpetiformis is an extraintestinal manifestation of what disease?

A

Coeliac disease

103
Q

Abdominal guarding and rebound tenderness are signs of what?

A

Peritonitis

104
Q

Ileus is a disruption of what?

A

Normal propulsive activity of the bowel

105
Q

Chronic H.pylori infection can lead to what?

A

Duodenal ulcers, gastric carcinoma

106
Q

Which type of peptic ulcer pain is:
1. Relieved on eating?
2. Worsened by eating?

A
  1. Relieved - duodenal
  2. Worsened - gastric

Year 4 Finals (15 decks)

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