Paediatrics Flashcards
What is considered a neonate?
Up to one month
What % dehydration is considered mild, moderate and severe?
Mild 3-5
Moderate 6-9
Severe >10
Patient with asthma comes in with difficulty breathing, O2 sats are 94%- what is their diagnosis?
Moderate acute asthma (as sats >92)
Patient with asthma comes in with difficulty breathing, increased RR and HR, O2 sats are 91%- what is their diagnosis?
Severe acute asthma
Give 5 features of life threatening acute asthma?
<92% Silent chest Cyanosis Poor respiratory effort Arrhythmia Exhaustion Altered consciousness
What is the blood gas/ electrolyte picture in a child with pyloric stenosis?
Hypokalemic, hypochloremic metabolic alkalosis (Raised pH, raised CO2 (compensation), raised bicarb, high base excess)
How to treat an acute exacerbation of asthma?
1) High flow oxygen (aim for sats of 94-98)
2) Neb SABA (Salbutamol)
3) Neb Ipratropium Bromide
4) Magnesium sulphate
5) Oral pred
- – Transport to PICU—
6) IV salbutamol
7) Aminophylline
Listen to lungs every hour until clear for 4 hours
After acute exacerbation what medication should patients be put on?
Send home with 3 days oral prednisone
What age does pyloric stenosis typically present?
3-6 weeks
Diagnose pyloric stenosis?
Blood panel
Feed and palpate olive mass in the abdomen
US abdomen
Treat pyloric stenosis?
Rehydrate
Ramstedt’s pylomyotomy (cut through thickened muscle)
How to estimate a child’s weight?
(Age + 4) *2
What size is a fluid bolus in a child? In what cases is this different?
20mg/kg
10ml/kh: DKA, trauma, heart failure
4 causes of wheeze in a child?
Asthma, bronchiolitis, viral induced wheeze, pneumonia
Treat someone with anaphylaxis?
ABCDE IM adrenaline IV hydrocortisone IV fluids IV Chlorphenamine (antihistamine) Oral antihistamines
Causative organism for bronchiolitis
RSV
What antibiotic to treat pertussis
Macrolide eg. Clarythromycin
Most common mutation in CF?
CTFR gene on chromosome 7
ΔF508
What is the difference between a phoria and a tropia?
Phoria: there all the time
Tropia: Only apparent when one eye covered
Treat biliary atresia?
Kasai procedure
Many end up with liver transplant
Signs of hypothroid in a neonate
Puffy, jaundiced, floppy, protruding tounge
What is cretinism?
Uncorrected hypothyroid- leads to low IQ and short stature
What is chronic lung disease of prematurity/ bronchopulmonary dysplasia?
Oxygen requirements after 36 weeks
What is a Caput succedaneum?
Swelling of the head- crosses the sutures, caused by edema
What is cephalohaematoma?
Blood between skull and periosteum- doesn’t cross the sutures
Can cause jaundice
Treat hypoxic ischaemic encephalopathy?
Therapeutic Hypothermia 33-35 degrees for 72 hours
Treat bacterial tonsillitis?
Pen V + ibuprophen
How many veins/ arteries are in the placenta?
2 arteries, 1 vein
2 causes of rash in a neonate
Erythema toxicum (reaction to air)
Herpes
Adams-Oliver syndrome
Complication of tonsillitis?
Peritonsillar abscess
2 symptoms and how to treat cows milk protein allergy?
Colic, Gord, blood in stool
Hydrolysed formula
What does TORCH stand for?
Toxoplasmosis Other (HIV, syphillis, varicella, fifth disease) Rubella CMV Herpes
Risk of varicella in first trimester of pregnancy?
Fetal scarring, abnormalities
Treatment of varicella in first 2 weeks of life?
Risk of death!
Acyclovir
Diagnosis and treatment of HSP?
Clinical diagnosis
Supportive
Monitor kidney function
NSAIDs for pain
What is CHARGE syndrome?
Inherited genetic disorder
Coloboma Heart defects Atresia of the chonae (nasal change) Retardation of growth/ development Genital abnormality Ear abnormality/ deafness
What is VACTERYL association?
Related birth defects
50% with TOF have another abnormality
Vertebral anomalies Anal atresia Cardiovascular anomaly TOF Esophageal atresia Renal abnormality Limb defects
What can those at high risk of bronchiolitis be given?
Palivuzimab- RSV vaccine
Treat sickle cell?
Hydroxycarbamide- produce fetal haemoglobin
What is included in the Centor criteria?
Risk that tonsillitis is bacterial Exudate Cervical lymphadenopathy No cough Fever
Antibiotic for meningococcal septicaemia?
Cefotaxime
3 Main cause of meningitis in <3 months
GBC
Ecoli
Listeria
Herpes simplex
3 main causes of meningitis in >3 months
Meningococcus, pneumococcus
Difference in LP of someone with viral vs bacterial meningitis
Viral: Raised lymphocytes
Bacterial: Neutrophils, high protein, low glucose
Main cause of osteomyelitis?
S. Aureus
Antibiotic for sepsis in a child?
IV cefuroxime
Treat ringworm?
Iraconazole
Complication of measles?
Encephalitis
Criteria for Kawasaki disease?
Crash + burn Conjunctivitus Rash Adenopathy Strawberry tongue (mucosal involvement) Hands (erythema) Fever >5 days
Treat Kawasaki disease?
IvIG
Aspirin
Defect in Fragile X?
Aortic root dilation
Can’t pass NG tube- what are you thinking?
Oesophagel atresia
Finding on MRI in intersusseption?
Bullseye
Treat intersusseption?
Air enema in the rectum
What is imprinting?
Methylation to turn off genes
What happens if there is imprinting of a) the paternal gene or b) the maternal gene on chromosome 15
a) Prader will
b) Angelman’s
Symptoms of Angelman’s?
Inappropriate laughter, seizures, speech delay
What is not produced properly in Duchenne?
Dystrophin
What is meant by esophoria (latent)?
One eye drifts in but only when you cover the other one
What is meant by exotropia (manifest)?
Can see misalignment- eye points out all of the time
By what age should a baby not have a squint?
3 months
How to diagnose a squint?
Corneal light reflex test
Manifest: Cover test- cover good eye, the other eye will move
Latent: Cover/ uncover test- Bad eye will drift under the cover, on removing the cover the eye will straighten
How to manage a squint?
Occlusion of good eye using a eye patch
Penalisation (blur good eye using atropine)
Injection of botulinum toxin
Surgery
What is a consequence of not correcting a squint?
Amblyopia (lazy eye)
What is faltering growth?
Fall across 2 centiles on a growth chart
What is CHARGE syndrome?
Coloboma Heart defect Atresia of the choanae Retardation of growth and development Genital abnormality Ear defect/ hearing loss
What is VACTERL association?
Vertebral abnormality Anal atresia Cardiac abnormality TOF Esophageal atresia Renal abnormality Limb deformity
What 3 things do those with aport syndrome get? How is it inherited?
Kidney disease
Hearing loss
Eye abnormality
X linked
Treat pertussis?
Clarythromycin
Triad in HUS?
Haemolytic anaemia
Low platelets
AKI
3 types of cerebral palsy?
Ataxic
Athetoid/ dyskinetic
Spastic
Types of spastic cerebral palsy and what do they affect?
Hemiplegia- half of body
Diplegia- legs
Quadriplegia- all 4 limbs
What causes HSP?
Antigen-antibody IgA deposition causes inflammation of blood vessels
Criteria for differentiating a septic hip?
Kocher
Fever
Raised WBC
Raised ESR
Treat transient synovitis?
NSAIDs
3 causes of cerebral palsy?
Antenatal: Cerebral malformation, congenital infection
Intrapartum: Asphyxiation
Post partum: Intraventricular haemorrhage, head trauma, meningitis
Treat cerebral palsy?
treat spasticity: Oral diazepam, baclofen, botulinum
5 day fever followed by 2 day rash- cause?
Herpes virus 6 (Roseola infantum)
