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Third Year, Still Here > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Which anticoagulant is associated with congenital heart defects?

A

Warfarin.

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2
Q

Foetal alcohol syndrome is associated with congenital heart defect (CHD). True or false?

A

True.

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3
Q

What is the most common cause of congenital heart defects?

A

Most CHD are genetic in origin.

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4
Q

Pressure in the foetal heart is highest on the _ side, which enables blood to bypass the lungs.

A

Right.

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5
Q

The ductus arteriosus connects the aorta to the _ _.

A

Pulmonary artery.

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6
Q

The foramen ovale is held open by high right _ pressure.

A

Atrial.

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7
Q

What are the two cyanotic forms of CHD?

A

Tetralogy of Fallot.
Transposition of the great arteries.

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8
Q

At what week of gestation does the foetal anomaly scan take place?

A

20 weeks.

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9
Q

Why might a baby with a congenital heart defect struggle to feed?

A

If the baby is cyanotic as a result of CHD, they will be reluctant to feed as this interferes with their breathing.

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10
Q

Which way is the blood shunted in ventricular septal defect and why?

A

Blood will be shunted left to right as pressure is highest in the left ventricle and the blood will move down the pressure gradient.

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11
Q

What is the most common congenital heart defect?

A

Ventricular septal defect (approximately 30% of all CHD).

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12
Q

The murmur most commonly associated with VSD is a _ murmur at the left _ _ .

A

Pansystolic, left sternal edge.

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13
Q

Small ventricular septal defects require surgical intervention. True or false?

A

False. Small VSD are often asymptomatic and usually close spontaneously.

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14
Q

What ECG findings would you expect to see in a baby with a large VSD?

A

Evidence of biventricular hypertrophy.

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15
Q

_ septal defect accounts for 10% of congenital heart defects.

A

Atrial.

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16
Q

Which murmur is associated with atrial septal defect and where would it be heard?

A

Ejection systolic murmur at the left sternal edge.

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17
Q

A child with patent ductus arteriosus will be cyanotic. True or false?

A

False. Patent ductus arteriosus causes left-to-right shunting from the aorta to the pulmonary artery, which occurs after blood has been oxygenated.

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18
Q

A continuous murmur beneath the left clavicle might signify which congenital heart defect?

A

Patent ductus arteriosus.

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19
Q

Which medication can sometimes be used to close a patent ductus arteriosus?

A

Indamethosine.

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20
Q

Why are NSAIDs contraindicated in pregnancy?

A

They are prostaglandin inhibitors and may cause the ductus arteriosus to close prematurely.

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21
Q

Which genetic condition is most closely associated with coarctation of the aorta?

A

Turner Syndrome.

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22
Q

Coarctation of the aorta is more common in females. True or false?

A

False. It is more common in males.

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23
Q

Why might metabolic acidosis be seen in babies with severe aortic coarctation?

A

Babies are at risk of necrosis in the limbs supplied by arteries that branch off post-coarctation, which causes elevated lactate.

24
Q

Pulmonary stenosis refers to narrowing of the pulmonary _.

A

Valve.

25
Q

Pulmonary stenosis is associated with _ _ hypertrophy.

A

Right ventricular hypertrophy.

26
Q

Why is pulmonary stenosis associated with right ventricular hypertrophy?

A

The narrow pulmonary valve forces the right ventricle to work harder in order to force blood to the lungs, resulting in hypertrophy.

27
Q

Tetralogy of Fallot consists of overriding aorta, _ stenosis, _ septal defect, and right _ hypertrophy.

A

Pulmonary stenosis, ventricular septal defect, and right ventricular hypertrophy.

28
Q

Most congenital cardiac defects are diagnosed via which imaging modality?

A

Echocardiogram.

29
Q

Transposition of the great arteries results in cyanosis immediately after birth. True or false?

A

True.

30
Q

The second heart sound in a baby with transposed great arteries will be unusually _. Why is this?

A

Loud. This is due to the fact that the aortic valve is in an anterior position in babies with TGA.

31
Q

In transposition of the great arteries, the _ is connected to the right ventricle.

A

Aorta.

32
Q

In some babies with transposed great arteries, the closure of the aortic valve will be palpable. True or false?

A

True.

33
Q

Which congenital heart defect results in a distinctive boot-shaped heart on echocardiogram?

A

Tetralogy of Fallot.

34
Q

Murmurs from _ _ and a patent ductus arteriosus can radiate to the back.

A

Pulmonary stenosis.

35
Q

What is the difference between an atrial septal defect and a patent foramen ovale?

A

These conditions present in a very similar way, but differ in their aetiology.

36
Q

Why is a nasopharyngeal aspirate important in the diagnosis of bronchiolitis?

A

Identifying the causal pathogen enables babies to be separated accordingly and reduces the risk that they will spread new infections to one another.

37
Q

Management of bronchiolitis is chiefly supportive and focuses on breathing and _.

A

Feeding.

38
Q

If a baby with bronchiolitis needs oxygen and a nasal cannula is not sufficient, what would be the next step?

A

High flow nasal oxygen (Airvo).

39
Q

What are the most common viral causes of pneumonia in children?

A

RSV or parainfluenza.

40
Q

The first-line antibiotic for the treatment of a bacterial pneumonia is _.

A

Amoxicillin.

41
Q

Croup is a/n _ respiratory tract infection causing inflammation of the _.

A

Upper, larynx.

42
Q

Which childhood respiratory condition is characterised by stridor and a seal-like barking cough?

A

Croup?

43
Q

Why is croup not seen in older children and adults?

A

The airway is funnel-shaped in early childhood, which makes the child more susceptible to breathing difficulties if the larynx is inflamed.

44
Q

How would you distinguish between epiglottitis and croup on immediate clinical presentation?

A

Epiglottitis is accompanied by the same barking cough, but children will have more extreme difficulty swallowing and their temperature will usually be over 39.

45
Q

_ is characterised by a softening of the tissues of the larynx, causing vocal cords to fall in when breathing.

A

Laryngomalacia.

46
Q

Laryngomalacia usually self-resolves by the time a child is one year old. True or false?

A

True.

47
Q

What radiological sign might you expect to see in both croup and epiglottitis?

A

Steeple sign.

48
Q

Which steroid is first-line prescribed in croup?

A

Dexamethasone.

49
Q

If dexamethasone alone is not sufficient to manage croup symptoms, which steroid would be prescribed next?

A

Nebulised budesamide.

50
Q

If a child with croup does not respond to nebulised budesamide, or they appear too acutely unwell for budesamide to be an option, what would be given next?

A

Nebulised adrenaline.

51
Q

The most common viral cause of epiglottitis is _ _ _.

A

Haemophilius influenza B.

52
Q

Why should you as a foundation doctor never inspect the throat in a suspected epiglottitis patient?

A

The child needs to be kept calm to prevent their breathing from being compromised further. Anaesthetics should be fast-bleeped to perform intubation.

53
Q

Why do babies with cystic fibrosis have difficulty passing meconium?

A

Excessive mucus in the digestive tract makes it difficult for the meconium to pass.

54
Q

Acute _ _ typically occurs two to three weeks after a group A streptococcal infection (especially pharyngitis).

A

Rheumatic fever.

55
Q
A

Third Year, Still Here (5 decks)

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