Paediatrics Flashcards
When in pregnancy to you check for anti D in rh-ve women?
at booking, 28 & 34 weeks’ gestation.
Biliary atresia
Apparently healthy term babies
Week 3 - jaundice, yellow urine and pale stools due to biliary tree occlusion by angiopathy
spleen palpable, liver hard and enlarged.
Kasai procedure = hepatoportoenterostomy
20% have associated cardiac malformations: polysplenia and situs inversus.
Babies may be excessively hungry.
US may help with diagnosis.
Percutaneous liver biopsy may show bile duct proliferation and bile plugs.
Liver unit
Meningococcal prophylaxis
ciprofloxacin
Antenatal CMV infection effects to neonate
cerebral calcification, microcephaly and sensorineural deafness.
Parvovirus B19 effects to neonate
hydrops fetalis
effects to neonate VZV
greatest risk to foetus is before 20 weeks gestation and can result in scarring of the skin, limb hypoplasia, microcephaly and eye defects
ADHD treatment
Methylphenidate
(dopamine/NE reuptake inhibitor)
BP, pulse,, BMI 6 monthly, ECG
Anaphylaxis doses
Adrenaline 1:1000
< 6 years - 150ug
6-12 - 300ug
12+ 500ug
Hydrocortisone < 6months - 25mg 6mo - 6yrs - 50mg 6-12 - 100mg 12+ 200mg
Chlorphenamine???
RPT 5 mins adrenaline
Osmotic laxative
Movicol and lactulose
Stimulant
Senna/ glycerol supp
docusate
Prophylaxis for home people in epiglottitis
Rifampicin
When do present with laryngomalacia?
4 weeks
Bronchiolitis - most common cause
RSV
Notes on whooping cough
Bordatella pertussis Infectious 3 weeks post sx lymphocytosis erythromycin and prophylaxis for contacts Notifiable Isolate until 2 days after tx
Treatment croup
Stat steroids
If moderate > hospital
Modified Westley score
Hand foot and mouth
vesicular rash
Coxsackie A16
sore throat, fevers
Chickenpox during pregnancy
If contact - (for PEP)
And unsure if immune - check varicella antibodies
If < 20/40 and no antibodies = VZIG within 10 days of contact. Infectious > 1/12#
If > 20/40 and no antibodies = VZIG or acicolovir BUT on days 7-14 post exposure **
If rash - ie has chickenpox
Specialist advice
>20/40 - ora aciclovir if presented within 24 hours
If <20/40 consider aciclovir with caution
Last 7 days
delivery after 7 days
Give baby VZIG
Monitor 1/12
Rubella in pregnancy
Sensorineural hearing loss’
Cataracts, glaucoma
Heart defects
Fragile X
Trinucleotide CCG repeat disorder
Long face, low set ears, autism, LD, macroorchidism, hypotonia, mitral valve prolapse
Patau syndrome
Trisomy 13 Microcephaly Small eyes Cleft palate Scalp lesions Polydactly
William’s syndrome
Short stature Learning difficulties Friendly, extrovert personality Transient neonatal hypercalcaemia Supravalvular aortic stenosis
Prader-Willi syndrome
Hypotonia
Hypogonadism
Obesity
Pierre-Robin syndrome
Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate
Noonan syndrome
Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis
Edward’s syndrome (trisomy 18)
Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers
Cri du chat syndrome (chromosome 5p deletion syndrome)
Characteristic cry (hence the name) due to larynx and neurological problems
Feeding difficulties and poor weight gain
Learning difficulties
Microcephaly and micrognathism
Hypertelorism
When to give anti D in rhesus negative Mums
28 and sometimes 34 weeks
if event is in 2nd/3rd trimester give large dose of anti-D and perform Kleihauer test - determines proportion of fetal RBCs present
Coombs test
Direct antiglobulin detects antibodies on bloods cells
Meningitis prophylaxis close contacts
Ciprofloxacin (1 dose)
Rifampicin
