Paediatrics Flashcards

1
Q

Measles

A

History:

  • 3Cs (conjunctivitis, cough, coryza)
  • Rash behind ears → face → toes
  • Koplik spot
  • measles immunisation history
  • contact with suspicious case

immediate action

  • notify the local health department /community disease centre
  • isolation of the child
  • take blood for measles serology
  • discuss nasal swab for Measles PCR with department of health
  • paracetamol fever
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2
Q

Osgood Schlatter disorder

A

C/F:
Pain on ant lower knee
Worse when active
limping

O/E
Pain when flex knee against resistance
Tender on tubercle tuberosity

Mx:
Self limiting
ICE pack
NSAIDs (can cause harm)
Paracetamol
Quadriceps strengthening exercise + modified activity (not full rest)
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3
Q

croup (laryngotracheobronchitis)

A

Parainfluenza virus but rarely RSV, influenza A and B

Epidemiology:
3 months - 6 years of age

C/F
Barking cough
Inspiratory stridor (in acute epiglottitis → expiratory stridor)
Fever 38-39

Sing of severity (stridor at rest, tracheal tug)

Chest X-ray: (not needed)
Steeple sign: subglottic narrowing

Mx:
Coal, warm steam
Minimal handling (limited examination)
Prednisolone PO 1mg/Kg repeat in 12 or 24 hours
Adrenaline nebuliser (5 ml of 1:1000)
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4
Q

Kawasaki disease (muco-cutaneous- LN)

A

C/F

  • Age < 5 years + fever > 5 days +
  • Bilateral conjunctivitis
  • Intra-oral erythema
  • Skin rash
  • LAP
  • Swelling of hands and feet

Complication

  • Myocarditis/pericarditis
  • Coronary a. Aneurysm
  • meningitis

Ix:

  • High ESR, CRP
  • Thrombocytosis (platelet high)
  • Echo

Treatment
1. IVIg within 1st 10 days
2. Prednisolone 2mg/Kg for 5/7: until CRP is normal
3. Aspirin 5mg/Kg for 6/52: until normal Echo
Complication: Reye syndrome
(the only condition to use ASPIRIN in children)

Follow up
- Echo every 5 years

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5
Q

Transient lactose intolerance

A

C/F
Profuse, explosive diarrhoea after drinking milk
usually happens after gastroenteritis

Treatment:

  • Lactose-free diet for 2-4 weeks (milk formula, cheese, yoghurt, ice-cream)
  • Then introduce lactose gradually
  • Soy milk (lactose-free) is the best to be given
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