Paediatrics Flashcards
80% of CF cases in UK are due to what
Mutation in delta508 on long arm of chr7
What organisms can colonise CF patients?
Staphylococcus aureus
Pseudomonas aeruginosa
Burkholderia cepacia
Aspergillus
What is the site of origin of stridor?
Extrathoracic
What is the site of origin of wheeze?
Intrathoracic
Stridor
Predominantly inspiratory - indicates obstruction to airflow in the extrathoracic airways down to the level of the thoracic inlet
What do you do if a case of whooping cough is suspected?
Prescribe oral azithromycin within first 21 days of symptoms and inform public health England
Complications of bordatella pertussis
subconjunctival haemorrhage
pneumonia
bronchiectasis
seizures
Mx for GOR
- 30 degree position during feeds
- Infant sleep on back
- Small and mode frequent feeds, ensure no overfeeding
- Trial of thickened formula OR trial of alginate eg gaviscon
- Trial of PPI or H2RA if refusal of feeds, faltering growth or distressed behaviour
- Metoclopromide in specialist care
Side effects of anti-epileptics Valproate Lamotrigine Vigabatrin Levetiracetam Carbamazepine
Valproate - weight gain, hair loss, rarely liver failure
Lamotrigine - rash
Vigabatrin - restriction of visual fields, sedation, behavioural disturbance
Levetiracetam - anorexia
Carbamazepine - visual disturbance
A 10-year-old boy is brought to the paediatric outpatient department for a review of his height. He was found to be on the 0.4th centile and his mid-parental height is the 98th centile. He also has widely spaced nipples, wide carrying angle, hypogonadism, pulmonary stenosis and developmental delay. What is the most likely diagnosis?
Noonans syndrome
Gain of function mutation in MAPK pathway (PTPN11) causes which condition
Noonan’s syndrome
What problem with the arms is seen in 50% of Noonan’s syndrome patients?
Cubitus valgus
Turners syndrome is associated with an increased likelihood of which GI condition
Coeliac disease
Cardiac associations with DS
AVSD, ventricular septal defect, tetralogy of fallot
GI associations with DS
Duodenal atresia, Hirschprung’s disease
Endocrine associations with DS
Hypothyroidism, Addison’s disease, T1DM
Ocular problems associated with DS
Cataracts
Malignancy associated with DS
Leukaemia
Musculoskeletal problems associated with DS
Atlanto-axial instability
What are DS patients at risk of later in life
Dementia
Treatment of status epilepticus
IV Phenytoin
Treatment for seizures in the community lasting more than 5mins
Buccal midazolam
How to treat febrile seizures?
If meningitis is excluded (need to ensure if first febrile convulsion under 12mths), then likely to be viral, so dress the child lightly and give regular anti-pyretics.
Diagnostic for absence epilepsy on EEG
Three spike waves per second in all leads