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MSRA > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Meningitis management <3 months and >3 months

A

<3 months= IV amoxicillin and cefotamine

> 3 months= IV cefotaxime (ceftriaxone) +/- dexamethasone if LP shows:
- WCC high, bacteria, or purulent CFS

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2
Q

Shaken baby triad (3)

A

Subdural haemorrhage
Retinal haemorrhage
Encephalopathy

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3
Q

Pethers (ischaemia) investigations (1)

A

X-ray
shows widening join spaces

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4
Q

Pethers management (2)
what are they at risk of? (1)

A

<6 years= conservative
>6 years= surgical consideration

Risk of OA

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5
Q

Scarlet fever is spread via respiratory route by
- what bacteria? (1)
- what management? (1)

A
  • Group A haemolytic streptococci (usually Streptococcus pyogenes)
  • 10/7 penicillin
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5
Q

Scarlet fever:
- when return to school? (1)

A

within 24hr
IT IS NOTIFIABLE DISEASE

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6
Q

Scarlet fever:
complications? (4)

A
  • otitis media: the most common complication
  • rheumatic fever: typically occurs 20 days after infection
  • acute glomerulonephritis: typically occurs 10 days after infection
  • invasive complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) rarer
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7
Q

Paediatric migrane:
management? (2)

A
  • 1st line= ibuprofen
  • 2nd line IF OVER 12 = triptans
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8
Q

Downs syndrome:
- most common cardiac abnormality? (1)
- haematological? (1)

A
  • Atrioventricular septal defect
  • ALL
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9
Q

Purulent discharge and conjunctival inflammation in <30 days old makes you think of… (1)
- management (1)
- responsible organisms (2)

A

ophthalmia neonatorum (conjunctivitis under 30 days)

–> REFER OPTHALOMOGY

Responsible organisms include
- Chlamydia trachomatis
- Neisseria gonorrhoeae

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10
Q

Hirschprung’s disease:
- management 1st line? (1)
- 2nd line? (1)
- associated with with congenital abnormality (1)

(aganglionic segment of bowel due to a developmental failure of the parasympathetic)

A
  • 1st= rectal washouts/ bowel irrigation
  • 2nd= surgery
  • Downs syndrome
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11
Q

Roseola infantum:
- age (1)
- main features? (2)
- school exclusion? (1)
- organism? (1)

A
  • 6 months - 2 years
  • fever followed later by rash 1-2 weeks later, erythematous across limbs and trunk
  • febrile seizures common
  • no school exclusion
  • human herpes virus 6 (HHV6)
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12
Q

Rubella:
- rash pattern? (1)
- other features (3)

A

starting on the face before spreading to the rest of the body

  • mild fever, sore throat and lymphadenopathy.
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13
Q

Croup:
- moderate features (5)
- severe features (5)

A

MODERATE:
- Frequent barking cough
- Easily audible stridor at rest
- Suprasternal and sternal wall retraction at rest
- No or little distress or agitation
- The child can be placated and is interested in its surroundings

SEVERE:
- Frequent barking cough
- Prominent inspiratory (and occasionally, expiratory) stridor at rest
- Marked sternal wall retractions
- Significant distress and agitation, or lethargy or restlessness (a sign of hypoxaemia)
- Tachycardia occurs with more severe obstructive symptoms and hypoxaemia

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13
Q

Measles:
- rash pattern? (1)
- other features? (4)

A

starts behind the ears and then spreads to the rest of the body.

4Ks:
It is associated with fever, conjunctivitis, coryzal symptoms and white koplik spots on the inside of the mouth.

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14
Q

Croup:
- management (1)
- age (1)
- when to admit? (1)

(stridor, fever, coryza, increased WOB)

A
  • Single dose of oral dexamethasone (0.15 mg/kg) is to be taken immediately regardless of severity
  • 6 months - 1 year
  • admit if ANY moderate/ severe Sx
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15
Q

Croup:
investigations/ diagnosis? (2)

A
  • clinical diagnosis
  • XR chest sometimes –> STEEPLE sign anterior view, THUMB sign in lateral view
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16
Q

Bow legs:
<4 yrs management? (1)

A
  • Bow legs in a child < 3 is a normal variant and usually resolves by the age of 4 years
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17
Q

Risks for surfactant lung disease (4)

A

male sex
diabetic mothers
Caesarean section
second born of premature twins

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18
Q

Caffeine in babies

A

can be used as a respiratory stimulant in newborn babies

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19
Q

Surfactant lung disease:
- CXR finding (1)
- management (4)

A
  • ‘ground-glass’ appearance with an indistinct heart border
  • corticosteroids to mum
  • O2
  • ventilation
  • exogenous surfactant via ET tube
20
Q

nocturnal enuresis:
- what age?

A

BEFORE 5 (so 3-4 years)

rewards –> enuresis alarm –> desmopressin

21
Q

Differential of: non-blanching petechial rash but NO fever (2)

A

ITP (recent cold)

AKA Immune (or idiopathic) thrombocytopenic purpura (ITP) is an immune-mediated reduction

22
Q

HUS triad (3)

A

microangiopathic haemolytic uraemia
acute kidney injury
thrombocytopenia

23
Q

Meningitis organisms
- <3 months
- 1month - 6 years
- >6 years

A

Neonatal to 3 months
Group B Streptococcus: usually acquired from the mother at birth. More common in low birth weight babies and following prolonged rupture of the membranes
E. coli and other Gram -ve organisms
Listeria monocytogenes

1 month to 6 years
Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
Haemophilus influenzae

Greater than 6 years
Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)

24
Q

Vitamin K in babies: who is deficient?

A

breastfed

25
Q

Raised FSH/LH in primary amenorrhoea

A

Turners syndrome (gonadal dysgenesis)

WOULD PRESENT EARLY

26
Q

Raised FSH, LH and low oestradiol with secondary amenorrhaea

A

premature ovarian failure

(cessation of menses for 1 year before the age of 40)

27
Q

intrauterine adhesions following dilation and curettage
+ secondary amenorrhoea

A

Asherman’s syndrome

28
Q
A
29
Q

Primary amenorrhoea, little or no axillary and pubic hair, elevated testosterone

A

androgen insensitivity syndrome

30
Q

development of male secondary sexual characteristics in females (such as deep voice and hirsutism)

A

Congenital adrenal hyperplasia (CAH)

impaired cortisol synthesis leading to surplus progesterone which is converted to extra testosterone to reduce the levels of progesterone. Unlike AIS, the body is still responsive to testosterone, therefore, this would mean that this patient would have hirsutism and excess male-pattern hair growth, including axillary and pubic hair, which is not seen here. A diagnosis of CAH would also not explain the bilateral lower pelvic swellings, which are likely to be undescended testes.

31
Q

medication to reduce size of uterine fibroids

A

GnRH agonist e.g. leuprolide

32
Q

COCP and surgery

A

don’t have 4-6 weeks prior to major surgery

33
Q
A
34
Q

best HRT for VTE risk

A

transdermal

35
Q

Strawberry cervix
- cause
- management

A

Trichomonas vaginalis

Oral metronidazole

36
Q

bacterial vaginosis

A

oral metronidazole

37
Q

gonorrhoea management

A

IM ceftriaxonec

38
Q

cottage cheese discharge
cause?
management?

A

thrust/ vaginal candidasis/ Candida albicans

medication:
oral fluconazole 150 mg as a single dose first-line
clotrimazole 500 mg intravaginal pessary as a single dose if oral therapy is contraindicated
If there are vulval symptoms, consider adding a topical imidazole in addition to an oral or intravaginal antifungal
if pregnant then only local treatments (e.g. cream or pessaries) may be used - oral treatments are contraindicated

39
Q

vulval erythema, fissuring, satellite lesions may be seen

A

thrush / candida

40
Q

recurrent thrush treatment?

A

4+ episodes / year = recurrent

confirm with swab
induction: oral fluconazole every 3 days for 3 doses

41
Q

Most common benign ovarian tumour in women under the age of 25 years

A

Dermoid cyst (teratoma)

42
Q

The most common cause of ovarian enlargement in women of a reproductive age

A

Follicular cyst

43
Q

Most common type of ovarian pathology associated with Meigs’ syndrome

A

fibroma

44
Q

commonest type of ovarian cyst

A

Follicular cysts

45
Q

If ruptures may cause pseudomyxoma peritonei

A

Mucinous cystadenoma

46
Q

The most common type of epithelial cell tumour

A

Serous cystadenoma

47
Q

May contain skin appendages, hair and teeth

A

Dermoid cyst (teratoma)

48
Q

most common ovarian cancer

A

serous carcinoma

49
Q

chocolate cyst

A

endometriotic cyst

MSRA (9 decks)

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