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MBBS Specialties > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What is the common pathogen causing pneumonia in infancy?

A

RSV

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2
Q

What are the common organisms causing pneumonia in childhood?

A

Strep pneumoniae

Mycoplasma pneumoniae/H.influenza

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3
Q

What are the four categories of child development?

A

Vision and fine motor
Gross motor
Speech, hearing and language
Social development

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4
Q

What can be given to aid closure of the ductus arteriousus?

A

Indomethacin (prostaglandin inhibitor)

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5
Q

What is the definition of precocious puberty?

A

Puberty occurring before 8 years in girls and 9 years in boys

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6
Q

When is puberty considered delayed?

A

If first signs have not shown by 13 years in girls and 14 years in boys

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7
Q

What is a red flag in terms of developmental milestones at 6 weeks?

A

Not smiling

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8
Q

By when should the developmental milestone of smiling be reached?

A

6 weeks

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9
Q

What is a red flag in terms of developmental milestones at 4 months?

A

Cannot bring hands together

Head lag still present

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10
Q

What is a red flag in terms of developmental milestones at 6 months?

A

Cannot roll over

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11
Q

What is a red flag in terms of developmental milestones at 9 months?

A

Cannot sit unsupported

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12
Q

What is a red flag in terms of developmental milestones at 12 months?

A

Unable to crawl

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13
Q

What is a red flag in terms of developmental milestones at 18 months?

A

Not walking

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14
Q

By when should the developmental milestone of bringing hands together and supporting their own head be reached?

A

4 months

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15
Q

By when should the developmental milestone of rolling over be reached?

A

6 months

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16
Q

By when should the developmental milestone of sitting unsupported be reached?

A

9 months

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17
Q

By when should the developmental milestone of crawling be reached?

A

12 months

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18
Q

By when should the developmental milestone of walking be reached?

A

18 months

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19
Q

What are the common complications of measles?

A

Febrile convulsions
Otitis media
Bronchopneumonia

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20
Q

What are the rarer, more serious complications of measles?

A

Meningitis
Encephalitis
Subacute sclerosing panencephalitis

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21
Q

What are the possible complications of Rubella?

A

Thrombocytopenia
Encephalitis
Arthritis
If exposure

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22
Q

What are the possible complications of mumps?

A 
Meningitis
Encephalitis
Pancreatitis
Nephritis
Orchitis (older males)
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23
Q

What is the criteria for Kawasaki’s disease? (5/6)

A 
Fever for 5 days
Conjunctivitis
Cervical lymphadenopathy
Polymorphous exanthema
Reddening, oedema and desquamation of hands and feet
Mucous membranes -Strawberry tongue
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24
Q

What is the common organism causing pneumonia in neonates?

A

Group B strep

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25
Q

What is McArdle’s disease?

A

Glycogen Storage disease type 5
Glycogen storage disease caused by a deficiency of myophosphorylase
Exercise intolerance - pain, early fatigue, painful cramps and myoglobin in the urine

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26
Q

What is Kawasaki’s disease?

A

Acute vasculitis of medium vessels, which classically involves the coronary arteries.
Prolonged fever, lymphadenopathy and desquamation of the fingers and toes

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27
Q

What are the possible complications of Kawasaki’s disease?

A

Coronary artery aneurysm

Myocarditis

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28
Q

What is a cavernous haemangioma?

A

Type of blood vessel malformation which leads to a collection of dilated blood vessels forming a benign tumour

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29
Q

What is Wilms tumour?

A

Nephroblastoma

Most common kidney cancer in children

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30
Q

What is the commonest presentation of a child with Wilm’s tumour?

A

An assymptomatic abdominal mass

Rarely - abdo pain, vomiting, HTN

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31
Q

What are the features of pyloric stenosis?

A

Projectile vomiting, typically 30 minutes after feeds
Constipation and dehydration occasionally
Occ. palpable mass may be present in abdomen
Hypochloraemic, hypokalaemic alkalosis

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32
Q

What are the features of Intussusception?

A

Paroxysmal abdominal colic pain
Vomiting
Blood stained stool - ‘red current jelly’
Sausage-shaped mass in the RLQ

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33
Q

At what age should a child with a fever automatically be referred to a paediatrician?

A

Any child less 38 is regarded as a red flag

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34
Q

What four things should be recorded in all febrile children?

A

Temperature
Heart rate
RR
CRT

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35
Q

What are the possible features of Wilms Tumour?

A

Abdominal mass
Painless haematuria
Flank pain
Other - anorexia, fever

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36
Q

What is Hirschsprung’s disease?

A

Aganglionic section of bowel due to the failure to develop the parasympathetic plexuses (Auerbach and Meissner)

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37
Q

What is the possible presentation of Hirschsprung’s?

A

Neonates - failure or delay to pass meconium

Older - constipation, abdominal distension

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38
Q

What is Erbs palsy?

A

Damage to the upper brachial plexus most commonly from shoulder dystocia
Adduction and internal rotation of the arm
Pronation of the forearm
‘Waiters tip’

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39
Q

What is Klumpke’s palsy?

A

Damage to the lower brachial plexus
Commonly affects the nerves innervating the hand
‘Claw hand’

40
Q

What are the features of Acute Epiglottitis?

A

Rapid onset
High temperature, generally unwell
Stridor
Drooling of saliva

41
Q

Which organism causes Acute Epiglottitis?

A

Haemophilus Influenzae Type B

42
Q

At what age should a child be referred to a paediatric surgeon regarding an undescended testis?

A

3 months
Make a diagnosis of cryptorchidism at this age
Need to be seen before 6 months old

43
Q

What are the possible complications of cryptorchidism?

A

Infertility
Torsion
Testicular cancer
Psychological

44
Q

What is the most common cause of headaches in children?

A

Migraines

45
Q

What is the acute management for migraines in children?

A

Ibuprofen (more effective than paracetamol)

Prophylaxis - 1st - pizotifen and propranolol
- 2nd - valproate, topiramate, amitryptiline

46
Q

What is Hand, foot and Mouth disease?

A

Self-limiting disease affecting children.
Caused by coxsackie A16 and enterovirus 71 most commonly
Contagious
Most common in age

47
Q

What are the clinical features of Hand, foot and mouth disease?

A

Mild systemic upset: sore throat, fever
Oral ulcers
Followed later by vesicles on palms and soles of feet

48
Q

What is the most common pathogen associated with Croup?

A

Parainfluenza Virus

49
Q

What are the features of Croup?

A

Stridor
Barking cough (worse at night)
Fever
Coryzal symptoms

50
Q

What features of croup prompt admission?

A

Moderate/severe

51
Q

What are the important differentials for Croup?

A

Acute Epiglottitis
Bacterial tracheitis,
Peritonsillar abscess
Foreign body inhalation

52
Q

What is the Rx for Croup?

A

Single dose of Dexamethasone (0.15mg/kg) to all children regardless of severity

Emergency - high flow 02, Nebulised adrenaline

53
Q

What is the major risk factor for NRDS?

A

Prematurity

54
Q

What is the major risk factor for Tachypnoea of the Newborn (TTN)?

A

Caesarean section

55
Q

What is the major risk factor for Aspiration Pneumonia in a newborn?

A

Meconium staining in the liquor

56
Q

What are the common organisms that cause meningitis in neonates to 3 months old?

A

Group B strep
E.coli
Listeria monocytogenes

57
Q

What are the common organisms that cause meningitis in the age group 1 month to 6 months?

A

Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus Influenzae

58
Q

What are the common organisms that cause meningitis in children greater than 6 years?

A

Neisseria meningitidis

Streptococcus pneumoniae

59
Q

What are the main features of Erythema Infectiosum?

A

Fifth disease or ‘slapped cheek’ syndrome
Caused by parvovirus B19
Lethargy, fever, headache
‘Slapped cheek’ rash spreading to proximal arms and extensor surfaces

60
Q

What are the key features of Rubella?

A

Rash - pink, maculapapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy - suboccipital and postauricular

61
Q

Which is the pathogen responsible for scarlet fever?

A

Group A haemolytic streptococci
(Usually strep. Pyrogenes)
Reaction caused to the erythrogenic toxins caused by strep.

62
Q

What are the characteristics of ADHD?

A

Extreme restlessness
Poor concentration
Uncontrolled activity
Impulsiveness

63
Q

What are the key features of patau syndrome?

A

Microencephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

64
Q

What are the key features of Edwards syndrome?

A

Micrognathia
Low set ears
Rocker bottom feet
Overlapping of fingers

65
Q

What are the key features of Fragile X?

A 
Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism
66
Q

What are the features of Noonan syndrome?

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

67
Q

What are the features of Pierre-Robin syndrome?

A

Micrognathia
Posterior displacement of the tongue
Cleft palate

68
Q

What are the key features of Prada-Willi syndrome?

A

Hypotonia
Hypogonadism
Obesity

69
Q

What are the key features of Williams syndrome?

A 
Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supra valvular aortic stenosis
70
Q

What is the commonest cause of gastroenteritis in children?

A

Rotavirus

71
Q

What are the features of hypernatraemic dehydration in children with diarrhoea?

A 
Jittery movements
Increased muscle tone
Hyperreflexia
Convulsions
Drowsiness/coma
72
Q

What three features must be present for a diagnosis of autism to be made?

A

Global impairment of language and communication
Impairment of social relationships
Ritualistic and compulsive phenomena

73
Q

What conditions are associated with Autism?

A

Fragile X

Rett’s syndrome

74
Q

List the criteria for admitting a child with Bronchiolitis

A

Episodes of apnoea

Persistent sats 50

75
Q

What are the commonest causes of haemorrhagic gastroenteritis?

A

Campylobacter

Salmonella

76
Q

What is the management for threadworms?

A

Single dose of mebendazole for the whole household and issue hygiene advice

77
Q

What are the features of Bronchiolitis?

A 
Coryzal symptoms (inc mild fever) precede:
Dry cough
Increasing breathlessness
Wheezing, fine inspiratory crackles
Occ feeding difficulties
78
Q

What are the central causes of hypotonia in a child?

A

Down’s syndrome
Prader-Willi syndrome
Hypothyroidism
Cerebral palsy (hypotonia may precede spasticity)

79
Q

What are the neurological and muscular problems that can cause Hypotonia in a child?

A 
Spinal muscular atrophy
Spina bifida
Guillain-Barré syndrome
Myasthenia Gravis
Muscular dystrophy
Myotonic dystrophy
80
Q

What are the risk factors for developmental dysplasia of the hip?

A 
Female
Breech
Positive family history
First born child
Oligohydramnios
Birth weight >5kg
Congenital calcaneovalgus foot deformity
81
Q

What are the three features that form the classical triad of Haemolytic Uraemic syndrome?

A

Haemolytic anaemia
Raised urea
Thrombocytopenia

82
Q

What pathogen commonly causes Haemolytic Uraemic syndrome?

A

Escherichia Coli Subtype 0157

83
Q

What are the main features of DKA?

A

Abdominal pain
Polyuria, polydipsia, dehydration
Kussmaul respiration (deep ventilation)
Acetone-smelling breath

84
Q

What are the features of Roseola Infantum?

A

High fever lasting a few days
Then a maculopapular rash develops
Occ febrile convulsions
Diarrhoea and cough common

85
Q

What causes Roseola Infantum?

A

Human Herpes Virus 6 (HHV6)

86
Q

What are the main types of cerebral palsy?

A

Spastic (hemiplegia, diplegia, quadriplegia)
Dyskinetic
Ataxic
Mixed

87
Q

Which type of cerebral palsy is intraventricular haemorrhage most commonly associated with?

A

Spastic diplegic CP

88
Q

What is the criteria for severe asthma in a 2-5 year old?

A

Sats 140/min
RR >40/min
Use of accessory muscles

89
Q

What is the criteria for a severe asthma attack in a child over the age of 5?

A

Sats 125/min
RR >30/min
Use of accessory neck muscles

90
Q

What is the criteria for a life-threatening asthma attack in a child aged between 2 and 5?

A

Sats

91
Q

What is the criteria for a life-threatening asthma attack in a child over the age of 5?

A

Sats

92
Q

What are the features for Achondroplasia?

A

short limbs (rhizomelia) with shortened fingers (brachydactyly)
large head with frontal bossing
midface hypoplasia with a flattened nasal bridge
‘trident’ hands
lumbar lordosis

93
Q

What are the antibiotics used to treat meningitis?

A

3 months: IV cefotaxime

94
Q

Which immunisations are live attenuated viruses?

A 
BCG
MMR
oral polio
yellow fever
oral typhoid
95
Q

Causes for neonatal hypoglycaemia?

A 
maternal diabetes mellitus
prematurity
IUGR
hypothermia
neonatal sepsis
inborn errors of metabolism
nesidioblastosis

MBBS Specialties (9 decks)

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