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Year 4 > Paediatrics and Neonatal > Flashcards

Paediatrics and Neonatal Flashcards

1
Q

Manoeuvre if child not protecting their own airway

A

Jaw thrust

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2
Q

Glucose range in children (normal)

A

3-5

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3
Q

Foreign Body in Bronchi

CXR findings

A

Unilateral hyperinflated lung

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4
Q

Kawasaki Disease

- Diagnostic criteria

A

Fever (>39 for at least 5 days)
4 out of 5 of:
Rash, conjunctivitis, mucous membrane changes, cervical lymphadenopathy, extremity changes
Note: lymphadenopathy may be unilateral

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5
Q

Mucous membrane changes seen in Kawasaki disease (2)

A

Strawberry tongue

Red fissuring lips

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6
Q

Extremity changes seen in Kawasaki disease (3)

A

Erythema of palms/soles
Swelling of fingers or toes
Desquamation of fingertips or toes

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7
Q

Adrenaline nebuliser dose used in croup

A

5ml of 1:1000 adrenaline

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8
Q

Steroid in Croup

A

Dexamethasone 0.15mg/kg

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9
Q

Steroid in Asthma

A

Prednisolone 1-2mg/kg (up to 60mg)

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10
Q

RSV Prophylaxis

A

Palivizumab

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11
Q

Abdominal pain
Preceding viral illness
Normal observations

A

Mesenteric adenitis

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12
Q

Investigation before starting domperidone

A

ECG - look for QT prolongation

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13
Q

Symbicort =

A

Steroid + LABA

Budesonide + Formoterol

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14
Q

Seretide =

A

Steroid + LABA

Fluticasone + Salmeterol

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15
Q

Rashes in meningococcal sepsis (2)

A

Non-blanching maculopapular

Blanching erythematous

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16
Q

Vesicles seen in… (3)

A

Chickenpox
Herpes simplex
Shingles

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17
Q

Petechiae vs purpura

A

Petechiae <2mm

Purpura >2mm

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18
Q

Erythema multiforme VS Steven Johnson syndrome

A

EM has NO mucous membrane involvement

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19
Q

Complication of Burns

A

Toxic Shock Syndrome

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20
Q

Presentation of HSP (3)

A

Purpuric rash - legs, buttocks
Abdominal pain
Physiologically well

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21
Q

Febrile Convulsions

  • Age
  • Risk of another convulsion
A

Usually 1-3 years old

Chance of repeats is ~50%

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22
Q

Differential of vomiting (<6 months) (4)

A

Posseting
Feeding problems
Pyloric stenosis
GORD

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23
Q

Differential of ‘gastroenteritis’ + abdominal pain (2)

A

Campylobacter

Surgical cause

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24
Q

Signs of Dehydration in Baby (6)

A 
Sunken eyes 
Sunken fontanelle 
Dry mucous membranes 
Peripheral mottliing 
Reduced skin turgor 
Delayed CRT
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25
Q

Hypernatraemic Dehydration

A

= high [Na+]

  • Associated with first few weeks of life where there is difficulty feeding
  • Can see high HR and BP, difficult to rouse
  • DON’T SEE FONTANELLE CHANGES
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26
Q

Causes of Neonatal Bradycardia (3)

A

Hypoxia
Congenital Heart Disease
Prematurity

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27
Q

NEC Diagnosis

A

Clinical Features + Radiological Features

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28
Q

Clinical Features of NEC

A

Bilious vomiting
Abdominal distension
Blood in stool

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29
Q

Radiological Features of NEC

A

Dilated bowel loops
Pneumatosis
Hepatobiliary Gas

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30
Q

Management of NEC

A

Stop feeding and start TPN
Consider antibiotics
May need surgical management

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31
Q

Complication of high bilirubin

A

Kernicterus

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32
Q

Heel prick test done…

A

5-9 days of life

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33
Q

Preventing hypoxic brain injury in neonates

A

Can use cooling measures

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34
Q

Grading Heart Murmurs

A

1-6

6 is the loudest, above 3 will have a thrill

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35
Q

Erythema toxicum =

A

Seen post-natally

Entirely normal skin, comes up a few days after birth, completely harmless

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36
Q

Presentation of Scarlet Fever (4)

A

Sore Throat
Fever
Peri-Oral Pallor
Strawberry Tongue

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37
Q

Cause of Scarlet Fever

A

Group A Streptococcus

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38
Q

Burn VS Scald

A 
Burn = dry heat
Scald = wet heat
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39
Q

Management of Intussusception

A

Pneumatic reduction under fluoroscopic guidance

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40
Q

Koplik Spots

A

Seen in measles

= grey blue spots seen in the mouth

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41
Q

Cephalohaematoma VS Caput Succendum

A

Cephalohaematoma doesn’t cross the sutures

Caput Succendum DOES

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42
Q

Investigating DDH

A
  • Need a hip USS if concerns about Ortolani or Barlow

- Hip USS at 6 weeks if breech delivery or breech after 36 weeks

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43
Q

Pre ductal VS post ductal

A

Pre ductal = R upper limb

Post ductal = lower limbs

44
Q

Preductal > Post-Ductal

A

= differential cyanosis
Aortic arch hypoplasia
Aortic stenosis
Persistent pulmonary hypertension

45
Q

Signs of Cardiac Failure in Kids (7)

A 
Pallor 
Cyanosis 
Tachypnoea 
Sweating 
Poor Feeding 
Increased Work of Breathing 
Hepatomegaly
46
Q

Approach to the suspected undescended testicle in the new born

A
  1. Check femoral canal to see if there has been maldescension
    - Unilateral = reassure should descend without intervention
    - Bilateral = senior review and paediatric surgeon referral
47
Q

Management of hyperbilirubinaemia

A

Plot on graph to decide whether phototherapy or IV Ig exchange is needed
STOP phototherapy when at least 50mmol/L below the treatment threshold

48
Q

Mechanism of phototherapy

A

= transforms bilirubin into water soluble tissues which are more easily eliminated

49
Q

Respiratory stimulant in neonates

When used

A

Use caffeine
Helps prevent apnoea and aids extubation
Should be started in <30 weeks or <1501g

50
Q

Contraindication to use suxamethonium

A

Duchenne Muscular Dystrophy

51
Q

Management of meningitis <3 months

A

Cefotaxime + Amoxicillin (listeria cover)

52
Q

Tetralogy of Fallot

A

VSD
Pulmonary Stenosis/Outflow Tract Obstruction
Overriding Aorta
Right Ventricular Hypertrophy

53
Q

Presentation of RDS (4)

A

Cyanosis
Nasal Flaring
Increased and shallow breathing
Grunting

54
Q

Not passed meconium, distended abdomen, bilious vomiting

A

Meconium ileus
= thickened meconium causes a small bowel obstruction
Occurs secondary to cystic fibrosis

55
Q

Dose of ceftriaxone

A

Approx 80mg/kg

56
Q

How does hypothermia in babies result in hypoxia?

A

Hypothermia > Hypoglycaemia > Increased o2 demand > Hypoxia

57
Q

Early onset neonatal sepsis

A

Group B Streptococcus

Consider E. coli

58
Q

Late onset neonatal sepsis

A

Candida

59
Q

Early VS Late Neonatal Sepsis

A

Early <72 hours

Late >72 hours

60
Q

APLS Formula for Estimating Weight

A

2 x (age +4)

61
Q

Presentation of Patent Ductus Arteriosus (4)

A

Continuous machinery like murmur
Left sided thrill
Heaving apex
Widened pulse pressure

62
Q

Foetal Alcohol Syndrome - Head Size

A

Microcephaly

63
Q

Surgical Management of Pyloric Stenosis

A

Ramstedt Pyloromyotomy

64
Q

Rash:
Sparing Face =
Starting on Face =

A

Sparing Face = Scarlet Fever

Starting on Face = Rubella

65
Q

RDS in Premature

Management

A

Give surfactant

Deliver via catheter using the ET tube

66
Q

Investigations for UTI < 3 months

A 
USS at/by 6 weeks after UTI 
DMSA scan (look at kidneys)
67
Q

Marker of exocrine pancreas function used in CF

A

Faecal elastase

68
Q

Bacteria seen in chest infection in CF (3)

A

Staph aureus
Haemophilus influenzae
Pseudomonas

69
Q

Complication of viral gastroenteritis

A

Transient lactose intolerance

70
Q

Association of Hirschsprung Disease

A

Down’s Syndrome

71
Q

Ix of Choice for C. Aneurysms in Kawasaki’s

A

ECHO

72
Q

Paracetamol Dose (Children)

A

15mg/kg

73
Q

Eyes and Seizures

A

Eyes open + no pupil reaction to light

More likely to be a seizure

74
Q

Choice for terminating seizure (child)

A

Lorazepam 0.1mg/kg

75
Q

Startled or injured

Apparent seizure

A

Consider breath holding attack

76
Q

Sandiffer Syndrome

A

= movements appearing like a seizure associated with severe GORD

77
Q

Resus Fluids in Children

A

20ml/kg of 0.9% saline over 10 minutes

78
Q

Maintenance Fluids - Children

A

100ml/kg for first 10kg
50ml/kg for next 10kg
20ml/kg for next 10kg
All per day

79
Q

Replacement Fluid - Children

A

100ml/kg

If appear to be clinically shocked

80
Q

Development - hand preference

A

> 12 months

If younger may be a sign of cerebral palsy

81
Q

Development - hop on one leg

A

3-4 years

82
Q

Maternal labetalol can result in…

A

Neonatal hypoglycaemia

83
Q

Management of hypoglycaemia in neonate

Factors

A

Depends on whether symptoms or not
Asymptomatic = nothing
Symptomatic = IV dextrose 10%

84
Q

Development - pull to stand

A

9 months

85
Q

Vomiting since birth

No relation to feeds

A

Hiatus hernia

86
Q

Hip XR finding in Perthe’s Disease

A

Increased femoral head density

87
Q

Development - suck reflex

A

Usually 33-34 weeks gestation

88
Q

Infection of Chicken Pox > Necrotising Fasciitis

A

Group A Strep

89
Q

Management of Scarlet Fever

A

Penicillin V

Can go back to education 24 hours after starting ABx

90
Q

Management of Kawasaki’s Disease

A

Aspirin

Single dose of IV immunoglobulin

91
Q

Decision about management of PDA

Factor

A

Depends on whether it is in isolation or occurs with another defect
Isolation = give indomethacin to close
Another defect = prostaglandin to keep it open until surgery can be done

92
Q

Maintenance Fluids in Children

A

100ml/kg for first 10kg
50ml/kg for next 10kg
20ml/kg for every kg afterwards

93
Q

Common association with measles

A

Otitis Media

94
Q

Age of birth risk for neonatal hypoglycaemia

A

< 37 weeks

95
Q

Sequelae of Roseola Infantum

- Cause

A
  1. High fever
  2. Maculopapular rash
  3. Febrile convulsions, diarrhoea and cough
    Cause = human herpes virus 6
96
Q

Pulse sites to check infant BLS

A

Brachial

Femoral

97
Q

Investigation of suspected intusseption

A

Abdominal USS

98
Q

Transposition of Arteries

How is it compatible with life?

A

It isn’t, there must be an associated defect which allows for mixing of blood
e.g. PDA = continuous machine like murmur

99
Q

What is imprinting?

Example?

A

= inherit the faulty gene from one parent and the other gene is ‘silenced’ even if it is normal
e.g. Prader Willi

100
Q

Management of Neonatal Hypoglycaemia

A

Defined as <2.6
Asymptomatic = normal feeding, monitor BMs
Symptomatic or very low <1 = need IV infusion of 10% dextrose

101
Q

What type of vaccine is the rotavirus vaccine?

A

Oral live attenuated

102
Q

Bilirubin in biliary atresia

A

See a conjugated hyperbilirubinaemia

103
Q

Presentation of hypothyroidism in children (2)

A

Small stature

Lethargy

104
Q

Heart disease seen in congenital rubella

A

Patent PDA

105
Q

Croup + Well + Stridor

A

Need admission - stridor indicates admission

106
Q

Asthma in child not controlled by leukotriene + SABA + ICS - next step?

A

Stop leukotriene

Add in LABA

Year 4 (27 decks)

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