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Paediatrics Flashcards

1
Q

what are the signs of periorbital cellulitis?

A

acute erythematous swelling of eyelid (unilateral)

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2
Q

what are the signs of orbital cellulitis?

A

painful eye movements, diplopia, visual disturbance, fever, lid swelling, PAIN, proptosis

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3
Q

how do you investigate a swollen eye?

A

CT orbit

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4
Q

what are the two types of squint?

A 
esotropia = convergent
exotropia = divergent
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5
Q

what are the two tests to diagnose a squint?

A
  1. corneal reflection test

2. cover test

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6
Q

how do you manage a squint? (3 Os)

A

OPTICAL
ORTHOPTIC - patching of eye encourages strengthening
OPERATIONS - botox injection/resection of rectus muscle

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7
Q

what is Hirschprungs disease?

A

absence of ganglia in the colon segment which leads to a functional GI obstruction

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8
Q

how do you manage a patient with hirschprungs?

A

resection of the aganglionic segment/colostomy

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9
Q

what is croup? which patients is it common in?

A

acute laryngotracheobronchitis - common in patients <6 years

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10
Q

features of croup?

A

stridor, barking cough, hoarseness, virally unwell

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11
Q

what causes croup?

A

parainfluenza

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12
Q

how do you manage croup?

A
  1. Dexamethasone

2. Nebulised adrenaline (call anaesthatist)

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13
Q

how does epiglottitis present differently to croup?

A

sudden onset, soft continues snorring stridor, drooling scretions, voice muffled

caused by H.Influenza B

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14
Q

how do you manage epiglottitis?

A

do not examine throat - call ENT and anaesthetics

IV Abx and steroid

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15
Q

what causes bronchiolotis?

A

RSV

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16
Q

features of bronchiolitis?

A

cough, coryza, fever, raised RR, wheeze, inspiratory crackles

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17
Q

signs of bronchiolitis?

A

reduced feeding, resp distress, hypoxia

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18
Q

how do you manage bronchiolitis?

A

O2, NG feed

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19
Q

commonest cause of pneumonia? (CAP)

A

strep.pneumoniae

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20
Q

signs that a patient has pneumonia?

A

high temperature, malaise, reduced feeding, resp distress, increased RR, reduced SpO2, grunting, intercostal recessions

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21
Q

when do you admit a patient with pneumonia?

A

respiratory distress signs or SpO2 <92%

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22
Q

how do you manage a viral induced wheeze?

A

SABA + steroids

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23
Q

signs of a viral induced wheeze over asthma?

A

virally unwell, no history of atopy/eczema, patient <5 years old

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24
Q

Name a DD of a child presenting with an asthma attack?

A

foreign body, pertussis, croup, pneumonia

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25
Q

what general measures do we do for asthma patients?

A

annual review of symptoms/exaccerbations/med use
check inhaler technique and adherence
personalised action plans

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26
Q

what drug therapy do we use for day to day management of asthma?

A
  1. SABA (salbutamol)
  2. Steroid (beclometasone)
  3. <5 = LTRA (monteleukast), >5 = LABA (salmeterol)
  4. increasing steroid dose
  5. prednisolone
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27
Q

how do you manage a child presenting with an acute asthma attack?

A
  1. sit patient up, high flow O2
  2. nebulised salbutamol and ipratropium bromide
  3. IV hydrocortisone

ESCALATE - MgSO4, aminophylline, IVI salbutamol/ICU

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28
Q

name some pitfalls in asthma management?

A

bad inhaler technique
reduced perception of severe attacks
satisfied with poor control
don’t notice diurnal variation

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29
Q

how to children present with a UTI?

A

non-specifically unwell, collapse, sepsis, vomiting, failure to thrive, colic

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30
Q

what is vesicoureteric reflux? why is it relevant?

A

backflow of urine from the bladder into the ureter

  • predisposes children to UTIs
  • causes renal scarring
  • ureters displaced laterally upon entry to the bladder
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31
Q

how can you investigate UTIs in children? what do they show?

A

micturating cystourethogram - shows the VUR
DMSA - shows renal scarring
urine dipstick/clean catch sample - microscopy and culture
US kidney and urinary tract

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32
Q

main cause of a UTI?

A

E.Coli

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33
Q

treatment for a UTI in a child?

A

GENERAL: avoid constipation, increase fluids, full voiding, repeat MSU

ABX

  • < 3 months - amoxicillin and gentamycin
  • > 3 months - trimethoprim
  • pyelonephritis - gentomycin
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34
Q

name some causes of nephritic syndrome?

A

post strep
HSP
alport syndrome
SLE

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35
Q

presentation of nephritic syndrome?

A

haematuria, oliguria, HTN, oedema, loin pain

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36
Q

signs that nephritic syndrome is caused by post strep? how do you manage this?

A

7-21 days after a sore throat

10 days penicillin

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37
Q

signs that nephritic syndrome is caused by HSP? what is HSP? how do you manage this cause?

A

IgA vasculitis, purpuric rash on buttocks

steroids and immunosuppressants

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38
Q

signs that nephritic syndrome is caused by Alport syndrome? how do you diagnose this?

A

x linked recessive inheritance
bilateral SN deafness
genetic testing

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39
Q

what investigations do you do for nephritic syndrome?

A

FBC, UE, bicarb, Ca, Ph, complement C3 and C4, dsDNA Abs, ANA Abs, ANCA Abs, blood cultures, throat swab, MSU (red cells/white cells, red cast cells, culture)
Renal US/CXR

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40
Q

General management for nephritic syndrome?

A

sodium restricted diet
diuretic
antihypertensive

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41
Q

what is the triad of nephrotic syndrome?

A

oedema, proteinuria, hypoalbunaemia

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42
Q

commonest cause of nephrotic syndrome?

A

minimal changes

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43
Q

signs of nephrotic syndrome in a child?

A

periorbital/scrotal oedema, anorexia, GI disturbance, frothy urine

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44
Q

how do you manage nephrotic syndrome?

A

restrict fluid and salt
prednisolone
monitor BP

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45
Q

name some causes of CKD in children?

A

congenital dysplastic kidneys
ADPKD
reflux nephropathy

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46
Q

what age does nocturnal enuresis normally stop?

A

age 3/4

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47
Q

how can you manage a child with nocturnal enuresis?

A
  1. underlying cause? DM/UTI/constipation
  2. advise on fluids/toilet advice/intake
  3. reward systems - star charts, enuresis alarm
  4. Desmopressin
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48
Q

what are the signs of hypospadias?

A

abnormal penis - ventral urethral meatus, hooded prepuce, chordee

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49
Q

what is the triad of haemolytic uraemic syndrome?

A

AKI, microangiopathic anaemia, thrombocytopenia

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50
Q

how does a Wilm’s tumour present?

A

abdo mass, painless haematuria, flank pain, anorexia

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51
Q

features of a retinoblastoma

A

loss of red reflex, strabismus, visual problems

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52
Q

how can you manage a retinoblastoma?

A

external beam radiotherapy, photocoagulation

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53
Q

name 2 common bone tumours in children?

A

osteosarcoma

ewing’s sarcoma

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54
Q

what are the X ray changes on an osteosarcoma?

A

Codman’s triangle - periosteal elevation and sunburst pattern

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55
Q

what are the X ray changes on ewing’s sarcoma?

A

Onion ring lesions

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56
Q

where do neuroblastoma’s arise from?

A

arise from neural crest tissue of the adrenal medulla and the sympathetic nervous system

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57
Q

what are the features of neuroblastomas?

A

abdo mass, pallor, weight loss, bone pain, limp

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58
Q

name some complications of undescended testes?

A

infertility, torsion, cancer

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59
Q

what increases the risk of undescended testes?

A

pre-term delivery

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60
Q

what are the signs of testicular torsion (twisting of the spermetic cord)?

A

pain severe, lower abdo pain, N&V

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61
Q

which reflex is lost in testicular torsion?

A

cremasteric reflex

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62
Q

how do you manage testicular torsion?

A

urgent surgical exploration

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63
Q

signs that a child is being affected by GORD?

A

child is WELL
recurrent regurgitation after eating (not projectile)
still thriving

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64
Q

Ix for GORD in children?

A

24hr pH test in the oesophagus

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65
Q

how do you manage a child with GORD?

A

ADVISE: normally improves by 1 year of age as the LOS matures
avoid overfeeding/lying down to eat
medication: Omeprazole, gaviscon, ranitidine

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66
Q

when does pyloric stenosis present and why?

A

presents at 2-8 weeks of age

pyloric muscle hypertrophy which causes a gastric outlet obstruction

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67
Q

what are the electrolyte disturbances in pyloric stenosis?

A

hypokalaemia
hypochloridaemia
metabolic alkalosis

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68
Q

how can you investigate a child for pyloric stenosis?

A

feed child –> relax stomach –> visible gastric peristalsis and an olive mass
US the stomach

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69
Q

Mx for pyloric stenosis?

A

correct UEs, fluids

pyloromyomectomy

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70
Q

name some common causes for gastroenteritis?

A

rotavirus, norovirus, E.Coli, salmonella

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71
Q

what do you need to assess in a child presenting with gastroenteritis?

A

DEHYDRATION STATUS

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72
Q

what is meckels diverticulum?

A

ileal remenant of vitello-intestinal duct

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73
Q

how can meckels diverticulum present?

A

painless rectal bleeding, volvulus, intesussuption

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74
Q

what is intessusuption?

A

bowel invaginating on itself proximally

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75
Q

how does intessusuption present?

A

periods of intense paina nd drawing up the knees
redcurrent jelly stool
shock
sausage mass

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76
Q

management of intessusuption?

A

1st line = air enema

2nd line = reduction via laparotomy

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77
Q

what is constipation?

A

hard stool, reduced frequency of defacation
pain
overflow diarrhoea

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78
Q

name some causes of dehydration?

A 
dehydration
reduced fibre intake
hirschprungs disease
hypothyroid
anorectal abnormalities
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79
Q

how does constipation lead to incontinence?

A
  1. longstanding constipation
  2. rectum overdistends
  3. reduced rectal sensation
  4. involuntary soiling
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80
Q

how can you manage constipation in children?

A

explain to parents
stool softener e.g. Movicol (escalating regime)
senna - stimulant laxative

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81
Q

what is the commonest hernia in children?

A

Inguinal - due to patent processus vaginalis - bulge appears when crying

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82
Q

how do you manage a hernia? (2/6 rule)

A

<6 weeks - operate in 2 days
<6 months - operate in 2 weeks
<6 years - operate in 2 months

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83
Q

what is kawasaki disease and what are the signs?

A

inflammatory vasculitis

fever > 5 days, cervical lymphadenopathy, cracked lips, peeling fingers, conjunctivitis, coronary artery aneurysms

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84
Q

Ix kawasaki disease?

A

ESR/CRP, ECHO

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85
Q

Mx for kawasaki disease?

A

aspirin
IVIG
follow up ECHO

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86
Q

Signs of measles?

A

cough, coryza, conjunctivitis, cranky, high temperature, maculopapular rash behind ears which spreads down body, koplik spots

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87
Q

Ix for measles?

A

IgG/IgM, PCR

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88
Q

name some complications of measles?

A

croup
pneumonia
subacute sclerosing paraencephalitis

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89
Q

what are the signs of rubella? when is it infectious?

A

mild illness
macular rash starting on face
infectious 5 days before rash to 5 days after rash started

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90
Q

effects of rubella on a foetus?

A

deafness
cataracts
CHD

91
Q

how do the skin lesions develop in chicken pox?

A

2 day temp –> macular –> papular –> pustules –> crust

lesions tend to occur on the trunk

92
Q

complications of chicken pox?

A

pneumonia
secondary infection
meningitis

93
Q

how can you manage the symptoms of chicken pox?

A

calamine lotion

trim nails

94
Q

name some meningial signs?

A

stiff neck, positive kernig and bruduski, photophobia

95
Q

name some septic signs?

A

raised heart rate and resp rate, reduced BP, mottled and cold peripheries

96
Q

name a sign of meningococcal disease?

A

non-blanching purpuric/petichial rash

97
Q

how do you manage meningococcal disease?

A
  1. IMMEDIATE BENPEN before hospital (IM)

2. Hospital - ABCDE, IV cefotaxime + dexamethasone

98
Q

how do you Ix acute bacterial meningitis?

A

throat swab PCR
blood/urine/stool culture
head CT
LP

99
Q

what are the signs of encephalitis?

A

flu-like illness, low GCS, raised temperature

100
Q

what is the main cause of viral encephalitis?

101
Q

what are the 3 main features of ADHD?

A
  1. impulsivity
  2. inattention
  3. hyperactive
102
Q

how do you investigate ADHD?

A

school reports, conners scale, observe in school, screen for an organic cause

103
Q

how do you manage ADHD?

A

parenting lessons, positive parenting
education programmes
methylphenidate

104
Q

name the 3 features of autism?

A
  1. impaired social interaction - unaware of others/no empathy/solitary play
  2. impaired imagination - less babbling/no facial expressions/no fantasy play
  3. poor range of activities - object pre-occupation
105
Q

how can you manage autism?

A

intensive early speech and social therapy
national autism society
social training
risperidone

106
Q

what is cerebral palsy?

A

disorder of movement/posture caused by a non-progressive lesion to the brain occuring < 2 years

107
Q

name some features of cerebral palsy?

A

epilepsy
delayed motor milestones
learning disability
language/speech problems

108
Q

how can you manage a patient with cerebral palsy?

A

physio/OT/ortho surgeons
botox
baclofen injections

109
Q

what is klinefelter syndrome? signs?

A

47XXY

infertility, hypogonadism, gynocomastia

110
Q

what is pattau syndrome? signs?

A

trisomy 13

cardiac and renal impairment, cerebral malformation, polydactyl, neural tube defect, cleft palate, micropthalmia, SGA

111
Q

what is edwards syndrome? signs?

A

trisomy 18
rockerbottom feet, SGA, overlapping fingers, renal and cardiac malformation, cerebral malformation, low set ears, prominant occiput

112
Q

what is turners syndrome? signs?

A

45X
wide and spade shaped chest, wide nipples, coarction of aorta, horseshoe kidney, recurrent OM, primary amenorrhea, short stature

113
Q

what is prader willi? signs?

A

loss of paternal genes on chromosoem 15. hypotonia, poor feeding - obesity and social problems

114
Q

what is angelman syndrome? signs?

A

loss of maternal genes on chromosome 15. laughing fits, physical and intellectual disability

115
Q

what is a sign of noonan’s syndrome?

A

ptosis and down turned eyes

116
Q

what is downs syndrome and what are the signs?

A

trisomy 21
flat occiput, low set ears, small eyes and mouth, large tongue, round face, short stature, epicanthal fold, single palmar crease

117
Q

what diseases are associated with downs syndrome?

A

coeliac disease, hirschprung, duodenal atresia, AD, leukaemia

118
Q

what is the 3 ways that downs syndrome is inherited?

A

non-meiotic dysfunction
robertsman translocation
mosaicism

119
Q

what is the defintion of precocious puberty?

A

<8 in girls, and <9 in boys

120
Q

name some gonadotropin dependant causes of precocious puberty (raised LH/FSH)

A

pituitary tumours

121
Q

name some gonadotropin independant causes of precocious puberty (low FSH/LH)

A

tumours in the gonads

122
Q

what do we use to stage puberty?

A

tanner’s chart

123
Q

Ix for precocious puberty?

A 
stage the puberty
CT/MRI head
bone age (skeletal Xray)
T4/TSH/LH/FSH/HCG/AFP/GH
US ovaries and adrenals
124
Q

what are some risk factors for nectrotizing enterocolitis?

A

premature, cows milk

125
Q

what are the signs of nectrotizing enterocolitis?

A

rectal bleeding, abdo distension, mucus PR, tender, shock

126
Q

what is the classic XRay sign of nectrotizing enterocolitis?

A

pneumonitis intestinalis (gas in the bowel wall)

127
Q

how do you manage nectrotizing enterocolitis?

A

stop feed, culture faeces, cross match blood

Abx (cefotaxime + vancomycin)

128
Q

what increases the risk of meconium aspiration?

A

increasing gestational age

distressed foetus

129
Q

what does aspiration of meconium cause?

A

chemical pneumonitis
obstruction
surfactant dysfunction

130
Q

how do you manage meconium aspiration?

A

ventilation
ABx
NO
surfactant

131
Q

what causes respiratory distress syndrome?

A

surfactant deficiency (RF = prematurity)

132
Q

which cells secrete surfactant?

A

type 2 pneumocytes

133
Q

How can you prevent RDS?

A

antenatal corticosteroids - stimulates surfactant production

134
Q

Features of RDS? on XRay?

A

raised RR, chest wall recessions, grunting, nasal flaring

ground glass appearance

135
Q

what is the DD of RDS?

A

meconium aspiration, transient tachypnoea of the new born

136
Q

how do you manage RDS?

A

Ventilate (21% O2)

ET surfactant therapy

137
Q

what is a side effect of ventilation for RDS?

A

bronchopulmonary dysplasia - caused by barotrauma and O2 toxicity

138
Q

what are the features of bronchopulmonary dysplasia?

A

O2 desaturations during feeding

leads to;

  • low IQ
  • cerebral palsy
  • asthma
  • exercise intolerance
139
Q

what are the signs of toxoplasmosis infection?

A

retinopathy, cerebral calcifications, hydrocephalus

140
Q

what are the signs of a parovirus B19 infection?

A

fetal hydrops

141
Q

what are the signs of a rubella infection?

A

deafness, CHD, cataracts

142
Q

what are the signs of a CMV infection?

A

SN deafness, liver dysfunction, SGA

143
Q

signs of a listeria infection?

144
Q

name some causes of hypoxic ischaemic encepalopathy?

A

cord prolapse
placenta abruption
maternal hypoxia
inadequate post natal circulation

145
Q

how do you manage HIE?

A

treat seizures

therapeutic hypothermia

146
Q

what are the physiological reasons for jaundice in a newborn?

A

increased production (short RBC lifespan)
hepatic immaturity
breast feeding can cause dehydration and reduced bilirubin elimination

147
Q

causes of jaundice in a baby <24 hours old?

A

RhD, ABO incompatibility, sepsis, G6PD/spherocytosis

148
Q

how do you investigate jaundice within 24 hours of birth?

A

COOMBS test, FBC plus film

149
Q

what does coombs test show?

A

presence of antibodies on a babies RBCs

150
Q

what is a cause of jaundice in a baby > 2 weeks?

A

sepsis, TORCH infection, breast milk, biliary atresia

151
Q

how do you investigate jaundice >2 weeks?

A

TORCH screen, sepsis 6, US liver

152
Q

what is biliary atresia?

A

congenital malformation of the bile duct causing accumulation of bile

153
Q

what is Kernicteris?

A

acute bilirubin encepalopathy

154
Q

signs of Kernicteris?

A

shrill cry, lethargy, poor feeding

155
Q

how do you manage Kernicteris?

A

phototherapy, exchange transfusion

156
Q

what are the long term effect of Kernicteris?

A

akethoid dyskinetic cerebral palsy

157
Q

what is the presentation of transient synovitis?

A

follows a viral infection - limp and pain, comfortable at rest, no temperature or toxic signs

158
Q

what Ix do you do for transient synovitis? what do these show?

A

US hip - effusion

159
Q

what is the criteria for septic arthritis?

A

KOCHER CRITERIA

  • not weight bearing
  • temperature
  • raised ESR/CRP/WCC
160
Q

common cause of septic arthritis?

161
Q

how do you IX septic arthritis?

A

FBC, UE, LFT, blood cultures, ESR, CRP, aspirate joint

162
Q

what is osteomyelitis and what bacteria commonly causes it?

A

Infections of the metaphysis of bone (normally the long bones in children)
S.Aureus

163
Q

how do you investigate osteomyelitis?

A

WCC/ESR/CRP/bone biopsy - gold standard

164
Q

what are the XRay changes shown early and late in osteomyelitis?

A 
EARLY - cloccae (erosions in the bone)
LATE -
- involcurum (elevated periosteum)
- sequestrum (dead bone)
- sinuses (discharging pus)
165
Q

Mx for osteomyelitis?

A

6 weeks of Cefotaxime and Vancomycin

166
Q

what is DDH?

A

stable acetabular dysplasia through to total dislocation

167
Q

what increases the risk of DDH?

A

breech, oligohydramnios, twin, sibling with DDH

168
Q

when and how do we screen childrens hips?

A

at 1 day and at 6 weeks
ORTOLANI - flex hips and abduct to try and lift femoral head to relocate hips
BARLOW - flexed hips and adduct the apply axial load

169
Q

what do you do of ortolani and barlow comes back as abnormal?

170
Q

how do you manage DDH?

A

Pavlik harness, surgery

171
Q

definition of JIA?

A

> 6 weeks of joint swelling and stiffness in a child <16

172
Q

what types of JIA are there?

A 
polyarthritis = >4 joints
oligoarthritis = <4 joints
systemic = fever and salmon rash
173
Q

features of JIA?

A

morning stiffness, joint swelling, can’t participate in hobbies, reduced growth, joint deformity

174
Q

name some complications of JIA?

A

uveitis, reduced growth, osteoporosis, anaemia

175
Q

how do you manage JIA?

A 
involve paeds rheumatology
NSAIDS/paracetamol
corticosteroids - in the joint or systemic
MTX
infliximab
176
Q

what is rickets?

A

failed mineralisation of growing bone

177
Q

what increases your risk of rickets?

A

dark skin, low UV exposure, malabsorption, vegan diet, CF, coeliac disease, maternal vitamin D deficiency

178
Q

name some signs of rickets

A 
harrison's sulcus
palpable costo-chondral joint
ping pong sensation on the head
widened wrists
delayed fontanelle closure
179
Q

how do you investigate rickets?

A

Vit D and calcium levels

X ray wrist

180
Q

what is congenital adrenal hyperplasia (CAH)?

A

autosomal recessive disorder. Deficiency of the 21a hydroxylase enzyme. Reduced gut cortisol results in negative feedback and increased ACTH and increased testosterone levels
Reduced mineralcorticoid synthesis (low Na and high K)

181
Q

features of a patient with CAH?

A 
clitoris hypertrophy 
fused labia
enlarged penis
salt losing crisis
tall
182
Q

what do you find on Ix with a patient with CAH?

A

low Na, high K, low glucose, metabolic acidosis
high testosterone
US female - ovaries?

183
Q

how do you manage a patient with CAH?

A

genital surgery for females
fludrocortisone/hydrocortisone
monitor growth

184
Q

Name the features of a L –> R shunt (breathless)?

185
Q

How do you investigate cardiology in children?

A

antenatal ECHO, ECHO/ECG/CXR

186
Q

Features of PDA? Mx?

A

ductus arteriosus remains open - continuous murmer.

need to shut with a coil

187
Q

features of ASD? what murmur do you hear?

A

recurrent chest infections and wheeze

Left upper sternal edge ejection systolic murmer

188
Q

features of VSD?

A

left lower sternal edge pansystolic murmer

189
Q

Name the causes of a R –> L shunt (cyanotic)?

A

Tetralogy of Fallot

transposition of the arteries

190
Q

what are the features of ToF?

A

overriding aorta
VSD
pulmonary stenosis
RVH

191
Q

what symptoms do you get with ToF?

what sort of murmer do you get?

A

symptoms of cyanosis and hypercyanosis on defacation/exercise
Harsh ejection systolic murmer

192
Q

what is the transposition of arteries and what symptoms do you get?

A

arteries are switched over - severe cyanosis at day 2 as the ductus arteriosus closes. NO MURMER

193
Q

how do you manage transposition of the arteries?

A

give prostaglandin and a atrial septoplasty - to allow for mixing of blood
surgical repair

194
Q

name the causes of an outflow obstruction in a well child?

A

pulmonary stenosis

aortic stenosis

195
Q

name the causes of an outflow obstruction in an unwell child?

A

coarction of the aorta

196
Q

what murmer is there in pulmonary stenosis?

A

soft ejection systolic murmer in the Left upper sternal edge

197
Q

what murmer is there in aortic stenosis?

A

ejection systolic murmer in the right upper sternal edge

198
Q

what are the features of coarction of the aorta?

A

restriction around ductus arteriosus
Radiofemoral delay
ejection systolic murmer
LV hypertrophy

199
Q

what causes Kwashiokor?

A

reduced protein intake

200
Q

what causes Marasmus?

A

lack of calories

201
Q

signs of diptheria?

A

muffled voice, dysphagia, bronchopneumonia, airway obstruction, tonisillitis with false membrane over the fauces

202
Q

how do you manage a patient with diptheria?

A

diptheria antitoxin and erythromycin

203
Q

features of Kallman syndrome?

A 
X linked recessive disorder
LACK OF SMELL
delayed puberty
hypogonadotropic hypogonadism
low sex hormones (FSH and LH)
204
Q

what is osteogenesis imperfecta?

A

brittle bone disease due to a disorder of collagen metabolism which results in fragility and fractures

205
Q

features of osteogenesis imperfecta?

A

childhood presentation
fractures after minor trauma
blue sclera
deafness secondary to osteosclerosis

206
Q

how do you investigate osteogenesis imperfecta?

A

Ca/Ph/PTH/ALP all NORMAL

207
Q

What is perthes disease?

A

avascular necrosis of the femoral head. Impaired blood supply and bone infarction.

208
Q

features of perthes disease?

A

10% bilateral
hip pain over a few weeks and a limp
stiffnes
reduced RoM

209
Q

Xray changes in perthes disease?

A

early - widened joint space

late - reduced femoral head size

210
Q

how do you investigate perthes disease?

A

Xray/bone scan - CATTERALL STAGING

211
Q

how do you manage perthes disease?

A

cast/brace, surgery

212
Q

which bone does Kohler disease affect?

A

Navicular bone

213
Q

presentation of Kohler disease and features on X ray?

A

pain in mid-tarsal region and a limp

X Ray - dense and deformed bone

214
Q

what is Osgood Schlatter disease?

A

inflammation of the tibial tuberosity in association with physical overuse - the pain occurs on strenuous activity and contraction of the quadricep

215
Q

what does an X ray show in osgood schlatter disease?

A

tibial tuberosity enlarged

216
Q

how do you manage osgood schlatter disease?

A

ice, oral anti-inflammatories, physio

217
Q

what is a slipped femoral epiphysis?

A

displacement through the growth plate - the epiphysis slips down

218
Q

presentation of a slipped femoral epiphysis?

A

50% patients obese
follows minor trauma - limp and groin pain
LIMITED flexion/abduction/medial rotation

219
Q

how do you investigate a slipped femoral epiphysis?

A

AP X ray of the hip

frog leg X ray

220
Q

how do you approach newborn resuscitation?

A
  1. Dry baby and keep warm
  2. Assess tone/RR/HR
  3. if gasping/not breathing –> 5 inflation breaths
  4. reassess chest movements
  5. If HR < 60bpm –> start compressions and ventilation breaths at a ratio of 3:1
221
Q

features of a febrile convulsion?

A

viral infection and raised temperature
seizure lasting <5 mins
tonic-clonic

222
Q

Mx of a febrile convulsion?

A

rectal diazepam, antipyretic

223
Q

what are the 4 areas of development that we assess?

A

social
gross motor
fine motor and vision
speech and hearing

Finals (21 decks)

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