Paediatrics Flashcards
Invx required for HSP
Urinalysis
Signs of adequate milk supply
- gaining 150-200g / week
- settled after feeds
- waking spontaneously for feeds
- passing one soft, yellow stool / day
- min 5 heavy nappies / day
Mx mastitis
- continue breastfeeding
- flucloxacillin 500mg QID PO 5-10 days
- paracetamol 1g QID / ibuprofen 400mg TDS
- check position / latching technique
- feed from affected side first
- refer to lactation consultant
- massage area
- apply heat pack prior to feed to help milk flow
- cold pack following feed for pain
- review in 24-48 hours if no improvement
Causes of poor growth / failure to thrive
- inadequate breastmilk supply
- inadequate intake of solids / restricted diet
- parental depression / anxiety
- poor social support
- neglect
- coeliac disease
- cows milk protein intolerance
- hyperthyroidism
- diabetes
- chronic liver disease
Risk factors for UTI
• bladder dysfunction: frequency, urgency,
incontinence or withholding manouevres
• chronic constipation or bowel dysfunction
• previous UTIs or previous undifferentiated febrile illnesses
• vesicoureteric reflux (VUR)
• family history of VUR, UTIs or renal abnormalities
• antenatally or postnatally diagnosed renal abnormality
• chronic sequelae: failure to thrive
Kawasaki disease
Fever of greater than 38.5 for > 5 days plus at least 4 of the following:
- bilateral conjuntivitis
- polymorphous rash
- cervical lymphadenopathy
- mucositis
- extremity changes (oedema hands / feet)
Tx for Kawasaki disease
- IV Immunoglobulin
- Aspirin
Aspirin continues until follow up echo at approx 6 weeks
Following IVIG tx for Kawasako - no live immunisations for how long?
11 months
Causes of nappy rash in children
Common
- irritant dermatitis / seborrhoeic derm / atopic derm
- candidiasis
- psoriasis
Uncommon
- staph (impetigo, folliculitis)
- perianal derm
- strep vulvovaginitis
Hx questions for an increasingly unsettled infant
- onset of crying, sudden or since birth
- timing of crying
- fever or other infective signs
- feeding including any changes to formula
- diarrhoea or change to stool including blood
- frequent vomiting
- number of wet nappies / day
- how does mother feel when baby continually crying
- eczema
- concerns about weight gain
DDx sudden onset crying infant
- corneal abrasion
- infection: UTI / middle ear
- inguinal hernia
- volvulus
- intussusception
- raised ICP
- hair tourniquet to fingers / toes
- NAI
Intussusception
- usually occurs 2mths - 2yrs
- intermittent pain & distress
- can be very well between episodes
- pallor / lethargy (usually during episodes)
- D&V
