Paediatrics Flashcards
Skin prick testing vs Serum allergen specific IgE?
Use serum allergen if risk of anaphylaxis is high
Risk factors for DDH (4)
Female
Frank breech
Family history
First born
What disease is this?
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Tetraology of Falot (boot shaped heart)
Management of transposition of great arteries? (2)
Prostaglandins to maintain PDA
Surgical repair in first two weeks of life
What is Eissenmenger’s syndrome?
Chronic pulmonary hypertension caused by a left-right heart shunt, leading to right ventricular hypertrophy that eventually causes the right ventricle to push blood into the left ventricle (bypassing the lungs) -> cyanosis
What infecious disease gives you a high fever THEN a rash?
Roseola
Intussuscepion clinical signs (2)?
Colicky abdo pain wih relief with child pulling knees to chest
Red current jelly stool (ischemic bowel)
What is this disease?
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Duodenal atresia
(Double bubble sign)
Toddler with new onse abdo pain, pulls knees to chest to make it better. Dx, physical exam, investigation, Mx?
Intussception (bowel teloscoping)
Sausage shaped mass
US: target sign
Air enema
<2 years old child has corzya symptoms and wheezing. Diagnosis? What’s it caused by and mx (3)
Bronchiolitis
Respiatory Syncytial Virus
Supportive care (High flow O2, IVT and suction fluids)
What’s this disease?
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Perthes’ disease
What’s this disease?
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Omphalocele
What is this disease?
Two associated issues?
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Congenital diaphragmatic hernia
Lung hypoplasia
Persistant pulmonary hypertension
VSD clinical features? (4)
<1 years
Pansytolic murmur over left sternal border
CHF and failure to thrive
What type of fracture is this?
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Salter-Harris fracture type 3: A physeal fracture that extends through the epiphysis
SALTER
Type I - S: “straight through”
Type II - A: “above” i.e. Proximal
Type III - L: “lower” i.e. Distal
Type IV - TE: “through everything”
Type V - R: “rammed”
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Continuous machinery murmur. What is the disease? What other clinical features (1)? How to manage? (1+1)
Patent ductus arteriosis
Collapsing pulse
IV indomethicin (prostaglandin antagonist)
If transposition of great arteries present (progressive cyanosis) -> give prostaglandins to maintain until surgical repair
Mx of DDH (3)?
<6 months: Pavlik harness
Failure of Pavlick harness -> Spica casts
Older + walking with fixed deformity -> Open reduction
What this disease?
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Osgood Schlatter’s Disease
Test for cystic fibrosis?
Sweat chloride test
Progressive cyanosis in first week of life is what disease?
Transposition of great arteries
Best test for intussusception?
US
Drooling child, hot potato voice, distress. Two diff dx?
Epiglottitis (unvaccineated against Hib)
Quinsy’s peritonsillar abscess: trimus, ipsilateral cervical lymphadenopathy, uvula shifted to contralateral side
Expiratory wheeze diff dx (4)
Asthma (>5 years)
Viral induced wheeze (<3 years)
Bronchiolitis (RSV virus < 2 years)
Inhaled foreign object (intrathoracic)
How to treat this condition?
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Otitis media
Analgesia and review in 72 hours
Consider amoxycillin if: <6 months, indigenous, bilateral ear infections <2 years, systemically unwell (not just fever), otorrhoea (perforated membrane)
Differential diagnosis for lower GI bleeding in children? (5)
Premature infant: necrotising enterocolitis
3 months-3 years: Intussusception (acute onset colicky abdo pain)
Merkel’s diverticulum (painless)
> 2 years: Ulcerative colitis (bloody diarrhoea)
Invasive gastroenteritis (E. Coli, Shigella) (fever + bloody diarrhoea)
Most common brain tumour of childhood? Ix?
Pilocytic astrocytoma
Stains with glial fibrillary acidic protein
Clinical features of coarctation of aorta?
Upper limb HTN, lower limb hypotension
Brachial-femoral delay
Claudication of lower limbs
Absent femoral pulses
Dx (2) and Mx (2) for pathological jaundice?
Bilirubin - conjugated riased usually
Plot total bilirubin on normogram
Phototherapy
Exchange transfusion
What’s this disease?
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Slipped Capital Femoral Epiphysis
Feature of duodenal atresia (3)?
Polyhydramnios
Biliary projectile vomiting
Double bubble xray
Acid/base balance in pyloric stenosis?
Hypochloremic, hypokalaemic metabolic alkalosis
Two aetiologies of otitis externa ?
Exposure to water -> psuedomonas aeruginosa
Digital trauma -> Staph epidermidis
Atiology for croup?
Parainfluenza virus
Physical exam finding for intussusception?
Sausage mass RUQ
Risk factor for coarctation of aorta?
Turner’s syndrome
Flow of PDA?
Desceding aorta to pulmonary artery
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What type of fracture is this?
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Salter-Harris type 2: physeal fracture that extends through the metaphysis
SALTER
Type I - S: “straight through”
Type II - A: “above” i.e. Proximal
Type III - L: “lower” i.e. Distal
Type IV - TE: “through everything”
Type V - R: “rammed”
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What’s this?
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DDH
Risk factors for transposition of great arteries? (1)
Diabetic mothers at conception (not GDM)
What type of fracture is this?
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Salter Harris Type 1: complete physeal fracture +/- displacement
SALTER
Type I - S: “straight through”
Type II - A: “above” i.e. Proximal
Type III - L: “lower” i.e. Distal
Type IV - TE: “through everything”
Type V - R: “rammed”
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What’s this disease and give three clinical features?
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Osteosarcoma
Metaphysis of bones (particularly proximal tibia and distal femur)
Sunburst appearance
Atraumatic pin point bony tenderness
What type of fracture is this?
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Salter-Harris type 4: A physeal fracture extended through both the metaphysis and epiphysis
SALTER
Type I - S: “straight through”
Type II - A: “above” i.e. Proximal
Type III - L: “lower” i.e. Distal
Type IV - TE: “through everything”
Type V - R: “rammed”
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What’s this?
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DDH
Fixed splitting of S2 in a child indicated what heart defect?
Atrial Septal Defect
Four complications of prematurity?
Bronchiopulmonary dysplasia
Retinopathy of prematurity
Intraventricular haemorrhage
Necrotising Entero Colitis
What is this disease?
What other associations does it have?
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Oesophageal atresia
VACTERL
Vertebra
Anus
Cardiac
Tracheo-oesophageal fistula
Esophageal atresia
Renal
Limbs
Management for pertussis?
Azithromycin
What’s this disease and give three clinical features.
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Ewing’s sarcoma
Mid shaft
Onion skin appearance
Atraumaic point bone tenderness
Projectile non billary vomiting straight after feeding. Dx, physical exam finding, investigation, mx?
Pyloric stenosis
Olive lump epigastrium
EUC: hypokalaemic, hypochloraemic metabolic alkalosis
NG tube, correct electrolytes, pyloromyotomy
4 hours post birth. Dx?
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Cephalohaematoma (does not cross midline)
Physical exam finding in pyloric stenosis?
Olive shaped lump in abdomen
Trisomy 21 associated with what paediatic conditions?
AtrioVentricular Septal Defect
VSD
ASD
ToF
Tx for GAS?
Phenoxymethylpenicillin
Screning for DDH (3)?
Barlow’ test (<3 months): attempt to dislocate with hip flexion an adduction with posterior force
Ortolani’ test (already dislocated hip): attemt to relocate with hip adbuction and use fingers on bum to push back in socket
USS at 4 weeks
Neonatal jaundice in first 24 hours. Pathological or physiological? 3 differential diagnoses?
Pathological
APO incompatability
Rh incompatability
Sepsis
Hours after birth. Dx?
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Caput succedaneum: croses midline
What’s tested on a Guthrie card? (4)
Cystic fibrosis
Congenital hypothyroidism
Phenylketouria (PKU)
Galactosaemia (unable to process milk)
Mx of absence seizures? (2)
Ethosuximide
Valporate
What type of fracture is this?
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Salter-Harris type 5: physeal fracture which is compressed
SALTER
Type I - S: “straight through”
Type II - A: “above” i.e. Proximal
Type III - L: “lower” i.e. Distal
Type IV - TE: “through everything”
Type V - R: “rammed”
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Barking cough and this CXR. Dx?
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Croup
(Steeple sign) <- didn’t need to do CXR for diagnosis
Conditions as a part of imperforate anus syndrome? (7)
VACTERL
Vertebra
Anus
Cardiac
Trachea-oesophagus fistula
Esophageal atresia
Renal
Limbs
What’s this disease?
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Gastroschisis
Tx for pertussis?
Azithromycin
Failure to pass meconium differentials (2)?
Imperforate anus
Meconium ileus in cytic fibrosis
Most sensitive indicator of successful newborn resuscitation?
HR
Risk factor for patent ductus arteriosis?
Maternal rubella
Ambigous genitalia + raised serum 17-hydroxyprogesterone levels
Congenital adrenal hyperplasia
Limping child differential dx? (5)
Missed developmental dysplasia of the hip (long standing since they could walk)
Perthe’s disease (slow onset develops limp)
Slipped Capital Femoral Epiphysis (gradual onset pain, usually obese child in early teens)
Transient synovitis (post URTI hip pain)
Septic joint (will not weight bere or move)
Young child with sore throat, lymphadenopathy, odynophagia, no cough. Two diff dx?
Group A Strep
EBV (+ splenomegaly)
What is this condition?
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Duodenal atresia
(Double bubble sign)
Differential dx for neonatal respiratory distress (5)?
Transient tachyopnoea of the newborn (TTN): full term baby via C section
Neonatal Respiratory Distress Syndrome/ Hyaline membrane disease: premature baby or maternal GD
Meconium aspiration syndrome: post term baby
Sepsis: GBS positive mother or chorioamnionitis
Hypoglycaemia: LGA, SGA, maternal GD
Coughing spasms and vomiting afterwards in young children?
Pertussis
Child with recurrent bacterial nasal infections, further investigations?
Look for foreign object
2 Complications from this disease?
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Parvovirus B19 (slapped cheek)
Aplastic crisis in sickle cell disease
Threat to pregancy (keep away from pregnant ladies)
Gastro-illness followed by anaemia, thrombocytopenia + petechiae, renal impairment?
HUS
Can have jaundice due to haemolytic anaemia.
TTP is usually in adults (altered mental status, renal impairment, fever, haemolytic anaemia, thrombocytopenia)
Young child with distal extremity muscle weakness, loss of pain/temp and vibration. Dx, Ix?
Charot-Marie-Tooth disease
Autosomal dominant condition
Ix with nerve conduction studies and genetic testing (defintive)