Paediatrics Flashcards
What are Koplik spots pathognomic of?
Measles
Rule of 9s for TBSA for burns in kids: back
18%
Describe the rash of rubella
A discrete pale pink maculopapular rash (not confluent as in measles).
Starts on the face and neck—spreads to the trunk and extremities.
Rule of 9s for TBSA for burns in kids: front chest/abdo
18%
Normal RR in baby aged 5 years or older
16
What is the most common cause of bowel obstruction in newborns?
Intussusception
Ix of intussusception?
U/S with target sign
Where is the rash of scarlet fever most prominent?
Prominent on neck, in axillae, cubital fossa (Pastia lines), groin, skinfolds
What must you consider if there’s a lump near the coccyx?
Sacro-coccygeal teratoma
What is the classical presentation of malrotation?
Bilious (grassy green) vomiting
How old is a neonate?
Less than 28 days
Grassy green vomiting suggests….
Malrotation
How does intussusception present?
Colicky abdominal pain
Vomiting
Red currant jelly stools
Red currant jelly stools suggests what?
Intussuception
What is German measles more properly known as?
Rubella
Normal HR in baby aged 5-12 years
80-140
Rx of intussusception?
Gas enema
Rule of 9s for TBSA for burns in adults: front of chest/abdo
18%
Normal HR in baby aged 1-4 years
90-160
When is chickenpox no longer infectious?
When vesicles have dried
How old is an infant?
28 days to 1 year
What are the 3 stages of whooping cough?
catarrhal, paroxysmal and convalescent
What are the characteristics of vomiting in pyloric stenosis?
Projectile
Non-bilious
Typically 1/2 an hour after feeding
Kid wants to feed after vomiting
What does an enlarged Virchow’s node suggest in a kid?
Neuroblastoma or Hodgkin’s disease
Normal HR in baby aged 12 years or over
60-130
Define intussusception
Small bowel telescopes (or envaginates) on itself
Rule of 9s for TBSA for burns in adults: back
18%
Who is the typical patient who develops intussusception (age and gender)
5-11 month boy
Normal HR in baby aged term to 12 months
100-180
What is the incubation period for chickenpox?
10-21 days (usually 15-16 days)
Ix to confirm pyloric stenosis?
U/S of abdomen
Define quinsy
Peritonsillar abscess complicating tonsillitis
Abscess forms between tonsil and wall of throat
Who is the typical patient to get pyloric stenosis (age and gender)
3-6 week old boy
Clinical reactivation of varicella zoster causes what?
Herpes zoster (aka shingles)
Rule of 9s for TBSA for burns: 1 leg
18%
What is the most specific feature of mumps?
Parotidomegally
Which organism causes slapped cheek syndrome?
Parvovirus
Normal RR in baby aged term to 3 months
30-60 or 30-50
Rule of 9s for TBSA for burns in kids: leg
14%
When does malrotation typically present?
First couple of days of life
Age of peak incidence of appendicitis?
10-12 years
What is the most common cause of vomiting in the child?
Infection
Rule of 9s for TBSA for burns: 1 arm
9%
Describe the appearance of Koplik spots
Bluish white dots ~1mm surrounded by erythema on the buccal mucosa
Rule of 9s for TBSA for burns in adults: head
9%
It presents as an acute febrile exanthematous illness with characteristic lesions on the buccal mucosa called Koplik spots (tiny white spots like grains of salt).
Measles
What are the 3 Cs of measles?
Coryza, cough, conjunctivitis
What is slapped cheek syndrome more properly known as?
Erythema infectiosum
AVPU scoring?
A = alert V = opens eyes to voice P = opens eyes to pain U = unresponsive
Ix for suspected malrotation?
Upper GI contrast study
What causes hand, foot and mouth disease?
Coxsackie virus
What are the characteristics of the cough in whooping cough?
- Paroxysms of severe coughing with inspiratory ‘whoop’
- Vomiting (at end of coughing bout)
- Coughing mainly at night
Mx of malrotation with volvulus?
Ladds procedure (untwist bowel) Appendicectomy
What is the treatment for scarlet fever?
Phenoxymethylpenicillin
Rule of 9s for TBSA for burns in kids: head
18%
What is the role for ABx in whooping cough?
Clarithromycin or azithromycin or erythromycin
Can reduce period of communicability if given in first 3 weeks of cough
But no effect on Sx
Which organism causes whooping cough?
Bordetella pertussis
When is a child with hand foot and mouth disease no longer infectious?
Once the blisters have disappeared
Describe the rash of varicella
Maculopapular vesicular rash with a centripetal distribution
What is the HEADSS acronym for in psychosocial Hx taking?
Home Education/employment Activities Drugs and alcohol Sex Suicide
Normal RR in baby aged 1-4 years
20
____ is a viral infection which causes swelling of the larynx and trachea, making the airway narrower, often causing a harsh, barking cough
Croup
Which organism causes scarlet fever?
Strep pyogenes (Group A strep)
Normal RR in baby aged 4-12 months
30-40
Rule of 9s for TBSA for burns in kids: arms
9%
Why is aspirin not given to kids?
Risk of Reye syndrome
What is the characteristic finding on FBE in whooping cough?
Lymphocytosis
What percentage of unimmunised children will eventually develop pertussis?
70%
When is mumps most infectious?
During the prodrome
Describe the rash of erythema infectiosum
Bright macular rash erupts on the face first
After a day or so, a maculopapular rash appears on the limbs
The rash lasts for only a few days but may recur for several weeks
What are the metabolic complications of pyloric stenosis?
HypoK, hypoCl metabolic alkalosis
What is the formula for oxygen delivery?
Oxygen delivery = HR x SV x Hb x SpO2 x 1.31
Definition of failure to thrive in kids?
BMI lower than 5th percentile
Definition of overweight in kids?
BMI is 85-95th percentile
Definition of obesity in childhood?
BMI over 95th percentile
What is the major determinant of the pubertal growth span in boys and girls?
Oestrogen
Paracetamol dosing in kids
15 ml/kg QID
Ibuprofen dosing in kids
10 mg/kg TDS
Empiric ABx for septic child with unknown focus and normal CSF?
fluclox + gentamicin
Empiric ABx for septic child with unknown focus and unknown CSF?
cefotaxime + flucloxacillin
ABx for fever in neonate with no focus?
Cefotaxime and flucloxacillin
ABx for child with UTI and unwell or less than 6 months
Ben pen and gentamicin
ABx for well child with UTI and well
Oral bactrim or trimethoprim
+/- 1 shot of gentamicin
ABx for child with pneumonia
Mild = amoxycillin Mod = benzyl penicillin Severe = fluclox + 3rd gen cephalosporin + consider azithromycin
ABx for child with meningitis
If younger than 2 months = cefotaxime + ben pen
If older than 2 months = 3rd gen cephalosporin