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MSRA > paediatrics > Flashcards

paediatrics Flashcards

1
Q

whooping cough mgt

A

azithromycin/ clarithromycin if onset of sx within past 21 days

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2
Q

fragile X syndrome features (in males) (6)

A
  • LD
  • large low set ears, long thin face, high arched palate
  • hypotonia
  • autism
  • mitral valve prolapse
  • large testes
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3
Q

Patau syndrome (trisomy 13) features (4)

A

Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

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4
Q

Edward’s syndrome (trisomy 18)
features (4)

A

Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers

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5
Q

Noonan syndrome (4)

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

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6
Q

Prader-Willi syndrome (3)

A

Hypotonia
Hypogonadism
Obesity

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7
Q

William’s syndrome (5)

A

Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis

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8
Q

Turner’s syndrome features:

A

short stature
shield chest, widely spaced nipples
webbed neck
bicuspid aortic valve (15%), coarctation of the aorta (5-10%)
primary amenorrhoea
cystic hygroma (often diagnosed prenatally)
high-arched palate
short fourth metacarpal
multiple pigmented naevi
lymphoedema in neonates (especially feet)
gonadotrophin levels will be elevated
horseshoe kidney

increased risk of autoimmune disease (thyroid, IBD)

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9
Q

causes of neonatal jaundice in 1st 24hrs

A

rhesus haemolytic disease
ABO haemolytic disease
hereditary spherocytosis
glucose-6-phosphodehydrogenase

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10
Q

causes of prolonged jaundice (after 24hrs)

A

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

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11
Q

chickenpox features

A

initially: fever

itchy rash
- starts on head/ trunk then spreads
- macular, then papular, then vesicular MPV

systemic upset = mild

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12
Q

measles feature:

A

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

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13
Q

measles cx

A

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

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14
Q

mumps features:

A

Fever, malaise, muscular pain

Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%

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15
Q

rubella features:

A

Rash:
pink maculopapular
initially face, then spreads to whole body
usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular

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16
Q

erythema infectiosum
i. causative organism
ii. other name

A

i. parvovirus B19
ii. slapped cheek - then spreads to proximal arms and under extensor surfaces

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17
Q

scarlet fever

cause

A

Reaction to erythrogenic toxins produced by Group A haemolytic streptococci

18
Q

scarlet fever
features

A

Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)

19
Q

scarlet fever mgt

A

penicillin V PO (10 days)

20
Q

scarlet fever cx

A

otitis media
rheumatic fever
acute glomerulonephritis
invasive cx - bacteraemia, meningitis, nec fasc

21
Q

hand, foot and mouth
causative organism

A

coxsackie A16 virus

22
Q

hand, foot and mouth
features

A

Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet

23
Q

roseola infantum

i. casuative organism
ii. other name

do we need school exclusion

A

i. HHV6
ii. sixth disease

NO

24
Q

roseola infantum

features:

A

high fever for few days
then maculopapular rash

Nagayama spots - papular enanthem on uvula + soft palate

febrile convulsions
diarrhoea and cough

25
Q

Kawasaki disease features:

A

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

26
Q

Kawasaki disease cx

A

coronary a. aneurysms

27
Q

most common cause of nephrotic syndrome in children

A

minimal change disease

28
Q

benpen doses for initial mgt of meningitis in community

A

<1 year 300mg
1-10yrs 600mg
>10yrs 1200mg

29
Q

pyloric stenosis electrolyte derangement

A

hypochloraemic, hypokalaemic alkalosis
(due to persistent vomiting)

30
Q

tetralogy of fallot
features:

A
  1. VSD
  2. RV hypertrophy
  3. RV outflow obstruction/ pulmonary stenosis
  4. overrriding aorta
31
Q

tetralogy of fallot

A

cyanosis
R>L shunt
ESM (sue to pulmonary stenosis
R sided aortic arch
“boot shaped” heart on XR

32
Q

Perthes disease

what is it?

A

AVN of femoral head

33
Q

Perthes disease

age of onset

A

4-8 yrs

34
Q

most common cause of cyanotic congenital heart disease:
i. at birth
ii. overall

A

i. TGA
ii. tetralogy of Fallot (usually present at 1-2 months)

35
Q

most common cause of acyanotic congenital heart disease:

A

VSD

36
Q

juvenile idiopathic arthritis

features:

A

pyrexia
salmon-pink rash
lymphadenopathy
arthritis
uveitis
anorexia and weight loss

37
Q

juvenile idiopathic arthritis
ix

A

ANA +ve (especially in oligoarticular JIA)
RF -ve

38
Q

patent ductus arteriosus features:

A

left subclavicular thrill
continuous ‘machinery’ murmur
large volume, bounding, collapsing pulse
wide pulse pressure
heaving apex beat

39
Q

patent ductus arteriosus mgt

A

indomethacin / ibuprofen

40
Q

paediatric asthma mgt:

A
  1. SABA
  2. SABA +ICS (start at this step if new dx + sx >3x weekly or night-time wakening)
  3. SABA + ICS+ LTRA
  4. SABA +ICS+ LABA
    …
41
Q

DDH RF: (7)

A
  • female
  • breech
  • FH
  • prim
  • oligiohydramnios
  • birth weigh >5kg
  • congenital calcaneovalgus foot deformity

MSRA (15 decks)

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