Paediatrics ILA

Question 1

What is a septic screen

Answer 1

A septic screen is a test to identify any possible infection

Question 2

What is the immediate management of sepsis

Answer 2

assess A-E, gain central access, give oxygen, give antibiotics - ceftriaxone, give IV fluids, take urine dipstick, take blood cultures, take bloods (FBC U&E, CRP, INR, lactate)

Question 3

What causes the purpura rash in meningitis

Answer 3

The purpura is a cutaneous manifestation of disseminated intravascular coagulation

Question 4

What is the non-immediate management for sepsis

Answer 4

ICU for intubation, CXR (pneumonia), Abdo and pelvic ultrasound (abdo cause), LP (meningitis), Meningococcal PCR blood test, serum cortisol (adrenal crisis)

Question 5

First line treatment for meningitis close contacts

Answer 5

To reduce risk of spreading give ciprofloxacin to close contacts - it is a notifiable disease so contact public health

Question 6

Define close contacts

Answer 6

People in the same household

Question 7

Juvenile Idiopathic Arthritis investigations

Answer 7

FBC, CRP, ESR

Question 8

Initial treatment for JIA

Answer 8

NSAIDs - ibuprofen

Question 9

Second line drugs for JIA

Answer 9

Steroids
DMARDs - methotrexate, sulfasalazine and leflunomide
Biologic therapy - tumour necrosis factor inhibitors etanercept, infliximab and adalimumab

Question 10

What is the diagnostic criteria for Kawasaki disease

Answer 10

Fever for at least 5 days with 4/5 of:
Mucositis: erythema and cracking of the lips, strawberry tongue and/or oral erythema
Conjunctivitis: bilateral conjunctivitis without exudate
Rash: maculopapular, erythroderma or erythema multiforme
Peripheral changes: erythema, oedema and/or desquamation of the hands and feet
Cervical lymphadenopathy

Question 11

Kawasaki disease management

Answer 11

The management is high dose aspirin and immunoglobulins within 10 days of onset of fever