Paediatrics Flashcards
1
Q
How do you calculate weight in paediatrics?
A
(Age + 4) x 2 = weight in kg
Now generally not considered accurate
2
Q
What is the formula for prescribing fluids in a child?
A
100mls/kg for first 10kg
50mls/kg for second 10kg
20mls/kg for further weight
Dehydrated 50mls/kg extra
Shocked 100mls/kg extra + 20mls/kg fluid bolus
3
Q
Which out of caput succundum and cepalohematoma cross suture lines?
A
Caput succundum
4
Q
What are some features of foetal alcohol syndrome?
A
Flattened philtrum
Thin upper lip
Microcephaly
5
Q
What is an omphalocele as opposed to a gastochisis?
A
Omphalocele - defect in the umbilicus
Gastroschisis - bowel develops outside of abdomen, next to umbilicus
6
Q
What are the five main features of autism?
A
- social impairment
- stereotypes behaviours
- repeated movements
- impaired communications
- sensory difficulty
- emotional lability
7
Q
What is included in the Guthrie blood spot test?
A
- CF
- MSUD
- PCK
- SCF
- thalassaemia
- HT
8
Q
What are some features of fragile X syndrome?
A
- learning difficulties
- large low set ears
- long thin face
- hypertonic
- mitral valve prolapse
- macroorchidism
9
Q
What murmur is heard in PDA?
A
Machine-like murmur, heard under the left clavicle
10
Q
What are the typical features of a Wilm’s Tumour?
A
Abdominal mass
Painless haematuria
Flank pain
This is a nephroblastoma, a common childhood malignancy
11
Q
What are some differentials of noisy breathing in babies?
A
Foreign body (acute onset) Cystic fibrosis (associated with faltering growth, meconium ileus) Laryngomalacia (congenital softening of the larynx cartilage, usually self-resolves)
12
Q
What is bronchopulmonary dysplasia and when does it occur?
A
Preterm infants treated with supplemental oxygen and ventilation
13
Q
What is the difference between a cephalhaematoma and a caput succedaneum?
A
Caphalhaematoma - usual develops after birth, doesn’t cross the suture lines, blood confined between skull and periosteum
Caput succedaneum - extraperiosteal blood collection, can cross suture lines, can be persent at birth
14
Q
What are the steps for newborn resuscitation?
A
Dry the baby, maintain temperature Assess tone, breathing, HR Open airway, 5 inflation breaths Assess HR, check chest movement If HR => start compressions 3:1 (breath) If no HR => repeat inflation breaths
15
Q
What extra vaccinations should be given other than the usual set?
A
BCG if at risk, Flu if at risk, Men ACWY going to university, varicella zoster if at risk of transmission, HPV 14 year old girls, DPT booster at 14
16
Q
What vaccinations are given at: 8 weeks/2 months (three + PO) 12 weeks/3 months (one + PO) 16 weeks/4 months (three) 12 months (four) 3 years, 4 months (two)
A
HiB/D/T/P/P/HepB (6-in-one), PCV, Men B, Rotavirus
D/P/HiB/HepB/P (6-in-one), Rotavirus
D/P/HiB/T/HepB/P (6-in-one), PCV, Men B
Men B, HiB/MenC, MMR, PCV
MMR, D/T/P/P (4-in-one)
17
Q
Describe the features of foetal alcohol syndrome.
A
IUGR, microcephaly, midfacial hypoplasia, micrognathia, smooth philtrum, microphthalmia, thin upper lip, irritability
18
Q
What are the pharmacological treatments in ADHD?
A
Methylphenidate (1st line, monitor growth), lisdexamfetamine, all drugs are cardiotoxic, perform a baseline ECG prior to starting treatment
19
Q
Name the 5 key symptom groups for autism
A
Social impairment, impaired communications, sensory difficulties, emotional lability, restricted, repetitive and stereotyped behaviour
20
Q
What are the 3 key symptoms for ADHD?
A
Hyperactivity, inattention, impulsivity
21
Q
Give some possible consequences of ADHD in later life.
A
Poor education and school performance. Higher risk of drug and alcohol abuse. Employment difficulty.
22
Q
How is ADHD assessed?
A
Clinical assessment (interview, behavioural observation)
23
Q
How is ADHD managed?
A
Education, school support, methylphenidate (Ritalin/Equasym, Melatonin for sleep)
24
Q
What age should a child learn to hop on 1 leg?
A
4 years
25
What are the 4 domains of development?
Gross motor, fine motor and vision, speech and social interactions
26
How does block building progress?
2 years = 6 blocks, 18 months = 8 blocks and train
27
What indicates abnormality in development?
Persistence of primitive reflexes
28
Describe some common features of Down's Syndrome
Round face, epicanthal folds (skin folds of the upper eyelid covering the inner corner of the eye), single palmar creases, small ears, short neck, hypotonia
29
What congenital cardiac problems are associated with Down's Syndrome?
ABSD, ASD, VSD, TOF, [Coarctation and AS is Turner’s]
30
What congenital bowel problems occur in Down's Syndrome?
Duodenal atresia, imperforate anus
31
What syndrome is trisomy 18 and what are the features of it?
Edward’s Syndrome, congenital heart defects, rocker bottom feet, low set ears, overlapping of fingers, micrognathia
32
What are some structural problems in Patau's Syndrome?
Microcephaly, small eyes, cleft lip/palate, polydactyl, scalp lesions
33
Name some other chromosomal based syndromes
Angelman’s (15), Noonans (webbed neck, pectus excavatum, PS, short stature), Fragile X (learning difficulties, macrocephaly, long face, large ears, large testicle size),
34
How do you estimate a child's weight?
(Age + 4) / 2
35
List 5 signs of dehydration in a child
Sunken fontanelle, dry mucous membranes, reduced urine output, thread tachycardic pulse, prolonged CRT, cool peripheries, lethargy
36
How much fluid over 24 hours would you give a 14-year-old dehydrated septic child, weight unknown?
Estimated weight = 36. 1000+500+120+(50x36)
37
What does the newborn screening test (Guthrie's test) measure in regards to CF?
Immunoreactive trypsinogen
38
What is tested for in the newborn heel prick test?
CF, SCD, CHT, IMD (MCADD, MSUD)
39
What do you give in a cardiac arrest?
IM adrenaline 200microgram 1:10,000
40
What are red flags in the NICE traffic light guidelines for a sick child?
RR>60bpm, grunting, HR below 100 or above 160 bpm, CRT>3 seconds, Temp >38, SpO2<95%, central cyanosis
41
How many resuscitation breaths to chest compression should be performed in a sick child?
15:2
42
What is Reye's Syndrome?
This is swelling of the liver and brain occurring in children given aspirin. It is a classic acute encephalopathy. There is elevated ammonia, ALT/AST and prolonged PT. Treatment is supportive care, correction of metabolic abnormalities and ICP control.
43
What is distributive shock?
This is when there is leakage of capillary fluid causing oedema and closing the airway.
44
What is sepsis?
Sepsis is a disseminated immune reaction leading to end-organ damage.
45
What are signs of an iron overdose?
Initial vomiting, potentially black stools, later liver failure and drowsiness
46
When should a head tilt be performed – in an infant or a child?
Infant, a child should ‘sniff the morning air’
47
What is the most common childhood leukaemia?
ALL
48
What are the potential presenting complaints of leukaemia?
```
Pallor
Fatigue
Bone pain
Bruising
Lymphadenopathy
Hepatosplenomegaly
Frequent infections
Testicular swelling
```
49
What tests should be done in suspected ALL?
FBC (low Hb, raised WCC, low platelets)
Blood film (auer rods for AML, large blast cells in ALL)
Serum electrolytes
CXR (mediastinal widening)
50
What courses of chemotherapy do you give in leukaemia?
```
Induction
Consolidation
Interim Maintenance
Delayed Intensification
Continued Maintenance
```
51
What aggressive forms of sarcoma are seen in children?
Osteosarcoma
| Ewing's
52
What are some symptoms of lymphoma
Painless lymphadenopathy, sweating, weight loss, fever, compression syndrome. Ix: CXR, CT scan, bone marrow, lymph node biopsy, FBC, blood film, cytogenetics. Mx: chemotherapy, bone marrow transplant, radiotherapy, rituximab
53
What is the classical feature of retinoblastoma?
Loss of red reflex in the eye
54
Give five investigations you would do in Wilms' tumour
Abdominal US, CT abdomen (claw sign in kidney), CXR/CT, urine catecholamine
55
Give 5 presenting features of nephro and neuroblastoma
Nephroblastoma – mass, haematuria, fever, association with aniridia and genital abnormalities (Down’s), Neuroblastoma – loss of skills in childhood, abdominal mass, proptosis if orbital involvement, bone pain, early morning vomiting, periorbital bruising, fever
56
What is WAGR complex?
Wilms’ Tumour, Aniridia, Genital Abnormalities, Mental Retardation
57
Why is a urine catecholamine test done?
Neuroblastomas produce breakdown products of adrenaline that end up the urine, it differentiates abdominal masses between neuro and nephroblastoma
58
What is the different between abdominal masses in neuro and nephroblastoma?
Neuroblastomas cross the midline, nephroblastoma do no cross the midline
59
What kind of cancer is a neuroblastoma?
Blue cell cancer, solid extracranial tumour
60
What is ITP?
Idiopathic thrombocytopenic purpura is often preceded by a viral illness. It is an immune-mediated reduction in platelet count, usually self-limiting.
61
What is typically the first sign of puberty in females?
Breast budding
62
What are the two tests done in the newborn hearing test?
Evoked emission and auditory brainstem response
63
Name some behavioral audiology tests?
Distraction testing
Visual reinforcement audiometry
Speech discrimination testing
64
How does hearing develop in an infant?
Initially startles at loud sounds, then turns towards voices and prolonged sound, 4-month smiles to voice, 7 months hears room entry, 9 months babbles
65
What are the symptoms of otitis media in a child?
Ear tugging, fever, crying, irritable, red ear drum
66
How is OM treated?
Amoxicillin
67
What antibiotics are given in tonsillitis?
Penicillin
68
What is an exotropia stabismus?
An outward looking squint
69
What are other kind of strabismus?
Esotropia - inward looking
| Hypertrophic - vertical
70
How do you test for a squint?
Cover test
| Corneal red-light reflex test
71
What is your management for a squint?
Refer to paeds
Conservative (optical or prism correction)
Surgery
Botox injection
72
What is amblyopia?
When lack of vision during development of the visual cortex leads to a stunting of the visual cortex
73
1. A 9 months old presents with 24 hr history of drowsiness, irritability. On examination he is a bit floppy and has red rash in armpit, groin and neck which are starting to peel.
What is the problem and what is your initial management?
Scalded skin syndrome
Caused by staph aureus exotoxin that binds to the skin and causes it to lose formation
74
A 8.5kg 9 month child is 5% dehydrated and required fluid - how much should be prescribed for the next 24 hours?
37.5ml/hr over 24hr - not including dehydration
53ml/hr over 24hr - including dehydration
75
What is the investigation of choice in Hirshsprung's Disease?
Rectal biopsy
76
1. A 3-week-old presents with prolonged jaundice. Onset was at day 3 of life, exclusive breast fed. Initially slow to regain birth weight but now happily gaining weight. O/E clinically jaundiced, afebrile and happy. Stools are yellow-green. Investigations show grossly raised unconjugated bilirubin. Conjugated bilirubin is within normal ranges. LFTs and various others are normal. Dx?
Breast milk jaundice
77
How might a young girl become infected with trichomonas?
Shared towels
78
What is on the Newborn Bloodspot screening test? Give 5
SCD, MSUD, PKD, Hypothyroidism, Thalassaemia, CF, G6PD deficiency, Inherited metabolic diseases, Medium-chain acyl-CoA dehydrogenase deficiency MCADD, HCU Homocystinuria
79
What are the diagnoses to the following typical presentations in a child?
- Bilious projectile vomiting in a child
- machine-like murmur under the left clavicle
- redcurrent jelly stool
- blue sclera
- immobile infant with a femur fracture
- white/clay coloured stool
- 'walking up' legs to standing position
- Bilious projectile vomiting in a child - pyloric stenosis
- machine-like murmur under the left clavicle - Patent Ductus Arteriosis
- redcurrent jelly stool - intusseption
- blue sclera - osteogenesis imperfecta
- immobile infant with a femur fracture - NAI
- white/clay coloured stool - biliary atresia
- 'walking up' legs to standing position - Duchene's muscular dystrophy
80
What causes cerebral palsy?
Hypoxia-ischaemic event, infection and inflammation, trauma during birth, neonatal encephalopathy
81
What are potential causes of neurodevelopmental disorders?
Chromosomal, foetal hypoxia, congenital infection (CMV, HIV, alcohol), prematurity, brain injury
82
What are different kinds of CP and what part of the brain does each one affect? Are there further ways to classify cerebral palsy?
Spastic (cortex problem, rigidity, tip-toe walking)
Ataxic (wide gait, hypotonic, balance disturbance)
Dyskinetic (basal ganglia)
Mixed, can further classify it as quadriplegic, hemiplegic or paraplegic
83
How is cerebral palsy managed? What teams are involved in their care?
OT/PT, SALT, Medical Team, Baclofen, Botox injections, Orthopaedic input, MDT
84
What are the 4 types of generalised seizures and their appearance?
Absence, Myoclonic, Generalised, Atonic
85
What is a focal onset seizure?
A seizure without loss of consciousness
86
Define status epilepticus and how it is treated?
A seizure with no threshold resulting in uncontrolled fitting for >5 minutes. Treat with benzos twice and then phenytoin
87
How do you treat absence seizures?
Valproate, ethosuximide
88
What is post-ictal weakness called?
Todd's Palsy
89
Describe the circulatory changes that occur around birth in the foetus
The baby breaths, decreasing pressure in pulmonary circulation and consequently in the right side of the heart. Previously the right side had higher pressure with a R=>L shunt, but as pressure drops, this reverses to a L=>R which forces closure of the FO. LA pressure also increases due to increased return of blood from the PA. The DA also closes.
90
A well-baby is found to have a systolic murmur at the upper left sternal edge. What are your differentials?
ASD - asymptomatic patient, soft blowing murmur, systolic only left sternal edge, wide-splitting of the second heart sound
91
A loud pansystolic murmur in an asymptomatic child is usually...?
VSD (the smaller the louder, it closes spontaneously)
92
What are your differentials in a cyanotic baby presenting with a murmur, blue and breathless in the first few days of life?
Tetralogy of Fallot, Transposition of the Great Arteries (AVSD is mixed so baby is blue and breathless)
93
How do you maintain the patency of a shunt and why would you do this?
Prostaglandins, to allow oxygen to be routed around the heart if baby is cyanotic
94
What can force the closure of a patent ductus arteriosus?
Prostaglandin inhibitors – NSAIDs, IV indomethacin or ibuprofen
95
What s the difference in presentation between a L=>R shunt and R=> shunt and name what defects are classified as which?
L=>R, baby is pink, breathless, acyanotic (VSD, ASD, PDA) can be outflow obstructions (coarctation in a sick child, PS in a well child). Cyanotic – unwell, blue, if put in 100% o2 will stay blue, (TGA and TOF)
96
What genetic diseases might result in a congenital heart defect?
Edward’s (18), Down’s, Patau, Noonan’s, DiGeorge. Other causes include maternal disorders (rubella), maternal drugs (warfarin, foetal alcohol)
97
What is TGA?
Transposition of the Great Arteries, the pulmonary artery and aorta are switched
98
What outflow obstructions result in breathlessness?
Coarctation of the aorta and Pulmonary stenosis
99
What is the commonest childhood arrythmia
Supraventricular tachycardia
100
What are the 4 features of Tetralogy of Fallot?
Overriding Aorta, Right Ventricular Hypertrophy, Pulmonary Stenosis, Ventricular Septal Defect – cyanosis, on x-ray – boot shape heart, surgery at 6 months to treat (BT shunt)
101
What murmur is heart on transposition of the great arteries?
There is no murmur, there is a cyanotic baby that is failing to thrive.
102
What is indomethacin?
An NSAID used to close the PDA. Prostaglandins keep it open.
103
What congenital cardiac diseases are associated with each of the following syndromes?
Down’s Syndrome
Turner’s Syndrome
Noonans
Down’s Syndrome – AVSD, VSD, TOF, ASD
Turner’s Syndrome – atrial stenosis, coarctation
Noonans – tricuspid stenosis, septal defects
104
What are some potential worries in people with short stature?
Psychosocial deprivation - abuse or neglect
| Chromosomal disorders and associated health problems
105
What are causes of tall stature?
Obesity
Secondary to... hyperthyroidism, precocious puberty, gigantism, congenital adrenal hyperplasia
Syndromes... Marfan's, Klinefelter, maternal diabetes
106
What can cause abnormalities in head growth?
Tall stature, familial macrocephaly, raised ICP, tumour
107
What is 45 XO and how does it present?
Turner's Syndrome
Oedema of the hand dorsa, feet and loose skinfolds at the nape of the neck
Low posterior hairline, prominent ears
Small mandible, high arched palette
Broad chest
Short stature, 1.5m
Aortic arch rupture, horseshoe kidney, recurrent otitis media
108
What is Kallmann Syndrome?
Failure of GnRH neurons, more common in males
Anosmia - loss of smell
Can cause primary amenorrhoea
109
What is hypogonadotropic hypogonadism?
Primary gonadal failure leading to lack of negative feedback so increase in GnRH, LH and FSH
110
What is the difference between gonadotropin dependent and independent precocious puberty?
Gonadotropin dependent - increased LH and FSH while independent has low FSH and LH and is due to adrenal or gonadal disorders
111
How does a DKA present and how is it treated?
Vomiting, acute illness, acidosis
Treat with immediate fluids and insulin
Monitor BMs and electrolyes
112
What does a high TSH and low T4 indicate? In what disease does this occur and how does it present?
Primary hypothyroidism
Congenital or due to iodine deficiency in mother
113
How do you estimate how tall a girl will be fully grown?
Mother's height + (FH-7.5cm)/2
114
What are some causes of delayed growth?
Neglect
Failure to thrive
Actual weight loss (over 2 centiles)
115
What counts as a delayed puberty?
Boys - early is <8, late is >13
| Girls - early is <9, late is >14
116
In a baby with clitoral hypertrophy what are the risks? How will males present? What is the lifelong treatment?
CAH
Abnormal hormone synthesis, low cortisol results in ACTH increase
Virilisation
Failure of aldosterone
Males present with enlarged penis and pigmented scrotum
Adrenal crisis in males, salt loss, 1-3 weeks old presentation with vomiting, weight loss, floppiness and circulatory collapse
117
What are some advantages and disadvantages of breast feeding?
Advantages – improved bond between mother and baby, improved immunity against infection, maternal risk of breast cancer decreases, decreased risk of NEC.
Disadvantages – difficult in multiple births, difficult to know exactly how much baby is having, requires mother to always be around
118
What alternatives to breast milk exist?
Formula milk (based on cow’s, removal of protein and extra iron and mineral content), Cow’s Milk (requires vitamin and iron supplements), Soya Milk
119
Give some organic and non-organic causes of FTT?
Non-organic – neglect, poverty, maternal depression, inadequate food availability. Organic – cleft lip/palate, congenital heart disease, GORD, malabsorption
120
What % weight loss is concerning in children?
10% weight loss or a drop of 2 major centiles
121
How do you investigate cow’s milk protein allergy?
Skin prick, IgE blood test, coeliac screen, FBC, BM, stool sample
122
Why symptoms occur in CF?
```
Sweat loss
Neuropathy
Atrophy of vas deference
Malabsorption
Steatorrhoea
FTT
Meconium ileus
Recurrent infections
```
123
How is CF investigated and managed?
Sweat Test
Serum IRT (immunoreactive trypsin)
Faecal elastase - low in pancreatic insufficiency
124
What treatment is used for a viral induced wheeze?
Inhaled steroids - brief high dose
| Bronchodilators - Beta agonist
125
What are the different types of brittle asthma?
Type 1 - daily periods of breathlessness and sudden frequent attacks
Type 2 - well-controlled, occasional severe attacks requiring emergency care
126
What metabolic abnormality is found in pyloric stenosis?
Hypochloraemia, hypokalaemia metabolic acidosis
127
What is the most likely causative organism for tonsillitis?
RSV??
128
Can bile be present in pyloric stenosis?
No, it occurs above the ampulla of vater
129
What is the most likely age pyloric stenosis presents?
2-8 weeks
130
What is your management for pyloric stenosis?
Stop oral feeds
IV fluids
Atropin
Pyloromyotomy
131
What is Hirshsprung’s Disease and how does it present in children?
This is a lack of ganglions in the rectal, presents with constipation in young children, failure to pass meconium, distended abdnomen, inflamed bowel. Treat with surgical resection and enema
132
What is NEC and how can it occur and present? What are the signs seen on x-ray?
Necrotising Enterocolitis is ischaemic reperfusion injury of the gut caused by infection and inflammation of bacterial invasion of mucosa. Signs include vomiting, infectious signs, abdominal distention, poor food tolerance. It is managed by surgical excision, NBM, antibiotics (gentamycin/metronidazole)
133
At what age is interssuption most common and how does it present?
Telescoping of the bowel, most common at ileo-caecal junction, fixed with air enema, fluoroscopy for diagnosis, common at 6m to 6 years
134
What do you treat bronchiolitis with?
Supportive treatment
| If severe O2, resp support, CPAP, inpatient care
135
What can cause stridor?
Epiglottis
| Croup
136
A 15-year old post-pubertal girl with diarrhoea and weight loss is suspected of IBD. Name 3 intestinal and 3 extraintestinal signs of IBD.
Oral granulomatosis, arthritis, uveitis, erythema nodosum, diarrhoea, haematemesis, perianal lesions, clubbing, malnutrition, mouth ulcers, palpable masses, abdominal tenderness
137
A young girl undergoes colonoscopy and is diagnosed with Crohn’s. Name 3 histological findings on biopsy of Crohn’s.
Epithelioid granulomas, transmural inflammation, skip lesions, perianal lesions, discontinuous inflammation
138
A Crohn’s patient is treated with prednisolone. Name 4 side-effects relevant to a teenage girl.
Weight gain. Menstrual cycle irregularities. Skin reactions. Mood alteration. Growth retardation.
139
What is a football sign and in what condition do you see it?
NEC – air collecting in abdomen, seen on X-Ray, collects anteriorly to abdominal viscera
140
A 1-year old child presents to their GP with bile-stained vomit with intermittent crying in pain and drawing up of legs to chest area. What is the most likely differential diagnosis?
Introsusception
141
Where in the bowel is the most common site of introsusception? What signs would you see on examination and USS?
Terminal ileum/ileo-coecal valve
Tender, red currant jelly stool, sausage shaped mass in abdomen
Doughnut shape/target sign
142
What are complications of introsusception?
Necrosis, bowel perforation, peritonitis
143
An 8-month-old child presents with bilious vomiting – what are your differentials?
Pyloric stenosis, malrotation with volvulus., NEC
144
What is your investigation of choice in pyloric stenosis and what would you see?
USS
| US will show hypertrophy of circular pylorus muscle – projectile vomiting
145
What kind of pulse do you get in ductus arteriosis?
Collapsing pulse
146
What is your investigation of choice for NEC and what might you see on it?
```
Abdo X-Ray
Dilated bowel loops (often asymmetrical)
Bowel wall oedema
Pneumoperitoneum
Portal venous gas
Intramural gas
Football sign (air around falciform ligament)
Rigler sign (air inside and outside bowel wall)
```
147
What is the charicteristic hallmark of intussception on examination?
Sausage shaped mass in right hypochonrium and emptiness in right lower quadrant (Dance's sign)
148
How does necrotising enterocolitis present?
Initial symptoms can include feeding intolerance, abdominal distension and bloody stools, which can quickly progress to abdominal discolouration, perforation and peritonitis.
149
Name 5 features of Turner’s Syndrome?
```
Webbed neck
Short stature
Lymphoedema of hands and feet
Low set ears and low posterior hair line
Wide carrying angle
```
150
Name a sign of Turner’s Syndrome at antenatal foetal ultrasound scan?
Foetal oedema of the neck, hands and feet
Cystic hygroma
Structure defects of the heart (Coarctation of the aorta, Aortic stenosis, Bicupsid aortic valve), kidneys (horseshoe kidneys)
151
What are signs of Kleinfelter’s Syndrome?
```
47 XXY
Hypogonadism
Small firm testes
Tall
Behavioural Problems
```
152
What are 3 signs of cystic fibrosis on examination?
```
Hyperinflation
Coarse inspiratory creps
Expiratory wheeze
Finger clubbing
Cyanosis
```
153
What does Congenital Adrenal Hyperplasia present as?
Salt-losing crisis – vomiting, dehydration, weight loss, floppiness, collapse – due to low cortisol
High androgens – virilisation of external genitalia in female infants, in males penis can be enlarged, scrotum pigmented
Precocious puberty
154
What is the most common cause of nephrotic syndrome in children?
Mineral change disease - glomerulonephritis
155
List 4 clinical features of Down’s Syndrome?
Intellectual impairment/mental retardation, congenital heart disease, stunted growth, leukaemia
156
Which 3 Biochemical Markers are measured in the Triple Test for Down’s Screening?
βHCG, αFetoProtein, Free Unconjugated Oestriol
157
Which finding on Ultrasound Scan is indicative of Down’s Syndrome?
Nuchal Translucency
158
Give the main risk factor for the development of Down’s?
Increasing Maternal Age
159
What are 6 signs you might see in a child with Down's Syndrome?
```
Epicanthal folds
Single palmar creases
Small ears
Round face
Flat nasal bridge
Flat occiput
Sandal gap between toes
```
160
What should you council parents of a Down's baby about?
Future prognosis
| Risk of future Down's babies
