paeds Flashcards
Noonan syndrome
webbed neck
pectus excavatum
short stature
PS
Patau syndrome
microcephaly
small eyes
polydactyly
cleft lip/palate
Edward’s syndrome
micrognathia - undersized lower jaw
low-set ears
rocker bottom feet
overlapping fingers
William’s syndrome
Short stature
Struggles = learning difficulties
Smiley = friendly, extroverted personality
Supravalvular AS
Pierre-Robin syndrome
small chin
posteriorly displaced tongue
cleft palate
when is MMR vaccine given
12-13 months
3-4 years
PDA features
continuous’ machinery’ murmur loudest at left sternal edge
left subclavicular thrill
collapsing pulse
lower UTI mx
<3 months - refer immediately
>3 months - oral ABX for 3 days (usually Trimethoprim, Nitrofurantoin, Cephalosporin or Amoxicillin)
meningitis mx
<3 months: IV Amoxicillin + IV Cefotaxime
>3 months: IV Cefotaxime
when is Men B vaccine given
2 months
4 months
12-13 months
respiratory red flags in feverish child
grunting
RR >60
moderate or severe intercostal recession
bilirubin findings in biliary atresia
elevated conjugated bilirubin
cephalohaematoma vs caput succedeneum
cephalohaematoma - swelling due to bleeding between periosteum and skull, does not cross suture lines
caput succedeneum - seen in newborns immediately after birth, crosses suture lines
7 S’s of innocent murmur
- Sensitive (changes with posture or respiration)
- Short
- Small
- Soft
- Sweet (not harsh)
- Single (no associated clicks or gallops)
- Systolic (limited to systole)
causative organism of croup
parainfluenza virus
what makes up the APGAR score
Appearance - colour Pulse - HR Grimace - reflex irritability Activity - muscle tone Respiratory effort
neonatal hypoglycaemia mx
asymptomatic - encourage normal feeding and monitor blood glucose
if symptomatic or very low (<1) - admit to NNU for IV 10% dextrose
features of acute epiglottitis
3 d's drooling distress dysphagia also adopt tripod position - lean forward extending neck
pneumonia with mycoplasma mx
erythromycin
when does precocious puberty occur in females and males
<8 years in females
<9 years in males
rate of CPR for children
100-120 bpm in all ages
infantile spasms vs infantile colic
spasm - child becomes distressed between spasms
colic - child becomes distressed during spasms
ix for NEC
AXR
school exclusion for hand, foot and mouth
children do not need to be excluded from school
when to refer for unilateral undescended testis
3 months of age
mx of biliary atresia
- Surgical intervention
- Ursodeoxycholic acid if surgery fails
- Liver transplant may be needed if surgery fails
what is used to measure a child’s weight to ascertain obesity
BMI percentile adjusted to age and gender
most common location of atopic eczema in infants
face and trunk
mx of croup
Dexamethasone PO
risk factors for meconium aspiration
post-term babies
history of maternal HTN, pre-eclampsia, chorioamnionitis, smoking or substance abuse
school exclusion for scarlet fever
24 h after commencing ABX
Scarlet fever vs Kawasaki
Scarlet fever: Sore throat Strawberry tongue Sandpaper rash Malaise, N&V, headache Fever lasts 24-48h
Kawasaki - CRASH and BURN: Conjunctivitis Rash lymphAdenopathy Strawberry tongue Hand and feet desquamation BURN: fever >5 days not responding to antipyretic
steps of paeds BLS
Shout for help
Open airway, look, listen and feel for breathing
5 rescue breaths
Check brachial (infants) or femoral (infants + children) pulse
15:2 compressions:breaths
mx of unresolving umbilical hernia at 3 years of age
delay referral until 5 years of age if still unresolved
features of bronchiolitis
coryzal symptoms incl. MILD fever first, then dry cough and breathlessness may be accompanied with wheeze and fine inspiratory crackles
risk factors for surfactant deficient lung disease
prematurity
diabetic mothers
C-section
TTN (transient tachypnoea of the newborn) - features and mx
most common after C-sections
features of respiratory distress - grunting and nasal flaring
supplementary oxygen if needed
often resolves within 1-2 days without treatment
mx of scabies
permethrin first line
Still’s murmur vs venous hum
Still’s murmur - low-pitched at LLSE
venous hum - continuous blowing noise below clavicles
most common complication of roseola infantum
febrile convulsions
most common complications of measles
otitis media
pneumonia
encephalitis
risk factors for DDH
female sex
breech presentation
FHx
oligohydramnios
Prader-Willi syndrome
hypotonia
hypogonadism
obesity
causes of neonatal hypotonia
neonatal sepsis
hypothyroidism
Prader-Willi
maternal drugs, e.g. benzodiazepines
most common fractures seen in NAI
radial
humeral
femoral
when to refer to hospital in bronchiolitis
RR >60
feeding 50%-75%
clinical dehydration
mx of bow legs
typically resolves by the age of 4-5 years so no mx needed if presenting before this
rashes in varicella zoster vs roseola infantum
both have fever followed by rash
varicella - macular, then papular then vesicular rash that starts on head/trunk before spreading
roseola - pale pink macular rash starting on trunk then spreading to face, arms and legs
triad of shaken baby syndrome
- retinal haemorrhages
- subdural haematoma
- encephalopathy
how to measure neonatal jaundice
must measure urgently (within 2 hours)
do not use transcutaneous bilirubinometer
types of laxatives used for paediatric constipation
Movicol and lactulose = osmotic
senna = stimulant
mx of constipation
- Movicol
2. add Senna (stimulant laxative) if constipation present after 2 weeks of using Movicol
omphalocele vs gastroschisis features + mx
omphalocele - abdominal contents protrude and are covered by peritoneum, staged repair beginning immediately and completed at 6-12 months
gastroschisis - defect in abdominal wall lateral to umbilical cord, immediate surgery
mx of seborrhoea dermatitis in children
mild-moderate: baby shampoo and baby oils
severe: 1% hydrocortisone
vitals in children >12 years
same as adults
features of umbilical granuloma
small, red growth of tissue seen in centre of umbilicus
usually wet and leaks small amounts of clear/yellow fluid
compression:ventilation ratio for newborn
3:1
features of fragile X syndrome
learning difficulties large low set ears, long thin face macroorchidism autism hypotonia
features of osteochondritis dissecans
pain after exercise
intermittent swelling and locking
features of chondromalacia patellae
common in teenage girls
anterior knee pain on walking up and down stairs and rising from prolonged sitting
features of osgood-schlatter disease
sporty teenagers
pain, tenderness and swelling over tibial tuberosity
mx of hydroceles in newborn male
usually resolve within first year of life
Gilbert’s syndrome vs biliary atresia
Gilbert’s - normal LFTs (but raised unconjugated bilirubin)
biliary atresia - abnormal LFTs (raised conjugated bilirubin)
branchial cyst vs cystic hygroma
branchial cyst - anterior triangle, near angle of mandible
cystic hygroma - posterior triangle, soft and transilluminate
mx of coarctation of aorta
administer prostaglandins to maintain PDA
mx of whooping cough
azithromycin or clarithromycin
features of neonatal sepsis
high fever
inconsolable crying
dehydration (sunken fontanelle)
respiratory distress - GRUNTING
features of meningitis in young children
non-specific signs such as irritability and poor feeding
bulging fontanelle
vomiting
fever
