Paediatrics Flashcards
which vaccines cannot be given together but have to be given 4 weeks apart
yellow fever and MMR
transient synovitis symptoms
- occurs following a viral infection
- sudden onset- pain on weightbearing- no pain at rest
- restricted ROM, especially internal rotation.
- no/mild fever
long term transient synovitis(>6 weeks)- what to suspect?
perthes disease- avascular necrosis of the epiphysis of the femoral head.
diagnostic test for perthes disease
bilateral hip x-ray
Treatment of perthe’s disease
1) early-bed rest and traction
2) late-long term calliper bracing /surgery
Juvenile idiopathic arthritis key signs
-question trigger- skin condition
-bloods-what is raised
treatment
- salmon pink -maculopapular rash
- raised ESR
- normocytic normochromic anaemia
- treatment - NSAIDs
age of diagnosis for the following MSK:
1) DDhip
2) perthes
3) SUFE
1) 0-5
2) 5-10
3) 10-15
sporty boys with knee pain
osgood-schlatter disease
complications of IUGR( and SGA) post-partum(4)- endox2, renal x1, bowel x1
1) hypoglycaemia(decreased glycogen stores)
2) Hypocalcaemia(not hypercalcaemia)- delayed development of the VIt D pathways
3) polycythaemia(chronic intrauterine hypoxia)
4) Necrotizing enterocolitis(chronic fetal bowel hypoxia)
RF for IUGR(3)
1) maternal substance abuse(eg: smoking)
2) congenital infection(eg: rubella)
3) maternal age over 40
Criteria for the diagnosis of ADHD
1) symptoms present for 6 months
2) impairment in two functional domains(Eg: home and school)
3) inattention(eg fidgeting, excessive running and climbing) and impulsivity(e: interrupting, difficulty waiting for turn)
type of inheritance neurofibromatosis(NF) type 1
Autosommal dominant
key finding on question for NF type 1
- cafe au lait spots- light brown skin patches
key ophthalmology finding with regards to NF1
Optic glioma(low grade brain tumour associated with astrocytes)
Symptoms of optic glioma
clumsiness, reduced vision, squints, flickering eyes, eye protrusion
the inheritance pattern of cystic fibrosis
autosomal recessive
complications of cystic fibrosis(4)
1) lung
2) reproduction
3) GI- which organs
4) nose
1) recurrent bacterial infections/lung due to increased secretions
2) infertility in men(absence of vas deferens)
3) liver cirrhosis and pancreas damage(due to secretions
4) nasal polyps
does CKD affect cystic fibrosis
no
Initial treatment for acute epiglottitis
Nebulised adrenaline and oxygen
Followed by IV cefotaxime
Senior involvement- anaesthetic, paeds involvement
Why do you start oral erythromycin on 8 year olds with headaches onset and patchy interstitial shadowing on cxr
Mycoplasma pneumoniae ( common in school going children)
Investigation for absence seizure
Trigger by hyperventilation for 3-4 mins while counting out loud
1st line for absence seizures
Sodium valproate
Indications for tonsillectomy
1) airway obstruction with persistent noisy breathing( proven sleep apnoea)
2) lymphoma suspicion
3) recurrent attacks of tonsillitis
4) 2 or more attacks of peritonsillar abscess
Di George syndrome ( CATCH-22)
1) cardiac defects
2) abnormal facies
3) thymic hypoplasia
4) cleft palate
5) hypocalcemia
Deletions for chromosome 22
Fragile X syndrome
Large jaw, enlarged testicles and large prominent ears
Downs syndrome features
1) ears
2) face
3) nasal bridge
4) folds
Small ears , rounded face, flat nasal bridge and epicanthic folds
Williams syndrome
- elastin loss: full lips, wide mouth, long medial cleft, flat nasal mouth, full cheeks
- Aortic/pulmonary stenosis
- socially disinhibited/overly friendly
copy a cross (age)
4
copy a circle
3
copy a square
4 1/2
copy a triangle
5
interactive play
3
symbolic(when a child uses objects to stand in for other objects.) eg: using a banana for a phone- what age do they do it
18-24 months
why does thyroglossal cyst protrude on protrusion of tongue
thyroglossal duct connects back of the tongue to the isthmus of the thyroid gland
croup - barking cough, stridor, midcostal recession - treatment
oral dexamethasone
stridor in 1st year of life, increases with supine position, crying and activity
laryngotracheomalacia
acute epiglottitis- severe stridor, drooling key organism
Haemophilus influenza
febrile seizures- common associations(3)
- viral infection
- tonsilitis
- otitis media
febrile seizures- when complex(2)
- 15min
- Repeated within 24 hours
- focal at onset or during the convulsion
febrile seizures- risk of epilepsy
2%
febrile seizures-higher risk of recurrence
low fever
Congenital cmv infection trademark findings(2 findings 1 CT finding)
1) sensorineural hearing loss
2) poor head growth
3) intracranial calcification on ct
X- linked ( father- son) - progressive renal disease and progressive hearing loss
Alport’s syndrome
Sensorineural hearing loss + hypothyroidism
Pendred syndrome
Respiratory distress syndrome key risk factor who gets it
Pre term- not enough surfactant produced by type 2 pneumocytes
Key prevention of paediatric respiratory distress syndrome
Antenatal corticosteroid
reason not to use aspirin in children
reyes syndrome- rapidly progressing brain disease- symptoms- vomiting, drowziness, personality changes, can present with hypoglycaemia and recent use of aspirin.
Ultrasound ordering plan with utis in babies
atypical infection (pseudomonas)- ultrasound with the acute infection
typical uti which responds to abx- within 6 months.
recurrent UTIs in under 6 months- ultrasound during acute infection.
APGAR score
A- activity-0=no limb movement 1=some flexion of arms and legs 2=active motion
P-pulse- 0 = no heart rate 1= slow HR<100 2= fast HR>100bpm
G-grimace-0=no response 1=grimace, 2=cry
A-appearance- 0=blue, 1=body pink, extremeties blue 2= completeley pink
R-respiratory effort 0=absent, 1= weak cry,hypoventilation,2= good strong cry
how long should you assess which pulse in neonatal life support
brachial pulse for 10 secs
causes of motor developmental delay
1) learning difficulties
2) abnormalities of muscle(cerebral palsy/duchenne)
3) environmental factors- overuse of a cot
cradle cap management(seborrhoeic dermatitis)
first line- baby shampoo + oils
severe- mild topical steroids eg: 1 % hydrocortisone
Most common cyanotic condition
Tetralogy of fallot
Most common cyanotic condition at birth
Tetralogy of fallot
Most common acyanotic congenital disease
Ventricular septal defect
