Paediatrics

Question 1

what is roseola infantum?

Answer 1

infantile disease caused by human herpes virus 6 (HHV6), sometimes called sixth disease

• common 6 months-2 years
• fever later followed by rash
• febrile seizures common

Question 2

what is a cephalohaematoma?

Answer 2

swelling on a baby’s head due to bleeding between the periosteum and skull

associated with instrumental delivery

does not cross suture lines and resolves in a few weeks

Question 3

what is kawasaki disease?

Answer 3

vasculitis seen in children

features:
- high grade fever >5 days
- bright red cracked lips, red palms and soles (later peel), strawberry tongue
- cervical lymphadenopathy

coronary artery aneurysm is a potential complication

Question 4

how is kawasaki disease treated?

Answer 4

1) high dose aspirin
2) IV immunoglobulin
3) echo (check for coronary artery aneurysm)

Question 5

what are some causes of stridor?

Answer 5

1) laryngomalacia
2) croup
3) inhaled foreign body
4) acute epiglottitis

Question 6

what is first line management for paediatric migraines?

Answer 6

ibuprofen

triptans may be used in children >12 but follow up needed. not licenced for under 18s. SEs include tingling, heat, heaviness, and pressure sensations

Question 7

why does croup cause stridor?

Answer 7

laryngeal oedema

Question 8

what is the most common causative organism for croup?

Answer 8

parainfluenza virus

Question 9

what is the peak incidence for croup?

Answer 9

6 months to 3 years

Question 10

what are some signs and symptoms of croup?

Answer 10

barking cough
stridor
fever
corzyal symptoms
increased WOB

Question 11

what x-ray findings may be present in a child with croup?

Answer 11

steeple sign (subglottic narrowing) on PA view

Question 12

what is the treatment for croup?

Answer 12

1) single dose oral dexamethasone

2) supportive- oxygen, adrenaline, fluids as needed

Question 13

which medication helps close a patent ductus arteriosus?

Answer 13

ibuprofen or indomethacin

Question 14

which medication helps keep a patent ductus arteriosus open (e.g. if pt has another cardiac defect which needs surgical repair and want to keep PDA open until after op)

Answer 14

prostaglandin E1

Question 15

what are some risk factors for DDH?

Answer 15

female
breech
family history
firstborn child
oligohydramnios

Question 16

what organism causes acute epiglottitis?

Answer 16

haemophilus influenza B

Question 17

what x-ray findings may you find in a patient with acute epiglottitis?

Answer 17

thumb sign

swelling of epiglottis on lateral view

Question 18

what age would a child learn to crawl?

Answer 18

9 months

Question 19

for paediatric BLS, at what rate should you give chest compressions?

Answer 19

100-120bpm

Question 20

what causes scarlet fever?

Answer 20

group A strep

Question 21

how is scarlet fever treated?

Answer 21

penicillin V

Question 22

what is the difference between scarlet fever and kawasaki disease?

Answer 22

1) scarlet fever
- group A strep
- fever, malaise, strawberry tongue, sandpaper rash
- treated with PO pencillin V for 10 days
- otitis media most common complication

2) kawasaki disease
- vasculitis unsure of cause, sometimes thought to be triggered by infection
- high grade fever, bright cracked lips, strawberry tongue, red and peeling palms and soles, conjunctival injection, cervical lymphadenopathy
- treated with high dose aspirin and immunoglobulins
- most common complication coronary artery aneurysm

Question 23

jaundice in the first 24 hours is always _______.

Answer 23

always pathological! 2-14 days usually physiological

Question 24

what are some causes of jaundice in the first 24 hours?

Answer 24

1) ABO/rhesus haemolytic disease
2) hereditary spherocytosis
3) G6PD deficiency

Question 25

what are some causes of jaundice in the 2-14 day period?

Answer 25

usually physiological, more common in breastfed babies.

1) high red cell turnover
2) immature liver less able to process bilirubin

Question 26

what are some causes of prolonged jaundice (>14 days)?

Answer 26

1) biliary atresia
2) hypothyroidism
3) galactosaemia
4) UTI
5) breast milk jaundice
6) congenital infections (CMV, toxoplasmosis)
7) prematurity (immature liver function)