Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Systems > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Paediatric assessment important measurements

A
  • Weight
  • Length/height
  • OFC
    Progressive growth chart important
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Weight

A
  1. 6 - 3.8kg to term
    - Gain 100-200g/week in first 6 months (double weight by 5/6 months)
    - 10 kg at 1y
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Length/height (>2y)

A

50cm at birth

75cm at 1y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

OFC

A

35cm at birth

45cm at 1y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Feeding

A

140-180 ml/kg/day

- 100 if ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Weight faltering causes

A

Deficient intake (maternal/infant)

  • Poor lactation
  • Incorrect feeds
  • Premature
  • Oro-palatal abnormalities
  • Neuromuscular disease

Increased metabolic demand

  • Congenital disease
  • Infection
  • Anaemia

Excessive loss

  • Vomiting: GOR, pyloric stenosis
  • Diarrhoea: malabsorption, gastroenteritis

Non-medical

  • Poverty
  • Dysfunctional family (depression, drug use)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Development influences

A

Genetic, environmental, positive early childhood experience, pathological (antenatal, post-natal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Assessment of child development

A
  • History and examination (including observation)
  • Pre/peri/postnatal events
  • Milestones (Child Health Programme Scotland)
  • Red book
  • Parental videos
  • Healthy Child Programme (UK)
  • Primary care tools: ASQ, PEDS, M-CHAT (autism), SOGS-2
  • Secondary care tools: Griffiths, Bayley, Wechsler
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Child Health Programme

A 
New-born exam (including hearing)
Blood spot screen
Health visitor
6-8w review
27-20m review
Orthoptist screen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Developmental domains

A 
Gross motor
Fine motor
Speech and language
Hearing and vision
Social and self help
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Milestones

A
  • Social smile by 2 months
  • Sit unsupported by 9 months
  • Walk unsupported and speech by 18 months
  • First words by 2 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Vaccinations (2-4 months)

A
  • Diphtheria
  • Tetanus
  • Pertussis
  • Polio
  • Haemophilus influenzae type B
  • Hepatitis B
    ^Repeat at 3 and 4 months
  • Pneumococcal disease
  • Meningococcal group B
    ^Repeat at 4 months
  • Rotavirus
    ^Repeat at 3 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Vaccinations (12 months)

A
  • Haemophilus influenzae type B
  • Meningococcal group B and C
  • Measles, mumps and rubella
  • Pneumococcal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Vaccinations (3 years 4 months)

A
  • Diphtheria
  • Tetanus
  • Pertussis
  • Polio
  • MMR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vaccinations (12-14 years)

A
  • HPV (cervical cancer types 16/18)
  • Diphtheria
  • Tetanus
  • Polio
  • Meningococcal groups A/C/W/Y
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Selective vaccinations

A
  • BCG (TB)
  • Hepatitis B
  • Meningococcal group A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Developmental progress red flags

A

Positive

  • Regression
  • Visual/hearing concerns
  • Floppiness, asymmetry
  • No speech by 18-24 months
  • Persistent toe walking
  • OFC out-with centiles

Negative

  • Sit unsupported by 12 months
  • Walk by 18m-2y
  • Hold objects by 5 months
  • Reach objects by 6 months
  • Points to share interest by 2 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Developmental delay

A

Delay in domains

  • Global
  • Isolated

Disorder
- Abnormal progression and presentation

Regression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Assessment of developmental delay

A

History and examination

Investigations (guided):
1st line
- Genetic testing (chromosomes)
- U&E
- CK
- Thyroid screen

2nd line

  • Metabolic testing
  • Ophthalmology
  • Audiology
  • Neuroimaging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Common causes for delayed development

A

Motor: cerebral palsy, coordination disorder

Sensory: deafness, visual impairment

Language/cognitive: impairment, disability

Social/Communication: autism, asperger

Syndromes

  • Down’s
  • Fragile X
  • William’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Additional Support Needs

A
  • Personalised learning plan
  • Individualised educational plan
  • Co-ordinated support plan (CSP): legal
  • Child’s plan (GIRFEC)
22
Q

Causes of vomiting (infants)

A
  • GOR
  • Cow’s milk protein allergy
  • Infection
  • Intestinal obstruction
  • Overfeeding
23
Q

Causes of vomiting (children)

A
  • Gastroenteritis
  • Infection
  • Appendicitis
  • Intestinal obstruction
  • Raised ICP
  • Coeliac disease
24
Q

Causes of vomiting (adolescent)

A
  • Gastroenteritis
  • Infection (H. pylori)
  • Appendicitis
  • Raised ICP
  • DKA
  • Cyclical vomiting syndrome
  • Eating disorders
25
Q

Pyloric stenosis

A

4-12 weeks (male) with high volume projectile non-bilious vomiting

  • Weight loss
  • Dehydration +/- shock

Test feed: olive tumour, visible gastric peristalsis

Blood gas: hypochloraemic, hypokalaemic metabolic alkalosis

US

Management: feed stop, NG tube inserted, fluid resuscitation and refer to surgery (Ramstedt’s pyloromyotomy)

26
Q

Gastro-oesophageal reflux (GOR)

- Clinical features

A

Very common: LOS lax, supine and liquid feeds

  • Effortless vomiting (haematemesis - rare)
  • Irritable, crying
  • Feeding problems, failure to thrive
  • Resp: apnoea, cough, wheeze, chest infection

Red flags:

  • Weight loss, poor weight gain
  • Recurrent/bilious vomiting
  • GI bleeding
  • Persisting diarrhoea
  • Dysphagia, stridor, hoarseness
27
Q

Sandifer’s syndrome

A

GORD, spastic torticollis and dystonia

28
Q

Gastro-oesophageal reflux (GOR)

- Investigation and management

A

History and examination

Investigate if >1 year

  • Growth monitor
  • Oesophageal pH study
  • Impedance monitor
  • Endoscopy
  • Video fluoroscopy
  • Barium swallow

Management:

  • Reassure as self-limiting
  • Feeding advice: fluid thickeners, position, volumes
  • Nutritional support
  • Medical treatment: Prokinetics, acid-suppressing (H2 receptor blockers, PPIs)
  • Surgery: Nissen fundoplication
29
Q

Intestinal obstruction

A

Bilious vomiting (red flag!)

Causes

  • Intestinal atresia
  • Malrotation +/- volvulus
  • Intussusception (telescope)
  • Ileus
  • CD with strictures

Investigation: AXR, contrast meal, exploratory laparotomy

30
Q

Chronic diarrhoea

A

4 or > stools/day for >4 weeks

  • Osmotic: movement of water into bowel to equilibrate osmotic gradient (enzyme, transport defect)
  • Secretory: associated with infection (Vibrio cholerae toxin and enterotoxigenic E. Coli)
31
Q

Chronic diarrhoea aetiology

A

Motility disturbance;
- Toddlers diarrhoea, IBS

Active secretion:
- Acute infective diarrhoea, IBD

Nutrient malabsorption:
- Allergy (CMPI), coeliac disease, CF

Fat malabsorption:
- Pancreatic/hepatobiliary disease

32
Q

Coeliac disease

- Aetiology and clinical features

A

Gluten-sensitive enteropathy
- Autoimmune: HLA DQ2/DQ8

  • Abdominal bloatedness
  • Diarrhoea
  • Constipation
  • Fatigue
  • Pallor
  • Failure to thrive
  • Poor weight gain
  • Short stature
  • Dermatitis herpatiformis
33
Q

Coeliac disease

- Investigation and Management

A

Endoscopy and duodenal biopsy

  • Partial/total villous atrophy
  • Epithelial lymphocytic infiltration
  • Crypt hyperplasia

Serological screens

  • Anti-tissue transglutaminase (anti-TTG)
  • Anti-endomysial
  • Serum IgA

Genetic testing

Refer to dieticians - life-long gluten-free diet

34
Q

Chronic constipation

- Aetiology

A

Infrequent passage of stool with difficulty and pain (no movement for 3+ days)

  • Poor diet: insufficient fluids
  • Social: school
  • Intercurrent illness (dehydration)
  • Medication: Gaviscon, opiates
  • Psychological
35
Q

Chronic constipation

- Clinical features

A

Bristol Stool Chart

  • Poor appetite
  • Irritable
  • Fatigue
  • Abdominal pain or distension
  • Withholding
  • Diarrhoea

Complications

  • Megarectum
  • Urinary retention, UTI
  • Soiling
36
Q

Chronic constipation

- Management

A
  • Education
  • Dietary modification
  • Psychological: reduce aversive factors, reward behaviour
  • Increase fluids
  • Isotonic laxatives (Movicol, Laxido)
  • Also osmotic laxatives
  • Stimulant laxatives
  • Manual evacuation
37
Q

Crohn’s disease

A

More severe, extensive disease in children.

Symptoms more general

  • Weight loss
  • Growth failure
  • Abdominal pain
  • Delayed sexual development
38
Q

Ulcerative colitis

A

More severe, extensive disease in children (pancolitis)

  • Diarrhoea
  • Rectal bleeding
  • Abdominal bleeding
39
Q

Inflammatory bowel disease undetermined

A

Can’t distinguish between CD and UC

40
Q

IBD Investigations

A

History
- Nocturnal, bloody diarrhoea, >6/8 stools/day

Examination

  • Ulcers/oral change (CD)
  • Rash: erythema nodosum (CD)
  • Perianal tags, fissures
  • Arthritis

Nutrition: height/weight

Biochemistry: stool calprotectin, CRP raised, low albumin

Bloods: FBC, ESR, thrombocytopenia

Microbiology: no stool pathogens

Radiology: MRI, USS, barium meal and follow through

Endoscopy/colonoscopy and biopsy
- Enteroscopy

41
Q

IBD Management

A

Medical

  • Anti-inflammatory
  • Immunosuppressive
  • Biologics (Inflixumab)

Nutritional

Surgical:

  • Colectomy
  • Limited in CD (not curative)
42
Q

Jaundice

A

Yellow discolouration of skin and tissues due to accumulation of bilirubin - sclera involvement (distinguish from carotenemia)

43
Q

Early jaundice (<24 hours)

A

Always pathological

Haemolysis

  • ABO or rhesus incompatibility
  • Bruising, cephalhaematoma
  • Red cell membrane/enzyme defects

Sepsis

44
Q

Intermediate jaundice (24 hours - 2 weeks)

A

Physiological

  • Shorter RBC lifespan (80-90 days)
  • Relative polycythaemia
  • Relative immaturity of liver function

Breast milk (can persist -> 12 weeks)

Haemolysis
Sepsis

Abnormal conjugation

  • Gilbert’s disease
  • Crigler-Najjar syndrome
45
Q

Prolonged (>2 weeks, >3 weeks preterm)

A

Conjugated jaundice (‘split’, pale stools) always abnormal

  • Extrahepatic obstruction
  • Neonatal hepatitis

Unconjugated: hypothyroidism, breast milk

46
Q

Extrahepatic obstruction

A

Biliary atresia

  • Congenital fibro-inflammatory disease of bile ducts (-> destruction)
  • Prolonged, conjugated jaundice, pale stools, dark urine
  • US, liver biopsy
  • Complication: LF
  • Kasai portoenterostomy, liver transplantation

Choledochal cyst

Alagille syndrome: dysmorphism, intra-hepatic cholestasis, congenital heart disease

47
Q

Neonatal hepatitis

A
  • Alpha-1-antitrypsin deficiency
  • Galactosaemia
  • Tyrosinaemia
  • Urea cycle defects
  • Haemochromatosis
  • Glycogen storage disorder
  • Hypothyroidism
  • Viral hepatitis
  • Parenteral nutrition
48
Q

Kernictus

A

Unconjugated bilirubin is neurotoxic (can cross blood brain barrier) and can deposit in brain.

  • Encephalopathy
  • Poor feeding
  • Lethargy
  • Seizures
  • Complications: severe choreoathetoid cerebral palsy, learning difficulties, sensorineural deafness

Management: phototherapy

49
Q

Breastfeeding

A

Exclusively for 6 months
- > complementary

  • Complete, well tolerated nutrition
  • Passive immunity
  • Inc. active immunity and development of gut mucosa
  • Dec. infection
  • Minimal antigen load
  • Dec. breast cancer, endometriosis
  • Inc. postpartum weight loss
50
Q

Formula

A

Standard: cow-milk based

Indications:

  • Pre-term
  • CMPI
  • Lactose intolerance
  • Nutrient dense
  • Disease-specific
  • Prevent transmission of BBVs, drugs

Benefits: accurate food volumes, don’t need mum, Vit K, dec. jaundice

Drawbacks: no immunological benefit, high antigen load, contamination, expensive

51
Q

Colic

A
  • Inconsolable crying
  • <3 months
  • > 3 hours/day
  • > 3 days/week
  • For at least a week

Systems (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions