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1 - MSRA > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Chromosomes in Patau’s vs Edwards

A

Patau’s - 13
Edward’s - 18

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2
Q

Features of Patau’s syndrome

A
  • Microcephalic
  • Small eyes
  • Cleft lip/palate
  • Polydactylyl
  • Scalp lesions
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3
Q

Features of Edward’s syndrome

A
  • Micrognathia
  • Low-set ears
  • Rocker bottom feet
  • Overlapping of fingers
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4
Q

Features of Fragile X

A
  • Learning difficulties
  • Macrocephaly
  • Long face
  • Large ears
  • Macro-orchidism
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5
Q

Features of Noonan syndrome

A
  • Webbed neck
  • Pectus excavatum
  • Short stature
  • Pulmonary stenosis
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6
Q

Features of Pierre-Robin syndrome

A
  • Micrognathia
  • Posterior displacement of tongue
  • Cleft palate
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7
Q

Features of Prader-Willi syndrome

A
  • Hypotonia
  • Hypogonadism
  • Obesity
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8
Q

Features of William’s syndrome

A
  • Short stature
  • Learning difficulties
  • Friendly, extroverted personality
  • Transient neonatal hypercalcaemia
  • Supravalvular aortic stenosis
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9
Q

Features of Cri du Chat syndrome

A
  • Characteristic cry due to larynx and neurological problems
  • Feeding difficulties and poor weight gain
  • Learning difficulties
  • Microcephaly and micrognathism
  • Hypertelorism
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10
Q

Hearing test used in newborn screening programme

A

Otoacoustic emission test

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11
Q

Hearing test used in newborns and infants

A

Auditory brainstem response test

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12
Q

Hearing test used at 6-9 months

A

Distraction test

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13
Q

Hearing test used at 18 months - 2.5 years

A

Recognition of simple objections, e.g. ‘where is the teddy’

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14
Q

Hearing test used >2.5 years

A
  • Performance testing
  • Speech discrimination testsH
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15
Q

Hearing test used >3 years

A

Pure tone audiometry

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16
Q

Features of chondromalacia patallae

A
  • Common in teenage girls
  • Anterior knee pain on walking up and down stairs and rising from prolonged sitting
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17
Q

Features of Osgood-Schlatter disease

A
  • Seen in sporty teenagers
  • Pain, tenderness, and swelling over tibial tubercle
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18
Q

Features of osteochondritis dissecans

A
  • Pain after exercise
  • Intermittent swelling and locking
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19
Q

Features of patellar subluxation

A
  • Medial knee pain due to lateral subluxation of patella
  • Knee may give way
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20
Q

Features of patellar tendonitis

A
  • More common in athletic teenage boys
  • Chronic anterior knee pain that worsens after running
  • Tender below patella on examination
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21
Q

Features of DDH

A
  • Barlow’s and Ortolani’s positive
  • Unequal skin folds/leg lengths
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22
Q

Features of transient synovitis

A
  • 2-10 years old
  • Acute hip pain associated with viral infection
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23
Q

Features of Perthe’s disease

A
  • 4-8 years old
  • Hip pain developing over few weeks
  • Limp
  • Stiffness and reduced range of movement

10% cases bilateral

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24
Q

XR changes in Perthe’s disease

A

Early changes - widening of joint space
Later changes - decreased femoral head size/flattening

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25
Q

Features of SUFE

A
  • 10-15 years
  • More common in obese children and boys
  • Knee or distal thigh pain
  • Loss of internal rotation of leg in flexion
  • May present following trauma or with chronic, persistent symptoms

20% cases bilateral

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26
Q

Features of JIA

A
  • Joint pain and swelling, usually medium sized joints e.g. knees, ankles, elbows
  • Limp
  • ANA may be positive
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27
Q

Features of septic arthritis

A
  • Acute hip pain
  • Systemic upset, e.g. pyrexia
  • Inability/severe limitation of affected joint
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28
Q

Poor prognostic factors ALL

A
  • Age <2 or >10
  • WBC >20 at diagnosis
  • T or B cell surface markers
  • Non-Caucasian
  • Male sex
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29
Q

Aortic stenosis associations

A
  • William’s syndrome
  • Coarctation of aorta
  • Turner’s syndrome
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30
Q

Management aortic stenosis in children

A

Aim to avoid or delay valve replacement
If gradient >60mmHg, ballon valvotomy may be indicated

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31
Q

Features of severe asthma attack in children

A
  • SpO2 <92%
  • PEF 33-50% best or predicted
  • Too breathless to talk or feed
  • HR >125 in >5 years, >140 in 1-5 years
  • RR >30 in >5 years, >40 in 1-5 years
  • Use of accessory neck muscles
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32
Q

Features of life-threatening asthma attack in children

A
  • SpO2 <92%
  • PEF <33% best or predicted
  • Silent chest
  • Poor resp effort
  • Agitation
  • Altered consciousness
  • Cyanosis
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33
Q

Initial management of ADHD in primary care

A

10 week watch and wait period - see if symptoms change or resolve - if persist, refer to secondary care

34
Q

Conservative management ADHD

A

Parents attending education and training programmes

35
Q

Indications drugs ADHD

A
  • Failure to respond to conservative methods
  • Severe symptoms
36
Q

First line treatment ADHD

A

Methylphenidate

37
Q

SEs methylphenidate

A
  • Abdominal pain
  • Nausea
  • Dyspepsia
  • Cardiotoxic
38
Q

Monitoring methylphenidate

A
  • Weight and height monitoring every 6 months
  • ECG at start of treatment
39
Q

Second line drug ADHD

A

Lisdexamfetamine

40
Q

Metabolic conditions that are X-linked recessive

A
  • Hunters
  • G6PD
41
Q

Metabolic conditions that are autosomal dominant

A
  • Hyperlipidaemia type II
  • Hypokalaemic periodic paralysis
42
Q

Structural conditions that are autosomal recessive

A
  • Ataxia telangiectasia
  • Friedreich’s ataxiaA
43
Q

Age benign rolandic epilepsy

A

4-12 years

44
Q

Features benign rolandic epilepsy

A
  • Seizures occur at night
  • Typically partial, secondary generalisation may occur
  • Child otherwise normal
45
Q

EEG benign rolandic epilepsy

A

Centrotemporal spikes

46
Q

Prognosis benign rolandic epilepsy

A

Excellent - seizures stop by adolescence

47
Q

What is caput succedaneum

A

Oedema of the scalp at presenting part of head, typically vertex

48
Q

Features caput succedaneum

A
  • Soft puffy swelling due to localised oedema
  • Crosses suture lines
49
Q

When does cephalohaematoma develop

A

Typically several hours after delivery

50
Q

Most common site cephalohaematoma

A

Parietal region

51
Q

How long does cephalohaematoma take to resolve

52
Q

When is chickenpox contagious

A

4 days before rash, 5 days after rash first appeared (once all lesions dry and crusted)

53
Q

Incubation period chickenpox

A

10-21 days

54
Q

Clinical features chickenpox

A

Fever initially
Itchy rash starting on head/trunk → spreading. Initially macular → papular → vesicular

55
Q

Who needs VZIG chickenpox

A
  • Immunocompromised
  • Newborns with peripartum exposure
56
Q

Complications chickenpox

A
  • Secondary bacterial infection
  • Pneumonia
  • Encephalitis
  • Disseminated haemorrhagic chickenpox
  • Arthritis
  • Nephritis
  • Pancreatitis
57
Q

What increases risk of secondary bacterial infection of chickenpox

58
Q

Features measles infection

A
  • Prodrome of irritability, conjunctivitis, fever
  • Koplik spots (white spots on buccal mucosa)
  • Rash
59
Q

Features of rash in measles

A

Starts behind ears → whole body
Discrete maculopapular rash becoming blotchy and confluent

60
Q

Features measles

A

Fever, malaise, muscle pain
Parotiditis - earache, pain on eating - unilateral → bilateral in 70%
Rash

61
Q

Features rubella

A

Pink maculopapular rash, initially on face → whole body, usually fades by 3-5 day
Lymphadenopathy - suboccipital and postauricular

62
Q

Cause erythema infectiosum

A

Parvovirus B19

63
Q

Features erythema infectiosum

A
  • Lethargy, fever, headache
  • Slapped cheek rash → proximal arms and extensor surfaces
64
Q

Cause scarlet fever

A

Reaction to erythrogenimc toxins produced by group A strep

65
Q

Features scarlet fever

A
  • Fever, malaise, tonsillitis
  • Strawberry tongue
  • Rash - fine punctuate erythema sparing area around the mouth (circumoral pallor)
66
Q

Features hand foot and mouth

A
  • Mild systemic upset - sore throat, fever
  • Vesicle sin mouth, and on palms/soles of feet
67
Q

Cause hand foot and mouth

A

Coxsackie A16

68
Q

Age of presentation coeliac in children

A

Usually before age of 3 (following introduction of cereals to diet)

69
Q

Gene associations coeliac

A

HLA-DQ2 and HLA-DQ8

70
Q

Features congenital diaphragmatic hernia

A
  • Pulmonary hypoplasia
  • Pulmonary hypertension

→ resp distress at birth

71
Q

Most common acyanotic CHD

72
Q

Most common cyanotic CHD

A

Tetralogy

TGA more common at birth as presents earlier (ToF 1-2 months)

73
Q

Age and consent

A
  • Under 16 if meet Fraser guidelines, but cannot refuse treatment deemed in their best interest
  • 16-18 presumed competent to consent to treatment
  • 18+ may consent or refuse
74
Q

First line management constipation with impaction

A

Movicol (polyethylene glycol 3350 + electrolytes) using escalating dose regime

75
Q

Second line management constipation with impaction

A

Add stimulant laxative if disimpaction not achieved in 2 weeks

76
Q

Treatment constipation without impaction/maint

A

Movicol

Add stimulant laxative if no response
Add lactulose or docusate if stools hard

77
Q

How long to continue laxatives childhood constipation

A

Continue at maint dose for several weeks after regular bowel habit established, then gradually reduce dose

78
Q

Role of dietary interventions in childhood constipation

A

Do not use alone as first line treatment

79
Q

Management constipation in infants <6 months

A
  • If bottle fed, extra water between feeds
  • If breastfed, constipation unusual - consider organic causes
80
Q

Features CMPA

A
  • Regurgitation and vomiting
  • Diarrhoea
  • Urticaria, atopic eczema
  • Irritability, crying
  • Wheeze, chronic cough
81
Q

Diagnosis CMPA

A

Often clinical

Skin prick/patch testing
Total IgE and specific IgE for CMP

82
Q

First line management CMPA

1 - MSRA (23 decks)

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