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YEAR 4 > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What are the 4 categories in mile stones?

A

gross motor skills
fine motor skills and vision
language and hearing
social and play

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2
Q

6 week old baby

A 
The surgeon 
head control in vertical
follows light with eyes
stops moving when spoken to 
smiles sociably
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3
Q

6 month old baby

A

curious baby
pushes on forearms, rolls stomach to back, weight bears
hand to hand transfer, palmar grasp, mouths things
babbles (mamama), screams when annoyed
friendly with strangers, plays with feet

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4
Q

12 month old baby

A 
drunk 
cruises around furniture, may take first steps
pincer grip, bangs and throws toys
responds to name, mumbles sounds
drinks from cup, waves bye bye
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5
Q

18 month old baby

A

dinner party
runs, climbs on adult chair
builds tower 3-4 blocks, hand preference, picture books
5-20 words, points to body parts
feeds with spoon, imitates adult activities

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6
Q

2 year baby

A 
Slow adult
double tread stairs, throws ball
tower 6-7 blocks, scribbles
50 words, talks to self, joins 2 words, simple instructions
hat and shoes, symbolic play
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7
Q

4 year baby

A 
Diva
runs up and down stairs, kicks and catches ball, hops
threads beads, copies cross, draws a man
Stories, counts to 20
dresses, takes turns
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8
Q

3 year baby

A

mini me
alternating feet on stairs, pedals trike
tower 9-10 bricks, copies circle, cuts with scissors
name and gender, lots of questions, simple conversation
washes hands, vivid play, sharing

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9
Q

What is DTaP/IPV/Hib/HepB?

A

diphtheria, tetanus and pertussis
polio
haemophilus influenzae B
hepatitis B

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10
Q

What does pertussis cause?

A

whooping cough

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11
Q

When is rotavirus immunisation given?

A

2 months and 3 months

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12
Q

What is diphtheria?

A

bacterial infection that infects mucous membranes
pseudomembranes (grey/white patches) develop that can block the airways
toxin produced that enters the blood stream causing myocarditis, arrhythmias, nerve damage

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13
Q

What is tetanus?

A 
bacterial infection (Clostridium tetani commonly found in soil) 
produce toxins that block release of inhibitory neurotransmitters (glycine and GABA)
causing muscle spasms (classically starts as lock jaw)
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14
Q

Difference between clostridium botulinum and clostridium tetani?

A

botulinum affects synapses at neuromuscular junction whereas tetanus affects synapses in the brain

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15
Q

What is pertussis?

A

bacterial infection that starts similarly to URTI but followed by violent coughing attacks in whihc patient gasps for air (whoop)
produces toxins that kill ciliated epithelial cells
can develop pulmonary hypertension (increased white blood cells in lungs) that leads to hypoxia

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16
Q

What is polio?

A

viral infection that attacks the motor neurons and cause permanent muscle paralysis can be fatal if affecting brain or
spread through fecal matter

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17
Q

What is haemophilus influenzae type B?

A

bacterial infection that can cause septicaemia, meningitis, epiglottitis

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18
Q

What is pneumococcal infection?

A 
bacterial infection (strep pneumoniae)
commonly causes meningitis
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19
Q

What is hepatitis B and what problems can it cause?

A

virus that affects the liver that can persist for years and cause serious liver damage
spread through blood and body fluids

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20
Q

Antibiotic for whooping cough?

A

macrolide abx: erythromycin

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21
Q

Management of HIB?

A

ceftriaxone

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22
Q

Management of epiglottitis?

A

IV ceftriaxone

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23
Q

When is the rotavirus vaccine given?

A

8 weeks, 12 weeks

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24
Q

What 4 vaccines are given at 8weeks?

A

DTaP/IPV/Hib/HepB
PCV
rotavirus vaccine
MenB

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25
Q

What 2 vaccines are given at 12weeks?

A

DTaP/IPV/Hib/HepB

rotavirus vaccine

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26
Q

What 3 vaccines are given at 16weeks?

A

DTaP/IPV/Hib/HepB
PCV
MenB

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27
Q

What 4 vaccines are given at 1year?

A

Hib/MenC
PCV
MMR
MenB

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28
Q

What vaccine is given annually between 2-11 years?

A

flu

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29
Q

What 2 vaccines are given at 3years 4 months?

A

DTaP/IPV

MMR

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30
Q

What vaccine is given to girls aged 11-13?

A

HPV (16 &18)

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31
Q

What 2 vaccines are given at 14years?

A

Td/IPV

MenACWY

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32
Q

Edwards chromosome

A

18

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33
Q

Patau chromosome

A

13

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34
Q

Down’s syndrome

A

21

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35
Q

ADHD triad

A

hyperactive, inattentitive, impulse

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36
Q

ADHD treatment

A

methylphenidate or atomextine

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37
Q

Autism

A

social communication
language
repetitive behaviour

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38
Q

Aspergers

A

autism but no problem with social communication

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39
Q

What is atresia?

A

absence or abnormal narrowing of a passageway

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40
Q

What vaccines are given at birth to at risk babies?

A

BCG (TB)
Flu
Heb B (if mother has hep B

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41
Q

What is an incubation period?

A

time of infection to onset of symptoms

42
Q

What do ventral (anterior) horns of spinal cord contain?

A

cell bodies of motor neurons

43
Q

What do dorsal (posterior) horns of spinal cord contain?

A

cell bodies of sensory neurons

44
Q

What bilirubin is lipid soluble?

A

UCB

45
Q

How does UCB get to the liver?

A

binds to albumin and transported from spleen/lymph nodes to liver

46
Q

What enzyme conjugates bilirubin?

A

UGT

47
Q

What bilirubin is water soluble?

A

CB

48
Q

What makes urine yellow?

A

urobilinogen (CB converted to this by SI microbes)

49
Q

What is gilberts syndrome?

A

low UGT levels

liver has reduced ability to conjugate UCB

50
Q

What is crigler najjar syndrome?

A

no UGT

liver cant conjugate any UCB (fatal)

51
Q

What does presence of HBsAg indicate?

A

active infection (acute or chronic)

52
Q

What does presence of IgGsAg indicate?

A

cured or vaccinated

53
Q

How do you differentiate between HBV cured or vaccinated?

A

cured individual also has IgGcAg

Vaccine only has surface antigen present so no antibodies can develop against core

54
Q

What happens in the window period of HBV infection?

A

HBsAg is so low (due to work of the IgMsAg) that is cant be detected but you are infected (IgMcAg is present and IgGcAg may be present if body is taking longer to clear virus)

55
Q

What hepatitis virus has double stranded DNA oppose to single stranded RNA?

A

HBV

56
Q

What is the ductus arteriosus?

A

connects pulmonary artery to descending aorta

57
Q

What is the newest vaccine to be introduced for children?

A

MenB

58
Q

When is baby first examined and when is the follow up?

A

examination of the new born within 72 hours

next examination 6-8weeks (GP)

59
Q

Epiglottitis presentation?

A

sudden onset fever, sore throat, drooling, dysphagia, no cough, muffled voice, inspiratory stridor

60
Q

Thumbprint sign?

A

epiglottitis

61
Q

Steeple sign?

A

croup

62
Q

Croup presentation?

A

barking cough with inspiratory stridor

no drooling

63
Q

Organism commonly causing croup?

A

viral: parainfluenza

64
Q

Organism commonly causing epiglottitis?

A

bacterial: HIB, strep pyogenes

65
Q

Managment of epiglottitis?

A

IV ceftriaxone

ITU, endotracheal intubation

66
Q

management of croup?

A

serious: O2, nebulised adrenaline, steroids

Non-serious: dexamethasone

67
Q

Whooping cough presentation?

A

cold like symptoms

attacks of whooping cough with gasps for air

68
Q

Management of whooping cough?

A

erythromycin

69
Q

Organism in whooping cough?

A

bordetella pertussis bacteria

70
Q

inheritance of CF?

A

AR

71
Q

What causes CF?

A

inherited mutation in CFTR gene that codes for NaCl channel

Decreased Cl into secretions which usually draws water in to help thin

72
Q

fat soluble vitamins?

A

ADEK

73
Q

Test for CF?

A

IRT screening in newborn
Sweat test NaCl >60
Genetic testing for CFTR mutations

74
Q

Where is CFTR gene found?

A

chromosome 7

75
Q

What is cerebral palsy?

A

group of movement disorders

76
Q

Overall function of the cerebellum?

A

balance and coordination

77
Q

Overall function of the basal ganglia?

A

helps initiate and prevent certain movements
habits
eye movements
cognition, emotion

78
Q

Function of the motor cortex?

A

motor function

79
Q

What is chorea?

A

irregular movements that flow from one part to another producing dance like movements

80
Q

What is dystonia?

A

sustained muscle contraction

81
Q

Where does PD affect?

A

substantia nigra in basal ganglia

82
Q

What are the three main types of cerebral palsy and what area of the brain is affected in each?

A

spastic (cerebrum)
dyskinetic (basal ganglia)
ataxic (cerebellum)

83
Q

What is baclofen?

A

muscle relaxant

84
Q

What is juvenille myoclonic syndrome?

A

brief episodes of involuntary muscle twitchin (myoclonic seizures) +/- absence +/- tonic clonic
common in 12-18yrs

85
Q

management of generalised epilepsy?

A

na valproate 2nd line/chil-bearing age lamotrigine

86
Q

management of focal/partial seizures?

A

carbamazapine, 2nd line lamotrigine

87
Q

For infants having repeat febrile convulsions what can you teach the mother?

A

rectal diazepam
buccal midazolam
ambulance if >5mins

88
Q

What are the risk factors for febrile convulsions?

A

age (6months to 5 years)
FH
rapid onset fever >38
vaccines (benefits outweigh risks)

89
Q

What is the classic presentation for febrile convulsion?

A

occurs early in viral infection
brief <5mins
generalised tonic-clonic

90
Q

Do antipyretics reduce chance of febrile seizures?

A

no

91
Q

What is a simple febrile seizure?

A

<15 mins
normal in 1hr
symmetrical generalised tonic-clonic
no repeat in 24hrs

92
Q

What is a complex febrile seizure?

A

15-30mins
repeat in 24 hrs
focal

93
Q

Who gets admitted with febrile seizures?

A

1st one

any features of complex seizure

94
Q

What are the chances of a repeat seizure and when does this increase?

A 
1 in 3
increased if <18 months
fever <39
onset shortly after fever began
FH
95
Q

What is the childhood chance of developing epilepsy and what are the risk factors that increase this chance?

A

2.5%
complex febrile seizures
FH
neurodevelopmental disorders

96
Q

Common cause of meningitis in 0-3months?

A

listeria
e-coli
GBS

97
Q

Common cause of meningitis 3months to 6 years?

A

h. influenzae (gram -ve rods)
n. meningitidis (meningococcus)
s. pneumoniae (pneumococcus)

98
Q

Common cause of meningitis in >6year olds?

A

neisseria meningitis (meningococcal)
gram -ve diplococci
s.pneumoniae

99
Q

What is a positive kernigs sign?

A

lie on back knee at 90degrees and straighten causes back pain

100
Q

What is a positive brudzinskis sign?

A

lie on back and flex neck causes knees to automatically flex

101
Q

Management of bacterial meningitis?

A

<3months: cefotaxime and amoxicillin

>3monhts: cefotaxime 1st dose then ceftriaxone

102
Q

Where is a lumbar puncture done?

A

between L3 and L4

YEAR 4 (27 decks)

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