Brainscape's Knowledge GenomeTM

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


See full index

Week 2 paces cases > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Jaundice differentials in a baby

A

Depends on timing
<2days => ABO incompatability or rhesus incompatability
Sepsis

2 days - 2 weeks 
G6PD 
Hereditary spherocytosis
Sepsis
Breast milk jaundice

> 2weeks
Biliary atresia

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

Causes of failure to thrive

A

Increased energy requirement => chronic issue =>CF, hyperthyroidism

Malabsorption = coeliac

Poor intake/neglect
(ask about school and mental health) or issue with feeding e.g. cleft palate

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

Features of failure to thrive

A

Crossing growth centiles

Child persistently in the bottom 5th percentile

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

Investigation and management of failure to thrive

A

Ensure adequate nutrition
Ensure social support and support at school as well as financial support

Ix for any potential Dx = sweat test, anti-TTg, FBC (anaemia), TFTs (hyperthyroidism)

Organic cause in <5%!

Dietician

Regular appointments to check progress

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

Factors that determine good growth in a child

A 
Adequate intake 
Endocrine levels 
Co-morbidities 
Emotional health (supported child)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Until which age should you correct height/weight etc. for prematurity?

A

2 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Whats the cut off for concern for number of centiles crossed?

A

2

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

By what age should a baby have doubled their original weight?

A

Around 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Average age of puberty in females

A

11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Order of puberty development in females

A

Breast budding
Pubic hair
Menarche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cut offs for precocious puberty in males/females

A

<8 for females

<9 for males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of precocious puberty

A

Central (most common), just normal puberty happening earlier
Peripheral = intracranial tumour, endocrine tumours e.g. McCune Albright syndrome

Congenital adrenal hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ix for precocious puberty

A

Brain MRI to rule out central tumour
USS of ovaries/testis to assess size + determine if gonadal tumour present
Endocrine levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mx of precocious puberty

A

Ix to rule out sinister causes

Give GnRH analogues to delay puberty and help with development and mental health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of delayed puberty

A

Late bloomer (most common, check with hand bone xray)

High gonadotrophin secretion
Kallmans syndrome
Turner’s syndrome

Low gonadotrophin secretion
Pituitary tumour

Systemic issues such as CF or Crohn’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Definition of delayed puberty in boys and girls

A

No pubertal development by the age of 14 in girls and 15 in boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common cause of delayed puberty

A

Late bloomer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

First line tests for delayed puberty

A

Hand xray for bone age

LH and FSH levels to rule out gonadotrophin issues

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

Symptoms of acute lymphoblastic leukamia (ALL)

A

Any children presenting in GP with bruising, enlarged lymph nodes and systemic illness should be referred for specialist assessment.

Lymphadenopathy is the most common sign in ALL.

Other symptoms which may be present include: hepatosplenomegaly, pallor or petechiae, fever, fatigue, dizziness, weakness, and epistaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Congential disorder that increases the risk of ALL

A

Down’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Diagnosis of ALL

A

Firstly do FBC and blood film
Bone marrow biopsy

Remember to screen for coagulopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Features of child with bone cancer

A 
FLAWS 
Limp or bone painn 
Ask about pain at NIGHT 
Ask if any signs of trauma 
Rule out NAI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of short stature

A 
Familial 
Delayed puberty (this tends to catch up)
Nutritional 
Chronic illness 
Genetic (Turner's and Down's)
Thyroid issues 
GH deficiency 
Chronic steroid use (e.g. Crohn's or another chronic illness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ix for short stature

A

Growth charts (plot mid parental height)
Bloods for FBC, thyroid, CRP, U&E
Imaging of bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Who should manage children with endocrine issues?

A

Paediatric endocrinologist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How do you calculate predicted height for a boy/girl

A

Mum + Dad + 13 all divided by 2 for a boy

  • 13 for a girl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

DDx or jaundice in a child

A

Pre-hepatic => haemolysis = G6PD, SCD, AIHA, HUS

Hepatic => Gilbert’s, hepatitis

Post-hepatic => Gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Neurological symptoms of jaundice indicate…

A

Kernicterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Management of jaundice in a newborn

A

Try to rule out sinister causes of jaundice

Plot on a bilirubin chart and use phototherapy or exchange transfusion if severe (very high levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Symptoms of croup

A

Viral URTI progressing to barking cough
Hoarse cry
Inspiratory stridor

Respiratory distress in severe cases
Symptoms get worse when the child is distressed

Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Most common cause of croup

A

Parainfluenza virus

Causes tissue swelling and oedema, limiting airflow and causing stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Signs of respiratory distress

A 
Nasal flaring 
Pursed lips
Head bobbing
Tracheal tug 
Intercostal recessions
Subcostal recessions 
Use of abdominal muscles (belly breathing)
Frightened look 
Sweating due to increased work
Grunting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

DDx for croup

A

Croup
Bacterial tracheitis (similar but with purulent secretions)
Epiglottitis
Foreign body (for the stridor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Mx of croup

A

Admit if <6mo or severe

Give wafted O2
Single dose of dexamethasone
Nebulised adrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is bronchiolitis?

A

LTRI infection of infants between 2-6 months old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What causes most cases of bronchiolitis?

A

RSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

RF for severe bronchiolitis

A

Prematurity

Chronic lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Typical features of bronchiolitis

A

Coryzal symptoms (fever, snotty nose and cough)
Then get LRTI Sx like dry cough and WHEEZE
They go off their feeds

Ex shows fine inspiratory crackles, widespread wheeze

Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Dx of bronchiolitis

A

Nasopharyngeal aspirate for rapid RSV testing incase you want to isolate them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

DDx for bronchiolitis

A

Viral wheeze
Asthma
Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Mx of bronchiolitis

A

Usually self-limiting unless signs of severe disease = hydration, antipyrexial meds such as ibuprofen and paracetamol

Hospital admission if:
Poor feeding (<50% normal), resp distress, low O2 sats, Hx of apnoea, resp rate >70

Mx in hospital = oxygen and NG feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Definition of pneuomia

A

LRTI with radiological changes (this is how you differentiate from croup and bronchiolitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Common causes of pneumonia

A

S. pneumoniae, H influenzae, S aureus

A typical = M pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Diagnoses to consider in an unwell, febrile child

A

Pneumonia
UTI
Meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Features of pneumonia in infants

A 
Cough 
Fever
Preceded by URTI Sx
Signs of respiratory distress
SPUTUM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Mx of pneumonia in children

A

Antibiotics
Anti-pyrexials
Consider admission if signs of repsiratory distress or low O2 sats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Why dont we use aspirin in young children <16yo?

A

Reyes syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Most common cause of epiglottitis

A

H influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Symptoms of epiglottitis

A 
Child stooped forward 
Drooling 
Dyspnoea 
Looks toxic 
High temperature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Mx of suspected epiglottis

A

Keep the child calm and give wafted O2 and nebulised adrenline

Get the crash trolley
Alert senior and anaesthetist as well as ENT

Intubate the patient
IV antibiotics
IV steroids and IV maintenance fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Features of a viral wheeze

A

SYMPTOM FREE BETWEEN BOUTS
Precipitated by viral infection e.g. coryzal
Unpredictable, non-sterotyped response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Features of asthma

A 
Precipitated by triggers
May be wheezy in the interim 
Responds to B agonist 
History of atopy
Night time cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Symptoms of pertussis infection

A 
Dry hacking cough 
Continuous cough
Petichae on face 
Child looks unwell
Afebrile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Mx of pertussis infection

A

Supportive :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Features of a life threatening asthma infection

A 
Hypotension 
Silent chest
Unable to talk 
Confusion
Coma 
Exhaustion 
PEFR <33%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Mx of asthma (chronic)

A

SILLI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Mx of asthma (acute)

A 
O2 
NEBS 
IV hydrocortisone or oral pred
IV salbutamol (ITU)
IV aminophylline
58
Q

What is HSP?

A

IgA mediated vasculitis

Often triggered by preceding strep nfection

59
Q

Features of Henoch-Scholein purpura

A

Palpable purpuric rash
Arthralgia
Abdominal pain
Renal involvement (nephrotic syndrome)

60
Q

Mx of HSP

A

Supportive and symptomatic treatemnt

= simple analgesia
Steroids for any renal involvement

61
Q

Features of a Wilm’s tumour

A 
Abdominal mass 
Loss of appetite 
Weight loss
Fever
Blood in urine
62
Q

Ix for Wilms tumour

A

Abdominal USS
Urine dip
Abdominal CT

63
Q

Mx of Wilm’s tumour

A

Surgery on kidneys (very sucessful)

64
Q

Features of IgA nephropathy

A 
Sore throat (centor => strep)
Few days later -> blood in urine
65
Q

Management of IgA nephropathy

A

ACEi

Supportive

66
Q

Management of post-streptococcal glomerulonephritis

A

Treat the infection (Abx)

Otherwise supportive unless high BP in which case give ACEi

67
Q

Additional questions to ask in paeds Hx

A 
DFIBS
Development 
Feeding 
Immunisations 
Birth 
School and social worker
68
Q

Red flags of bedwetting

A

Headache

They were fine and now bad again

69
Q

Bad causes of bed wetting

A

Abuse
SOL
UTI

70
Q

Stepwise Mx of bedwetting

A 
Ix 
Star chart
Reduce caffeine and other drinks before bed
Enuresis alarm 
Desmopressin
71
Q

Features of SUFE

A

Limping child
Obese
Externally rotated leg
Frog’s leg xray shows disruption of Klein’s line

72
Q

Management of SUFE

A

Bilateral screwing

73
Q

Features of Perthes disease in children

A

Painful knee/hip
Limp
X-ray shows avascular necrosis

74
Q

Management of Perthes

A

<6yo and/or <50% damage = conservative (analgesia and physiotherapy)
>6yo and/or >50% necrosis -> operative

75
Q

Red flags of joint pain in children

A

Fever
Weight loss
Night pain!

76
Q

Features of transient synovitis

A

Illness 4-6w ago (usually viral)
Now cant see, pee or climb a tree
Multiple joints painful

77
Q

Management of transient synovitis

A

Supportive with analgesia

78
Q

Features of measles infection

A

Rash that starts on the face and spreads to the rest of the body
Koplik spots

79
Q

Features of Scarlet fever infection

A 
S
Scarlet fever
Strep
Sore throat
Strawberry tongue
80
Q

Features of rubella infection

A

Rubella = fruit juice

Pink rash on the back and torso

81
Q

Features of parvovirus infection

A

Red cheeks thats warm to touch

Systemically unwell

82
Q

Features of hand foot and mouth infection

A

Vesicles in mouth, on hands and sole of feet

83
Q

Features of roseola infection

A

RoseOla

Fever then as it subsides a rash appears thats maculopapular

84
Q

Features of Kawasaki’s disease

A 
Strawberry tongue 
Refratory, >5day fever
Peeling palms and soles 
Irritable child 
Lymphadenopathy 
Rash is never vesicular
85
Q

Ix in Kawasakis disease

A

Bloods (infective picture)
ECG
Echocardiogram for coronary artery aneurysm

86
Q

Mx of Kawasaki

A

High dose aspirin (watch out for Reyes)

IVIG

87
Q

What is Reyes syndrome

A

Acute encephalopathy and fatty degeneration of the liver

Seen with aspirin Mx in children

88
Q

Features of chickenpox

A

Caused by VZV
Viral prodrome (mild fever, headache, malaise)
Pruritic rash thats very itchy, they crust over

89
Q

Features of meningitis

A 
Headache
Photophobia
Neck stiffness
Feel very unwell
Non-blanching rash
90
Q

Complications of chickenpox

A

Encephalitis
Meningitis
Bacterial infection e.g. impetigo

91
Q

Risks of chickenpox

A

Pregnant women
Neonates
Immunocompromised

92
Q

Ix and Mx for measles

A

Salivary swab is required to Dx

Mx = supportive

93
Q

Complication of port wine stain on head

A

Sturge Weber syndrome

94
Q

What is cerebral palsy?

A

Permanent issue with motor or positional function

95
Q

Causes of cerebral palsy

A 
Usually prenatal (ischaemic event)
Shoulder dystocia or traumatic birth 
Seizures 
Kernicterus 
Meningitis/encephalitis
96
Q

Symptoms of cerebral palsy depend on…

A

Where the lesion is
Cortex -> UMN
Lower than cerebellum -> LMN

Delayed development
Stiff muscles or floppy
Persistence of primitive reflexes

97
Q

Types of cerebral palsy

A

Spastic (most common) damage in the brain leads to say a hemiplegia

Dyskinetic = issues with basal ganglia causing poor coordination, hypotonia etc

98
Q

Managment of cerebral palsy

A 
MDT
Physio
Pain management 
School support 
Nutrition 
Spasticity medication
99
Q

Features of idiopathic thrombocytopaenic purpura

A

Viral illness followed by sudden onset of purpura and petichiae in a child
Epistaxis
Low platelet count

Diagnosis of exclusion
Must rule out HUS, TTP, DIC, NAI!

100
Q

Mx of ITP

A

Usually supportive

Can use oral steroids or IVIG if severe bleeding

101
Q

Features of pyloric stenosis

A

Projectile vomiting
Olive shaped mass
Still wanting to feed

102
Q

Mx of pyloric stenosis

A

Dx = abdominal USS
ABG shows hypochloaraemic, hypokalaemic metabolic acidosis
Supportive until Ramstedt pyloromyotmy

103
Q

Features of DKA

A 
Abominal pain 
Vomiting 
Diabetes background or features (weight loss, increased urination)
Hyperkalaemia 
Ketonuria 
High ketones in blood
High glucose
104
Q

Management of DKA

A

Fluids until systolic >90
1L over 1 hour
1U insulin / kg / hr
Once glucose <14, add dextrose
Monitor potassium and correct accordingly
Keep monitoring ECG for tented T waves or arrythmia
Look out for hypercoagubility

105
Q

Features of T1DM

A 
Excess urination
Weight loss
Dizzy spells 
Sweet breath 
Hx of atopy
106
Q

Mx of T1DM

A

Insulin
Capillary glucose measurements
Regular monitoring and screening with opthal and urine creatinine

107
Q

Features of coeliac disease

A 
Weight loss
Chronic diarrhoea 
Dermatitis herpetiformis 
Failure to thrive 
Abdominal pain 
Fatigue 
Buttocks wasting 
Angular stomatitis and ulcers (iron deficiency)
108
Q

Coeliac disease biopsy features

A

Villous atrophy and crypt hyperplasia

109
Q

Common anaemia alongside coeliac

A

Microcytic because of poor iron absorption

110
Q

Auto-antibody in coeliac

A

Anti-TTG

111
Q

Definitive diagnosis of coeliac disease

A

Jejunal biopsy

112
Q

DDx for coeliac disease

A

IBS
IBD
Pancreatic issues (CF)
Lactose intolerance

113
Q

Coeliac disease Mx

A

Gluten free diet
Screening for MALT
Iron supplements if needed
Dietician involvement

114
Q

Features of neglect/abuse

A 
Posterior rib fracture 
Spiral fractures 
Retinal haemorrhages 
Failure to thrive 
Wetting and soiling 
Self harm 
Dishevelled appearance 
Story not lining up
115
Q

Who do you inform if any suspicion of neglect or abuse?

A

Senior immediately

116
Q

Features of otitis media

A

Child tugging at ear
Fever
Distracted and not feeding well
Bulging tympanic membrane

117
Q

When should you perform your ENT assessment?

A

At the end of the examination (can cause distress)

118
Q

Managment of URTI (coryzal, bit of a cough and fever)

A

Steam inhalation
Calpol
Lemsip if older

119
Q

Management of otitis media

A

Analgesia

120
Q

Management of otitis media with effusion

A

Topical chlorphenamine and oral analgesia

121
Q

Management of ear wax blocked ears

A

Olive oil drops

122
Q

Features and diagnosis of Hirschsprungs

A

Delayed passage of meconium

Rectal biopsy shows decreased ganglion cells

123
Q

Features of Down’s syndrome during birth and 1st few days

A

Hypotonia

Poor feeding

124
Q

How can a diagnosis of Down’s syndrome be made?

A

Amniocentesis during pregnancy

Karyotype testing

125
Q

Clinical features of Down’s syndrome

A

Flat nasal bridge
Single palmar crease
Sandal gap between toes
Learning difficulties

126
Q

Conditions you are more likely to develop in Down’s syndrome

A

Leukaemia
Cardiac defects
Hypothyroidism
Alzheimers

127
Q

Most common cardiac defect in Down’s

A

Atrioventricular septal defect

128
Q

Core features of autism

A 
Poor social skills
Impaired language (e.g. speech delay)
Repetitive behaviours (hand flapping, tip-toe gait)
129
Q

Features of Asperger’s

A

Retain IQ and language levels

130
Q

Ix for autism

A

HEARING ASSESSMENT
Heel prick looking for metabolic issues such as phenylketonuria
Remember that this could just be a normal child, wide variety of personalities

131
Q

Management of autism

A

MDT
BIOPSYCHOSOCIAL

Educational support at school
SALT
Support groups
Behaviour analysis

Medical = anti-psychotics if the child has repetitive tendency to injury themselves

132
Q

Associated issues with autism

A 
Mood disorders
Seizures
Learning difficulties 
Anxiety
OCD
ADHD
Hyperactivity 
Sleep deficits
133
Q

Causes of PUO (fever >3w)

A

Infection (Kawasaki)
Malignancy (leukaemia)
Rheumatic disease (JIA)
Inflammatory (IBD)

134
Q

Causes of neonatal sepsis

A

E.coli
Group B strep
Listeria

135
Q

Features of intussception

A 
Child crying and off food
Bringing knees up to chest 
Red current jelly stool
Colicky pain 
Vomiting (billous early)
Sausage shaped mass in upper abdomen
136
Q

Ix of intussception

A

Abdo USS shows target sign

Contrast enema = gold standard

137
Q

Mx of intussception

A

NBM
IV fluid
Air sufflation
Analgesia

138
Q

DDx rectal bleeding in child

A 
Meckels
IBD
Cows milk protein intolerance (younger child)
Abuse 
Coagulopathy 
Anal fissure
139
Q

What is epilepsy?

A

The enduring predisposition for generating unprovoked seizures

140
Q

Dx of epilepsy

A

> 2 unprovoked seizures

>24hr apart

141
Q

What are infantile spasms

A

West syndrome
Poor prognosis, associated with tuberous sclerosis

Have Salaam attacks (can be mistaken for colic)

142
Q

DDx for seizure in infants

A 
Epilepsy 
Breath holding spell (injury/upset, hold breath, go blue, collapse, recover quickly)
Vasovagal attack
Febrile convulsion 
Encephalitis

Week 2 paces cases (3 decks)

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