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Finals Revision - Last Min > Paeds > Flashcards

Paeds Flashcards

1
Q

When is puberty precocious and delayed?

How is puberty defined in boys and girls?

A

Precocious:

  • Girls <8
  • Boys <9

Delayed:

  • Girls >13
  • Boys >14

Boys: growth of testes >4ml

Girls, 3 stages:

  • thelarche - breast budding
  • adrenarche - body hair and odour
  • menarche - period
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2
Q

When is primary amenorrhoea?

A

15 y/o with secondary sex characteristics

13 y/o without secondary sex characteristics

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3
Q

Usual cause of acute diarrhoea in children?

Causes of chronic?

A

Rotavirus - vomiting and fever for first 2 days as well
Rehydration

Chronic:

  • Cow’s milk intolerance
  • Toddler’s diarrhoea - vary in consistency, often contains undigested food
  • Coeliac disease
  • post-gastroenteritis lactose intolerance
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4
Q

Management of DDH?

A

Most unstable hips will spontaneously stabilise by 3-6 weeks of age

Pavlik haress in kids <5 months and still unstable

If older - surgery

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5
Q

2 y/o, dropping centiles, nasal polyps?

A

Consider CF

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6
Q

LH and Testosterone pattern in:

  • Primary hypogonadism (Klinefelter’s)?
  • Hypogonadotrophic hypogonadism (Kallman’s syndrome)
  • Androgen insensitivity syndrome?
  • Testosterone secreting tumour?
A

Primary hypogonadism (Klinefelter’s):
LH - high
Testosterone - low

Hypogonad Hypogonad (Kallman’s):
LH - low
Testosterone - low

Androgen insensitivity:
LH - high
Testosterone - normal/high

Testosterone secreting tumour:
LH - low
Testosterone - high

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7
Q

CI for breastfeeding?

A 
HIV
Drugs:
- lithium
- amiodarone
- chemo (plus methotrexate and leflunomide)
- antidepressants (not SSRI)
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8
Q

Gross motor milestones:

6 weeks, 3 months, 6 months, 9 months, 12 months, 18 months, 2 years, 3 years, 4 years, 5 years?

A

6 weeks - head control

3 months - no head lag on pulling up to sit

6 months - pushes onto arms when lying on stomach

9 months - sits without support, pulls to stand, holds onto furniture, may crawl

1 year - cruises furniture, walks with one hand held

18 months - runs, squats to pick up ball

2 years - stairs with 2 feet

3 years - stairs with 1 foot

4 years - hops, tip toes

5 - bike

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9
Q

Fine motor milestones:

6 weeks, 3 months, 6 months, 9 months, 12 months, 18 months, 2 years, 3 years, 4 years, 5 years?

A

6 weeks - follows torch with eyes

3 months - hand regards - hands held in midline

6 months - palmar grasp

9 months - index finger to point

1 year - pincer grip

18 months - tower of 3 bricks

2 years - scribbles, tower of 6-7 bricks

3 years - draw circles, tower of 9

4 years - simple picture of man

5 - triangle

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10
Q

Language milestones:

6 weeks, 3 months, 6 months, 9 months, 12 months, 18 months, 2 years, 3 years, 4 years?

A

6 weeks - stills to voice

3 months - starting to vocalise

6 months - babbles, screams when annoyed, mama/dada

9 months - localises to sound, babbles for self-amusement

1 year - responds to name

18 months - knows 5-20 words

2 years - simple instructions, 50+ words, combine 2 words

3 years - knows own name, asks who/what questions

4 years - stories, count to 20, asks when/where/how questions

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11
Q

Social milestones:

6 weeks, 3 months, 6 months, 9 months, 12 months, 18 months, 2 years, 3 years, 4 years, 5 years?

A

6 weeks - social smile

3 months - reacts pleasurably to familiar sounds

6 months - friendly with strangers

9 months - distinguishes strangers, plays peek-a-boo

1 year - drinks from cup

18 months - feeds with spoon, mimics adults

2 years - puts on shoes, messy, symbolic play

3 years - vivid imagination, understands sharing

4 years - dresses & undresses

5 - ties shoe laces

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12
Q

Red flags of development?

A
  • asymmetrical movement
  • not reaching for objects by 6 months
  • unable to sit unsupported by 12 months
  • unable to walk by 18 months
  • no speech by 10 months
  • loss of skills
  • concern over vision and hearing
  • showing signs of handedness before 12 months - possible cerebral palsy
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13
Q

Infantile colic:

  • age?
  • what does it look like?
A

<3 months

Bouts of excessive crying and pulling-up of legs, often worse at evenings

Happens to 20% infants, cause unknown

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14
Q

Red flags for feverish child?

What should you do?

A
  • pale/mottled/blue skin
  • No response to social cues, appears ill
  • weak, high-pitched cry
  • Grunting
  • tachypnoea >60, chest indrawing
  • reduced skin turgor
  • Age <3 months and >38 degrees
  • Neck stiffness, non blanching rash, bulging frontanelle, neck stiffness, seizure

Refer urgently up to paeds
Don’t prescribe abx unless apparent source

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15
Q

Do kids need kept off school with hand foot and mouth?

Head lice?

A

No

No

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16
Q

Hearing tests in kids?

A

Newborn - otoacoustic emissions test

If abnormal - brainstem auditory response test

6-9 months - distraction test - health visitor

Before school - pure tone audiometry

17
Q

Hypospadias management?

A

Corrective surgery at 12 months

Essential they are not circumcised prior as the foreskin may be used in repair

18
Q

Vaccines given:

  • at birth?
  • 2 months?
  • 3 months?
  • 4 months?
  • 12 months?
  • 3-4 years?
  • 12-13 years?
  • 13-18 years?
  • annually 2-8 years?
A

Birth: BCG if at risk

2 months: 6 in 1, oral rotavirus, MenB

3 months: 6 in 1, oral rotavirus, pneumococcal

4 months: 6 in 1, Men B

12 months: HiB/MenC, MMR, pneumococcal, MenB

3-4 years: 4 in 1 booster, MMR

12-13 years: HPV

13-18 years: 3 in 1 teenage booster, MenACWY

Annually 2-8 years: flu

19
Q

What’s in the 6 in 1 vaccine?

What’s in the 4 in 1 pre-school booster?

A

tetanus, diphtheria, polio, whooping cough, HepB, H influenza B
(given at 2, 3, 4 months)

4 in 1: tetanus, diphtheria, polio, whooping cough

3 in 1 teenage: tetanus, diphtheria, polio

20
Q

Type of fluid for maintenance in young people/kids?

A

0.9% saline (+ glucose if needed)

as opposed to more dilute for adults

21
Q

Reflex anoxic seizure?

A

Kids 6 months - 3 years old

In response to painful/emotional stimuli:

  • goes pale
  • falls to floor
  • may start starts shaking (anoxic seizure)
  • rapid recovery

Neurally mediated by vagus nerve

22
Q 
Mongolian blue spots?
Milia?
Stork mark/salmon patch?
Port wine stain?
Strawberry haemangioma?
Spitz naevi?
A

Mong B: Slate grey congenital melanocytosis usually over buttocks/back, start regressing after 1y/o

Milia: Small, benign, keratin filled cysts on face, occur at any age but common in newborns

Stork/Salmon: blotchy pink vascular birthmarks found on forehead, eyelids or nape of neck, usually disappear over a couple of months but may persist. 50% prevalence in newborns

Port wine: deep red/purple, vascular birth marks that tend to be unilateral. Unlike others, they remain and tend to darken and raise over time. Rx cosmetic camouflage/laser therapy

Strawberry: erythematous, multilobed haemangioma that grows until 6-9 months then regresses, usually gone by 10y/o. Common on face, neck, scalp. If blocking visual field/bleeding then propranolol.

Spitz: pink/red naevus which grow rapidly to about 1cm in kids on face or legs, usually excised to be safe

23
Q

Nappy rash?

Management?

A

Irritant contact dermatitis, spares skin folds

  • Keep skin clean and dry - change nappies regularly
  • Leave undressed if possible
  • topical steroids if bad
  • barrier creams with every nappy once healed (zinc/castor oil)
24
Q

seborrhoeic dermatitis in newborns - how does it usually present?
in infants?
Management?

A

Cradle cap - itchy, yellow (maybe erythematous) scale on scalp

Infants - flexures - axillae, neck creases, groin with NO skin fold sparing

Rx: emollients +/- steroids

25
Q

Roseola cause?
Presentation?
How to differentiate from Rubella?

A

HHV-6

High fever followed by discrete pink macular rash once fever subsides

High fever, lack of sub occipital lymph nodes

26
Q

What is erythema toxicum?

A

Harmless rash seen in babies aged 2-5 days old

Pustules with surrounding erythema, can become widespread and confluent

Self limiting, no Rx

27
Q

Monitoring if giving a kid methylphenidate (1st line) or lisdex (2nd line) for ADHD?

A

Both need ECG monitoring

Methylphenidate needs height and weight monitoring, can stunt growth

28
Q

Early onset and late onset sepsis and causes of each?

Risk factors?

A

EOS <72hrs - GBS (75%), E Coli

LOS 7-28 days - environmental - staph epi, listeria, klebsiella, pseudomonas

RF: mother with previous GBS infection or colonisation screened, PPROM, intraparum infection
Low birth weight, prematurity, maternal chorioamnionitis

29
Q

If prolonged jaundice, what should be screened for?

A

G6PD deficiency
Galactosaemia
Hypothyroidism
a1-antitrypsin deficiency

30
Q

ABG of pyloric stenosis?

ABG of diarrhoea?

A

hypokalaemic, hypochloraemic metabolic alkalosis

Metabolic acidosis

31
Q

4 features of TOF??

A

TOF - overriding aorta, pulmonary stenosis, VSD, RVH
-> boot shaped cardiomegaly, ejection systolic murmur, tet spells

B blockers for tet spells

32
Q

glucose level for neonatal hypoglycaemia?
Management if asymptomatic?
If symptomatic?

A

<2.6

If asymptomatic - encourage breastfeeding and monitor regularly

If symptomatic (jittery, pale, tachypnoeic, irritable, weak cry, hypotonia) - admit to neonatal unit for 10% dextrose infusion

Finals Revision - Last Min (12 decks)

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