paediatrics Flashcards
whooping cough mgt
azithromycin/ clarithromycin if onset of sx within past 21 days
fragile X syndrome
cardiac issue
mitral valve prolapse
Patau syndrome (trisomy 13) features (4)
Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions
Edward’s syndrome (trisomy 18)
features (4)
Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers
Noonan syndrome (4)
Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis
Prader-Willi syndrome (6)
ch 15
short stature
Hypotonia
Hypogonadism
Obesity + hyperphagia
almond shaped eyes
LD + behavioural issues
William’s syndrome (5)
Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis
Turner’s syndrome cardiac features:
bicuspid aortic valve (15%)
coarctation of the aorta (5-10%)
causes of neonatal jaundice in 1st 24hrs
rhesus haemolytic disease
ABO haemolytic disease
hereditary spherocytosis
glucose-6-phosphodehydrogenase
causes of prolonged jaundice (after 24hrs)
biliary atresia
hypothyroidism
galactosaemia
urinary tract infection
breast milk jaundice
jaundice is more common in breastfed babies
mechanism is not fully understood but thought to be due to high concentrations of beta-glucuronidase → increase in intestinal absorption of unconjugated bilirubin
prematurity
due to immature liver function
increased risk of kernicterus
congenital infections e.g. CMV, toxoplasmosis
chickenpox features
initially: fever
itchy rash
- starts on head/ trunk then spreads
- macular, then papular, then vesicular MPV
systemic upset = mild
measles feature:
Prodrome:
irritable, conjunctivitis, fever
Koplik spots:
white spots (‘grain of salt’) on buccal mucosa
Rash:
starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent
measles cx
otitis media (= most common)
pneumonia (=most common cause of death)
encephalitis: typically occurs 1-2 weeks following the onset of the illness)
subacute sclerosing panencephalitis: very rare, may present 5-10 years following the illness
febrile convulsions
keratoconjunctivitis, corneal ulceration
diarrhoea
increased incidence of appendicitis
myocarditis
mumps features:
Fever, malaise, muscular pain
Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%
rubella features:
Rash:
pink maculopapular
initially face, then spreads to whole body
usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular
erythema infectiosum
i. causative organism
ii. other name
i. parvovirus B19
ii. slapped cheek - then spreads to proximal arms and under extensor surfaces
scarlet fever
cause
Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
scarlet fever
features
Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)
scarlet fever mgt
penicillin V PO (10 days)
scarlet fever cx
otitis media
rheumatic fever
acute glomerulonephritis
invasive cx - bacteraemia, meningitis, nec fasc
hand, foot and mouth
causative organism
coxsackie A16 virus
hand, foot and mouth
features
Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet
roseola infantum
i. casuative organism
ii. other name
do we need school exclusion
i. HHV6
ii. sixth disease
NO
roseola infantum
features:
high fever for few days
then maculopapular rash
Nagayama spots - papular enanthem on uvula + soft palate
febrile convulsions
diarrhoea and cough
Kawasaki disease features:
high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel
Kawasaki disease cx
coronary a. aneurysms
most common cause of nephrotic syndrome in children
minimal change disease
benpen doses for initial mgt of meningitis in community
<1 year 300mg
1-10yrs 600mg
>10yrs 1200mg
pyloric stenosis electrolyte derangement
hypochloraemic, hypokalaemic metabolic alkalosis
(due to persistent vomiting)
tetralogy of fallot
features:
- VSD
- RV hypertrophy
- RV outflow obstruction/ pulmonary stenosis
- overrriding aorta
tetralogy of fallot on XR
boot shaped heart
Perthes disease
what is it?
AVN of femoral head
Perthes disease
age of onset
4-8 yrs
most common cause of cyanotic congenital heart disease:
i. at birth
ii. overall
i. TGA
ii. tetralogy of Fallot (usually present at 1-2 months)
most common cause of acyanotic congenital heart disease:
VSD
juvenile idiopathic arthritis
features:
pyrexia
salmon-pink rash
lymphadenopathy
arthritis
uveitis
anorexia and weight loss
juvenile idiopathic arthritis
ix
ANA +ve (especially in oligoarticular JIA)
RF -ve
patent ductus arteriosus features:
left subclavicular thrill
continuous ‘machinery’ murmur
large volume, bounding, collapsing pulse
wide pulse pressure
heaving apex beat
patent ductus arteriosus mgt
indomethacin / ibuprofen
paediatric asthma mgt:
- SABA
- SABA +ICS (start at this step if new dx + sx >3x weekly or night-time wakening)
- SABA + ICS+ LTRA
- SABA +ICS+ LABA
…
DDH RF: (7)
- female
- breech
- FH
- prim
- oligiohydramnios
- birth weight >5kg
- congenital calcaneovalgus foot deformity
tuberous sclerosis
i. inheritance
ii. features
i. AD
ii. hypomelanotic macules (ash leaf spots)
seizures
developmental delay
angiofibroma
renal and cardiac cx
