Paediatrics 3A Flashcards
Signs of respiratory distress in children?
- Raised respiratory rate
- Use ofaccessory musclesof breathing, such as thesternocleidomastoid,abdominal andintercostalmuscles
- Intercostalandsubcostal recessions
- Nasal flaring
- Head bobbing
- Tracheal tugging
- Cyanosis(due to low oxygen saturation)
- Abnormal airway noises
- Wheeze - whistling sound caused by narrowed airways, typically heard during expiration
- Grunting - caused by exhaling with the glottis partially closed to increase positive end-expiratory pressure
- Stridor - high pitched inspiratory noise caused by obstruction of the upper airway, for example incroup
Stridor vs wheeze?
Stridor - on inspiration (croup + acute epiglottitis)
Wheeze - on expiration
Vaccine given to babies with chronic lung disease of prematurity?
Palivizumab - to prevent RSV causing bronchiolitis
This involvesmonthly injectionsof amonoclonal antibody against the virus calledpalivizumab.
Coryzal symptoms?
Runny nose
Sneezing
Mucus in throat
Watery eyes
(signs of viral URTI)
Features making viral induced wheeze more likely than ASTHMA?
- Presenting before 3 years of age
- No atopic history
- Only occurs during viral infections
- Not triggered by asthma triggers like cold, exercise, strong emotions, dust
Presentation of viral induced wheeze?
Evidence of a viral illness for 1-2 days (fever, cough and coryzal symptoms) preceding the onset of:
- Shortness of breath
- Signs of respiratory distress
- Expiratorywheezethroughout the chest
Complications of mumps?
- Pancreatitis (abdo pain)
- Orchitis (testicular painand swelling)
- Meningitis (confusion, neck stiffness, headache)
- Sensorineural hearing loss
Presentation of measles?
- Incubation periodof10 days
- Prodromal period (flu-like illness with conjunctivitis) with fever OVER 39
- Koplik’s spots (RED in mouth; 1-2 days before rash)
- RASH (spreads down from face)
erythematous, macular rash with flat lesions.
Complications of measles?
Pneumonia
Diarrhoea
Dehydration
Encephalitis
Meningitis
Hearing loss
Vision loss
Death
Differential diagnoses for measles?
All of them have NO Koplik’s spots
- Rubella
- Parvovirus B19
- HSV6 (roseala infantum)
- Scarlet fever (strep)
- May be early meningococcal disease (it later becomes purpuric
- Kawasaki disease
- EBV - infectious mononucleosis
When is the MMR given?
- 1 year
- 3 years + 4 months
What vaccines are given at 8 weeks (2 months)?
- 6 in 1 (Hib, Hep B, diphtheria, tetanus, polio, pertussis)
- Meningococcal B
- Rotavirus (oral gel)
When is the 6-in-1 vaccine given?
- 8 weeks (2 months)
- 12 weeks (3 months)
- 16 weeks (4 months)
What vaccines are given at 12 weeks (3 months)?
- 6 in 1 (Hib, Hep B, diphtheria, tetanus, polio, pertussis)
- Pneumococcal
- Rotavirus (oral gel)
What vaccines are given at 16 weeks (4 months)?
- 6 in 1 (Hib, Hep B, diphtheria, tetanus, polio, pertussis)
- Meningococcal B
What vaccines are given at 1 year?
- 2-in-1 (haemophilus influenza type B and meningococcal type C)
- Pneumococcal
- MMR(measles, mumps and rubella)
- Meningococcal type B
When is the pneumococcal vaccine given?
12 weeks + 12 months
What vaccines are given at 3 years + 4 months?
- 4 in 1(diphtheria, tetanus, pertussis and polio)
- MMR vaccine(second dose)
When is the flu vaccine given to children?
Annually from age 2 – 8
When is the HPV vaccine given?
12-13 years
2 doses given 6-24 months apart
What vaccines are given at 14 years?
- 3 in 1(diphtheria, tetanus, polio)
- Meningococcal ACWY
Newborn blood spot screening test
Taken on day 5 (day 8 at the latest) after consent from the parent.
Heel prick - 4 drops onto screening card.
Sickle cell disease
Cystic fibrosis
Congenital hypothyroidism
Phenylketonuria
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
Maple syrup urine disease (MSUD)
Isovaleric acidaemia (IVA)
Glutaric aciduria type 1 (GA1)
Homocystin
Presentation of slapped cheek syndrome / parvovirus B19?
Associated with arthritis
- Starts with mild fever, coryza and non-specific viral symptoms such as muscle aches and lethargy.
- After 2 - 5 days the rash appears quite rapidly as a diffuse bright red rash on both cheeks, as though they have “slapped cheeks”.
- A few days later areticularmildly erythematous rash affecting the trunk and limbs appears that can be raised and itchy. Reticular means net-like.
Most dangerous complication of slapped cheek syndrome?
Aplastic anaemia
(parvovirus B19 reduces erythropoiesis)