Paediatrics Flashcards
Why are normal limb variants often responsible for unnecessary referrals to orthopaedics?
Many will self-resolve naturally with time
How can limb abnormalities in paediatrics present?
Rotational abnormalities
Angulation abnormalities
What are some Rotational Abnormalities in lower limbs of paediatrics?
In-Toeing
Out-Toeing
What are some causes of In-Toeing in paediatrics?
Metatarsus Adductus
Internal Tibial torsion
Femoral Anteversion
What is Metatarsus adductus?
Paediatric condition in which the metatarsals adduct towards the midline.
Position is set before birth, usually resolves in a few months.
When should a child with Metatarsus adductus be referred to orthopaedics?
If rigid or unresolved by 9 months
What is Internal Tibial Torsion?
Inward twist below knee, that usually resolves by 10 years
What treatment is available if an Internal Tibial Torsion persists beyond 10 years?
Osteotomy
What is Femoral Anteversion?
Paediatric condition with inward rotation at hip, more common in females than males.
Usually resolves by 10 years
How does Femoral Anteversion present?
Awkward running posture and inward patellae.
W sitting position
What Is Out-Toeing?
External rotation of foot
Normal in infancy, usually resolves by 18-24 months
What are some more serious causes of Out-Toeing?
Perthes
SUFE
What are some causes of angulation deformities in paediatrics?
Bow Legs - Genu Varum
Knock Knees - Genu Valgum
Pes Planus
What is Genu Varum?
Bow legs
Common in newborns and infancy, usually straighten by aged 2
What other conditions can lead to Bow Legs?
Metaphyseal fracture
Blounts disease
Rickets
What is Genu Valgum?
Knock Knees
Common between age 3-4
Usually straighten by 7 years
What should Intermalleolar distance be in kids?
<8cm
When should Knees be referred?
If unilateral or progressive
What is Pes Planus?
Flat feet
Normal in neonates and toddlers
Usually resolves by 4-8 years
When does Pes Planus need treatment?
If symptomatic
Which organism causes Chicken Pox?
Varicella Zoster
How does Chicken Pox present?
Initially forms Spots
Then Blisters
Then Scabs
Then Crusts
What symptoms are common with Chicken Pox?
Fever
Aches and Pains
How is Chicken Pox Spread?
Coughing
Sneezing
Lesions
How long is Chicken Pox infectious for?
Until all lesions have scabbed over
What is Molluscum Contagiosum?
Skin infection presenting with small, firm raised papules that are itchy but not painful.
How is Molluscum Contagiosum spread?
Direct contact and contaminated surfaces
What is Hand Foot and Mouth disease?
A mild, self-resolving illness that usually resolves within 10 days
Which virus is responsible for Hand Foot and Mouth disease?
Cocksackie Virus
How does Hand Foot and Mouth disease present?
Sore Throat, then mouth ulcers, then blisters on hands and feet
How does Eczema present?
Areas of dry, scaly, red, itchy skin
Which areas of skin are usually affected in Eczema?
Face and Nappy Areas in babies
Limbs in older children
What is Seborrhoeic Dermatitis also known as?
Cradle Cap
How does Seborrhoeic Dermatitis present?
Non-inflamed yellow scales
What is the treatment for Seborrhoeic Dermatitis?
Gentle emollient, removal of scales
Which pathogen is responsible for Impetigo?
Staph Aureus
How does impetigo present?
Formation of Crusting or Bullous lesions usually on face.
Can occur on body
What treatment is recommended for Impetigo?
Topical Abx if localised
Which pathogen is responsible for Scarlet Fever?
Strep. Pyogenes
How does Scarlet Fever present?
Sore Throat Fever Headache Vomiting Abdo Pain Myalgia
How long after the fever does the rash present in Scarlet Fever?
12-48h, usually starts on neck
How does the rash present in Scarlet Fever?
Sandpaper texture
Peri-oral sparing
Strawberry tongue - First white then red
What symptoms do Measels present with?
Fever
Conjunctivitis
Cough
Coryza
Where does the rash present in measels?
Face and neck initially, then spreads to body and limbs
What are Koplick’s spots?
White patches on mucous membranes
What do Koplick’s spots indicate?
Measels
What is Rubella?
German Measels
How doe Rubella present?
URTI symptoms
Pale pink rash starting behind ears and face
Some cervical lymphadenopathy
What is Roseola Infuntum?
3 day rash that presents initially with a sore throat and high temperature, then develops a rash 3-4 days later
What is Kawasaki Disease?
Acute inflammatory illness giving systemic vasculitis and cardiac complications
What are symptoms of Kawasaki Disease?
Red, bloodshot eyes High fever Red cracked lips and tonuge Widespread rash Red, swollen feet and hands
What is the treatment for Kawasaki disease?
IV Immunoglobulin
Which organism causes Meningiococcal disease?
Neisseria Meningitidis
What are symptoms of Meningiococcal Disease?
Fever Headache Stiff neck Confusion Photophobia
What is the treatment for Meningiococcal disease?
IM Abx
What are important things to look for in examining an unwell child?
Alertness ?smiling/reactive ?Active ?Normal colour ?Respiration ?Wet eyes and mouth ?Rash ?Pain
What should be examined in an unwell child?
Mucous membranes Skin Fontanelle if baby RR and lungs HR Temp CRT Area of pain
What guidance helps inform management with an unwell child?
NICE Traffic light system
