PAEDIATRICS 3 Flashcards

1
Q

How might an older child present with DDH?

A

Trendelenberg gait and leg length discrepancy

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2
Q

How is duchennes diagnosed?

A

Raised CK
Genetic testing is the diagnostic tool of choice now rather than muscle biopsy

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3
Q

School exclusion for rubella?

A

5 days from the onset of the rash

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4
Q

School exclusion for measles?

A

4 days from the onset of the rash

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5
Q

School exclusion for mumps ?

A

5 days from the onset of swollen glands

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6
Q

Investigations to diagnose infantile spasms?

A

EEG will shows hypsarrhythmia
CT or MRI as 70% with have abnormalities e.g. tuberous sclerosis which is the most common cause

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7
Q

What is the likely cyanotic congenital heart disease that presents in the first days of life? What about in the first 1-2 months of life?

A

Days - Transpoistion of the great arteries
Months - tetralogy of fallot

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8
Q

What is enuresis?

A

Involuntary discharge of urine by day/night/both in a child aged 5 years or older, in the absence of congenital or acquired defects of the nervous system or urinary tract

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9
Q

Possible underlying causes of enuresis in children?

A

Constipation
Diabetes mellitus
UTI if recent onset

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10
Q

Location of cystic hygroma and branchial cyst?

A

Cystic hygroma is usually behind the sternocleidomastoid muscle
Banchial cyst is usually anterior to this

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11
Q

Outline scoring system for APGAR?

A

Appearance- pink (2), extremities blue (1), blue all over (0)
Pulse >100 (2), <100 (1), absent (0)
Grimace - cries in stimulation/coughs/sneezes (2), grimaces (1), nil (0)
Activity - active movement (2), limb flexion (1), flaccid (0)
Resp effort - strong crying (2), weak irregular crying (1), nil (0)

0-3 low
4-6 moderate lo1
7-10 good

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12
Q

What does it mean if there is raised immunoreactive trypsinogen on heel prick testing?

A

It can indicate cystic fibrosis so a sweat test is indicated

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13
Q

How much more likely are children with Down’s syndrome to get leukaemia?

A

> 30x more likely to get ALL
100x more likely to get AML

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14
Q

Features of congenital rubella syndrome?

A

Sensorineural deafness
Congenital cataracts
Congenital heart disease
Growth retardation
Hepatosplenomegaly
Purpuric skin lesions
Salt and pepper chorioretinitis
Microphthalmia
CP

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15
Q

Features of congenital CMV?

A

Growth retardation
Blueberry muffin skin lesions - pinpoint petechiae
Microcephaly
Sensorineural deafness
Encephalitis/seizures
Hepatosplenomegaly

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16
Q

Features of congenital toxoplasmosis syndrome?

A

Neuro - cerebral calcification, hydrocephalus, chorioretinitis
Ophthalmic - retinopathy & cataracts

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17
Q

Features of foetal varicella syndrome?

A

Skin scarring
Microphthalmia (small eyes)
Limb hypoplasia
Microcephaly
LD

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18
Q

What does variable expressivity mean in genetics?

A

Expressivity is the degree to which a genotype is expressed as a phenotype within an individual
Variable expressivity is when individuals with a shared genotype exhibit varying phenotypes

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19
Q

From what age can a transcutaneous bilirubinometer be used in babies to measure the bilirubin level?

A

From 24 hours old

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20
Q

When is puberty considered delayed?

A

In boys when there are no signs of testicular development by age 14
In girls when there is no sign of breast development by 13 or no periods by age 15

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21
Q

When is it considered early menarche?

A

When it starts before the age of 12

22
Q

What are orofacial clefts (e.g. cleft lip) associated with?

A

Maternal AED use in pregnancy
Rubella in pregnancy
Smoking in pregnancy
Benzo use in pregnancy
Trisomies

23
Q

Prognosis of umbilical hernias>

A

Usually resolve spontaneously by age 3

24
Q

What are the 2 most common causes of pulmonary hypoplasia?

A

Olighydramnios
Congenital diaphragmatic hernia

25
Q

Features of severe croup?

A

Frequent barking cough
Prominent inspiratory strider at rest
Marked sternal wall retractions
Significant distress and agitation, or lethargy and restlessness (hypoxia)
Tachycardia

26
Q

Features of moderate croup?

A

Frequent barking cough
Easily audible strider at rest
Suprasternal and sternal wall retraction at rest
No or little distress/agitation
Child can be placated and is interested in its surroundings

27
Q

Which children with suspected croup should be admitted?

A

If mod-severe
<3 months old
If they have known upper airway abnormalities e.g. laryngomalacia
If uncertain about diagnosis and need to rule out things like epiglottitis, FB inhalation, bacterial tracheitis

28
Q

When can a child ask what and who questions?

A

At 3

29
Q

When does a child ask why, when and how questions?

A

At 4

30
Q

When can a child draw a circle?

A

3

31
Q

When can a child draw a line?

A

2

32
Q

When can a child draw a square and triangle?

A

5

33
Q

When can a child draw a cross?

A

4

34
Q

LP findings indicative of bacterial rather than viral infection?

A

Turbid fluid
Elevated opening pressure
Raised WBC - predominantly neutrophils
Increased protein
Reduced glucose

35
Q

Radiological features of rickets?

A

Fraying - in distinct margins at the metaphysis
Widening of joints esp in the wrist

36
Q

Management of a child <3 with a limp?

A

Admit

37
Q

Heart sounds in transposition of the great arteries?

A

No murmur
Single loud S2

38
Q

What can increase the risk of a secondary bacterial infection after chicken pox?

A

Use of NSAIDs

39
Q

Prognosis of perthes in a child under 6?

A

Very good - just need observation!

40
Q

What are Epstein pearls?

A

Congenital cysts found on the hard palate usually in the midline

41
Q

What are Bohn’s nodules?

A

White masses found in the inner labial aspect of the maxillary alveolar ridges

42
Q

Biggest risk factor for NRDS?

A

Prematurity

43
Q

XR findings in NRDS?

A

Diffuse ground glass appearance with low lung volumes and a bell-shaped thorax

44
Q

What is omphalitis?

A

Umbilical cellulitis that occurs in the first few days of life

45
Q

What is an umbilical granuloma?

A

A red growth of tissue on the umbilcus which appears wet and will leak clear/yellow fluid
Presents in the first few weeks of life

46
Q

What % of children with roseola infantum will get febrile convulsions?

A

10-15%

47
Q

What causes roseola infantum?

A

HHV 6

48
Q

What typically causes loss of internal rotation whilst the hip is flexed in a child?

A

SUFE

49
Q

When can a child return to school with scarlet fever?

A

24 hours after staring the antibiotics

50
Q

Investigation of choice for vesicoureteric reflux?

A

Micturiting cystourethrogram

51
Q

Criteria for immediate request for CT head in children?

A

Loss of consciousness >5 mins
Amnesia >5 mins
Abnormal drowsiness
3 or more discrete episodes of vomiting
?NAI
Post-traumatic seizure (but with no Hx of epilepsy)
GCS <14 (or if a baby under 1 then GCS <15)
Suspicion of open or depressed skull injury or tense fontanelle
Basal skull fracture signs
Focal neurological deficit
If under 1 - presence of bruise, swelling, laceration >5cm on head
Dangerous mechanism of injury