Paediatrics Flashcards
When does cows milk protein allergy usually
Present
First 3 months
What kind of reactions are seen in cows milk protein allergy
Both immediate (ige mediated) abe delayed (non ige)
Features of cows milk allergy
6
Vomiting Diarrhoea Urticaria / atopy Colic Wheeze Rarely Angioedema
If formula fed, management of cow milk allergy
3
-Extensive hydrolysed formula replacement
Amino acid based formula in severe allergies
If breast fed, management of cows milk allergy
3
Continue breast feeding
Eliminate cows milk protein
Use EHF milk when breastfeeding stops until 12 months
When does cows milk allergy resolve
1-2 years
Fragile x- big or small head
Big
Definition of microcephaly
<2nd centile
What is craniosynostosis
Premature closing of cranial sutures, causing deformity of the skull
Barlows test
Dislocates hip
Ortolanis?
Relocate a dislocated femoral head
Risk factors for DDH
6
Female Breech Family history First born child Oligohydraminos Heavy baby
What is used to diagnose DDH
US
How to manage DDH
Most relocate by 3-6 weeks of age
Older children may need surgery
Dances sign in instussuseption
Right hypochonrial mass
Empty RIF
Necrotising enterocolitis findings
Bloating
Bloody stool
Failure to thrive
Becoming peritonitis
When is neonatal jaundice pathological
In the first 24 hours
Causes of jaundice < 24 hours
Rhesus haemolytic disease
Abo haemolytic disease
Hereditary spherocytosis
G6d
When is pertussis offered to prenant women
20-32 weeks
Epstein’s pearl?
Small cyst that self resolved on hard palate of a newborn
Incubation of chicken pox
10-21 days
Infectivity time of chicken pox
4 days before rash until 5 days after
Common complication of chicken pox
Bacterial infection of lesions
Rare complications of chicken pox
Pneumonia
Encephalitis
Disseminated haemorrhaging chickenpox
Arthritis
Vaccines at birth
BCG/ hep B if risk factors
2 month vaccines
6 in 1 (diphtheria, tettanus, whooping cough, polio hib hep b)
Oral rotavirus
PCV
Men B
3 months vaccine
6 in one
Oral rotavirus
4 month vaccines
6 in 1
PCV
MEN b
12-13 months
Hib
MEN c
PCV
MEN B
2-8 years
Annual nasal flu vaccine
3-4 years vaccine
4 in 1 pre school booster
(Dip tet pertussis polio)
MMR
12-13 years vaccine
HPV
Non ige mediated allergy?
Not as serious
No anaphylaxis
Rash start behinds ears in which disease
Measles
Features of kawasakis
Fever > 5 days Conjunctivitis Strawberry tongue Cervical LN Blistering hands
Rubella features
Fever
LN
Rash begins on face and move downwards
Koplik spots in what disease
Measles
Management of kawasaki
High dose aspirin
IV immunoglobulins
ECHO
Complication of kawasakis
Coronary artery aneurysm
What should be trialed in babies with gord
Ppi or H2ra
Cause of rash after fever
Roseola infatum
Incubation of roseola jnfatum
5-15 days
When a should with just a fever be sent to paeds
< 3 months > 38.5
Contraindications to MMR
Immunosuppressive Live vaccine within last 4 weeks Allergy to neomycin Immunoglobulin therapy Egg protein allergy
Features of Wilm tumour
Abdo mass
Painless haematuria
Flank pain
Mets to lung in 20%
Commonest headaches in children
Migraines
3 months motor
Reaches for object
Fixes and follows
6 months motor
Palmar grasp
Pass objects from one hand to another
Visually insatiable
9 months motor
Points with finger
Early pincer
12 months motor
Good pincer grip
What is acrocyanosis
Peripheral cyanosis in the newborn
Petechiae are really what
Bleeding under the skin
Commonest malignancy in children
ALL
3 broad features of ALL
Neutropenia
Anaemia
Thrombocytopenia
Treatment of mild croup
Oral dex
Mild croup features
Occasional barking cough
No chest recessions
Looks well
Virus of croup
Parainfluenza
Cystic fibrosis genetics
Autosomal recessive
What to do before CPR in a child
5 rescue breaths
Patau chromosome?
13
5 symptoms of hand foot and mouth excluding rash
Fever Abdo pain Anorexia Cough Sore throat
Fever with transient synovitis?
Often mild
Benign Rolandic seizures characterised by…
Partial seizures at night
Prognosis of benign rolandic seizures
Good, stop by adolescence
Treatment of seb derm in babies
Baby shampoo and baby oil
Is positional head molding normal innewborns? (Bones overlapping in skull)
Yes
Treatment of labial adhesions
Oestrogen cream
Sumatriptan nasal spray only in what age?
> 12 years
Caput succadenum?
Trauma causing head swelling
Transient, crosses suture lines
7-8 months gross motor
Sits without support
9 months gross motor
Pulls to standing
Crawls
12 months gross motor
Cruises
Walks with one hand held
13-15 month gross motor
Walks unsupported
2 years gross motor
Runs
Causes of prolonged raised bilirubin > 14 days old
Biliary atresia Hypothyroidism Galactosemia UTI Congential infections
4 features of tetralogy of fallot
VSD
right ventricular hypertrophy
Pulmonary stenosis
Overriding aorta
4 symptoms of tetralogy of fallot
Cyanosis
Right to left shunt
ESM
Boot shaped heart
Down’s syndrome risk calculation
1/1000 at 30
Download by 3 for every 5 years
Which comes first perthes or sufe
Perthes
What is ophthalmia neonatorum
Chlamydia trachomatis
Neisseria gonorrhoea
Xray findings in transient tachypnoae of the newborn
Hyperinflation and fluid in the horizontal fissure
Treatment of whooping cough
Oral azithromycin
When to exclude whooping cough from school
2 days post Abx
What vitamins should children be given
Vit a c d from 6 months to 5 years
When should pre terms get vaccinated
Chronological age
Who’s affected in x linked
Males
First sign of puberty in girls
Breast development
Usually age of mencarche
11-15
Is asymmetrical breast growth in women normal?
Yes
Features of retinoblastoma
Loss of red reflex
Strabismus
Visual problems
When to be off school post mumps
5 days post onset of swelling of glands
Commonest cause of hypothyroidism In children
Autoimmune thyroiditis
Risks of undescended testes?
Infertility
Cancer
Torsion
Causes of htn in children
Renal disease
Coarctation aorta
CAH
Circumcise hypospadias pre op?
No
Corrective surgery by 2
Breastfed babies at risk of what vit deficiency
K
Newborn downs have what tone
Hypotonia
Symptoms of osteochondritis dissecans
Joint pain
Locking
Swelling
Nephrotic presents at
Proteinuria
Hypoalbuminaemia
Oedema
Commonest cause of GN in children
Minimal change nephropathy
What closes PDA in majority of cases
Indomethacin
What can be used to keep a PDA open
Prostaglandins
When to refer bow legs
> 6cm intercondylar distance
First line constipation children
Movicol
Virus in croup?
Parainfluenze
Measles prodrome
Irritability
Conjuctivitis
Fever
Koplik spots
When to refer for undescended testis
Wait 6 months then rv
Pain on walking up and down stairs
Chondromalacia patallae
When to give Ben pen 1.2g
> 10 years
Most common meningitis bug up to 3 months
GBS
What to add in haemophillus meningitis
Dexamethosone and IV cefotaxime
When does night time enuresis become pathological?
> 5
Cause of sticky eye in < 1 year
Lacrimal duct obstruction
Resolved by 1
Which testicular tumour has raised AFP
Teratoma
Murmur in PDA
Continuous murmur that radiates to the back
4 features of tetralogy of fallot
Overriding aorta (boot shaped)
VSD
RVH
Right ventricular outflow obstruction
VSD causes what on echo growing up
Biventricular hypertrophy
Systolic murmur
