paediatrics Flashcards
What is the most likely diagnosis?
Five day old baby born at term and weighing 3kg becomes lethargic and stops feeding. There is significant icterus and the baby appears clinically ill.
Elevated WCC, metabolic acidosis, raised bilirubin.
Neonatal sepsis.
Metabolic acidosis and elevated WCC point towards bacterial infection exaggerating underlying physiological jaundice.
What is the most likely diagnosis?
4 day old baby born at term by SVD weighing 3.85kg. Baby is being breastfed and is feeding well.
Mild icterus was noted previously and has now rapidly worsened.
Raised bilirubin (95% unconjugated) and low Hb. Mother and baby are Group A Rh +ve. Parents are of Mediterranean origin.
G6PD deficiency.
Increasing jaundice probably due to severe haemolysis (low Hb and high indirect bilirubin).
What is the most likely diagnosis?
6 day old infant begins vomiting and then has a prolonged seizure. Prior to this she was displaying irritability and lethargy.
O/E - infant is ill with moderate jaundice and significant liver enlargement.
Hypoglycaemia, elevated liver enzymes (ALT, CRP, bilirubin) and presence of reducing substances found in urine.
Galactosaemia.
Hypoglycaemia leading to seizures ass, with jaundice, hepatomegaly, elevated liver enzymes and presence of reducing substances in urine.
What is the most likely diagnosis?
6 week old infant presents with jaundice persistent since birth. Mother has recently arrived from India. Baby is sniffly and has a cough.
Liver is palpable 3cm below the costal margin.
Elevated indirect and direct bilirubin, elevated ALT, GGT and ALP.
CXR is clear but right humerus shows periosteal reaction.
Neonatal hepatitis.
May be due to congenital syphilis. Sniffles may be due to syphilitic rhinitis and periostitis.
Newborn immediately vomiting uncurdled milk after feeding.
Tracheoesophageal fistula.
What causes pyloric stenosis?
Hypertrophy of the pyloric sphincter.
What causes annular pancreas?
Abnormal rotation and fusion of dorsal and ventral pancreatic buds.
What is an omphalocele?
Loops of bowel covered by a membrane and projecting into umbilical cord.
What causes ileal (Mickel’s) diverticulum?
Failure in degeneration of vitelline duct.
