Paediatrics Flashcards
When can most children undress themselves?
4y
When can most children jump by?
2y
When can most children roll from front to back?
4/12
How do we dx CF?
Sweat test
How does cow’s milk protein allergy present?
Combination of skin and GI sx
E.g. severe eczema + N&V
Tx cow’s milk protein allergy?
Extensively hydrolysed forula
What is an atypical UTI in children?
Seriously ill
Poor urine flow
Abdominal or bladder mass
Raised creatinine
Septicaemia
Failure to respond to tx with abx by 48h
Infection by non-E .coli organisms
How do we tx UTI in 5y.o.
Trimethoprim first-line
Or nitro
Amoxicillin has high levels of resistance so +ve culture needed
What is a common cause of nappy rash? Tx?
Candida albicans
Topical antifungal
How do we treat impetigo?
Topical hydrogen peroxide
Second line fusidic acid
How do we estimate weight in <=10y.o.?
Weight = (age+4) * 2
What is fifth disease otherwise known as?
Erythema infectiosum or slapped cheek syndrome
What causes fifth disease?
Parvovirus B19
How does fifth disease present?
Rash sparing nasolabial folds
Rash on arms and trunk following sore throat and fevers sx the week before
What is acute splenic sequestration?
Life-threatening complication of sickle cell disease
Sudden enlargement of the spleen with a decrease in Hb concn and substanial reticulocytosis
How does acute splenic sequestration present?
Shocked, sudden abdo pain and distension, large mass from the left costophrenic angle to the umbilicus
How does congenital hypothyroidism present?
Lethargy, poor feeding, constipation, symmetrically poor weight gain, length and head circumference
Sometimes umbilical hernia
How does growth hormone deficiency present?
Standing height and growth velocity reduced
Increased subcutaneous fat around the trunk
Pubertal onset delayed
How do we test for growth hormone deficiency?
Insulin tolerance test for dx
MRI head to r/o tumour
Give a risk factor for necrotizing enterocolitis
Formula feed
Where may you see redcurrant stool?
Intussusception
What is screened for in the bloodspot test?
Phenylketonuria
Congenital hypothyroidism
Sickle cell
CF
Medium chain acyl-CoA dehydrogenase deficiency
Maple syrup urine disease
Homocystinuria
Glutaric acidaemia type 1
Isovaleric acidaemia
Where do you see blast cells?
ALL
What is a stork mark?
Pink, flat and irregularly shaped mark on the back of the neck, and/or the forehead, eyelids and sometimes the top lip
What is protozoal gastroenteritis?
Consider this if the diarrhoea lasts most than 14 days
How does hand, foot and mouth disease present?
Sore throat, dysphagia, pyrexia (up to 39deg), vesicles in oral cavity, hands and feet
What are the TORCH infections?
Pass from mother to foetus during childbirth
Toxoplasma gondii
Other agents
Rubella
Cytomegalovirus (CMV)
Herpes simplex virus
Other agents incl. treponema pallidum, VZV, parvovirus B19, Zika virus
What is the most common childhood epilepsy?
Benign rolandic epilepsy
- partial
- usually resolve by adolescence
Why do we treat neonatal jaundice?
Avoid neurotoxicity
What is ECMO? What is it used for?
Extracorporeal membrane oxygenation
Technique to provide both cardiac and respiratory support oxygen to pts whose lungs are severely dysfunctional e.g. in RDS or Primary Pulmonary Hypertension
What causes roseola infantum?
HHV-6 - supportive tx
Where would you see abdominal breathing?
Normal in infants
How do we initially support newborn babies after delivery?
Warm and stimulate by rubbing (vast majority of infants respond to just these two manouvres)
What is Riedel’s lobe?
Downward tongue-like projection of the anterior edge of the right liver lobe to the right of the gallbladder, seen most frequently in the liver. Sometimes can extend down to the RIF! Normal variant
In which population is RDS more common in?
Males
Where do you see the double bubble sign?
Duodenal atresia
How does duodenal atresia present?
Vomiting within first 24hrs of life, absence of breath sounds, scaphoid abdomen
How does Hirschsprung disease present?
One year old child with a PMH of delayed passage of meconium presents with constipation and vomiting
Where do you see a thumbprint sign on CXR?
Epiglottitis
How do we treat epiglottitis?
Third gen cephalosporin e.g. cefotaxime
How do we catch a urine sample in a young child?
Clean catch urine
What is erythema toxicum neonatorum?
Toxic erythema of the newborn
Harmless red rash that occurs on the skin of newborns
How do we treat erythema toxicum neonatorum?
Self-limiting
How do we investigate henoch-schonlein purpura?
Urine dipstick looking for blood or protein in urine
Refer to secondary care
What is haemorrhagic disease of the newborn?
Vitamin K deficiency bleeding
Where do you see dermatitis herpetiformis?
Coeliac disease - it results as a form of gluten causes inflammation
What is DIC?
Activation of the coagulation system leads to deposition of fibrin throughout the circulation, further compromising organ and tissue perfusion. It also leads to consumption of platelets and clotting factors, as they are being used up to form the blood clots. This leads to thrombocytopenia, haemorrhages and an inability to form clots and stop bleeding. This is called disseminated intravascular coagulopathy (DIC).
