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Paediatrics Flashcards

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USMLE® Step 1 flashcards
1
Q

Foetal shunts

  1. Ductus venosus
  2. Foramen ovale
  3. Ductus arteriosus
  4. Patent - cause
  5. Patent - presentation
A
  1. Connects umbilical vein to IVC; bypass liver
  2. Connects RA to LA; bypass RV / pulm circulation
  3. Connects pulm artery to aorta; bypass pulm circulation
  4. Rubella, prematurity
  5. Asymptomatic, or if large L-R shunt then SOB, difficulty feeding, poor weight gain, LRTI (monitor with echo until 1y)
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2
Q

Murmurs

  1. Innocent (flow, during systole) murmurs - features
  2. Refer if
  3. Pan-systolic - differentials
  4. Ejection-systolic - differentials
  5. Split 2nd heart sound (S2) - cause
  6. Atrial septal defect
  7. Ventricular septal defect
  8. Patent ductus arteriosus
  9. Coarctation of the aorta
  10. Pulmonary stenosis
A
  1. Soft, short, systolic, symptomless, situation-dependent (quieter standing, worse if unwell)
  2. Loud (+ on standing), diastolic, other symptoms
  3. VSD, MR, TR
  4. HOCM (4th IC, left sternal border), AS, PS (ToF)
  5. Pulmonary valve closes slightly later than aortic valve
  6. Mid-systolic, crescendo-decrescendo murmur, loudest at upper left sternal border, fixed split S2
  7. Pan-systolic, 3/4th IC, left sternal border, + thrill
  8. Normal S1, continuous crescendo-decrescendo “machinery” murmur (may continue during S2)
  9. Systolic, below left clavicle/scapula
  10. Ejection systolic, loudest in pulmonary area (2nd IC, left sternal border)
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3
Q

Septal defects - atrial and ventricular

  1. Features
  2. Complications - atrial
  3. Complications - ventricular
  4. Ventricular - associated with which syndromes (2)
  5. Atrial - associated with what structural defect
  6. Structural defect causes what on auscultation
  7. Eisenmenger syndrome - causes (3)
  8. Pathophysiology/features
  9. Management - pre-heart/lung transplant
A
  1. NO cyanosis, but right overload/strain, leading to right HF + pulmonary HTN
  2. Stroke post-VTE, AF/flutter,
  3. Higher risk of IE (prophylactic ABX in surgery)
  4. Down’s / Turner’s syndrome
  5. Ebsteins anomaly (low tricuspid valve so bigger RA and smaller RV), causing R-L shunt. Linked to WpW
  6. ‘Gallop’ rhythm - 3rd and 4th heart sounds
  7. ASD, VSD, patent ductus arteriosus
  8. Pulmonary pressure greater than systemic pressure, so shunt reverses (becomes R-L) so blood bypasses lungs + patient becomes cyanotic
  9. Oxygen, sildenafil (pulmonary HTN), venesection (polycythaemia), anticoagulation (thrombosis)
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4
Q

Coarctation of the aorta (no shunt)

  1. Associated condition
  2. Signs
  3. If critical at birth, give what before surgery
  4. Pulmonary valve stenosis - associated diseases
  5. Signs
  6. Tetralogy of Fallot - 4 problems
  7. Risk factors
  8. CXR - defining feature
  9. Tet spells - what
  10. Another cyanotic HD with shunt
A
  1. Turner’s syndrome
  2. No cyanosis, weak femoral pulses, systolic murmur below left clavicle/scapula, LV heave post-hypertrophy, underdeveloped left arm/legs, headache/nose bleeds
  3. Prostaglandin E to keep DA open (do same in ToF)
  4. ToF, William/Noonan/congenital rubella syndromes
  5. Cyanosis, palpable thrill in pulmonary area, RV heave from hypertrophy, raised JVP with giant a waves
  6. VSD and overriding (right-leaning) aorta, alongside pulmonary valve stenosis (so RV deoxygenated blood more likely to go into aorta), causing RV hypertrophy
  7. Rubella, old/diabetic/alcohol drinking mother
  8. ‘Boot-shaped’ heart from RV thickening
  9. Acute worsening, can happen when waking / crying / on exertion. Squat increases SVR so blood goes to lungs
  10. Transposition of great arteries
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5
Q

Acute SOB

  1. Bronchiolitis - commonest age, + causes
  2. Auscultation
  3. Management - SUPPORTIVE
  4. What makes more severe
  5. Pneumonia - commonest bacteria + virus
  6. If unvaccinated
  7. ABX - 1st line
  8. Recurrent LRTIs - differentials
  9. Croup - age group, common causative virus
  10. Presentation
  11. Mild vs moderate vs severe
  12. Management
  13. Epiglottitis - causative organism
  14. Presentation
  15. Lateral X-ray - finding
A
  1. < 1 year (3-6 months), RSV (also adenovirus, rhinovirus)
  2. Harsh breath sounds, fine inspiratory wheeze, dry cough, crackles
  3. Minimal handling, adequate intake, nasal saline drops/suction, O2 if <92%
  4. Bronchopulmonary dysplasia, CHD, CF
  5. Streptococcus pneumoniae, RSV
  6. Group B streptococcus, haemophilus influenzae
  7. Amoxicillin, + macrolide if atypical suspected (or PI)
  8. Reflux, aspiration, neurological/heart disease, asthma, CF, primary ciliary dyskinesia, immune deficiency
  9. 6-24 months, parainfluenza virus
  10. ‘Barking’ cough, hoarse, stridor, low fever
  11. Mild (cough but no stridor/RD at rest), moderate (add RD at rest), severe (add agitation/lethargy)
  12. Maybe admit, supportive, oral dexamethasone (single dose), if worse then O2 + nebulised adrenaline
  13. Haemophilus influenza type B (HIB)
  14. Sore throat, stridor, drooling, tripod, high fever
  15. ‘Thumbprint sign’ from oedematous epiglottis
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6
Q

Wheeze

Asthma

  1. Acute - moderate
  2. Severe
  3. Life-threatening
  4. Management ‘O SHIT ME’
  5. Can discharge when
  6. Long term management - 3rd line
  7. Viral wheeze (expiratory, global) - features vs asthma
  8. If focal wheeze, consider what (3)
A
  1. Peak flow >50%
  2. PF <50%, sats <92%, no sentences, respiratory distress, RR >40 if 1-5, >30 if >5, HR >140 if 1-5, >125 if >5
  3. PF <33%, sats <92%, exhaustion, poor respiratory effort, hypotension, silent chest, cyanosis, reduced GCS
  4. Oxygen, Salbutamol (back to back), Hydrocortisone / prednisolone (1mg/kg for 3 days), ipratropium, Theophylline infusion (only in ITU as need daily levels, U+Es, ECG monitor), Magnesium IV, Escalate to CC
  5. Child well on maximum 6 puffs salbutamol 4 hourly
  6. LTRA (if under 5), LABA (if 5+)
  7. <3 years old, no atopy, only during viral infections
  8. Inhaled foreign body, lesion, focal infection
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7
Q

Other paediatric respiratory conditions

  1. Laryngomalacia - cause
  2. Presentation
  3. Whooping cough - causative organism
  4. Presentation
  5. Diagnosis
  6. Management
  7. Key complication
  8. Chronic lung disease of prematurity (CLDP) - aka
  9. Diagnosis
  10. Prevention
  11. To complete respiratory exam, do what (3)
A
  1. Supraglottic larynx causes partial airway obstruction
  2. Chronic inspiratory stridor, worse if feeding, upset, lying back or during URTIs (no respiratory distress)
  3. Bordetella pertussis (gram negative bacteria)
  4. Coryzal symptoms for a week, then coughing fits, inspiratory ‘whoop’ when coughing ends (lasts 8 weeks)
  5. NP/nasal swab with PCR testing or bacterial culture
  6. Notifiable disease, supportive, ABX (macrolide or co-trimoxazole, + prophylactic to vulnerable close contacts)
  7. Bronchiectasis
  8. Bronchopulmonary dysplasia
  9. CXR changes, + needs O2 after 36 weeks GA
  10. Corticosteroids e.g. betamethasone to mother if showing signs of labour < 36 weeks
  11. Vital signs, growth chart, ENT
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8
Q

Cystic fibrosis (autosomal recessive)

  1. CFTR mutation - commonest type
  2. How many are carriers, how many born with CF
  3. Consequence - GI
  4. Respiratory
  5. Reproductive
  6. 1st sign of CF, + associated signs
  7. Other signs
  8. Diagnosis - 1st
  9. Gold-standard - confirming 1st result
  10. Genetic testing for CFTR gene - when
  11. Common colonisers
  12. Management - medical
  13. Monitoring/screening requirements
  14. Primary ciliary dyskinesia - aka, inheritance, linked with
  15. Kartagener’s triad (not all will have all 3)
  16. Diagnostic test
A
  1. Delta-F508 (codes for particular chlorine channel)
  2. 1 in 25 are carriers, 1 in 2500 born with CF
  3. Blocked ducts (thick pancreas/biliary secretions) so lack of digestive enzymes e.g. lipase in tract, so malabsorption, steatorrhoea, abdo pain, failure to thrive
  4. Thick secretions, less airway clearance, bacterial colonisation, frequent infections
  5. Male infertility (bilateral absent vas deferens)
  6. Meconium ileus (with abdo distention + vomiting)
  7. Nasal polyps, finger clubbing, crackles/wheeze
  8. Newborn heel prick (immune reactive trypsinogen)
  9. Sweat test (pilocarpine), diagnose if Cl- >60mmol/l
  10. Pregnancy (amniocentesis/CVS) / shortly after birth
  11. Staph. aureus, pseudomonas, h. influenza, klebsiella
  12. CREON tablets, prophylactic flucloxacillin, bronchodilators, nebulisers (dornase alpha, saline), vaccinations (pneumococcal, varicella, influenza)
  13. Regular sputum/CXR, monitor for DM (50% need insulin), osteoporosis (DEXA), USS abdo, low vit D, liver failure (30%)
  14. Kartagener’s, autosomal recessive, consanguinity
  15. Paranasal sinusitis, bronchiectasis, situs inversus
  16. Ciliated epithelium sample, assess ciliary function (from nasal brushing / bronchoscopy)
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9
Q

Cardiac abnormality - summary

  1. Acyanotic, with shunt
  2. Acyanotic, no shunt
  3. Cyanotic, with shunt
  4. Cyanotic, no shunt
  5. Symptoms
  6. Signs
  7. Complications
A
  1. ASD, VSD, PDA
  2. Coarctation of aorta
  3. ToF, TGA
  4. Severe pulm. stenosis, T/P atresia, hypoplastic L heart
  5. Problems breast feeding, failure to thrive, syncope, squatting, oedema, sweating
  6. Murmur, high HR/RR, clubbing, cyanosis (esp. feeding)
  7. Infective endocarditis, paradoxical embolism, polycythaemia, pulmonary HTN
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10
Q

Respiratory - main causes of problems

  1. Neonates
  2. Infants
  3. Under 5
  4. Over 5
  5. Respiratory distress - signs
  6. Bronchiolitis vs pneumonia
A
  1. Resp. distress syndrome (premature, less surfactant, atelectesis + low O2/high CO2 - CXR ‘ground glass’; apnoea (20s + low HR, give IV caffeine)
  2. Bronchiolitis, pneumonia, croup, GI reflux/aspiration, HF
  3. Viral induced wheeze, croup, pneumonia
  4. Asthma, pneumonia
  5. Tachypnoea, head bobbing, tracheal tug, abdominal movements to aid ventilation, sub/intercostal recession
  6. Pneumonia - focal signs, higher grade fever
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11
Q

Seizures

  1. GTC - 1st line
  2. Focal
  3. Myoclonic
  4. Absence
  5. Atonic
  6. MRI to rule out structural pathology if (3)
  7. Key blood test if afebrile seizure
  8. Febrile convulsion - cause (+ other differentials)
  9. Simple - definition
  10. Complex - definition
  11. Management
  12. Reoccurs how often
A
  1. Sodium valproate (SEs: liver damage, hair loss)
  2. Carbamazepine (agranulocytosis, P450 inducer, aplastic anaemia) / lamotrigine (SJS, leukopaenia)
  3. Valproate
  4. Ethosuximide (night terrors, rash) / valproate
  5. Valproate (3 minutes, maybe Lennox-Gastaut synd)
  6. 1st seizure <2yo, focal, don’t respond to 1st line
  7. Blood glucose
  8. Viral (+ infection, epilepsy, SOL, syncope, trauma)
  9. GTC, <15 minutes, once during febrile illness.
  10. Focal/partial, >15 minutes, >1x during febrile illness
  11. Antipyretic, reassure parents, safety netting, benzodiazepines if > 15 minutes
  12. 1 in 6
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12
Q

Shaken baby syndrome

  1. Triad
  2. 1st line investigations
A
  1. Retinal haemorrhage, subdural haematoma, encephalopathy
  2. CT scan, FBC, LFT, clotting, toxicology, urinalysis,
    LP (if stable/not contraindicated)
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13
Q

Lyme disease

  1. Presentation
  2. Neurological manifestations (3)
  3. Diagnosis confirmed via
  4. Management
A
  1. Erythema migrans, fatigue, lymphadenopathy, myalgia, headache, fever
  2. Meningitis, facial palsy, cerebellar ataxia
  3. Antibody testing
  4. Amoxicillin / doxycycline
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14
Q

Cerebral palsy

  1. Definition
  2. Causative factors (3)
  3. Types (3) and what has been damaged
  4. MRI - indications
  5. Hypoxic ischaemia encephalopathy - causes
  6. How to stage
  7. Management
A
  1. Mixed neurological disorder (mostly motor/posture), caused by non-progressive injury to developing brain in the first two years of life
  2. Antenatal (80%), hypoxic ischaemic injury during delivery, post-natal (IC haemorrhage, head injury, sepsis)
  3. Spastic (cortex), extrapyramidal (basal ganglia), ataxic (cerebellum)
  4. Rule out neurodegenerative/metabolic conditions if aetiology unclear or signs of regression
  5. Maternal shock, intrapartum haemorrhage, prolapsed cord, nuchal cord
  6. Sarnat Staging
  7. Therapeutic hypothermia
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15
Q

Meningitis

  1. Non-specific presentation in babies
  2. Investigations
  3. Bacterial - commonest organisms in children (2)
  4. Commonest in neonates
  5. Antibiotics - prehospital
  6. Hospital if <3 months
  7. > 3 months
  8. If risk of penicillin-resistant pneumococcal infection (e.g. recent foreign travel or antibiotic use)
  9. Steroids - what, when, why
  10. Viral - commonest causes (3)
  11. Investigations
  12. Management
A
  1. Hypotonia/thermia, poor feeding, lethargy, bulging fontanelles
  2. LP, blood culture, blood for meningococcal PCR
  3. Neisseria meningitidis (gram-negative diplococcus), Strep. pneumoniae (gram-positive pneumococcus)
  4. Group B streptococcus (for neonatal sepsis too)
  5. IM benzylpenicillin
  6. Cefotaxime AND amoxicillin
  7. Ceftriaxone (80mg/kg) or cefotaxime
  8. Vancomycin
  9. Dexamethasone 4x/d if >3mo + LP positive for bacteria - anti-sensorineural hearing loss/neuro damage
  10. HSV, enterovirus, VZV
  11. CSF sample for HSZ/enterovirus/VZV PCR
  12. Supportive, + aciclovir (clinical/CSF positive decision)
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16
Q

Encephalitis

  1. Commonest in neonates
  2. Commonest in children
  3. Presentation
  4. Investigations
  5. Management
A
  1. HSV-2
  2. HSV-1 (+ VZV, CMV, EBV, adenovirus, influenza)
  3. Focal neurology/seizures, altered consciousness, unusual behaviour, fever
  4. LP with viral PCR, CT if not (GCS <9, haemodynamically unstable, active seizures, post-ictal)
  5. Aciclovir
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17
Q

Hydrocephalus

  1. Commonest cause
  2. Other causes
  3. Presentation
  4. Complication of VP shunt (management)
A
  1. Aqueductal stenosis
  2. Arachnoid cysts, Arnold-Chiari malformation
  3. Big head, bulging anterior fontanelle, sleepiness, poor tone, poor feeding/vomiting
  4. Infection, peri-operative intraventricular haemorrhage, blockage, over-drainage, outgrowing (replace every 2y)
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18
Q

Muscular dystrophy

  1. Sign suggesting proximal muscle weakness
  2. Duchenne MD (X-linked recessive) - caused by
  3. Present at what age, with what
  4. Management - medical
  5. Name if dystrophin gene less severely affected
A
  1. Gower’s sign (when standing up from lying position)
  2. Defective gene for dystrophin on X-chromosome
  3. 3-5yo, weakness around pelvic muscles
  4. Oral steroids (slow progression), creatine supplements
  5. Becker’s MD (symptoms at 8-12yo)
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19
Q

Diarrhoea

  1. Differential diagnosis
  2. Viral - commonest causes (2)
  3. E.coli - presentation, management
  4. Traveller’s diarrhoea - organism, management
  5. If lymphadenopathy - organism
  6. Haemolytic uraemic syndrome (HUS) - triad
  7. Cause
  8. Features
  9. Investigations
  10. Management
A
  1. IBD, IBS, gastroenteritis, appendicitis, coeliac disease, lactose intolerance
  2. Rotavirus, norovirus (adenovirus more subacute)
  3. Cramps, bloody diarrhoea, vomiting, NO ABX
  4. Campylobacter jejuni, give azithromycin/ciprofloxacin
  5. Yersinia (gram-negative bacillus), mesenteric lyphadenitis so Ddx in appendicitis
  6. Microangiopathic non-immune haemolytic anaemia,
    thrombocytopenia, AKI
  7. E.coli (+ shigella) - shiga toxin
  8. Diarrhoea, severe abdominal pain, vomiting
  9. Stool culture, FBC, blood film, G+S, COOM, LDH, coagulation screen, biochemistry
  10. Supportive - RRT, anti-HTN, fluid balance, transfusions
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20
Q

Constipation

  1. History
  2. Idiopathic - 1st line laxative
  3. Secondary causes
  4. Red flags
  5. Intestinal obstruction - signs
  6. Causes - neonate
  7. Causes - slightly older
A
  1. <3/week, hard, ‘rabbit dropping’, straining, pain, retentive posturing, overflow soiling
  2. Movicol
  3. Hirschsprung’s, CF, hypothyroid, spinal cord lesion, sexual abuse, intestinal obstruction, anal stenosis, cow’s milk intolerance
  4. Meconium ileus (Hirschprungs, CF), vomiting (intestinal obstruction/Hirschprungs), ribbon stool/abnormal anus (anal stenosis), abnormal lower back/buttocks (spina bifida, sacral agenesis), failure to thrive (coeliac disease, hypothyroid, safeguarding), acute severe abdominal pain + bloating (obstruction, intussusception)
  5. Absolute constipation (stool/flatus), vomiting (projectile, bile stained), abdominal pain/distention, abnormal bowel sounds (high pitched/tinking at first, then absent)
  6. Meconium ileus, hirschprungs, oesophageal/duodenal atresia, imperforate anus
  7. Intussusception, malrotation/volvulus, strangulated hernia
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21
Q

Coeliac disease

  1. What is it
  2. Antibodies
  3. Endoscopy finding
  4. Presentation
  5. Neurological signs (3) - rare
  6. Linked autoimmune diseases
  7. Associated malignancies (3)
A
  1. Autoimmune disease, inflammatory response to gluten
  2. Anti-TTG, anti-endomysial (EMA) (check IgA levels 1st)
  3. Crypt hypertrophy, jejunal villous atrophy
  4. Failure to thrive, diarrhoea, fatigue, weight loss, mouth ulcers, anaemia (iron/B12/folate deficiency), dermatitis herpetiformis on abdomen
  5. Peripheral neuropathy, cerebellar ataxia, epilepsy
  6. T1DM, thyroid, hepatitis, PBC, PSC
  7. Enteropathy-associated T-cell lymphoma (EATL) of the intestine, non-hodgkin lymphoma, small bowel adenocarcinoma (rare)
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22
Q

Intussusception

  1. Presentation
  2. Associated conditions
  3. Gold-standard investigation
  4. Management - medical
  5. Surgical - indication (3)

Hirschprung’s disease

  1. Diagnosis
  2. Associated conditions
  3. Main complication
  4. Necrotising entercolitis - presentation
  5. Bloods
  6. AXR finding
A
  1. Severe colicky abdominal pain, ‘Red currant jelly’ stool, pale/lethargic, palpable RUQ ‘sausage shaped’ mass, vomiting, intestinal obstruction - in 6-24mo boys
  2. Viral illness, HSP, CF, intestinal polyps, Meckel D
  3. Abdominal USS + contrast enema
  4. Fluid resuscitation, broad IV ABX (co-amoxiclav), pneumatic reduction therapeutic enema
  5. Failed enema, highly distended abdomen, peritonitis
  6. Rectal biopsy - congenital absence of mesenteric parasypathetic ganglion cells (colonic aganglionosis)
  7. Down’s/Waardenburg syndrome, NF, MEN 2
  8. Hirschprung-associated entercolitis (HAEC) - fever, abdominal distention, bloody diarrhoea, sepsis within 2-4 weeks of birth - leads to toxic megacolon/perforation
  9. Premature, won’t feed, tender/distended abdomen,
    no bowel sounds, blood in stool
  10. Metabolic acidosis, low platelets
  11. Pneumatosis intestinalis (gas in bowel wall)
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23
Q

Fluids

  1. Bolus - amount (vs in trauma)
  2. Maintenance - fluid of choice
  3. Total fluids in 24 hours - A + B + C
A
  1. 20 ml/kg of 0.9% NaCl (10ml/kg in trauma)
  2. 0.9% NaCl + 5% dextrose
  3. A (100 ml/kg first 0-10 kg)
    B (50 ml/kg 10-20 kg)
    C (20 ml/kg 20 kg+)
24
Q

Jaundice

  1. Prolonged - definition
  2. Think pathological if prolonged or (2)
  3. Haemolytic anaemia - causes (3)
  4. Hepatic causes (3)
  5. Post-hepatic causes (3)
  6. History - important questions (3)
  7. Associated symptom
  8. Bedside test
  9. Gold-standard test
  10. Other tests
  11. Emergency presentation
  12. Biliary atresia (narrow/absent bile duct) - blood test
  13. Management
A
  1. > 2 weeks after birth (physiological resolves by then)
  2. Within first 24 hours, serum bilirubin <95 percentile
  3. G6PD, Rhesus disease, ABO incompatibility
  4. Sepsis, hepatitis, TORCH infections
  5. Biliary atresia, choledochal cysts, bilary stricture
  6. Age at onset, how marked is it, stool/urine colour
  7. Brushing
  8. Transcutaenous bilirubinometer
  9. Serum bilirubin
  10. Direct Coombs (haemolysis), haematocrit, FBC, (polycythaemia, anaemia) reticulocyte count, blood smear, blood groups (ABO)
  11. Kernicterus - acute bilirubin encephalopathy
  12. High conjugated bilirubin (can make but not excrete)
  13. Kasai portoenterostomy, liver transplant
25
Q

GORD

  1. Presentation - babies
  2. Vomiting - differentials

Red flags

  1. Intestinal obstruction
  2. Pyloric stenosis
  3. Peptic ulcer, oesophagitis or varices
  4. Meningitis/raised ICP
  5. Gastroenteritis
  6. Cows milk protein allergy
  7. Sandifer syndrome
  8. Other more serious differentials
A
  1. Chronic cough, hoarse cry, feeding distress/reluctance, pneumonia (aspiration), poor weight gain
  2. Overfeeding, GORD, pyloric stenosis, gastritis, appendicitis, other infections, obstruction
  3. Projectile, bile-stained, keep nothing down, distention
  4. Projectile, keeping nothing down
  5. Haematemsis, melaena
  6. Reduced GCS, bulging fontanelle, neuro signs
  7. Blood in stool, diarrhoea
  8. Blood in stool, rash, angioedema, other signs of allergy
  9. Torticollis + dystonia associated with GORD
  10. Infantile spasms (West syndrome), seizures
26
Q

Pyloric stenosis

  1. Presentation
  2. Vomiting - description
  3. Examination finding post-feeding
  4. Blood gas finding
  5. Diagnosis
  6. Management - surgical
A
  1. First few weeks of life; hungry, thin, pale, failing to thrive
  2. Projectile, keeping nothing down
  3. Firm, round mass in upper abdomen ‘large olive’ from pyloric hypertrophy
  4. Hypochloraemic metabolic alkalosis
  5. Abdominal USS
  6. Laparoscopic pyloromyotomy (‘Ramstedt’s operation’)
27
Q

Abdominal pain

  1. Surgical causes
  2. Medical causes
  3. Appendicitis - presentation
  4. Diagnosis
  5. Important differentials
A
  1. Appendicitis (central to RIF), intussusception, bowel obstruction
  2. HSP (with non-blanching rash on legs/buttocks), tonsillitis (central), pneumonia (upper), constipation (low), pyelonephritis (loin), mesenteric adenitis (low/RIF)
  3. Loss of appetite, N+V, Rovsing’s sign, guarding, rebound/percussion tenderness
  4. Clinical + raised inflammatory markers,
    CT if likely other cause, USS if F, diagnostic laparoscopy
  5. Ectopic, ovarian cyst, Meckel’s diverticulum (distal ileum problem causing volvulus/intussusception)
28
Q

Type 1 Diabetes Mellitus

  1. Potential triggering viruses (2)
  2. Insulin - functions (2)
  3. Glucagon - made where, due to what, functions (2)
  4. Symptoms of hyperglycaemia
  5. Antibodies associated with islet cell destruction (3)
  6. Tests to check for other autoimmune diseases (2)
  7. DKA - diagnosis (3 parts)
  8. In children, correct dehydration over how long
A
  1. Coxsackie B virus, enterovirus
  2. Causes cells to absorb glucose from blood and use as fuel, tells liver/muscle cells to absorb glucose from blood to store as glycogen
  3. Alpha cells, if low BM, tells liver to do glycogenolysis + gluconeogenesis (cortisol also tells liver to do this)
  4. Polyuria, polydipsia, weight loss, bedwetting, recurrent infections
  5. Anti-insulin anti-GAD, anti-islet cell antibodies
  6. TFTs/TPO, anti-TTG
  7. Hyperglycaemia >11, ketosis >3, acidosis <7.3
  8. 48 hours, to reduce risk of cerebral oedema
29
Q

Adrenal insufficiency

  1. Primary - cause
  2. Bloods
  3. Management - medical
  4. Other advice/management
  5. Addisonian crisis - bloods
  6. Secondary - cause
  7. Bloods
  8. Tertiary - cause
  9. Congenital adrenal hypoplasia - inheritance, deficiency
  10. Bloods
  11. Presentation - female neonate
  12. Older child
  13. Why skin pigmentation
  14. Management
A
  1. Autoimmune adrenal gland damage (Addison’s)
  2. Low cortisol (even after synacthen administered),
    high ACTH, low aldosterone, high renin
  3. Hydrocortisone (replaces C), fludrocortisone (A)
  4. Steroid card, emergency ID tag, when unwell (increase steroids, monitor BM)
  5. Hypotension, low BM, low Na+, high K+
  6. Low ACTH made (pituitary damage/hypoplasia)
  7. Low cortisol, low ACTH, normal aldosterone/renin
  8. Low CRH made in hypothalamus (stopped steroids)
  9. Autosomal recessive, 21-hydroxylase enzyme (usually converts progesterone into aldosterone/cortisol)
  10. High testosterone (converted from progesterone), low adrenal cortisol/aldosterone
  11. Virilised ‘ambiguous’ genitalia, low Na+/BM, high K+
  12. Skin pigmentation, tall, deep voice, small testicles/absent periods, early puberty
  13. ACTH produced due to low cortisol; byproduct of this is melanocyte-stimulating hormone
  14. Hydrocortisone, fludrocortisone, surgery for virilism
30
Q

Growth hormone deficiency

  1. GH - produced where, stimulates what
  2. Congenital deficiency - causes
  3. Secondary deficiency - causes
  4. Presentation
  5. GH stimulation test - which medications used (4)
  6. Management (tertiary)
A
  1. Anterior pituitary, insulin-like growth factor 1 (IGF-1)
  2. Hypothalamus/pituitary gland problem (GH1/GHRHR gene mutations, empty sella syndrome)
  3. Infection, trauma, surgery
  4. Micropenis, severe jaundice, hypoglycaemia, small
  5. Glucagon / insulin / arginine / clonidine
  6. Daily SC somatropin (GH)
31
Q

Delayed puberty

  1. Scale used to determine stage of puberty
  2. Hypogonadism (low oestrogen/testosterone) - 2 types
  3. How to assess for constitutional delay
A
  1. Tanner
  2. Hypogonadotrophic (low FSH/LH) - hypothalamus / pituitary bad (low GH, high prolactin, Kallman - no smell)
    Hypergonadotrophic (high FSH/LH but no response by gonads) - gonad absence/damage, Klinefelter, Turner
  3. Wrist x-ray
32
Q

UTI

  1. Symptoms
  2. Pyelonephritis - diagnosis
  3. Urinalysis
  4. Management - stat IV ABX (ceftriaxone) when
  5. If >3 months + otherwise well
  6. Recurrent UTI - investigations
  7. Other test if < 6 months, + what for
  8. Investigation 4-6m post-UTI if atypical/recurrent
A
  1. Fever, lethargy, irritable, suprapubic pain, dysuria
  2. Fever >38, loin pain/tenderness
  3. Dipstick (nit/leucocytes, send MSU to lab if 1/2 positive)
  4. <3 months old, acutely unwell, persistent vomiting (also do septic screen)
  5. PO ABX - trimetho/nitrofurantoin/cefalexin/amoxicillin
  6. Abdo USS within 6 weeks for all <6 months after 1st UTI + >6 months if recurrent. USS during illness if aytypical UTI
  7. Micturating Cystourethrogram, for vesico-ureteric reflux
  8. DMSA (dimercaptosuccinic acid) scan - look for scarring
33
Q

Nephrotic syndrome (basement membrane malfunction)

  1. Classic presentation
  2. Classic finding triad
  3. Other clinical findings
  4. Commonest paediatric cause (90% under 10yo)
  5. Findings from this cause
  6. Other secondary disease causes
  7. Investigations - general
  8. Investigations for secondary cause
  9. Management
  10. Complications
A
  1. Frothy urine, generalised oedema, pallor
  2. Hypoalbuminaemia (<25g/L), oedema, proteinuria
    (3+ urine dip or >1g/m2/day)
  3. Deranged lipids, HTN, hypercoagulability
  4. Minimal change disease (isolated nephrotic syndrome)
  5. Renal biopsy normal, small molecular weight proteins + hyaline casts on urinalysis
  6. Intrinsic kidney disease (FSGS, membranoproliferative), systemic illness (HSP, DM, infection)
  7. Plasma albumin, urine dipstick/24 hour urine protein, lipids, U+E, TFT, FBC
  8. Complement levels (SLE), auto-antibodies, HbA1C
  9. 4 weeks high dose prednisolone (if steroid resistant, use ACE-i / immunosuppressants), low salt diet, diuretics
  10. Hypovolaemia, infection, thrombosis, renal failure
34
Q

Leukaemia - general

  1. Bone marrow failure - triad
  2. Tissue infiltration - triad
  3. Symptoms
  4. 1st line investigations
  5. Specialist investigations
  6. Commonest order in children (+ peak ages)
  7. Abnormal bruising - other differentials
  8. Specific complications of management
A
  1. Pancytopaenia - thrombocytopenia, anaemia, leukopenia
  2. Bone pain, hepatosplenomegaly, lymphandenopathy
  3. Fatigue, fever, failure to thrive, anaemia, petechiae, abnormal bruising, bleeding, lymphadenopathy, hepatosplenomegaly
  4. FBC, blood film, CXR, clotting screen
  5. Bone marrow aspirate, LP
  6. ALL (2-3y), AML (< 2y), CML (< 1y, + Ph chromosome)
  7. HSP, NAI
  8. Stunted growth, neuro/cardiotoxicity, infertility, secondary malignancy (AML)
35
Q

Kawasaki disease

  1. AKA
  2. Features (5)
  3. Raised inflammatory marker
  4. Management
A
  1. Mucocutaneous lymph node syndrome
  2. High grade fever >5 days, conjunctival injection, cervical lymphadenopathy, bright red cracked lips, strawberry tongue, red palms/soles
  3. ESR
  4. IV aspirin, maybe IV IG
36
Q

Anaemia in children

  1. Commonest general cause
  2. Causes of above (3)
  3. Serious SE of low iron
  4. Blood film - results
  5. Management
A
  1. Iron deficiency anaemia
  2. Insufficient intake, malabsorption, chronic blood loss
  3. Decreased cognitive/psychomotor performance
  4. Hypo-chromic, microcytic cells
  5. Diet advice (+ limit milk), iron replacement (continue 2-3 months after target levels met), transfusion (rare)
37
Q

Sickle cell anaemia

  1. Inheritance
  2. Dysfunctional protein
  3. Up to what month is this not a problem (+ why)
  4. Trait vs symptomatic
  5. Diagnosis
  6. Sickle cell crisis - cause
  7. Triggers
  8. Types (4)
  9. Acute chest syndrome - definition
  10. Management - acute
  11. Management - long-term
  12. Hereditary spherocytosis (AD) - presentation
  13. Blood results
  14. Management
A
  1. Autosomal recessive (gene on chromosome 11)
  2. Beta globin chain - RBCs deform when deoxygenated (HbS instead of HbB - normal 2x HbA, 2x HbB)
  3. 6 months (foetal Hb (2 gamma chains instead of 2 B) still in circulation
  4. 1 HbS (aysmptomatic), vs 2 abnormal variants
  5. Haemoglobin electrophoresis
  6. Deformed RBCs get stuck
  7. Hypoxia, cold, dehydration, exercise, stress, infection
  8. Vaso-occlusive (pain), sequestration (spleen pain, hypovolaemia), aplastic (from parvovirus B19), haemolytic (jaundice, commoner with G6PD defiency)
  9. Fever/respiratory symptoms + new infiltrates on CXR
  10. Analgesia (no NSAIDs if renal impairment), oxygen, keep warm/hydrated, treatment of any infection
  11. Prophylactic penicillin V, vaccines UTD, close monitoring, hydroxyurea/carbamide, marrow transplants (can be curative)
  12. Jaundice (intermittent), gallstones, failure to thrive, hepatosplenomegaly, aplastic crisis (parvovirus)
  13. Spherocytes, reticulocytosis, raised mean corpuscular Hb concentration (MCHC)
  14. Folate supplements, splenectomy /cholecystecomy
38
Q

Thalassaemia

  1. Inheritance pattern, what part of Hb affected
  2. Type of anaemia
  3. Clinical features - general
  4. Alpha - chromosome, specific features, management
  5. Beta - chromosome
  6. B-major - definition
  7. B-intermedia =
  8. B-minor =
  9. What cells may indicate thalassaemia
A
  1. Autosomal recessive; Globin chain - alpha / beta
  2. Microcytic
  3. Delayed growth, congestive HF, splenomegaly, bone deformity, increased risk of infections, iron overload
  4. 16, pronounced forehead, blood/marrow transfusions, splenectomy
  5. 11
  6. 2 deletion genes (no B-globin production) - severe microcytic anaemia, splenomegaly, bone deformities. Regular transfusion, chelation, spleen out, BM transplant
  7. 2 defective/deletion genes, occasional transfusions
  8. Carrier of one abnormal, mild microcytic, monitoring
  9. Target cells
39
Q

Anaemia in children - causes

  1. RBC destruction
  2. RBC loss
  3. RBC slow production
A
  1. G6PD, sickle cell, thalassaemia, drug induced/viral haemolytic, physiological anaemia of newborn
  2. Haemorrhagic disease of newborn, cow’s milk protein enteropathy, clotting disorders, menstruation
  3. Iron deficiency, chemotherapy, leukaemia
40
Q

Idiopathic thrombocytopenic purpura (ITP)

  1. What it is
  2. Clinical features
  3. History
  4. Investigation
  5. Management - general
  6. Management if severe (platelets <10)
  7. Platelet count should be normal within how long
  8. Other differential for acute purpura with low platelets
A
  1. Virus leads to/spontaenous development of platelet membrane glycoprotein AB - so autoimmune platelet destruction (type II hypersensitivity)
  2. Thrombocytopaenia (other bloods normal), petechial rash, purpura bruising/ecchymoses, strange bleeding
  3. Child <10 years old, post-viral, symptoms over 1-2 days
  4. Bone marrow aspirate before giving corticosteroids
  5. Avoid high bleeding risk activities - contact sports, invasive procedures, NSAIDs/aspirin, safety netting
  6. IV Ig, PO prednisolone / transfusions (blood/platelets)
  7. 3 months (monitor until normal again)
  8. Acute lymphoblastic leukaemia
41
Q

Henoch-Schonlein Purpura

  1. AKA
  2. Precipitants (2)
  3. Clinical features
  4. Rash - description
  5. Acute investigations
  6. Management
  7. Follow up tests (2)
  8. Complications
  9. Other differentials for purpura with NORMAL platelets
A
  1. IgA vasculitis
  2. Infection (URTI/gastroenteritis), vaccination
  3. Commonest in <10yo, purpura, arthralgia (knee/ankle), abdominal pain, IgA nephritis (haematuria, proteinuria)
  4. Raised, purpuric (buttocks + limb extensor surfaces)
  5. BP, urine dip, renal function, albumin, FBC, clotting
  6. Symptomatic (analgesia) NO NSAIDs IF RENAL IMPAIRMENT
  7. BP, urine dip
  8. GI haemorrhage, intussusception, infarction.
  9. Viral infection, NAI, meningitis, septicaemia
42
Q

Other childhood cancers

  1. Along sympathetic chain / adrenal glands
  2. In kidney
  3. Central skeleton
  4. Long bones
  5. Rhabdomyosarcoma - can be found where (4)
A
  1. Neuroblastoma
  2. Nephroblastoma (Wilm’s tumour)
  3. Ewing’s sarcoma
  4. Osteosarcoma
  5. Bladder, pelvis, nasopharynx, parameningeal
43
Q

Enuresis

  1. Age at which should be dry in day
  2. Age at which should be dry at night
  3. Primary nocturnal
  4. Causes
  5. Management
  6. Secondary nocturnal
  7. Causes
  8. Diurnal
  9. Pharmacological management
A
  1. 2 years
  2. 3-4 years
  3. Never managed to be dry at night
  4. Normal variant (FH), overactive bladder, fluid intake, failure to wake, chronic constipation
  5. Lifestyle change, encouragement
  6. Have previously been dry for >6 months
  7. UTI, constipation, T1DM, psychosocial
  8. In daytime - urge (overactive bladder) and stress
  9. Desmopressin (NE), oxybutinin (overactive bladder), imipramine
44
Q

Other renal/urological diseases

  1. ARPKD (chromosome 6) - presentation
  2. Lack of amniotic fluid leads to
  3. Other feature
  4. Multicystic dysplastic kidney (MCDK) - diagnosis
  5. Wilms tumour - presentation, management
  6. Posterior urethral valve - signs on antenatal USS
  7. Presentation
A
  1. Oligohydramnios + PKs in collecting ducts (foetal USS)
  2. Potter syndrome (underdeveloped ear cartilage, low set ears, flat nasal bridge, skeletal abnormalities), foetal pulmonary hypoplasia
  3. Liver fibrosis
  4. Antenatal USS (one kidney cystic, one normal)
  5. Child <5yo with abdominal mass/pain, haematuria, lethargy, fever, HTN, weight loss - nephrectomy
  6. Oligohydramnios, hydronephrosis
  7. Young boy, difficulty urinating, recurrent UTI
45
Q

Systems review - history

  1. General
  2. Cardiorespiratory
  3. GI
  4. GU
  5. Neurological
  6. ENT
  7. Birth history
  8. Specific feeding questions
  9. Social
A
  1. Fever, weight loss, night sweat, growth, alert, feeding
  2. Cough, wheeze, stridor, sweating, dyspnoea, cyanosis
  3. Feeding, abdo pain, N+V, diarrhoea, constipation
  4. Wet nappies, frequency, urgency, continence, dysuria
  5. Seizures, headaches, abnormal movements
  6. Sore throat, sore ear, noisy breathing
  7. Pregnancy issues, born at term, birth weight, mode of delivery, perinatal issues, neonatal issues
  8. Breast/bottle fed, type of formula, cow’s milk, weaning (normal 6-12 months)
  9. Who’s at home, smokers, family tree, nursery/school, any social services involvement
46
Q

Genetic profiles

  1. Edward’s syndrome
  2. Patau’s syndrome
  3. Klinefelter syndrome
  4. Turner’s syndrome (+ feature)
  5. Fragile X - clinical features
  6. Lynch syndrome - inheritance, high risk of what
    Subsequent surveillance
  7. Familial adenomatous polyposis - mutation, what
    Surveillance
  8. Prader-Willi - clinical features
A
  1. Trisomy 18
  2. Trisomy 13
  3. XXY
  4. XO - short stature, webbed neck, wide carrying angle, horseshoe kidney, coarctation of aorta, infertility
  5. LDs, large low ears, long thin face, high palate, autism, macroorchidism, hypotonia, mitral valve prolapse
  6. AD; high risk of colorectal + endometrial carcinoma
    Colonoscopy every 1-2 years from age 25
  7. APC gene mutation; leads to 100% colon cancer risk
    Colonoscopys every 5 years if have FAP but no polyps
  8. Hypotonia in infancy, short, LDs, hypogonadism, infertility, childhood obesity, behavioural problems
47
Q

Chicken pox

  1. Cause
  2. Presentation - initial
  3. Then what
  4. Infectious from when to when
  5. Management - supportive
  6. VZ immunoglobulin (VZIG) if
  7. Consider IV aciclovir if
  8. Common complication, + what cause
  9. Other complications
  10. Shingles - what it is
A
  1. VZV primary infection, spread via respiratory route
  2. Initially a fever
  3. Itchy rash, starts on head/trunk then spreads (macular, then papular , then vesicular); mild systemic upset
  4. 4 days before rash to 5 days after rash first appeared (when lesions are dry/crusted over)
  5. Keep cool, trim nails, camamile lotion, off school
  6. Immunocompromised, or newborns with peripartum exposure
  7. If chickenpox then develops in above patients
  8. Secondary bacterial infection (group A strep)
  9. Pneumonia (miliary), encephalitis (cerebellar involvement) disseminated haemorrhagic chickenpox, arthritis, nephritis, pancreatitis
  10. Reactivation of dormant VZV in dorsal root ganglion
48
Q

Other infectious diseases - presentation

  1. Measles - prodrome (3), causative virus
  2. Full presentation
  3. Mumps
  4. Rubella
  5. Scarlet fever
  6. Hand, foot + mouth disease
  7. Infectious mononucleosis - cause
  8. Presentation
  9. Produces what after up to 6 weeks, test via what (2)
  10. Complications
A
  1. Irritable, conjunctivitis, fever (Paramyxovirus)
  2. Koplik spots (white spots on buccal mucosa)
    Maculopapular rash - starts behind the ear, spreads to whole body, becomes blotchy and confluent
  3. Fever, malaise, myalgia, parotitis (earache/pain if eats)
  4. Pink maculopapular rash (on face, spreads everywhere, fades by day 3-5)
    Lymphadenopathy (posterior auricular and suboccipital)
  5. Fever, malaise, tonsillitis, strawberry tongue
    Fine punctuate erythema sparing the face
  6. Vesicles (mouth, palms/soles), mild systemic upset
  7. EBV
  8. Sore throat, itchy rash post-amoxicillin/cephalosporin
  9. Heterophile antibodies; Monospot/Paul-Bunnell tests
  10. Splenic rupture, GN, haemolytic anaemia, thrombocytopaenia, Burkitt’s lymphoma
49
Q

Development - normal

  1. Primitive reflexes (4)
  2. Gross M - age to roll + sit unsupported (curved back)
  3. Stand unaided
  4. Walk - unsteady vs steady
  5. Run, then jump/kick ball
  6. Fine M - palmar grasp
  7. Crude-fine pincer grip
  8. Building blocks - tower of 2, then 3
  9. Speech/language - turns to own name + babbling
  10. Few words
  11. 2 part commands, then what/where, then 3 part commands and why/when/how
  12. Talks about past/present/future
  13. Social - stranger anxiety (peaks + lost when)
  14. Shares
A
  1. Moro (<3 months)
    Grasp (<3 months)
    Stepping (<4, >12 months)
    Asymmetrical tonic neck reflex (< 6 months)
  2. 5-6 months
  3. 10 months
  4. 12 vs 15 months
  5. 18 months, then 2 years
  6. 6 months
  7. 9-10 months
  8. 15 months, then 18 months
  9. 3-4 months
  10. 12 months
  11. 2 years, then 3 years, then 4 years
  12. 5 years
  13. Peaks 8-9 months, loses at 2 years
  14. 3 years
50
Q

Developmental delay

  1. Broad causes (3)
  2. C/M - examples
  3. M - examples
  4. Ch - examples
  5. Global delay - causes
  6. Gross motor
  7. Fine motor
  8. Language
  9. Personal/social
A
  1. Cerebral/muscular, metabolic, chromosomal
  2. Cerebral palsy, Duchenne’s muscular dystrophy
  3. Foetal alcohol, epilepsy, inborn (mitochondrial)
  4. Down’s, Edward’s, Patau’s, Fragile X
  5. Metabolic and chromosomal conditions
  6. CP, ataxia, vision, DMD, myopathy, spina bifida
  7. CP, ataxia, visual impairment
  8. Deafness, learning disability, neglect, autism
  9. Emotional/social neglect, parenting issues, autism
51
Q

Ortho - brief

  1. Hip disorders - limping child - investigations
  2. 0-4 years (3)
  3. 5-10 years (3)
  4. 10-16 years
  5. Knee pain - Osgood–Schlatter disease - rest, NSAIDs
  6. Patellar tendonitis
  7. Talipes equinovarus - positional abnormality
  8. Talipes calcaneovalgus
  9. Management
  10. Osteogenesis imperfecta - features
A
  1. Bilateral hip x-ray, FBC, CRP, metabolic panel (SUFE)
  2. DDH, septic arthritis, transient sinovitis
  3. Septic arthritis, transient sinovitis, Perthe’s disease
  4. Septic arthritis, SUFE, Perthe’s disease
  5. Tibial epiphyseal inflammation causing prominent tibial tuberosity + knee pain on exertion (sporty 10-15yo boys)
  6. Athletic teenage boys; chronic anterior knee pain that worsens after running, sub-patellar tenderness
  7. Plantar flexion and supination
  8. Dorsiflexion and pronation
  9. Ponseti method - physio, achilles tenotomy, brace
  10. Easy fractures, lax ligaments, blue/grey sclera, triangular face, deafness from early adulthood
52
Q

Psychiatry - differences in paediatrics

  1. 1st line antidepressant
  2. Medication in OCD
  3. ADHD - 1st line medication + SEs (6 week trial)
  4. Monitoring requirements
A
  1. Fluoxetine 10mg
  2. SSRIs
  3. Methylphenidate (dopamine/norepinephrine RI); abdominal pain, nausea, dyspepsia
  4. ECG at start (potentially cardiotoxic), weight and height every 6 months in children
53
Q

Failure to thrive - general causes

  1. Structural barrier to adequate nutrition (3)
  2. Malabsorption (4)
  3. Inadequate nutrition (4)
  4. Increased energy requirements (4)
  5. Cannot process nutrients properly (1)
A
  1. Abnormal facial structure, cleft, pyloric stenosis
  2. Cystic fibrosis, coeliac, cow’s milk protein allergy, chronic diarrhoea
  3. Maternal malabsorption (breastfeeding), iron deficiency anaemia, neglect, poverty
  4. Hyperthyroidism, chronic disease, malignancy, chronic infection (HIM, immunodeficiency)
  5. Inborn errors of metabolism
54
Q

APGAR score

  1. Measured out of
  2. Done when
  3. Stands for
  4. A
  5. P
  6. G
  7. A
  8. R
A
  1. 10
  2. 1, 5, 10 minutes
  3. Appearance, pulse, grimmace, activity, respiration
  4. Central cyanosis (0), peripheral cyanosis (1), pink (2)
  5. Absent (0), <100 (1), >100 (2)
  6. No response (0), little response (1), good response (2)
  7. Floppy (0), flexed limbs (1), active (2)
  8. Absent (0), slow/irregular (1), strong/crying (2)
55
Q

Blood spot (heel prick) screening

  1. When
  2. Which diseases (9)
  3. How long for results to come back
A
  1. 5-8 days
  2. Sickle cell, CF, hypothyroid,
    6x metabolism (phenylketonuria, MCADD, maple syrup urine disease, isovaleric acidaemia, glutaric aciduria T1, homocystinuria)
  3. 6-8 weeks
56
Q

Birth injuries

  1. Caput seccendaneum
  2. Cephalohaematoma (traumatic subperiosteal haematoma)
  3. Facial paralysis - cause, management (forceps)
  4. Erb’s palsy - injured area
  5. Associated with
  6. Clinical features
  7. Other injury associated with shoulder dytocia
A
  1. Scalp oedema (outside periosteum), crosses suture lines
  2. Blood between skull + periosteum, does not cross suture lines; increased risk of anaemia/jaundice
  3. From forceps; CN 7 function returns over few months
  4. C5/C6 nerves in the brachial plexus
  5. Shoulder dytocia, traumatic birth
  6. ‘Waiter’s tip’ - shoulder internal rotation, elbow extension, wrist flexed facing backwards (pronation)
  7. Clavicle fracture
57
Q

Childhood vaccines

  1. ‘6-in-1’ vaccine - components
  2. Given when
  3. 8 weeks - other vaccines given (3)
  4. 12 weeks (1)
  5. 16 weeks (2)
  6. 1 year (4)
  7. 3 years 4 months (2)
  8. 12-13 years (1)
  9. 14 years (2)
  10. Yearly flu jabs between what ages
A
  1. Diphtheria, tetanus, pertussis, polio, HI B, hepatitis B
  2. 8, 12 and 16 weeks of age (2, 3, 4 months)
  3. Pneumococcal (PCV), rotavirus, meningitis B (Men B)
  4. Rotavirus
  5. PCV, Men B
  6. PCV, Men B, Hib/Men C, MMR
  7. MMR, 4-in-1 preschool booster (DTP, pertussis/WC)
  8. HPV vaccine
  9. Men ACWY, 3-in-1 teenage booster (DTP)
  10. 2-10 years

Medical School (28 decks)

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