Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Student Finals > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Neonatal Cardiovascular Physiology

Changes in fetal circulation before delivery (6)

A

Umbilical vein: transports blood from placenta to fetus
Ductus venosus: connects umbilical vein to IVC
Foramen ovale: blood flows through from right atrium to left atrium
Ductus arteriosus: a smaller volume of blood goes from right atrium to right ventricle and into the pulmonary artery, the ductus arteriosus is a channel between pulmonary artery and aortic arch to allow blood to bypass lungs
Lungs: no respiratory function; filled with amniotic fluid, alveoli are small, arterioles + venules are contracted
Umbilical arteries (2): come off left and right iliac arteries and take blood back to placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Neonatal Cardiovascular Physiology

Changes in fetal circulation after delivery (4)

A

Lungs: as body passes through birth canal, amniotic fluid is squeezed out of lungs, alveoli become larger, vessels relax and vascular pressure stops to allow more blood to lungs
Ductus venosus: fibroses to become hepatic ligamentum teres
Foramen ovale: closes (if stays open, oxygenated blood flows from left -> right atrium)
Ductus arteriosus: functional closure at days 2-3 and anatomical closure by fibrosis at days 10-14 (if stayed open, blood would flow from aorta to pulmonary artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Innocent Murmurs

Proportion of murmurs (1)

A

70-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Innocent Murmurs

Types (4)

A

Still’s murmur
Pulmonary outflow murmur
Carotid/brachiocephalic arterial bruits
Venous hum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q 
Innocent Murmurs 
Common features (5)
A

Sysotlic murmur (except venous hum which is continuous)
No other signs of cardiac disease
Soft murmurs, grade 1/6 or 2/6
Vibratory, musical
Varies with position, respiration, exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Innocent Murmurs

Still’s Murmur (4)

A

Most common
LV outflow murmur
Soft systolic murmur
Heard at apex- left sternal border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Innocent Murmurs

Chromosomal causes of congenital heart disease (4)

A

Trisomy 18 (Edwards syndrome)- VSD + ASD
Trisomy 21 (Downs syndrome)- AVSD
Turner syndrome- coarctation of aorta
Noonan syndrome- pulmonary stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Coarctation of the Aorta

Aetiology (2)

A

Narrowing of aortic wall, usually at start of aorta

Turner’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Coarctation of the Aorta

Signs + symptoms (8)

A 
Poor feeding 
Lethargy 
Tachypnoea 
Radial-radial or radial-femoral delay 
Cold lower limbs 
Crescendo-decrescendo systolic or continuous murmur in left infraclavicular area or under left scapula 
Severe cardiovascular collapse after ductus arteriosus closure 
Acyanotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Coarctation of the Aorta

Investigations (4)

A

ECG (RVH in neonates, LVH in adults)
CXR (congestive cardiac failure, indentation of aortic shadow)
Echocardiography
Cardiac MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Coarctation of the Aorta

Treatment (3)

A

Need to keep ductus arteriosus open: prostaglandin E1 infusion reopens it to allow some blood to flow from pulmonary artery to aorta and to systemic circulation
Congestive cardiac failure: inotropes and diuretics
Balloon angioplasty +/- stenting followed by resection with end to end anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Coarctation of the Aorta

Complications (3)

A

Hypertension
Re-coarctation
Aortic dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Paediatric Pulmonary Stenosis

Aetiology (1)

A

Noonan syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Paediatric Pulmonary Stenosis

Signs + symptoms (3)

A

Ejection systolic murmur at right upper sternal edge with radiation to back, pulmonary ejection click, delayed S2 (if severe), parasternal thrill and heave
Reduced exercise tolerance
Exertional chest pain and syncope if severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Paediatric Pulmonary Stenosis

Investigations (3)

A

ECG (RVH, RAH, RAD)
Echo (measure flow across valve)
CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Paediatric Pulmonary Stenosis

Treatment (2)

A

Balloon valvuloplasty to increase blood supply before puberty (causes pulmonary regurgitation but usually well tolerated)
Valve replacement surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Paediatric Aortic Stenosis

Aetiology (2)

A

William’s syndrome

Bicuspid valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Paediatric Aortic Stenosis

Signs + symptoms (6)

A 
Ejection systolic murmur at the right upper sternal edge with radiation to the carotids 
Heave 
Angina 
Syncope 
Dyspnoea 
Fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Paediatric Aortic Stenosis

Investigations (2)

A

ECG (LAD, LVH)

Doppler echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Paediatric Aortic Stenosis

Treatment (2)

A 
Balloon valvuloplasty to increase blood supply before puberty (causes aortic regurgitation but less well tolerated than pulmonary) 
Valve replacement (earlier than in pulmonary)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ventricular Septal Defect

Classification (2)

A

Muscular: lower and smaller
Pemimembranous: higher and larger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ventricular Septal Defect

Associations (4)

A

Maternal TORCH infection
Drugs: phenytoin, lithium, alcohol, cocaine
Maternal diabetes
Down’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ventricular Septal Defect

Signs + symptoms (3)

A

Pansystolic murmur at lower left sternal edge
Signs of heart failure (tachycardia, tachypnoea)
Failure to thrive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ventricular Septal Defect

Treatment (2)

A

Small and asymptomatic defects: monitoring, 50% resolve spontaneously
Surgery if large

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Ventricular Septal Defect

Complications (3)

A

Eisenmenger’s complex
Right heart failure
Right ventricular hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Ventricular Septal Defect

Eisenmenger’s complex (3)

A

RVH leads to pressure in the right ventricle exceeding pressure in the left ventricle during systole
Causing a reversal of the shunt to become R–>L
So the defect becomes cyanotic (if this happens it needs a heart-lung transplant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Atrial Septal Defect

Associations (1)

A

Down’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Atrial Septal Defect

Pathology (2)

A

Failure of ostium secundum to close

Fewer presenting features in childhood as atria have much lower pressure and pressure is similar between the two

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Atrial Septal Defect

Signs + symptoms (2)

A

Ejection systolic murmur at pulmonary area

Usually asymptomatic in childhood and can present in adulthood with AF, heart failure or pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Patent Ductus Arteriosus

Anatomy (3)

A

In fetal circulation it allows a connection between the pulmonary trunk and aorta
Helps oxygenated blood from the right heart bypass the lungs and go straight to the body
When the fetal lungs open and the placenta is no longer the source of oxygenation, this shunt should close to allow blood to get to the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Patent Ductus Arteriosus

Pathology (2)

A

Pressure in aorta is greater than in the duct causing L–>R shunts
Causes additional blood in the pulmonary circulation leading to lung hyperperfusion and steal from systemic circulation causing systemic ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q 
Patent Ductus Arteriosus 
Risk factors (2)
A

Prematurity

Down syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Patent Ductus Arteriosus

Signs + symptoms (4)

A

Infra-clavicular continuous murmur
Thrill
Pulse may be bounding and collapsing
If large, may show symptoms of circulatory overload: shortness of breath, feeding difficulties and poor weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Patent Ductus Arteriosus

Treatment (2)

A

Form term babies there is good chance of spontaneous closure within the first year, so monitor with echos and prostaglandin inhibitors (eg. indomethacin) may help to promote closure
For preterm babies give prostaglandin inhibitors and surgical closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Transposition of the Great Vessels

Pathology (4)

A

Failure of spiralling of the aorticopulmonary septum in development
Aorta comes from right ventricle
Pulmonary artery comes from the left ventricle
Leads to 2 separate right heart and left heart systems, so the oxygenated and deoxygenated blood exist in 2 separate circuits- incompatible with life unless a fetal shunt is maintained in the neonate (patent foramen ovale, PDA, VSD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Transposition of the Great Vessels

Signs + symptoms (3)

A

Cyanosis
Tachypnoea
No murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Transposition of the Great Vessels

Treatment (2)

A

Buy time: prostaglandin E1 to maintain patency of ductus arteriosus, Rashkind’s procedure (catheter used to poke a hole through atrial septum to re-open foramen ovale)
Transfer to specialist unit for surgical ‘switch’ procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Tetralogy of Fallot

Pathology (4)

A

Right ventricular outflow tract obstruction (pulmonary stenosis)
Right ventricular hypertrophy
Ventricular septal defect
Overriding aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Tetralogy of Fallot

Associations (2)

A

22q11 deletion syndrome (DiGeorge)

Down’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Tetralogy of Fallot

Signs + symptoms (3)

A

Cyanosis (because even though the heart pumps more blood it is at least partly deoxygenated)
Ejection systolic murmur (pulmonary stenosis)
Tet spells: develop blue skin/lips after crying/feeding due to rapid drop in O2 in blood, toddlers or older children might instinctively squat when they’re short of breath to increase blood flow to the lungs by kinking the femoral arteries to create a temporary LV outflow tract obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Paediatric Heart Failure

Aetiology (6)

A 
Left to right shunt (volume overload): VSD, PDA
Valvular regurgitation (volume overload) 
Outflow tract obstruction (pressure overload): stenosis of valves 
Coronary insufficiency (low O2 supply): coronary artery anomalies 
Cardiomyopathies: systolic dysfunction (low cardiac output), diastolic dysfunction (elevated pulmonary capillary pressure) 
Arrhythmias: systolic dysfunction (low cardiac output)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Paediatric Heart Failure

Presentation in infants (4)

A

Difficulty in feeding
Cyanosis
Tachypnoea
Sinus tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Paediatric Heart Failure

Presentation in children (5)

A 
Fatigue 
SOB 
Tachypnoea 
Exercise intolerance 
Abdominal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Normal Development

Weight (2)

A 
Initial weight loss: acceptable for breast fed babies to lose up to 10% and formula fed to lose up to 5% by day 5, should be back at birth weight by day 10 
Average weekly weight gain: 
- 0-3 months 200g 
- 3-6 months 150g 
- 6-9 months 100g 
- 9-12 months 75-50g
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q 
Normal Development 
6 weeks (1)
A

Smiling (social)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q 
Normal Development 
8 weeks (2)
A

Fix eyes on object and attempt to follow, prefer face to object (fine motor)
RED FLAG- no social smile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q 
Normal Development 
3 months (2)
A

Cooing noise, comfort from parents (language)

Takes things to mouth (social)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q 
Normal Development 
4 months (1)
A

Supports head up, rolls from belly to back (gross motor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q 
Normal Development 
5 months (1)
A

RED FLAG- can’t hold an object

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q 
Normal Development 
6 months (4)
A

Can hold body up but not have balance to sit unsupported, rolls back to belly (gross motor)
Palmar grip (fine motor)
Noise with consonants, responds to tone of voice (language)
Recognises several people (social)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q 
Normal Development 
9 months (4)
A 
Sits unsupported, crawling (bottom shuffling is a normal variant), pulls to standing (gross motor) 
Scissor grip (fine motor) 
Babbles with certain sounds for different things, may respond no, looks for toys that fall out of sight (language) 
Apprehensive of strangers (social)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q 
Normal Development 
12 months (5)
A

RED FLAG- cannot sit unsupported
Walks whilst holding onto furniture (gross motor)
Pincer grip, scribbles (fine motor)
Single words, follows simple instruction (language)
Points, waves, claps, copies actions (social)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q 
Normal Development 
15 months (1)
A

Walking (gross motor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q 
Normal Development 
18 months (3)
A

RED FLAG- can’t stand independently
RED FLAG- no words
RED FLAG- no interest in others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q 
Normal Development 
2 years (4)
A

RED FLAG- can’t walk themselves
Run and kick a ball (gross motor)
Pencil grip (fine motor) but v basic
Dry by day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Normal Development

2.5 years (1)

A

RED FLAG- not running

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q 
Normal Development 
3 years (2)
A

Climb stairs 1 foot at a time

Bowel control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q 
Normal Development 
4 years (2)
A

Walks up stairs normally

Dry by night, dresses self

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q 
Normal Development 
RED FLAGS (9)
A 
Loss of milestones 
No social smile by 8 weeks 
Can't hold object by 5 months 
Can't sit unsupported by 12 months 
Can't stand independently by 18 months 
No words by 18 months 
No interest in others by 18  months 
Can't walk by 2 years 
Can't run by 2.5 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Newborn Examination (3)

A

HBV immunisation if mother HBV +ve
Bloodspot: CF, congenital hypothyroidism, sickle cell disease
Clinical examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Newborn Hearing Screening (2)

A

Otoacoustic emission test by 28 days

Auditory brainstem response test if abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Health Visitor Input (4)

A

1st visit: feeding, maternal mental health, jaundice
Health visitor + GP review at 6-8 weeks
27-30 month review of development and physical measurements
Last visit age 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Immunisation

5 in 1 (3)

A

Don’t tell Peter’s Parents, Bro
Diphtheria, tetanus, pertussis, polio, H.influenzae B
2 months, 3 months, 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Immunisation

Pneumococcal Conjugate Vaccine (PCV) (1)

A

2 months, 4 months, 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q 
Immunisation
Rotavirus vaccine (1)
A

2 months, 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Immunisation

Meningococcal B vaccine (1)

A

2 months, 4 months, 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q 
Immunisation
MMR vaccine (2)
A

1 year

3 years 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Immunisation

4 in 1 (2)

A

Don’t tell Peter’s Parents

Diphtheria, tetanus, pertussis, polio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Immunisation

3 in 1 (3)

A

Don’t tell Peter
Diphtheria, tetanus, polio
14 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q 
Immunisation
2 months (4)
A

5 in 1
PCV
Rotavirus
Men B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q 
Immunisation
3 months (2)
A

5 in 1

Rotavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q 
Immunisation
4 months (3)
A

5 in 1
PCV
Men B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q 
Immunisation
1 year (3)
A

PCV
Men B
MMR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Immunisation

3 years 4 months (2)

A

MMR

4 in 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q 
Immunisation
14 years (1)
A

3 in 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Developmental Delay

Definition (2)

A

Performance 2 standard deviations below the mean of age-appropriate norm
Correct for prematurity until 2 y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Developmental Delay

Differentials (5)

A

Global developmental delay (performance 2SD below expected in 2+ domains)
Motor impairment: delayed maturation, cerebral palsy, muscular dystrophy
Sensory impairment: deafness, visual impairment
Speech and language impairment: specific language impairment, deaf, lack of stimulus, learning difficulty, bilingual
Social impairment: autism, elective mutism, learning disability, attachment issues, neglect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Global Developmental Delay

Aetiology (4)

A

Prematurity
Genetic disorder
Neglect
Congenital infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q 
Cerebral Palsy (Motor Delay) 
Definition (1)
A

Permanent non-progressive (lesion is static, however clinical picture isn’t) motor disorder due to brain damage before birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q 
Cerebral Palsy (Motor Delay) 
Aetiology (3)
A

Prenatal: placental insufficiency, smoking, alcohol, drugs, ToRCH infection
Perinatal: prematurity, anoxia
Postnatal: CMV, rubella, head trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q 
Cerebral Palsy (Motor Delay) 
Classification (4)
A

Spastic: increased tone and reduced function- damage to UMNs
Dyskinetic: problems controlling muscle tone with hypertonia and hypotonia- damage to basal ganglia
Ataxic: problems with coordinated movement- damage to cerebellum
Mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q 
Cerebral Palsy (Motor Delay) 
Patterns (4)
A

Monoplegia (one limb)
Hemiplegia (one side of body)
Diplegia (four limbs affected but mostly the legs)
Quadriplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q 
Cerebral Palsy (Motor Delay) 
Signs + symptoms (7)
A 
Spasticity
Weakness/paralysis
Poor coordination 
Delayed walking 
Sensory impairment 
Contractures 
Primitive reflexes (persistence of 2+ suggests child will be non-ambulatory): moro startle reflex, parachute reflex, tonic neck reflex, neck righting reflex, extensor thrust
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q 
Muscular Dystrophy (Motor Delay) 
Aetiology (3)
A

Duchenne’s muscular dystrophy (X-linked recessive- Xp21)
Becker’s muscular dystrophy
Myotonic dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q 
Muscular Dystrophy (Motor Delay) 
Signs + symptoms (8)
A 
Delayed gross motor skills 
Progressive muscle weakness 
Shoulders and arms held back when walking 
Protruding abdomen 
Poor balance 
Toe walking 
Foot drop 
Symmetrical proximal weakness: waddling gait, calf hypertrophy, +ve Gower's sign (uses hands to push up onto legs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q 
Muscular Dystrophy (Motor Delay) 
Investigations (4)
A

Creatinine kinase (>1000)
Muscle biopsy
DNA serology
EMG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Autism Spectrum Disorder (Social Delay)

Epidemiology (2)

A

1:100

M>F 4:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Autism Spectrum Disorder (Social Delay)

Signs + symptoms (4)

A

Reciprocal social interaction difficulties: lack of socio-emotional cue recognition, difficulty modifying behaviour in social situation
Communication difficulties: poor use of language, inflexible language use (stereotypies and persistent echolalia- repeating what you say)
Restricted, repetitive and stereotyped patterns of behaviour, interests and activities: rituals, routines, resistance to change
Infants tend to hit early milestones but may lose some around 2y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Clef Lip and Palate

Epidemiology (2)

A

70% of cleft lip cases have cleft palate too

Associated with T13, T18 and 22q11 deletion syndrome

90
Q

Clef Lip and Palate

Pathology (2)

A 
Cleft lip: maxillary and fronto-nasal facial processes fail to merge at around 5 weeks gestation (complete if continues to nose) 
Cleft palate: 2 skull plates forming 
Hard palate (palatine process and nasal septum) fail to merge at around 9 weeks
91
Q

Clef Lip and Palate

Treatment (2)

A

Special bottles and teats for feeding

Surgical repair at 6-12 months

92
Q

Short Stature

Definition (1)

A

Height 2+ SDs below the mean for children of that sex and age

93
Q

Short Stature

Physiological (3)

A

Familial: grow at normal rate and end up as predicted
Constitutional delay: normal growth but timing of puberty delayed, appear to fall off centiles until reach puberty and become a normal height
Small for gestational age

94
Q

Short Stature

Pathological (8)

A 
Iatrogenic (steroids) 
Under-nutrition 
Psychosocial 
Chronic disease (IBD, JIA, coeliac) 
Hypothyroidism 
Growth hormone deficiency 
Turner's syndrome 
Noonan's syndrome
95
Q

Toddler’s Diarrhoea

Pathology (1)

A

Motility disturbance

96
Q

Toddler’s Diarrhoea

Signs + symptoms (1)

A

Quickly after eating food and still has obvious food particles in it

97
Q

Toddler’s Diarrhoea

Treatment (1)

A

Self-limiting (most common cause of diarrhoea in children), although it is viral (rotavirus gastroenteritis)

98
Q

Newborn Examination

Head (8)

A

Circumference (50th centile = 35cm)
Shape (odd shapes from difficult labour soon resolve)
Fontanelles (tense if crying or intracranial pressure increases, sunken if dehydrated)
Red reflex (absent in cataract and retinoblastoma)
Breathing out the nose whilst closing mouth tests for choanal atresia
Otoacoustic screening
Complexion (cyanosed, pale, jaundiced)
Check mouth for cleft palate

99
Q

Newborn Examination

Arms and hands (3)

A

Single palmar creases (normal or trisomy 21)
Waiter’s tip sign of Erb’s palsy
Clinodactyly (5th finger is curved towards the ring finger- normal or trisomy 21)

100
Q

Newborn Examination

Thorax (3)

A

Watch respirations
Check grunting and intercostal recession
Listen to heart and lungs

101
Q

Newborn Examination

Abdomen (3)

A

Expect to feel liver
Assess skin turgor
In first 24h ensure baby passes urine (consider posterior urethral valves in boys if not) and stool (consider Hirschprung’s, CF, hypothyroidism if not)

102
Q

Newborn Examination

Legs (2)

A 
DDH 
Femoral pulses (exclude coarctation)
103
Q

Newborn Examination

Back (1)

A

Tufts of hair +/- dimples suggests spina bifida occulta

104
Q

Newborn Examination

Dysmorphism (7)

A

Down’s (T21): excess nuchal folds, single palmar crease, sandal gap, hypotonia, oval face, small smooth + protruding tongue, small + low set ears, small nose with flat + low bridge
Patau’s (T13): microcephaly, cleft lip + palate, hypotonia, FTT
Edward’s (T18): low set ears, rockerbottom feet, overlapping fingers, IUGR, low birth weight
22Q11: cleft palate, hooded eyes, tubular nose and broad nose tip
William’s: sunken nasal bridge, puffy eyes, blue eye with Starburst pattern, long philtrum, small chin
Noonan’s: neck webbing, pectus evatum, deep philtrum, arched palate
Fragile X: enlarge testicles, facial symmetry, macrocephaly, long ears

105
Q

Neonatology

Definitions (2)

A

Preterm <37wks, extremely preterm <28wks

Low birth weight <2.5kg, v low birth weight <1.5kg, extremely low <1kg

106
Q 
Neonatology
APGAR Score (7)
A

Respiratory effort: strong, crying (2), weak, irregular (1), nil (0)
Colour: pink (2), blue extremities (1), blue all over (0)
Muscle tone: active movement (2), limb flexion (1), flaccid (0)
Reflex irritability: cries on stimulation (2), grimace (1), nil (0)
0-3= v low
4-6= low to moderate
7-10= good condition

107
Q

Respiratory Distress Syndrome

Aetiology (1)

A

No surfactant before 34 weeks

108
Q

Respiratory Distress Syndrome

Pathology (2)

A

Increased work of breathing as lungs collapse after end of each breath
No functional residual capacity

109
Q

Respiratory Distress Syndrome

Signs + symptoms (6)

A 
Tachypnoea
Expiratory grunting 
Subcostal and intercostal recession 
Cyanosis 
Nasal flaring 
Fatigue
110
Q

Respiratory Distress Syndrome

Treatment (2)

A

Surfactant

CPAP

111
Q

Respiratory Distress Syndrome

Complications (2)

A 
Pneumothorax 
Bronchopulmonary dysplasia (inflammation and scarring of lungs)
112
Q

Respiratory Distress Syndrome

Prevention (1)

A

Antenatal steroids

113
Q

Intraventricular Haemorrhage

Aetiology (1)

A

Rupture of germinal matrix blood vessels

114
Q

Intraventricular Haemorrhage

Pathology (1)

A

Blood vessels in germinal matrix (lateral to ventricles) lack structural support and rupture

115
Q

Intraventricular Haemorrhage

Signs + symptoms (7)

A 
Diminished/absent reflex 
Poor muscle tone 
Drowsiness 
Tense/bulging fontanelle 
Cyanosis
Failure to suck 
Twitching/convulsions
116
Q

Intraventricular Haemorrhage

Investigations (1)

A

Cranial USS

117
Q

Intraventricular Haemorrhage

Treatment (3)

A

Fluid replacement
Anticonvulsants
Acetazolamide (prevents post-haemorrhagic hydrocephalus)

118
Q

Neonatal Jaundice

Physiological jaundice causes (4)

A

Increased bilirubin production in neonates due to shorter RBC lifespan
Decreased bilirubin conjugation due to hepatic immaturity
Absence of gut flora impedes elimination of bile pigment
Exclusive breast feeding

119
Q

Neonatal Jaundice

Physiological jaundice classification (3)

A

After 24h
Unconjugated (yellow skin, normal urine and stools)- pre-hepatic
Total serum bilirubin <15mg/dL and daily risk <5mg/dL

120
Q

Neonatal Jaundice

Early jaundice causes (5)

A

Sepsis: abnormal conjugation
Slow gut motility: hypothyroidism, CF, Hirschprung’s disease
HAEMOLYSIS:
- Rhesus haemolytic disease: 2nd Rh+ve pregnancy after Rh-ve mum delivers Rh+ve baby in 1st pregnancy
- ABO incompatibility: haemolysis from maternal antibodies, eg. A/B babies born to O mothers
Red cell anomalies: hereditary spherocytosis, G6PD

121
Q

Neonatal Jaundice

Early jaundice classification (6)

A

Jaundice within 24h of birth is always abnormal
Peak total serum bilirubin >15mg/dL and daily rise >5mg/dL
Sepsis screen: urine and blood cultures
Haemolysis: ABO and rhesus typing, direct and indirect Coomb’s test, G6PD assay
Coomb’s test: rhesus, haemolytic disease- +ve direct, ABO incompatibility- +ve indirect
Unconjugated (yellow skin, normal urine and stools)

122
Q

Neonatal Jaundice

Prolonged jaundice causes (5)

A 
Breastfeeding 
Sepsis 
Hypothyroidism 
Cystic fibrosis
Biliary atresia
123
Q

Neonatal Jaundice

Prolonged jaundice classification (2)

A 
Split bilirubin (conjugated = biliary atresia, yellow skin, dark urine + pale stools) 
USS biliary tree if conjugated
124
Q

Neonatal Jaundice

Treatment (2)

A

Phototherapy: converts bilirubin to soluble products that can be excreted without conjugation
Exchange transfusion: blood warmed to 37 degrees, aim is to remove bilirubin in those with severe or rapidly rising hyperbilirubinaemia

125
Q

Neonatal Jaundice

Complications (1)

A

Kernicterus: more likely if bilirubin >360mmol/l, yellow staining of brain, lethargy, poor feeding, hypertonicity, shrill cry

126
Q 
Neonatal Jaundice
Breastfeeding jaundice (3)
A

Pathology: increased beta-glucuronidase in breast milk leads to increased deconjugation and reabsorption of bilirubin and the persistence of physiological jaundice
Unconjugated jaundice within 2 weeks of brith
Treat by continuing breastfeeding with formula, supplementation, phototherapy if required

127
Q

Neonatal Sepsis

Aetiology (2)

A

Early onset: transplacental or ascending infection by GBS, E.coli, listeria
Late onset: environmental infection by coagulase negative staphylococci, Staph aureus, GBS, candida

128
Q 
Neonatal Jaundice
Risk factors (2)
A

Early onset: prolonged rupture of membranes, maternal infection (chorioamnionitis, UTI, pyrexia), preterm labour, fetal distress
Late onset: central lines and catheters, congenital malformations

129
Q

Neonatal Jaundice

Pathology (1)

A

More at risk if <28wks as maternal IgG not passed on until 3rd trimester

130
Q

Neonatal Jaundice

Signs + symptoms (7)

A 
Non-specific 
Temp may be high or low 
Lethargy 
Poor feeding 
Early jaundice 
Cyanosis 
Hypo/hyperglycaemia
131
Q

Neonatal Jaundice

Investigations (3)

A

FBC, CRP, blood cultures, glucose
VBG
CXR

132
Q

Neonatal Jaundice

Treatment (2)

A

Early onset: IV penicillin + gentamicin until cultures

Late onset: IV flucloxacillin + gentamicin until cultures

133
Q

Neonatal Jaundice

Complications (4)

A

Meningitis
DIC
Pneumonia + respiratory failure
Hypotension and shock

134
Q

Hypoxic Ischaemic Encephalopathy

Pathology (1)

A

Brain injury secondary to hypoxia during birth

135
Q

Hypoxic Ischaemic Encephalopathy

Aetiology (5)

A 
Maternal hypoxia 
Intrapartum haemorrhage (placental abruption) 
Cord prolapse 
Nuchal cord (wrapped around neck) 
Inadequate neonatal resuscitation
136
Q

Hypoxic Ischaemic Encephalopathy

Signs + symptoms (3)

A

If mild presents with poor feeding, irritability, hyper-alert (usually resolves within 24h)
If moderate presents with poor feeding, lethargy, hypotonic seizures, takes weeks to resolve and up to 40% develop cerebral palsy
If severe presents with reduced consciousness, apnoeas, flaccid and reduced (absent reflexes, up to 50% mortality and up to 90% develop cerebral palsy)

137
Q

Hypoxic Ischaemic Encephalopathy

Investigations (2)

A

Umbilical artery blood gas- acidosis

Poor Apgar scores

138
Q

Hypoxic Ischaemic Encephalopathy

Treatment (2)

A

Resuscitation and ventilation

Therapeutic hypothermia to reduce inflammation and neurone loss after the acute hypoxic injury

139
Q

Biliary Atresia

Pathology (2)

A

Occlusion of biliary tree

Bile outflow obstruction

140
Q

Biliary Atresia

Signs + symptoms (2)

A 
Conjugated jaundice (dark urine and pale stool) around week 3 of life 
Hepatosplenomegaly
141
Q

Biliary Atresia

Investigations (4)

A

Total serum bilirubin
Split bilirubin (conjugated)
Abdominal USS
Liver biopsy

142
Q

Biliary Atresia

Treatment (2)

A 
Kasai procedure (hepatoportoenterostomy): intestinal limb (Roux-en-Y) attached to bile duct to drain bile from porta hepatis 
Liver transplant
143
Q

Rhesus Haemolytic Disease

Aetiology (1)

A

2nd Rh+ve pregnancy after Rh-ve mother delivers Rh+ve baby in 1st pregnancy (1st Rh+ve pregnancies can be affected by threatened miscarriage, APH)

144
Q

Rhesus Haemolytic Disease

Pathology (2)

A

During 1st pregnancy fetal RBCs leak into the Rh-ve mother’s circulation stimulating isomerisation (production of anti-D IgG)
In subsequent Rh+ve pregnancies, these antibodies cross the placenta causing haemolytic anaemia

145
Q

Rhesus Haemolytic Disease

Signs + symptoms (6)

A 
Early unconjugated jaundice 
CCF
Hepatosplenomegaly 
Progressive anaemia 
Bleeding 
Kernicterus
146
Q

Rhesus Haemolytic Disease

Investigations (2)

A

+ve direct Coomb’s test

Total serum bilirubin

147
Q

Rhesus Haemolytic Disease

Treatment (3)

A

Exchange transfusion
Phototherapy
IV immunoglobulin

148
Q

Rhesus Haemolytic Disease

Prevention (1)

A

Anti-D immunoglobulin for Rh-ve mothers

149
Q

Necrotising Enterocolitis

Pathology (1)

A

Inflammatory and ischaemic bowel necrosis

150
Q

Necrotising Enterocolitis

Signs + symptoms (8)

A 
Abdominal distension with increasing gastric aspirates 
Visible bowel loops 
Altered bowel movements and mucoid bloody stool 
Palpable bowel mass 
Tenderness
Bilious vomit
Loss of bowel sounds 
Erythematous abdomen
151
Q

Necrotising Enterocolitis

Investigations (3)

A

AXR (pneumatosis intestinalis- visible air in gut wall)
Stool cultures
Platelets- marker of disease severity, lower = severe

152
Q

Necrotising Enterocolitis

Treatment (3)

A

TPN
IV antibiotics
Laparotomy if progressive
Distension/perforation

153
Q 
Meconium Aspiration Syndrome
Risk factors (3)
A

Post dates
Maternal DM/HTN
Difficult labour (fetal distress)

154
Q

Meconium Aspiration Syndrome

Signs + symptoms (1)

A

Respiratory distress

155
Q

Meconium Aspiration Syndrome

Investigations (3)

A

Sepsis screen
Capillary gas
CXR

156
Q

Meconium Aspiration Syndrome

Treatment (4)

A

Suction below vocal cords
Intubation and ventilation
IV fluids and antibiotics
Surfactant

157
Q

Meconium Aspiration Syndrome

Complications (1)

A

Persistent pulmonary hypertension of the newborn

158
Q

Vitamin K Deficiency Bleeding

Aetiology (1)

A

No enteric bacteria to vit K

159
Q

Vitamin K Deficiency Bleeding

Signs + symptoms (2)

A

2-7 days post partum

Baby is usually well, apart from bruising/bleeding

160
Q

Vitamin K Deficiency Bleeding

Investigations (2)

A

Prothrombin time increased

Platelets normal

161
Q

Disseminated Intravascular Coagulation

Signs + symptoms (4)

A

Septic signs
Petechiae
Venepuncture oozings
GI bleeding

162
Q

Disseminated Intravascular Coagulation

Investigations (4)

A

Platelets low
INR high
Fibrinogen low
D-dimer high

163
Q 
Autoimmune Thrombocytopenia (ITP)
Pathology (3)
A

Develops in utero
Fetomaternal incompatibility of platelet antigens
Most are first born, 80% recurrence in later pregnancies

164
Q 
Autoimmune Thrombocytopenia (ITP)
Treatment (1)
A

Platelet transfusion

165
Q 
Capillary Hemangioma (Strawberry Naevus) 
Risk factors (4)
A

Female
Premature
White
Mother underwent chorionic villus sampling

166
Q 
Capillary Hemangioma (Strawberry Naevus) 
Signs + symptoms (2)
A

Erythematous, raised, multi-lobed lesion that can appear on any site in the body (usually face, scalp or back) in 1st month of life (usually not at birth)
Increase in size until 6-9 months before regressing over next few years

167
Q 
Capillary Hemangioma (Strawberry Naevus) 
Treatment (1)
A

Usually none unless visual field obstruction where can use propranolol

168
Q

Stork Mark

Pathology (1)

A

Areas of capillary dilatation on the eyelids, central forehead and back of the neck (where stork holds baby), they blanch on pressure and fade with time

169
Q

Oesophageal Atresia

Pathology (2)

A 
Oesophageal atresia and tracheo-oesophageal fistula are a spectrum of abnormalities 
Isolated OA (7%) and TOF (4%) can occur but are rare
170
Q 
Oesophageal Atresia 
Prenatal signs (2)
A

Polyhydramnios

Small stomach

171
Q 
Oesophageal Atresia 
Postnatal signs (7)
A 
Cough 
Airway obstruction 
Increased secretions 
Blowing bubbles 
Distended abdomen 
Cyanosis 
Aspiration
172
Q

Oesophageal Atresia

Treatment (3)

A

Stop feeding
Suck out oesophageal pouch
Surgical repair

173
Q

Congenital Diaphragmatic Hernia

Pathology (2)

A

A developmental defect in the diaphragm allowing herniation of abdominal contents into the chest
Leads to impaired lung development

174
Q

Congenital Diaphragmatic Hernia

Signs + symptoms (3)

A

Difficulty resuscitating at birth
Respiratory distress
Bowel sounds in one hemithorax

175
Q

Congenital Diaphragmatic Hernia

Investigations (2)

A

Prenatal: US
Postnatal: CXR

176
Q

Congenital Diaphragmatic Hernia

Treatment (2)

A

Prenatal: fetal surgery
Postnatal: NG tube, surgery

177
Q

Febrile Fit

Definition (1)

A

A simple febrile convulsion is a single tonic-clonic symmetrical generalised seizure lasting <15 min, occurring as temp rises rapidly in a febrile illness (typically in a normally developing child 6m-6y, occurring in 3% of kids)

178
Q

Febrile Fit

Investigations (6)

A 
Need to rule out more serious causes 
FBC, U&amp;E, Ca, glucose 
Glucose
MSU 
CXR
Temp
179
Q

Febrile Fit

Treatment (4)

A

Recovery position
If fit >5 mins: IV lorazepam, buccal midazolam or PR diazepam
If fit >10 mins: treat as status epilepticus
1/3 have recurrences

180
Q

Hydrocephalus

Pathology (2)

A

CSF building up abnormally within the brain and spinal cord

Due to either over-production or a problem with draining/absorbing

181
Q

Hydrocephalus

Aetiology (4)

A

Most commonly, aqueductal stenosis (congenitally stenosed aqueduct between 3rd and 4th ventricle) leading to insufficient drainage of CSF and build up in the lateral and third ventricles
Chiari malformation
Haemorrhage
Infection

182
Q

Hydrocephalus

Presentation in babies/children (6)

A 
Enlarged and rapidly increasing head circumference since cranial bones don't fuse until 2 years 
Bulging fontanelles 
Poor feeding 
Vomiting 
Poor tone and head control 
Irritability
183
Q

Hydrocephalus

Presentation in adults (6)

A 
Headache 
Lethargy 
Gait abnormality 
Memory/concentration decline 
Visual changes 
Vomiting
184
Q

Hydrocephalus

Treatment (1)

A

VP (ventriculoperitoneal) shunt which drains the CSF from the ventricles- needs replaced every 2 years

185
Q

Failure to Thrive

Definition (1)

A

Significantly low rate of weight gain- crossing centiles

186
Q

Failure to Thrive

Non-organic causes (7)

A 
Poverty 
Maternal depression 
Maternal drug use 
Difficult parent-child interactions 
Child neglect 
Poor feeding skills 
Eating disorders
187
Q 
Failure to Thrive
Organic causes (6)
A

Poor lactation or incorrectly prepared feeds
Prematurity
Oro-palatal anomaly
Neuromuscular disease
Congenital: CF, inborn errors of metabolism, cardiac disease
Nutrient loss: pyloric stenosis, malabsorption, diarrhoea, coeliac, pancreatic insufficiency

188
Q

Failure to Thrive

Investigations (2)

A

Check feeding techniques

Trial of feeding in hospital, if weight gain = non-organic

189
Q

Attention Deficit Hyperactivity Disorder

Signs + symptoms (3)

A

Inattention: can’t listen to detail, sustain attention in activities follow instructions, finish homework, loses/forgets things
Hyperactivity: squirming/fidgeting, talks incessantly, restless, always on the go
Impulsivity: blurts out answers, interrupts, intrudes on others

190
Q 
Attention Deficit Hyperactivity Disorder
Differential diagnoses (4)
A

Age-appropriate behaviour
Low (or high) IQ
Hearing impairment
Behavioural disorders

191
Q

Attention Deficit Hyperactivity Disorder

Treatment (4)

A

Parent training/education
CBT
1st line methylphenilate (Ritalin)
Atomoxetine for more long term option

192
Q

Oppositional Defiant Disorder

Signs + symptoms (3)

A

Negative, hostile and defiant behaviour without serious violation of societal norms or rights of others
May only be present in one environment
More evident in interactions with familiar adults/peers

193
Q

Oppositional Defiant Disorder

Treatment (3)

A

Parent training programme
Cognitive therapy
Multisystem therapy (eg. with young person, family, school)

194
Q

Paediatric Asthma

Treatment (6)

A 
1: as required SABA 
Proceed if needed >3x per week or if many exacerbations or if wakes from sleep >1x per week
2: low dose ICS 
3: LABA if >5, LTRA if <5
4: increase ICS +/- theophylline 
5: prednisolone
195
Q

Paediatric Asthma

Treating an attack (7)

A

1: high flow 100% O2
2: salbutamol nebuliser with ipratropium bromide
3: hydrocortisone
4: one dose IV magnesium sulfate
5: aminophylline
6: nebulisers continuously until improving
7: CPAP, ITU

196
Q

Croup

Epidemiology (2)

A

6m-3y

Parainfluenza type 1

197
Q

Croup

Signs + symptoms (4)

A

2 day duration, well child, stridor, hoarse voice, barking cough, worse at night
Mild: occasional barking cough, no stridor at res, no/mild recessions, child looks well
Moderate: frequent barking cough and stridor at rest, recessions at rest, no distress
Severe: prominent inspiratory stridor at rest, marked recessions, distress, agitation, lethargy

198
Q

Croup

Treatment (3)

A

Single dose oral dexamethasone
Nebulised adrenaline if distressed
Inhaled ICS if severe

199
Q

Testicular Torsion

Epidemiology (2)

A

Neonates

13-16y/o

200
Q

Testicular Torsion

Signs + symptoms in neonates (2)

A

Painless

Smooth testicular enlargement with a dark colour that doesn’t transilluminate

201
Q

Testicular Torsion

Signs + symptoms in adolescents (8)

A 
Sudden onset 
Constant unilateral testicular pain and swelling (may follow minor trauma or sport) 
Associated nausea and vomiting
Hemi-scrotum discolouration and tenderness 
High riding and horizontal testis 
Absent cremasteric reflex 
Reactive hydrocele 
Impaired gait
202
Q

Testicular Torsion
Investigations (2)
Treatment (1)

A 
Investigations: 
- urinalysis and MC&amp;S
- USS if doubt 
Treatment: 
- urgent de-torsion (delay will result in testicular infarction)
203
Q

Hydrocele

Epidemiology (1)

A

Neonates

204
Q

Hydrocele

Aetiology (1)

A

Collection of fluid in scrotum due to patent processus vaginalis

205
Q

Hydrocele

Signs + symptoms (5)

A

Scrotal swelling that increases with crying and straining
Bluish in colour
Transilluminates
Soft and non-tender
May occur in torsion, trauma, epididymitis or on its own

206
Q

Hydrocele

Investigations (1)

A

USS if doubt

207
Q

Hydrocele

Treatment (2)

A

Not required, 90% resorb and tunica vaginalis closes by 2 y/o
Consider surgical repair if still present after 2 y/o

208
Q

Intussusception

Epidemiology (2)

A

Most common cause of intestinal obstruction in children

Typically 6-12 months, more common in boys

209
Q

Intussusception

Aetiology (1)

A

Telescoping of one intestinal segment into another causing obstruction

210
Q

Intussusception

Signs + symptoms (5)

A 
Bilious vomiting 
Episodic intermittent inconsolable crying, with drawing the legs up (colic)  
PR blood (like redcurrant jelly) 
Sausage shaped mass in RUQ 
In between pains there may be no signs
211
Q

Intussusception

Investigations (1)

A

US abdo shows target sign

212
Q

Intussusception

Treatment (2)

A

Enema reduction

Laparotomy if fails or signs of peritonitis

213
Q

Pyloric Stenosis

Epidemiology (2)

A

More common in boys

3-8 weeks

214
Q

Pyloric Stenosis

Signs + symptoms (6)

A

Non-bilious projectile vomiting after feeds
Constipation
Alert, anxious and always hungry
Palpable left –> right LUQ peristalsis during a feed
Olive-sized pyloric mass
Dehydration

215
Q

Pyloric Stenosis

Investigations (2)

A

U&E: metabolic alkalosis with hypokalaemia and hypochloraemia
US if unsure

216
Q

Pyloric Stenosis

Treatment (2)

A

Fluid resuscitation bolus of 09% saline then replacement at 1.5x maintenance rate with 5% dextrose + 0.45% saline
Surgery

217
Q

Non-Accidental Injury

Definitions (3)

A

Child abuse: deliberate infliction of harm to a child or failure to prevent harm
Neglect: persistent failure to meet a child’s basic physical or psychological needs that is likely to result in serious impairment of the child’s health and development
Munchausen’s by proxy: parent fabricates symptoms in child to gain attention via unnecessary interventions

218
Q

Paediatric UTI

Signs + symptoms (3)

A

Neonatal: fever, vomiting, lethargy, irritability, failure to thrive
Pre-verbal: fever, abdo/loin pain, vomiting
Verbal: frequency, dysuria, changes in continence

219
Q

Paediatric UTI

Investigations (2)

A

Clean catch samples- urinalysis, microscopy and culture

US

220
Q

Paediatric UTI

Treatment (3)

A

<3m: IV amoxicillin + gentamicin
>3m: trimethoprim, nitrofurantoin
Pyelonephritis: gentamicin, cefotaxime/co-amoxiclav

221
Q

Fetal Alcohol Syndrome

Signs + symptoms (3)

A

Failure of growth: reduced eight, length and head circumference
Craniofacial abnormalities: microcephaly, flat philtrum, thin upper lip
Neurodevelopment: learning difficulty, hyperactivity, attention deficit

Med Student Finals (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions