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Medicine > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

breathing difficulty DD

A

cough, wheeze, stridor, neck swelling, asthma, cf

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2
Q

cough DD

A

croup, pneumonia, bronchiolitis, HF, acute asthma, TB, viral-induced wheeze, whooping cough, inhaled foreign body, GORD, post-nasal drip, tracheooesophageal fistula, passive smoking, cf

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3
Q

croup presentation

A

barking cough (night), stridor, coryzal symptoms, hoarse voice

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4
Q

pneumonia presentation

A

fever, cough, resp distress, chest/abdo pain, intercostal recession, crackles, consolidation signs, tachopnea, grunting

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5
Q

bronchiolitis age

A

<2 y.o.

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6
Q

bronchiolitis presentation

A

coryza, cough, SOB, resp distress, difficulty feeding, apnoea in young infants, wheezing, crackles, chest overexpansion

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7
Q

HF arises from what congenital abnormality

A

L to R shunts: ASD, VSD

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8
Q

acute asthma presentation

A

known asthmatic, Hx of atopy, wheeze, cough (worse at night/with exercise), SOB, increased work of breathing, fear

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9
Q

TB presentation

A

TB contact, no BCG immunisation, haemoptysis, night sweats

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10
Q

viral induced wheeze presentation

A

wheeze with URTI, may respond to bronchodilators

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11
Q

viral induced wheese progression

A

some progress to asthma

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12
Q

whooping cough aka

A

pertussis

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13
Q

pertussis aka

A

whooping cough

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14
Q

pertussis presentation

A

paroxysmal coughing spasms during expiration, followed by sharp intake of breath (whoop), apnoea in infants, V, skin colour change

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15
Q

inhaled foreign body age group

A

toddlers

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16
Q

inhaled foreign body presentation

A

Hx of choking, ux wheeze, sudden onset

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17
Q

cough Hx

A

infection (pyrexia, LOA), recurrence, atopy, FH, PMH, prematurity

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18
Q

cough O/E

A

resp distress (grunting, nasal flaring, intercostal recession, tachopnea), additional noises (wheeze, stridor, cough), consolidation (reduced air entry, crackles, bronchial breathing, dullness to percussion, reduced expansion), clubbing, chest deformity, congenital heart DZ, cyanosis, pyrexia, talking in full sentences, PEFR

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19
Q

cough investigations

A

CXR, FBC, sputum culture, nasopharyngeal aspirate, pernasal swab, viral titres, blood cultures, Mantoux test, bronchoscopy

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20
Q

viral causes of pneumonia

A

RSV, influenza, parainfluenza, adenovirus, Coxsackie virus

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21
Q

bacterial causes of pneumonia

A

Strep pneumoniae, H influenzae, staph, Mycoplasma pneumoniae, GBS (newborn)

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22
Q

bacterial pneumonia causative agents in underlying L DZ e.g. cf

A

Pseudomonas aeruginosa, Staph aureus

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23
Q

pneumonia risk factors

A

congenital abnormality of bronchi, inhaled foreign body, immunosuppression, recurrent aspiration (tracheooesophageal fistula), cf

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24
Q

widespread pneumonia aka

A

bronchopneumonia

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25
Q

first line Abx for CAP

A

amoxicillin

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26
Q

complications of pneumonia

A

pleural effusion, septicaemia, bronchiectasis, empyema, L abscess

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27
Q

cause of bronchiolitis

A

RSV, adenovirus, influenza, parinfluenza

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28
Q

RSV

A

winter epidemics, highly infectious

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29
Q

bronchiolitis indications for admission

A

poor feeding, apnoea, increasing resp distress, O2 requirement

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30
Q

bronchiolitis duration

A

7-10/7

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31
Q

bronchiolitis management

A

O2, bronchodilators, supportinve therapy

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32
Q

prophylaxis against bronchiolitis in high risk infants

A

monoclonal Ab, palivizumab, passive immunity

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33
Q

pertussis is caused by

A

Bordella pertussis

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34
Q

pertussis occurs in

A

young infants, those not fully vaccinated

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35
Q

pertussis diagnosis

A

clinical, lymphocytosis >20 is suggestive

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36
Q

pertussis cough duration

A

months

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37
Q

pertusis management

A

supportive

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38
Q

croup aka

A

acute laryngotracheobronchitis

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39
Q

acute laryngotracheobronchitis aka

A

croup

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40
Q

croup affects children aged

A

6 months - 1 year

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41
Q

croup cause

A

parainfluenza URTI

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42
Q

croup most common at what time of year

A

winter

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43
Q

signs of severe croup

A

increased work of breathing, cyanosis, restlessness

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44
Q

croup management

A

mild cases are self limiting, steroids may reduce severity of symptoms + therefore need for hospital admission, severe cases require intubation + ventillation

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45
Q

acute epiglottitis is caused by

A

H. influenzae

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46
Q

acute epiglittitis prevalence

A

rare, Hib vacination

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47
Q

acute epiglottitis presentaiton

A

young children, sepsis, inability/painful to swallow/talk, drooling, muffled voice

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48
Q

acute eppiglottitis management

A

immediate transfer to theatre for intubation

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49
Q

stridor DD

A

laryngeal anomalies, laryngomalacia, upper airway obstruciton, tracheal abnormality, vascular ring, croup, tonsillar abscess, anaphylaxis, epiglottitis, inhaled foreign body

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50
Q

laryngeal abnormalities may include

A

vocal cord paralysis (brain lesion/trauma), papilloma (vertical HPV transmission)

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51
Q

laryngomalacia is

A

a floppy larynx

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52
Q

laryngomalacia presentation

A

variable stridor from birth, sometimes biphasic, loudest when crying, disappears when setttled

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53
Q

laryngomalacia cause

A

prolapse of the aryepiglottic folds into upper larynx

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54
Q

course of laryngomalacia

A

resolves w/i few months

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55
Q

upper airway obstruction may include

A

severe micrognathia (Piere Robin S), pharyngeal cyst, haemangioma

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56
Q

tracheal abnormalities may include

A

subglottal stenosis (following prolonged intubation), tracheomalacia (recurrent lobar collapse)

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57
Q

vascular ring is

A

a congenital abnormality of the great vessels, worsens over t, feeding difficulties

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58
Q

vascular ring investigations

A

barrium swallow (indentation), high res CT (for Sx planning)

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59
Q

tonsillar abscess aka

A

quinsy

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60
Q

quinsy aka

A

tonsillar abscess

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61
Q

inhaled foreign body investigations

A

CXR, rigid bronchoscopy

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62
Q

stridor Hx

A

duration, intermittant, well vs sick baby, coryzal symptoms, choking, atopy Hx (anaphylaxis)

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63
Q

stridor O/E

A

severity, work of breathing, intercostal recession, degree of oxygenation, wheeze, hyperexpansion, rash, angioedema, murmur

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64
Q

epiglottitis investigations

A

don’t do anything until airway secured, FBC, blood cultures

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65
Q

persistent stridor investigations

A

microlaryngoscopy to assess larynx + vocal cords, barium swallow

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66
Q

neck swelling DD

A

mastoiditis, parotid gland = mumps, thyroid gland = thyroiditis, LN: cervical adenitis, infectious mononucleosis, lymphoma, atypical mycobacterium

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67
Q

mastoiditis presentation

A

tender, inflammation, swelling behind ear, ear pushed out, medical emergency

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68
Q

mastoiditis is a complication of

A

OM

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69
Q

complications of mastoiditis

A

meningitis, sinus thrombosis

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70
Q

mastoiditis management

A

IV ABx, Sx mastoidectomy

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71
Q

mumps presentation

A

swelling overlying angle of jaw, ear displaced up + out, ux or bx, fever, malaise, pain on swallowing sweet/sour liquids

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72
Q

thyroiditis presentation

A

ant midline swelling, smooth, diffusly enlarged, non-tender, insidious onset, hypo/hyper/euthyroid

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73
Q

thyroiditis investigations

A

T4, TSH, thyroid autoAb

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74
Q

cervical adenitis presentation

A

tender, swollen ant cervical chain LN, ux or bx, fever, sore throat, acutely unwell

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75
Q

cevical adenitis investigations

A

FBC (high WCC)

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76
Q

infectious mononucleosis presentation

A

fever, sore throat, large purulent tonsils, generalised lymphadenopathy, splenomegaly

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77
Q

infectious monmomucleosis causative agent

A

EBV

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78
Q

infectious mononucleosis investigations

A

blood film (atypical lymphocytes)

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79
Q

lymphoma presentation

A

firm, non-tender node, immobile, matted, malaise, night sweats, persistent fever, hepatosplenomegaly, weight loss

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80
Q

atypical mycobacterium is caused by

A

Mycobacterium avium intracellulare

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81
Q

atypical mycobacterium presentation

A

cervical lymphadenitis

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82
Q

atypical mycobacterium investigaitons

A

excision biopsy (diagnostic)

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83
Q

neck lump Hx

A

malaise, sore throat, fever, duration

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84
Q

thyroiditis Hx

A

tiredness, constipation, underachievement at school, hyperactivity, increased appetite, palpitations, heat intolerance

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85
Q

neck lump O/E

A

location, ear displacement, mobility, tenderness, other sites, dehydration, systemic illness

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86
Q

mastoiditis investigations

A

tympanocentesis (identify organ + drain infection)

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87
Q

lymphadenopathy investigations

A

FBC, EBV serology, throat culture, CXR, Mantoux, interferon-gamma release assay, biopsy

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88
Q

asthma triggers

A

viral illness, allergens, cold

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89
Q

long term sequealae of uncontrolled asthma

A

poor growth, chronic chest deformity, time off school, frequent acute exacerbations

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90
Q

asthma pathophysiology

A

genetic predisposition, environmental trigger causes bronchocontriction, mucosal oedema, excess mucus production, airway narrowing leads to SOB + wheeze

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91
Q

mild asthma

A

SOB, nil distress, PEFR reduced, sats >92%

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92
Q

moderate asthma

A

too SOB to talk/feed, RR >30~40/min HR >125~140bpm (>5~2-5 y.o.), PEFR <50% expected, <92% sats

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93
Q

severe asthma

A

PEFR <33% expected, <92% sats, silent chest/cyanosis, fatigue, drowsiness, confusion, hypotension

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94
Q

asthma Hx

A

cough, wheeze, triggers, t of day, how many acute exacerbations, severity, affect on life (limit activities, school), f of reliever Rx use, effectiveness, atopy

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95
Q

asthma investigations

A

PEFR, CXR, allergy tests, spirometry, height, weight, inhaler technique

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96
Q

asthma O/E

A

wheeze, silent chest, chronic chest deformity

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97
Q

asthma management

A 
environmental control (passive smoking, house dust mites), education
1. SABA 2. inhaled corticosteroids 3. leukotrine antagonist/LABA (if 5-12 y.o.)
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98
Q

asthma diagnosis

A

based on clinical picture + response to bronchodilators

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99
Q

hospital managemento fo severe asthma exacerbation

A

high flow O2, regular salbutamol/ipratropium bromide (NEB/spacer), systemic corticosteroids

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100
Q

cf sequelae

A

nasal polyps, sinusitis, cough, purrulent sputum, pneumonia, chronic pseudomonas infections, bronchiectasis, chest deformity, eventual resp failure, finger clubbing, obstructive jaundice of the neonate (rare), biliary stasis, liver cirrhosis, salt loss, poor weight gain, short stature, malabsorption, pancreatic insufficiency, poor fat absorption, steatorrhoea, abdo distension, rectal prolapse, DIOS, DM, meconium ileus, male infertility, feaml sub fertility, delayed puberty

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101
Q

cf Hx

A

FH, failure to thrive, ravenous appetite, cough, wheeze, recurrent chest infections, recurrent sinusitis, bulky pale offensive stools (difficult to flush)

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102
Q

cf-related DM indication

A

fall in L function, weight loss

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103
Q

cf O/E

A

finger clubbing, malnutrition, poor weight gain, poor growth, delayed puberty, nasal polyps, chest deformity, crackles, hepatosplenomegaly (rare)

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104
Q

cf pathophysiology

A

abnormal CFTR channel leading to excessive secretions which block bronchioles, pancreatic exocrine failure, absence of vas deferens in males

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105
Q

management of cf

A

resp: bronchodilators, ABx, steroids, DNase EZ nebs, PT, immunisations (influenza, pneumococcal)
GI: pancreatic EZ capsules, high calorie diet, fat soluble vitamin supplements, dietician, salt supplementation, urodeoxycholic acid
optimisation of blood glucose is associated with improved L function, assisted conception
L/heart-L transplantation

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106
Q

cf diagnosis

A

newborn screening, genetic testing, sweat test

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107
Q

cf prognosis

A

life expectancy 40-50 y.o., FEV1 is best measure of DZ progression

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108
Q

sore throat DD

A

tonsillitis, cervical adenitis, infectious mononucleosis

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109
Q

fever DD

A

non-specific viral infection, viral URTI, OM, dehydration, tonsillitis, post immunisation, septic arthritis, meningococcal septicaemia, strep sepsis, TSS, malaria, influenza, chickenpox, measles, rubella, non-specific viral rash, pneumonia, UTI, post-Sx, Kawasaki’s DZ, facticious

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110
Q

misleading pyrexia readings

A

taking T post-hot drink, deliberate manipulation of thermometer, excessive crying/exertion, overheading due to swaddling

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111
Q

OM presentaiton

A

tugging at ear, red tympanic membrane, fever, hearing loss, irritability

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112
Q

tonsillitis presentation

A

sore throat, enlarged tonsils, smelly breath, dysphagia, fever, tender cervical lymphadenopathy

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113
Q

septic arthritis presentation

A

painful joint, swelling, effusion

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114
Q

influenza presentation

A

fever, cough, headache, anorexia, arthralgia

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115
Q

UTI presentation

A

f, dysuria, loin/suprarubic pain, V

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116
Q

Kawasaki’s DZ criteria

A

fever >5/7 + 4 of: conjunctival injection, mucous membrane change (e.g. dry cracked lips, strawberry tongue), cervical lymphadenopathy, polymorphous rash, red oedematous palms/soles leads to skin peeling

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117
Q

fever Hx

A

duration, pattern, pain, malaise, anorexia, V, coryza, cough, rash, infected contacts, vaccinations, hydration

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118
Q

fever investigations

A

FBC, throat swab, blood culture, LP, urinalysis, CXR

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119
Q

fever O/E

A

check T’c (PO, axillary, PR), well vs unwell child, rash, tachopnea, tachycardia, dehydration, chest, throat, ears, CNS

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120
Q

fever management

A

treat cause, undress, cool with tepid water, paracetamol, ibuprofen

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121
Q

viral URTI presentation

A

coryza, acute pharyngitis, fever (v common 6-8/year)

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122
Q

tonsillitis causative agent

A

viral > bacterial

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123
Q

OM causative agents

A

Strep pneumoniae, H influenzae, viral

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124
Q

OM in > common in children with

A

Eustachian tube dysfunction

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125
Q

OM complications

A

conductive deafness, mastoiditis, secretory OM (glue ear)

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126
Q

cyanosis in the newborn may be a sign of

A

may be normal immediately after birth, RDS, congenital heart DZ

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127
Q

cyanosis in children DD

A

croup, asthma, resp failure, acute upper airway obstruction, choking

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128
Q

mec aspiration Hx

A

Hx of mec stained liquor, tachypnoea

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129
Q

mec aspiration is associated with

A

persistent pulmonary HTN - R to L shunting across the patent duct leading to cyanosis

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130
Q

RDS (resp distress S) causes

A

surfactant deficiency, prematurity, IUGR, pneumonia, pneumothorax, HF

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131
Q

signs of RDS

A

tachypnoea, intercostal recession, cyanosis, grunting

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132
Q

RDS on XR

A

ground glass appearance due to alveolar collapse

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133
Q

RDS management

A

optimise oxygenation, support breathing (CPAP, nasal prongs, ventilation), surfactant via endotracheal tube

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134
Q

heart defects causing cyanosis

A

R to L shunt across pulmonary duct, pulmonary HTN (leading to R to L shunt), pulmonary atresia, severe pulmonary stenosis, tricuspid atresia, Ebstein’s anomaly, Tetralogy of Fallot (pulmonary stenosis), transposition of the great arteries, total anomalous pulmonary venous drainage, truncus arteriosus, massive VSD

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135
Q

transposition of the great arteries presentation

A

severe cyanosis + acidosis after birth, only mixing of circulations occurs via duct

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136
Q

transposition of the great arteries management

A

prostaglandin E2 (keep duct open), emergency atrial septostomy, Sx w/i 2/52 of life

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137
Q

Tetralogy of Fallot presentation

A

cyanosis, murmur, hyper-cyanotic spells (relieved by squatting down)

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138
Q

pulmonary narrowing leads to a R to L shunt

A

Tetralogy of Fallot

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139
Q

Tetralogy of Fallot management

A

Sx at 2-3/12 of age

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140
Q

AVSDs cause

A

HF, murmur, mild cyanosis

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141
Q

management of VSDs

A

Sx in infancy

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142
Q

resp failure features

A

SOB, tachypnoea, cyanosis, nasal flaring, grunting, intercostal recession, restlessness, confusion

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143
Q

resp failure causes

A

upper airway obstruction, lower airway, neurological, severe HF with pulmonary oedema, drug ingestion

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144
Q

Hx of mec stained liquor, tachypnoea may indicate

A

mec aspiration

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145
Q

surfactant deficiency, prematurity, IUGR, pneumonia, pneumothorax, HF are allrisk factors for

A

RDS

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146
Q

prostaglandin E2 (keep duct open), emergency atrial septostomy, Sx w/i 2/52 of life is the management for

A

transposition of the great arteries

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147
Q

Turner’s S genotype

A

45, XO

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148
Q

features of Turner’s S

A

short stature, shield chest, widely spaced nipples, webbed neck, bicuspid aortic valve, coarctation of the aorta, 1’ amenorrhoea, cystic hygroma, high arched palate, short 4th MC, multiple pigmented naevi, lymphoedema in neonates

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149
Q

increased incidence in Turner’s S

A

AI DZ: AI thyroiditis, Crohn’s

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150
Q

fertility in Turner’s S

A

sub/infertile

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151
Q

increased incidence of AI DZ: AI thyroiditis + Crohn’s in

A

Turner’s S

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152
Q

3 major congenital infections

A

rubella, toxoplasmosis, CMV

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153
Q

most common congenital infection in the UK

A

CMV

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154
Q

features of rubella

A

SN deafness, congenital cataracts, congenital heart DZ (PDA), glaucoma

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155
Q

features of toxo

A

cerebral calcification, chorioretinitis, hydrocephalus

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156
Q

features of CMV

A

growth retardation, purpuric skin lesions

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157
Q

other features of rubella

A

growth retardation, hepatosplenomegaly, purpuric skin lesions, ‘salt + pepper’ chorioretinitis, micropthalmia, cerebral palsy

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158
Q

other features of toxo

A

anaemia, hepatosplenomegaly, cerebral palsy

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159
Q

other features of CMV

A

SN deafness, encephalitis/seizures, pneumonitis, hepatosplenomegaly, anaemia, jaundice, cerebral palsy

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160
Q

Down S clinical features

A

upslanting palpebral fissures, epicanthic folds, Brushfield spots (iris), protruding tongue, small ears, round/flat face, flat occiput, single palmar crease, ‘sandal gap’, hypotonia, congenital heart defects, duodenal atresia, Hirschprung’s DZ

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161
Q

cardiac complications of Down S

A

AV septal canal defects, VSD, secundum ASD, tetralogy of Fallot, isolated PDA

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162
Q

later complications of Down S

A

males infertile, females subfertile, LD, short stature, recurrent resp infections, hearing impairment (from glue ear), ALL, hypothyroidism, AD, atlantoaxial instability

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163
Q

von Willebrand DZ mode of inheritance

A

AD

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164
Q

gonadotrophin levels in Turner’s S

A

elevated

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165
Q

roseola infantum aka

A

exanthem subitum, sixth DZ

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166
Q

roseola infantum is caused by

A

HHV6

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167
Q

roseola infantum typically affects children aged

A

6/12 - 2 years

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168
Q

features of roseola infantum

A

high fever (days), followed my maculopapular rash, febrile convulsions, diarrhoea, cough

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169
Q

HHV6 causes

A

roseola infantum

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170
Q

high fever (days), followed my maculopapular rash, febrile convulsions, diarrhoea, cough are features of

A

roseola infantum

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171
Q

mode of inheritance of haemophilia A, B

A

X-linked recessive

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172
Q

mode of inheritance of retinoblastoma

A

AD

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173
Q

tumour suppressor gene vs oncogene

A

tumour suppressor gene = loss of function leads to increased risk of ca
oncogene = gain of function leads to increased risk of ca

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174
Q

loss of function of this type of gene leads to increased risk of ca

A

tumour suppressor

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175
Q

gain of function of this type of gene leads to increased risk of ca

A

oncogene

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176
Q

fine motor 3/12

A

reaching, fixes + follows 180’

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177
Q

fine motor 6/12

A

palmar grip, hand to hand

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178
Q

bricks 18/12

A

tower of 3

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179
Q

bricks 2 years

A

tower of 6

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180
Q

bricks 3 years

A

tower of 9

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181
Q

drawing 18/12

A

circular scribbles

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182
Q

drawing 2 years

A

verticle line

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183
Q

drawing 3 years

A

circle

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184
Q

drawing 4 years

A

cross

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185
Q

drawing 5 years

A

square + triangle

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186
Q

speech + hearing 3/12

A

turns to sound

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187
Q

speech + hearing 6/12

A

babbling

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188
Q

speech + hearing 9/12

A

mama, dada, understands ‘no’

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189
Q

speech + hearing 1 year

A

1 word, responds to name

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190
Q

speech + hearing 2 years

A

combines 2 words

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191
Q

speech + hearing 3 years

A

short sentences, questioning, colours, counting

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192
Q

birth vaccinations

A

BCG, hep B (if risk factors)

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193
Q

<1 y.o. vaccines

A

diptheria, tetanus, whooping cough, polio, HiB, rotavirus, pneumococcal, Men B

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194
Q

> 1 y.o. vaccines

A

MMR, flu vaccine, HPV, Men ACWY

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195
Q

chicken pox features

A

initial fever, itchy rash (starts head/trunk, spreads), macular, then papular, then vesicular, mild systemic upset

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196
Q

measles features

A

prodrome = irritable, conjunctivitis, fever
Koplik spots = white spots (grains of salt) on buccal mucosa, rash starts behind ears then to whole body, discrete maculopapular rash becomes blotchy + confluent

197
Q

mumps features

A

fever, malaise, m pain, parotitis (earache, pain on eating), ux to bx

198
Q

rubella features

A

pink maculopapular rash face initially spreads to body, 3-5/7 fades, suboccipital + postauricular lymphadenopathy

199
Q

erythema infectiosum aka

A

fifth DZ, slapped cheek S

200
Q

BCG, hep B (if risk factors) vaccines given

A

at birth

201
Q

diptheria, tetanus, whooping cough, polio, HiB, rotavirus, pneumococcal, Men B vaccines given

A

<1 y.o.

202
Q

MMR, flu vaccine, HPV, Men ACWY vaccines given

A

> 1 y.o.

203
Q

erythema infectiosum caused by

A

parovirus B19

204
Q

erythema infectiosum features

A

lethargy, fever, headache, ‘slapped cheek’ rash spread to proximal arms + extensor surfaces

205
Q

scarlet fever caused by

A

reaction to erythrogenic toxins produced by group A haemolytic strep

206
Q

scarlet fever features

A

fever, malaise, tonsillitis, ‘strawberry’ tongue, fine punctate erythema rash (sandpaper texture), sparing face, late desquamation

207
Q

hand, foot + mouth DZ caused by

A

coxsackie A16 virus

208
Q

hand, foot + mouth DZ features

A

mild systemic upset (sore throat, fever), oral, palm + sole vesicles

209
Q

initial fever, itchy rash (starts head/trunk, spreads), macular, then papular, then vesicular, mild systemic upset are features of

A

chicken pox

210
Q

prodrome = irritable, conjunctivitis, fever
Koplik spots = white spots (grains of salt) on buccal mucosa, rash starts behind ears then to whole body, discrete maculopapular rash becomes blotchy + confluent are features of

A

measles

211
Q

fever, malaise, m pain, parotitis (earache, pain on eating), ux to bx are features of

A

mumps

212
Q

pink maculopapular rash face initially spreads to body, 3-5/7 fades, suboccipital + postauricular lymphadenopathy aer features of

A

rubella

213
Q

fifth DZ, slapped cheek S aka

A

erythema infectiosum

214
Q

parovirus B19 causes

A

erythema infectiosum

215
Q

lethargy, fever, headache, ‘slapped cheek’ rash spread to proximal arms + extensor surfaces are features of

A

erythema infectiosum

216
Q

reaction to erythrogenic toxins produced by group A haemolytic strep causes

A

scarlet fever

217
Q

fever, malaise, tonsillitis, ‘strawberry’ tongue, fine punctate erythema rash, sparing face, late desquamation are features of

A

scarlet fever

218
Q

coxsackie A16 virus causes

A

hand, foot + mouth DZ

219
Q

mild systemic upset (sore throat, fever), oral, palm + sole vesicles are features of

A

hand, foot + mouth DZ

220
Q

mode of inheritance of osteogenesis imperfecta

A

AD

221
Q

mode of inheritance of G6PD deficiency

A

X-linked R

222
Q

tetralogy of Fallot CVS abnormalities

A

pulmonary stenosis
VSD
RVH
overriding aorta

223
Q

pulmonary stenosis, VSD, RVH, overriding aorta describe

A

tetralogy of Fallot

224
Q

mode of inheritance of Gilbert’s S

A

AR

225
Q

mode of inheritance of vit D R rickets

A

X-linked D

226
Q

cf gene mutation is on

A

ch 7

227
Q

ductus arteriosus travels between

A

aorta + pulmonar artery

228
Q

PDA is classed as

A

an acyanotic congenital heart defect

229
Q

uncorrected PDA can lead to

A

late cyanosis in lower extremities aka differential cyanosis

230
Q

risk factors for PDA

A

premature babies, born at high altitude, maternal rubella infection in 1st trimester

231
Q

features of PDA

A

subclavian thrill, continuous ‘machinery’ murmur, loudest under L clavicle, large V, bounding collapsing pulse, wide pulse P, heaving apex beat

232
Q

management of PDA

A

indomethacin (closes connection), Sx if another heart defect present too

233
Q

congenital vessel running between aorta + pulmonar artery

A

ductus arteriosus

234
Q

late cyanosis in lower extremities aka differential cyanosis are complications of untreated

A

PDA

235
Q

premature babies, born at high altitude, maternal rubella infection in 1st trimester are risk factors for

A

PDA

236
Q

subclavian thrill, continuous ‘machinery’ murmur, large V, bounding collapsing pulse, wide pulse P, heaving apex beat are features of

A

PDA

237
Q

indomethacin is the management of

A

PDA

238
Q

age range of children that get scarlet fever

A

2-6 y.o.

239
Q

scarlet fever transmission

A

droplet

240
Q

scarlet fever diagnosis

A

throat swab

241
Q

scarlet fever management

A

PO penicillin V (don’t wait for results), azithromycin in PenA, return to school after 24h, notifiable DZ

242
Q

threadworm aka

A

Enterobius vermicularis, pinworm

243
Q

symptoms of threadworm

A

perianal itch esp at night

244
Q

most common cause of diarrhoea in children

A

rotavirus

245
Q

McCune-Albright S features

A

precocious puberty, cafe-au-lait spots, polyostotic fibrous dysplasia, short stature

246
Q

mode of inheritance of Alport’s S

A

X-linked D

247
Q

LH and testosterone in Kleinifelter’s S

A

LH high, testosterone low

248
Q

Kleingelter’s S aka

A

1’ hypogonadism

249
Q

PO penicillin V (don’t wait for results), azithromycin in PenA, return to school after 24h, notifiable DZ is the management of

A

scarlet fever

250
Q

Enterobius vermicularis aka

A

threadworm, pinworm

251
Q

rotavirus is the most common cause of

A

diarrhoea in children

252
Q

LH and testosterone in Kallman’s S

A

LH low, testosterone low

253
Q

LH and testosterone in androgen insensitivity S

A

LH high, testosterone N/high

254
Q

LH and testosterone in testosterone secreting tumour

A

LH low, testosterone high

255
Q

Kallma’sn S aka

A

hypogonadotrophic hypogonadism

256
Q

LH high, testosterone low

A

Kleinfelter’s S

257
Q

1’ hypogonadism aka

A

Kleinfelter’s S

258
Q

LH low, testosterone low

A

Kallman’s S

259
Q

hypogonadotrophic hypogonadism aka

A

Kallman’s S

260
Q

LH high, testosterone N/high

A

androgen insensitivity S

261
Q

LH low, testosterone high

A

testosterone secreting tumour

262
Q

features of Kleinfelter’s S

A

tall, lack of 2’ sexual characteristics, small firm testis, infertile, gynaecomastia (increased incidence of breast ca), elevated gonadotrophin levels

263
Q

features of Kallman’s S

A

ansomnia, delayed puberty, hypogonadism, cryptorchidism, low sex hormones, LH/FSH inappropriately low/N

264
Q

androgen insensitivity genotype + phenotype

A

46 XY, phenotypically female

265
Q

features of androgen insensitivity S

A

1’ amenorrhoea, undescended testes (groin swelling), breast development

266
Q

management of androgen insensitivity S

A

counselling (raise child as female), bx orchidectomy, oestrogen therapy

267
Q

Edward’s S ch abnormality

A

trisomy 18

268
Q

Edward’s S features

A

micrognathia, low set ears, rocker bottom feet, overlapping of fingers

269
Q

tall, lack of 2’ sexual characteristics, small firm testis, infertile, gynaecomastia (increased incidence of breast ca), elevated gonadotrophin levels are features of

A

Kleinfelter’s S

270
Q

ansomnia, delayed puberty, hypogonadism, cryptorchidism, low sex hormones, LH/FSH inappropriately low/N are features of

A

Kallman’s S

271
Q

46 XY, phenotypically female

A

androgen insensitivity S

272
Q

1’ amenorrhoea, undescended testes (groin swelling), breast development are features of

A

androgen insensitivity S

273
Q

micrognathia, low set ears, rocker bottom feet, overlapping of fingers are features of

A

Edward’s S

274
Q

trisomy 18

A

Edward’s S

275
Q

most common acyanotic congenital heart defects

A

VSD, ASD, PDA, coarctation of the aorta, aorrtic valve stenosis

276
Q

most common cyanotic congenital heart defects

A

tetralogy of Fallot, TGA (transposition of the great arteries), tricuspid atresia

277
Q

homocysteinuria features

A

fine fair hair, LD, seizures, downward lens dislocation, VTE risk, malar flush, livedo reticularis

278
Q

features of Patau S

A

microcephalic, small eyes, cleft lip/palate, polydactyly, scalp lesions

279
Q

fine fair hair, LD, seizures, downward lens dislocation, VTE risk, malar flush, livedo reticularis are features of

A

homocysteinuria

280
Q

ch abnormality in Patau S

A

trisomy 13

281
Q

microcephalic, small eyes, cleft lip/palate, polydactyly, scalp lesions are features of

A

Patau S

282
Q

trisomy 13

A

patau S

283
Q

Pierre-Robin S features

A

micrognathia, post displacement of tongue, cleft pallate

284
Q

Pierre-Robin S v similar to

A

Treacher-Collins S

285
Q

diff between Treacher-Collins S + Pierre-Robin S

A

TCS is AD therefore +ve FH

286
Q

micrognathia, post displacement of tongue, cleft pallate are features of

A

Pierre-Robin S

287
Q

mnagement of Kawasaki’s DZ

A

high dose aspirin, IV Ig, ECHO

288
Q

complications of Kawasaki’s DZ

A

coronary a aneurysm

289
Q

aspirin is usually CI in children due to

A

Reye’s S

290
Q

Reye’s S is

A

a rapidly progressing encephalopathy

291
Q

symptoms of Reye’s S

A

V, personality change, confusion, seizures, LOC

292
Q

Reye’s S associated with

A

aspirin use, recent viral infection, inborn errors of metabolism

293
Q

high dose aspirin, IV Ig, ECHO is the management for

A

Kawasaki’s DZ

294
Q

coronary a aneurysm is a complication of

A

Kawasaki’s DZ

295
Q

aspirin use in children, recent viral infection, inborn errors of metabolism are associated with

A

Reye’s S

296
Q

tricuspid atresia is when

A

there’s an absence of a tricuspid valve therefore no blood can travel RA to RV, leading to hypoplastic RV, ASD + VSD must also be present

297
Q

William’s S features

A

short stature, LD, friendly, extrovert, transient neonatal hypercalcaemia, supravalvular aortic stenosis

298
Q

short stature, LD, friendly, extrovert, transient neonatal hypercalcaemia, supravalvular aortic stenosis are features of

A

William’s S

299
Q

Prada-Willi S features

A

hypotonia, hypogonadism, obesity

300
Q

hypotonia, hypogonadism, obesity are features of

A

Prada-Willi S

301
Q

patellar subluxation presentation

A

medial knee pain (due to lateral subluxation of the patella), knee may give way

302
Q

medial knee pain, knee may give way is the presentation of

A

patellar subluxation

303
Q

fragile X S features

A

LD, macrocephaly, long face, large ears, macroorchidism

304
Q

LD, macrocephaly, long face, large ears, macroorchidism are features of

A

fragile X S

305
Q

Noonan S

A

webbed neck, pectus excavatum, short stature, pulmonary stenosis

306
Q

measles is caused by

A

measles virus, RNA paramyxovirus

307
Q

measles treansmission

A

droplet

308
Q

complications of measles

A

encephalitis, subacute sclerosing panencephalitis, febrile convulsions, giant cell pneumonia, keratoconjunctivitis, corneal ulceration, diarrhoea, appendicitis, myocarditis

309
Q

encephalitis, subacute sclerosing panencephalitis, febrile convulsions, giant cell pneumonia, keratoconjunctivitis, corneal ulceration, diarrhoea, appendicitis, myocarditis are complications of

A

measles

310
Q

Wilms’ tumour typrically presents at

A

< 5 y.o.

311
Q

features of Wilms’ tumour

A

abdo mass, painless haematuria, flank pain, anorexia, fever

312
Q

abdo mass, painless haematuria, flank pain, anorexia, fever are features of

A

Wilms’ tumour

313
Q

chondromalacia patellae is

A

softening of the cartilage of the patella

314
Q

chondromalacia patella is common in

A

teenage girls

315
Q

features of chondromalacia patellae

A

ant knee pain when walking up/down stairs, rising from prolonged sitting

316
Q

management of chondromalacia patellae

A

PT

317
Q

softening of the cartilage of the patella describes

A

chondromalacia patellae

318
Q

ant knee pain when walking up/down stairs, rising from prolonged sitting are features of

A

chondromalacia patellaei

319
Q

intussusception usually affects

A

6-18/12 olds, boys > girls

320
Q

intussusception features

A

paroxysmal abdo colic pain, draw knees up, turn pale, V, blood stained stools (red current jelly), sausage mass in RLQ

321
Q

intussusception investigations

A

US

322
Q

management of intissusception

A

reduction by air insufflation, Sx

323
Q

Meckel’s diverticulum rule of

A

2’s: 2% of population, 2 ft from ileocaecal valve, 2 in long

324
Q

paroxysmal abdo colic pain, draw knees up, turn pale, V, blood stained stools (red current jelly), sausage mass in RLQ are features of

A

intussusception

325
Q

presentation of Meckle’s diverticulum

A

abdo pain, PR beeding, intestinal obstruction (2’ to omphalomesenteric band, volvulus, intussuption)

326
Q

management of Meckle’s diverticulum

A

Sx

327
Q

abdo pain, PR beeding, intestinal obstruction (2’ to omphalomesenteric band, volvulus, intussuption) is the persentation of

A

Meckle’s diverticulum

328
Q

DDH risk factors

A

female, breech, FH, 1st born child, oligohydramnios, >5kg, congenital calcaneovalgus foot deformity

329
Q

Barlow test

A

attempts to dislocate the articulated femoral head, flexed knees, push into bed

330
Q

Ortolani test

A

attempts to relocate a dislocated femoral head, abduction, external rotation of hips

331
Q

investigations if suspect DDH

A

US

332
Q

management of DDH

A

spontaneous resolution, harness, Sx

333
Q

female, breech, FH, 1st born child, oligohydramnios, >5kg, congenital calcaneovalgus foot deformity are risk factors for

A

DDH

334
Q

attempts to dislocate the articulated femoral head, flexed knees, push into bed describes

A

Barlow test

335
Q

attempts to relocate a dislocated femoral head, abduction, external rotation of hips describes

A

Ortolani test

336
Q

bronchiolitis invesitgations

A

immunofluorescence of nasopharyngeal secretions (may show RSV)

337
Q

Hirschsprung’s DZ is caused by

A

an aganglionic section of bowel due to developmental failure of the parasympathetic nervous plexuses

338
Q

Hirschsprung’s DZ presentation

A

failure/delay to pass mec, constipation, abdo distension

339
Q

Hirschsprung’s DZ associations

A

DS, males

340
Q

an aganglionic section of bowel due to developmental failure of the parasympathetic nervous plexuses is the cause of

A

Hirschsprung’s DZ

341
Q

failure/delay to pass mec, constipation, abdo distension are features of

A

Hirschsung’s DZ

342
Q

Osgood-Schlatter DZ presentation

A

sporty teenager, tenderness + swelling over tibial tubercle

343
Q

sporty teenager, tenderness + swelling over tibial tubercle describes

A

Osgood-Schlatter DZ

344
Q

pyloric stenosis presents

A

2-4/52 of life (up to 4/12)

345
Q

presentation of pyloric stenosis

A

projectile V (30’ post-feed), constipation, dehydration, palpable mass in upper abdo

346
Q

metabolic changes in pyloric stenosis

A

hypochloraemic, hypokalaemic alkalosis

347
Q

management of pyloric stenosis

A

Ramstedt pyloromyotomy

348
Q

projectile V (30’ post-feed), constipation, dehydration, palpable mass in upper abdo describes

A

pyloric stenosis

349
Q

Ramstedt pyloromyotomy is the proceedure used to correct

A

pyloric stenosis

350
Q

when to refer for gross motor delay

A

12/12 if not seated usupported, 18/12 if not walking

351
Q

APGAR score assesses

A

Appearance (colour), Pulse, Ggrimace (reflex irritability), Activity (m tone), Respiratory effort (/10)

352
Q

APGAR score values

A

0-3 = v low, 4-6 = moderate low, 7-10 good

353
Q

acute limp <3 years old management

A

urgent hospital appointment

354
Q

causes of a limping child

A

transient synovitis, septic arthritis/osteomyelitis, juvenile idiopathic arthritis, trauma, DDH, Perthes DZ, slipped upper femoral epiphysis

355
Q

features of septic arthritis/osteomyelitis

A

unwell child, high fever, painful, immobile leg, swelling/redness later

356
Q

features of juvenile idiopathic arthritis

A

painless limp, salmon-pink rash, bx, pyrexia, lymphadenopathy, arthritis, uveitis, anorexia, weight loss

357
Q

feature of Perthes DZ

A

4-8 y.o., AVN of femral head, progressive pain, hip stiffness, reduced ROM (hip)

358
Q

features of slipper upper femoral epiphysis

A

10-15 y.o., posterioinferior displacement

359
Q

transient synovitis features

A

acute onset, accompanies viral infections, well child, mild fever, boys > girls, 2-12 y.o.

360
Q

unwell child, high fever, painful, immobile leg, swelling/redness later

A

septic arthritis/osteomyelitis

361
Q

painless limp, salmon-pink rash, bx, pyrexia, lymphadenopathy, arthritis, uveitis, anorexia, weight loss

A

juvenile idiopathic arthritis

362
Q

4-8 y.o., AVN of femral head, limp

A

Perthes DZ

363
Q

10-15 y.o., posterioinferior displacement, limp

A

slipped upper femoral peiphysis

364
Q

limp, acute onset, accompanies viral infections, well child, mild fever, boys > girls, 2-12 y.o.

A

transient synovitis

365
Q

neonatal assessment if passed mec in utero plus

A

RR >60, grunting, HR <100/>160, cap refil >3, T’c >38, O2 sats <95%, central cyanosis

366
Q

RR >60, grunting, HR <100/>160, cap refil >3, T’c >38, O2 sats <95%, central cyanosis warrents neonatal assessment in the presence of

A

in utero mec

367
Q

Perthes DZ management

A

< 6y.o. good prognosis w/o intervention

> 6y.o. Sx

368
Q

risk factors for slipped upper femoral epiphysis

A

obesity, short stature

369
Q

red flag constipation symptoms

A

from birth/1st weeks of life, >48h mec, ribbon stools, faltering growth, abdo distension, leg weakness, locomotor delay

370
Q

management of paediatric constipation

A
  1. diet/lifestyle changes + movicol 2. stimulant
371
Q

venous hum murmur is due to

A

turbulent flow in great v returning to the heart, benign

372
Q

venous hum murmur heard as

A

continuous blowing noise under clavicles

373
Q

Still’s murmur is heard as

A

low pitched sound at lower L sternal edge

374
Q

characteristics of innocent ejection murmurs

A

soft, short, posture variation, localised, not diastolic, no thrill, no added sounds, asymptomatic

375
Q

turbulent flow in great v returning to the heart, benign

A

venous hum murmur

376
Q

low pitched sound at lower L sternal edge

A

Still’s murmur

377
Q

continuous blowing noise under clavicles

A

venous flow murmur

378
Q

jaundice in 1st 24h is

A

always pathological

379
Q

causes of 1st 24h jaundice

A

Rh/ABO haemolytic DZ, hereditary spherocytosis, G6PD

380
Q

physiological jaundice occurs

A

2-14/7 post birth

381
Q

causes of prolonged jaundice

A

biliary atresia, hypothyroidism, galactosuria, UTI, breast milk jaundice, congenital infections (CMV, toxo)

382
Q

investigations in prolonged jaundice

A

conjugated (biliary atresia) + unconjugated billirubin, TFTs, Coombs’ test, FBC, blood film, urine MC&S, urine reducing sugars, U+E, LFTs

383
Q

Rh/ABO haemolytic DZ, hereditary spherocytosis, G6PD are causes of

A

jaundice in the 1st 24h

384
Q

biliary atresia, hypothyroidism, galactosuria, UTI, breast milk jaundice, congenital infections (CMV, toxo) are causes of

A

prolonged jaundice

385
Q

mesenteric adenitis presentation

A

central abdo pain, URTI

386
Q

malrotation presentation

A

high caecum at midline, complicated by volvulus leading to bile stained V

387
Q

malrotation is a feature of

A

exomphalos, congenital diaphragmatic hernia, intrinsic duodenal atresia

388
Q

exomphalos is

A

weakness of the baby’s abdominal wall

389
Q

necrotising enterocollitis presentation

A

abdo distension, passage of bloody stools

390
Q

risk factor for necrotising enterocollitis

A

prematurity, emperical ABx beyond 5/7

391
Q

transient synovitis management

A

rest, analgesia, it’s self-limiting

392
Q

nocturnal enuresis is defined as

A

involuntary discharge of urine by day/night/both in a child >5 y.o. in the absence of congenital/acquired defects of the NS/urinary tract

393
Q

potential underlying causes of nocturnal enuresis

A

constipation, DM, UTI

394
Q

management of nocturnal enuresis

A

fuids (just advice, don’t restrict), diet, toileting behaviour, reward system
< 7 y.o. enuresis alarm
>7 y.o. desmopressin

395
Q

threadworm management

A

single dose mebendazole for household + hygine advice

396
Q

thyroglossal cyst presentation

A

ant triangle, midline, below hyoid, thin walled, anechoic on USS

397
Q

branchial cyst presentation

A

ant to sternocleidomastoid, near angle of the mandible, anechoic on USS

398
Q

dermoid cyst presentation

A

midline of neck, external angle of eye, post to pinna, suprahyoid, heterogeneous on imaging, multiple inclusions e.g. hair follicles

399
Q

cystic hygroma presentation

A

post to sternocleidomastoid, painless, fluid filled, hypoechoic on USS

400
Q

infantile haemangioma presentation

A

either trianges, rapidly growing, spontaneously regress,

401
Q

ant triangle, midline, below hyoid, thin walled, anechoic on USS

A

thyroglossal cyst

402
Q

ant to sternocleidomastoid, near angle of the mandible, anechoic on USS

A

branchial cyst

403
Q

midline, suprahyoid, heterogeneous on imaging

A

dermoid cyst

404
Q

post to sternocleidomastoid, painless, fluid filled, hypoechoic on USS

A

cystic hygroma

405
Q

either trianges, rapidly growing, spontaneously regress,

A

infantile haemangioma

406
Q

mild croup

A

occasional barking cough, no stridor at rest, no/mild recessions, well child

407
Q

moderate croup

A

f barking cough, stridor at rest, recessions at rest, no distress

408
Q

severe croup

A

prominent inspiratory stridor at rest, marked recessions, distress, agitation, lethargy, tachycardia

409
Q

occasional barking cough, no stridor at rest, no/mild recessions, well child

A

mild croup

410
Q

f barking cough, stridor at rest, recessions at rest, no distress

A

moderate croup

411
Q

prominent inspiratory stridor at rest, marked recessions, distress, agitation, lethargy, tachycardia

A

severe croup

412
Q

necrotising enterocilitis on AXR

A

dilated bowel loops, , bowel wall oedema, pneumatosis intestinalis (intramural gas), portal venous gas, pneumoperitoneum, Rigler’s sign (air inside + outside of bowel), football sign (air outlining the falciform ligament)

413
Q

precocious puberty is defined as

A

<8 y.o. in femailes, <9 y.o. in males

414
Q

congenital diaphragmatic hernia is characterised by

A

herniation of the abdominal viscera into the thoracic cavity due to incomplete formation of the diaphragm

415
Q

consequences of congenital diaphragmatic hernia

A

pulmonary hypoplasia, pulmonary HTN, resp distress

416
Q

herniation of the abdominal viscera into the thoracic cavity due to incomplete formation of the diaphragm are characteristics of

A

congenital diaphragmatic hernia

417
Q

pulmonary hypoplasia, pulmonary HTN, resp distress are consequences of

A

congenital diaphragmatic hernias

418
Q

transient lactose intollerance is a common complication of

A

viral gastroenteritis

419
Q

time points to assess APGAR score

A

1, 5, 10 mins

420
Q

gastroschisis describes

A

a congenital defect in the ant abdo wall lat to the umbilical cord

421
Q

exomphalos vs gastroschisis

A

exomphalos = abdo contents are covered in an amniotic sac formed by amniotic membrane + pertioneum

422
Q

omphalocele refers to

A

a defect in the umbilicus itself

423
Q

features of foetal alcohol S

A

small head, flattened philtrum, thin upper lipf

424
Q

types of nappy rash

A

irritant dermatitis, Candida dermatitis, seborrhoeic dermatitis, psoriasis, atopic eczema

425
Q

features of irritant dermatitis nappy rash

A

most common cause, irritant effect of urinary ammonia + faeces, creases are charcteristically spared

426
Q

Candida dermatitis nappy rash features

A

erythematous rash, involves flexures, characteristic satellite lesions

427
Q

seborrhoeic dermatitis nappy rash features

A

erythematous rash with flakes, ?coexistant scalp rash

428
Q

psoriasis nappy rash features

A

less common, erythematous scaly rash, also present elsewhere on skin

429
Q

atopic eczema nappy rash features

A

other areas of skin affected

430
Q

nappy rash: most common cause, irritant effect of urinary ammonia + faeces, creases are charcteristically spared

A

irritant dermatis

431
Q

nappy rash: erythematous rash, involves flexures, characteristic satellite lesions

A

Candida dermatitis

432
Q

nappy rash: erythematous rash with flakes, ?coexistant scalp rash

A

seborrhoeic dermaititis

433
Q

nappy rash: less common, erythematous scaly rash, also present elsewhere on skin

A

psoriasis

434
Q

vesicoureteric reflux is

A

the abnormal backflow of urine from bladder into ureters + kidneys

435
Q

vesicoureteric reflus predisposes to

A

recurrent UTIs

436
Q

the abnormal backflow of urine from bladder into ureters + kidneys

A

vesicoureteric reflux

437
Q

persistent fever/serious recurent infections DD

A

occult abscess (e.g. dental), atypical pneumonia, hepatitis, UTI, osteomyelitis, HIV, infectious mononucleosis, TB, IE, IBD, collagen vascular DZ, neoplastic DZ, facticious fever

438
Q

IE symptoms

A

heart murmur, fever, malaise, anorexia, clubbing, splinter haemorrhages, splenomegaly

439
Q

symptoms of collagen vascular DZ

A

remitting fever, systemic juvenile chronic arthritis (Still’s DZ)

440
Q

PUO in children

A

prolonged fever, >1/52 in young children, 2-3/52 in adolescents

441
Q

if fever >5/7 suspect

A

Kawasaki’s DZ

442
Q

IE in childrent often occurs as a complication of

A

congenital heart DZ, indwelling central venous catheters (PTN, chemo)

443
Q

most common IE organism in children

A

Strep viridans

444
Q

IE management

A

6/52 IV ABx

445
Q

common osteomyelitis causative organisms

A

Staph a, H. influenzae, enterobacter, Strep pyogenes

446
Q

recommendations for PTs with splenectomy/hyposplenism

A

pneumococcal vacination, penicillin prophylaxis

447
Q

HIV presentation in children

A

failure to thrive, recurrent oral candidiasis, diarrhoea, hepatosplenomegaly, severe bacterial infections

448
Q

heart murmur, fever, malaise, anorexia, clubbing, splinter haemorrhages, splenomegaly are symptoms of

A

IE

449
Q

remitting fever, systemic juvenile chronic arthritis (Still’s DZ) are symptoms of

A

collagen vascular DZ

450
Q

suspect Kawasaki’s DZ if fever duration >

A

5/7

451
Q

failure to thrive, recurrent oral candidiasis, diarrhoea, hepatosplenomegaly, severe bacterial infections may be the presentaion of

A

HIV in children

452
Q

headache causes

A

tension headache, eye strain, migraine, sinusitis, dental caries, raised ICP, infection, analgesia headache, HTN

453
Q

tension headache symptoms

A

band of P, worse later in day, precipitated by stress

454
Q

migraine presentation

A

throbbing, sometimes ux, episodic, can be f, N, V, FH, visual auras (halos, zig-zag lines)

455
Q

sinusitis presntation

A

bony tenderness, nasal congestion

456
Q

raised ICP presentation

A

worse in am, worse lying down, V, papilloedema, focal neuro signs, HTN, bradycardia, blured vision

457
Q

analgesia headache presentation

A

f use of NSAIDs/paracetamol

458
Q

diagnostic criteria for migraine

A

episodic occurence, completely well between attacks, aura, throbbing headache, sometimes ux, +ve FH, impairment of function during attack, 1-72h duration

459
Q

management for migraines

A

simple analgesia (paracetamol, NSAIDs), antiemetics, sleep hygine, avoiding trigger foods (cheese, chocolate, citrus fruit, nuts, caffeinated drinks), migraine diary, B-blockers/pizotifen (severe cases)

460
Q

tension headache management

A

reassure, rest, sympathy, simple analgesia

461
Q

cluster headache presentation

A

sudden onset, ux, periorbital pain, clusters of a few times/d for a few weeks, redness, orbital swelling, tears

462
Q

cluster headaches are exacerbated by

A

alcohol

463
Q

cluster headache management

A

s/c or nasal triptans (serotonin agonist) = acutely, CaCh blockers to prevent recurrences

464
Q

benign intracranial HTN should be considered in

A

chronic headache, obesity, older child, papilloedema, N brain imaging

465
Q

band of P, worse later in day, precipitated by stress describes

A

tension headache

466
Q

throbbing, sometimes ux, episodic, can be f, N, V, FH, visual auras (halos, zig-zag lines) describes

A

migraine

467
Q

bony tenderness, nasal congestion describes

A

sinusitis

468
Q

worse in am, worse lying down, V, papilloedema, focal neuro signs, HTN, bradycardia, blured vision describes

A

raised ICP headache

469
Q

sudden onset, ux, periorbital pain, clusters of a few times/d for a few weeks, redness, orbital swelling, tears describes

A

cluster headache

470
Q

chronic headache, obesity, older child, papilloedema, N brain imaging describes

A

benign intracranial HTN

471
Q

types of fits, faints + funny turns

A

apnoea, febrile convulsion, breath holding spells (cyanotic), reflexic anoxic spells (pallid), infantile spasms, hypoglycaemia, metabolic conditions, epilepsy, syncope, hyperventillation, cardiac arrhythmias

472
Q

febrile seizures presentation

A

6/12-5 y.o., sudden rise in T’c, lasts a few mins

473
Q

breath holding spells (cyanotic) presentation

A

older babies/toddlers, precipitated by crying (pain, anger)

474
Q

apnoea presentation

A

found limp/twitching, <6/12, no precipitating event

475
Q

consider underlying cause in apnoea

A

reflux, sepssis, arrhythmia

476
Q

reflex anoxic spell (pallid) presentation

A

precipitated by minor injury, pale, collapses, rapid recovery, may be eye rolling, incontinence, clonic stiffening

477
Q

infantile spasm presentation

A

form of myoclonic epilepsy, jacknife spasms, clusters, developmental regression

478
Q

types of epilepsy

A

simple absence, partial epilpesy, complex partial epilepsy, myoclonic epilepsy

479
Q

simple absence epilepsy presentation

A

fleeting vacant look

480
Q

partial epilepsy presentation

A

twitching/jerking of face/arm/leg

481
Q

complex partial epilpsy presentation

A

altered/impaired consciousness, strange sensations, semi-purposeful movements (chewing, sucking), may have postictal phase

482
Q

myoclonic epilepsy presentation

A

shock-like jerks, sudden falls, known neuro disabilty

483
Q

syncope presentaiton

A

precipitated by pain/emotion/prolonged standing, blurred vision, lightheadedness, sweating, nausea, resolves on lying down

484
Q

hyperventillation presentation

A

precipitated by excitement, excessive deep breathing

485
Q

breath holding spells (cyanotic) management

A

reassure, don’t change behaviours, will grow out of them (usually by 18/12)

486
Q

reflex anoxic spell (pallid) management

A

reassure, put child in recoery position, disappear before school age

487
Q

fever >5/7 + 4 of: conjunctival injection, mucous membrane change (e.g. dry cracked lips, strawberry tongue), cervical lymphadenopathy, polymorphous rash, red oedematous palms/soles leads to skin peeling

A

criteria for Kawasaki’s

488
Q

features suggestive fo hyponatraemia

A

jittery, increased m tone, hyperreflexia, convulsions, drowsiness, coma

Medicine (30 decks)

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