Paediatrics Flashcards
What age range do neonates come under?
Birth to 1 month (unless premature)
Why is it important to always give the patient options?
The patient is a child and so may no be able to e.g swallow tablets
What age range do infants come under?
1 month to 2 years
What age range do children come under?
2 to 12 years
What age range do adolescents come under?
12 to 18 years
At what point do you class a premature baby as a neonate?
When they reach the day they were expected
Which cough and cold remedies do the MHRA advice against in children under 6?
- Brompheniramine, Chlorphenamine and Diphenhydramine
- Dextromethorphan and Pholcodeine
- Guaifenesin and Ipecacuanha
- Phenylephrine, Pseudoephedrine, Ephedrine, Oxymetazoline and Xylometazoline
They can be used in children 6-12 but only be treated with advice from the pharmacist and product packaging.
What can Napkin Dermatitis (Nappy Rash) be caused by?
Urea (ammonia) and faeces with irritate the skin and cause discomfort.
Where abouts do the lesions for Napkin Dermatitis present?
Normally only on the bottom itself. It wouldn’t present in skin folds in e.g the legs or arms (could be fungal infection or something else - referral needed).
Differential Diagnosis: Irritant Dermatitis Flexure? Satellite lesions? Other sites affected? Rash?
Flexure: No
Satellite lesions: No
Other sites affected: No
Rash: Red raw
Differential Diagnosis: Candidiasis Flexure? Satellite lesions? Other sites affected? Rash?
Flexure: Yes
Satellite lesions: Yes
Other sites affected: Yes
Rash: Bright red and well demarcated (clear boundary)
Differential Diagnosis: Seborrhoeic Dermatitis Flexure? Satellite lesions? Other sites affected? Rash?
Flexure: Yes
Satellite lesions: No
Other sites affected: Yes
Rash: Shiny or greasy
Differential Diagnosis: Psoriasis Dermatitis Flexure? Satellite lesions? Other sites affected? Rash?
Flexure: Yes
Satellite lesions: No
Other sites affected: Yes
Rash: Often no scaling present
What are the referral symptoms for Nappy Rash
Severe rash
Signs of bacterial infection
Treatment failure following 7 days of appropriate treatment
Psoriasis
What are the treatment options for napkin dermatitis (nappy rash)
Barrier preparations (to try and reduce skin irritation)
- Zinc containing products e.g Zinc & Castor oil, Sudocrem, Vasogen
- Titanium containing products e.g Metanium
- Dimethicone products (protect against water) e.g Conotrane, Siopel
Metallic products repel the water from the skin and causes a protective layer, protecting against faeces and urea.
What advice would you give to a patient with napkin dermatitis (nappy rash)
- Avoid coarse towelling materials
- Use quality nappies to maintain dry nappy/skin interface
- Change nappies frequently
- Allow skin to breathe whenever possible
- Avoid powder preparations
- Use fragrance and alcohol free wipes
What is the incubation period of chicken pox?
10-20 days
What are the first symptoms to show when a patient is infected with chicken pox?
Fever, headache and sore throat followed by a rash a few days later
How long is a child with chicken pox contagious for?
Usually for the first 3 days after the rash appears until the vesicles have crusted over
Where abouts on the body is the chicken pox rash most common?
The face, front and back rather than at the extremities
What are the referral symptoms for chicken pox?
- Secondary infection due to scratching (S aureas)
- Signs of a chest infection
- Severely ill
- Any signs of chicken pox in pregnancy or new born (<4 weeks old)
- Coexisting conditions
- Dehydration (ensure children drink plenty of water!)
What is the usual suggested treatment for chicken pox?
Purely symptomatic
- Antipyretics
- Antihistamines
- Calamine lotion
Lifestyle advice
The resurgence of the chicken pox virus can cause what?
Shingles
What are the characteristic features of shingles?
- Follows a particular line where the infected nerves are
- Pain can be severe (sharp, stabbing or burning pain)
When do you refer shingles?
Always (nothing is available OTC)
- If on the face, more urgent medical attention is neededd
How long is the incubation period of measles?
10 days
Infants under what age are not affected by measles?
4 months
How long is a patient with measles infectious for?
4 days before the onset of the rash and until 5 days after it disappears
What are Koplik’s spots?
Little white grainy spots inside the mouth
Is measles a problem in pregnant women?
Yes! it can damage the foetus and cause premature birth
What are the pro-dromal symptoms of measles?
- Fever (39C)
- Cough and cold
- Sore throat (swollen lymph nodes)
- Reddish eyes
- Sensitivity to light
- Koplik’s spots
How does the measles rash develop?
Emerges red, confluent and starts at the hair line and progresses rapidly over 24-48 hours to cover the whole body (lasting for 3 days)
What are the complications of measles?
- Otitis media
- Pneumonia
- Febrile convulsions
- Encephalitis
- More severe in adults and pregnant women
What is the incubation period of Mumps and how long is it before the patient is contagious?
14-25 Days and the patient is contagious a week before symptoms show.
What are the symptoms of Mumps?
- Begins with 2 days of discomfort
- Increasing temperature (up to 40C)
- Head ache, Ear ache, Sore throat and pain on opening mouth
- Jaw stiffness
- Swollen parotid glands
- Earlobes may stick out
- Face looks swollen
- Mild cases last 3-4 days, most cases 7 days or more
What are the complications of Mumps?
Orchitis (swelling of testes)
Oophoritis
Pancreatitis
Meningitis
How do you confirm an infestation of headlice?
Physical presence of a louse or egg on the scalp (not a ‘nit’ i.e a dead case)
What are the 3 types of treatment option for headlice?
Wet combing
Physical insecticide
Chemical insecticide
What are the two drugs available OTC for the treatment of threadworm?
Mebendazole and Piperazine
How does mebendazole work?
inhibits the worms uptake of glucose
How does Piperazine (Pripsen) work?
It paralyses the worm and is combined with senna to expel the worm
What are the referral symptoms for a fever?
- Child under 3 months
- Child 3-6 months with fever over 39C
- Fever with no other symptoms
- Febrile convulsions
- Purpuric rash
- Stiff neck
- Duration > 5 days
- Unresponsive child
- Signs of dehydration
How do you treat a fever?
Paracetamol or Ibuprofen > 3 months old
Paracetamol can be used in 2 month old in certain situations
How long should vomiting last in infancy before it is worrying?
> 24 hours or contains bile
