Paeds Flashcards
1
Q
What are the common features of croup?
A
- stridor
- barking cough
- fever
- coryzal symptoms
2
Q
How is croup treated?
A
Single dose of oral dexamethasone
3
Q
When should children with croup be admitted? (3)
A
If moderate/severe:
- frequent barking cough
- audible stridor at rest
- significant distress
4
Q
When is the peak incidence of croup?
A
6 months - 3 years
5
Q
How does necrotising enterocolitis present? (3)
A
- feeding intolerance
- abdominal distension
- bloody stools
6
Q
How would you diagnose necrotising enterocolitis?
A
Abdominal X ray
7
Q
What are the cardinal features of abdominal intussusception?
A
- paroxysmal abdo colic pain
2. red currant jelly stool
8
Q
How is abdominal intussusception diagnosed?
A
Abdominal US
9
Q
How does pyloric stenosis generally present?
A
- projectile vomiting typically 30mins after feed
10
Q
At what age does pyloric stenosis typically present?
A
2-7 weeks
11
Q
At what age does intussusception generally present?
A
6 months
12
Q
What metabolic imbalance is associated with pyloric stenosis?
A
- hyponatraemia
- hypokalaemia
- hypochloraemic alkalosis
13
Q
How is pyloric stenosis diagnosed?
A
Test feed
- gastric peristalsis can be observed
- olive shaped mass in RUQ palpable
14
Q
What are the characteristics of fragile X syndrome? (4)
A
- learning difficulties
- macrocephaly
- long face
- macro-orchidism
15
Q
What is the most common pathogen responsible for bronchiolitis?
A
Respiratory Syncytial Virus (RSV)
16
Q
What are the key features of bronchiolitis?
A
Coryzal symptoms preceding: 1. dry cough wheezing 2. breathlessness 3. feeding difficulties
17
Q
What is the management for bronchiolitis?
A
Mostly supportive
- humidified oxygen if needed
- nasogastric feeding if needed
18
Q
What are the major risk factors for SIDS? (4)
A
- prone sleeping
- parental smoking
- hyperthermia
- prematurity
19
Q
What are the characteristic features of measles?
A
- fever
- maculopapular rash
- koplik spots (white papules in mouth)
20
Q
What is the most common complication of measles?
A
otitis media
21
Q
What is the most frequent pathogen to cause chronic infection in CF patients?
A
Pseudomonas aeruginosa
22
Q
How and when do patients with biliary atresia normally present?
A
In first few weeks of life:
- jaundice past 2 weeks
- dark urine/pale stools
- abnormal growth
23
Q
What would the serum bilirubin show in a child with biliary atresua?
A
Raised conjugated bilirubin
24
Q
What are the key lab features of ALL?
A
- anaemia
- neutropenia
- thrombocytopaenia
25
How does ALL present clinically? (4)
1. pallor
2. lethargy
3. splenomegaly
4. petechiae
26
At what ages are febrile seizures most common?
Between 6 months and 5 years
27
If a seizure is brief (less than 5 mins) and tonic-clonic what kind of seizure is it most likely to be?
Febrile convulsion
28
What may cause chicken pox to develop into necrotising fasciitis?
Secondary bacterial infection of lesions with Group A strep
29
When is jaundice in the newborn expected?
1. Before 24 hours
| 2. After 2 weeks
30
Give a cause of jaundice within 24 hours of birth
Rhesus haemolytic disease
31
Which babies are more likely to be jaundiced?
1. breast-fed
| 2. preterm
32
Which organism is responsible for the whooping cough?
Bordetella Pertussis
33
What are the diagnostic criteria for whooping cough?
Acute cough lasting 2 wks or more with one/more of:
- paroxysmal cough
- inspiratory whoop
- post-tussive vomiting
- undiagnosed apnoeic attacks
34
In which condition would you expect to see loss of internal rotation of the leg in flexion?
Slipped capitol femoral epiphysis
35
What is the most common cause of cyanotic congenital heart disease?
Tetralogy of Fallot
36
What are the 4 characteristic features of tetralogy of fallot?
1. ventricular septal defect
2. right ventricular hypertrophy
3. pulmonary stenosis
4. overridding aorta
37
How does tetralogy of fallot present? (2)
1. cyanosis/collapse in first month of life
| 2. ejection systolic murmur at left sternal edge
38
When should patients with bronchiolitis be referred to hospital? (3)
1. RR over 60
2. 50-75% of usual food/fluid intake
3. clinical dehydration
39
Give 3 causes of cyanotic congenital heart disease?
1. Tetralogy of Fallot (TOF)
2. Transposition of the Great Arteries (TGA)
3. Tricuspid atresia
40
What is the initial management of suspected cyanotic congenital heart disease?
1. supportive care
| 2. prostaglandin E1
41
What is the most common cause of gastroenteritis in children?
Rotavirus
42
When is Meningitis B vaccine given?
2, 4 and 12 months
43
How does cystic fibrosis typically present in children? (3)
1. neonate = meconium ileus
2. recurrent chest infections
3. malabsorption (steatorroeah/failure to thrive)
44
Give 4 features of cystic fibrosis besides lung/GI tract
1. short stature
2. diabetes mellitus
3. delayed puberty
4. infertility/subfertility
45
Which lab test diagnoses whooping cough?
Per nasal swab culture
46
What is the Kocher criteria used for?
To determine the likelihood of a child having septic arthritis
47
Which parameters are used in Kocher's criteria? (4)
1. non-weight bearing
2. fever >38.5
3. WCC >12
4. ESR >40
48
How does chickenpox normally present? (3)
1. fever initially
2. itchy rash starting on head/trunk before spreading
3. mildly systemically unwell
49
How does the rash of chickenpox normally change?
macular -> papular -> vesicular
50
How does measles initially present? (prodrome/rash)
Prodrome:
- irritable
- conjunctivitis
- fever
Rash:
- discrete maculopapular rash starts behind ears
51
How does measles develop after the initial stages? (2)
1. Kolpik spots on buccal mucosa
| 2. rash spreads to whole body and becomes confluent and blotchy.
52
What are the key features of rubella? (rash/lymph nodes)
1. pink maculopapular rash starting on face, before spreading to whole body, rash fades by 3-5 day
2. lymphadenopathy: suboccipital and postauricular
53
What are the two other terms used to describe erythema infectiosum?
1. fifth disease
| 2. slapped-cheek syndrome
54
Which organism is responsible for erythema infectiosum?
Parvovirus B19
55
What causes Scarlet fever?
Reaction to erythrogenic toxins produced by group A haemolytic streptococci
56
What are the key features of scarlet fever? (5)
1. fever
2. malaise
3. tonsilitis
4. 'strawberry tongue'
5. fine punctate erythema rash sparing area around mouth
57
What does infection of the coxsackie A16 virus cause in children?
Hand, foot and mouth disease
58
What are the key features of hand, foot and mouth disease?
1. mild systemic upset
2. sore throat
3. fever
4. vesicles in mouth and on palms/soles of feet
59
What is the first sign of puberty in boys?
Testicular growth
60
What is the first sign of puberty in girls?
Breast development
61
What is a potential complication of Kawasaki disease?
Coronary artery aneurysm
62
What are the criteria for diagnosing Kawasaki disease? (7)
1. fever > 5 days
2. 4 other features of:
- non-purulent conjunctivitis
- red mucous membranes
- cervical lymphadenopathy
- rash
- peeling fingers/toes
- red oedematous palms/soles
63
What is the management of Kawasaki disease?
1. IV immunoglobulin
| 2. High dose aspirin
64
Which vaccines do you get between ages 3-4? (2)
1. 4 in 1 pre school booster (diptheria/tetanus/whooping cough/polio)
2. MMR
65
At what ages do you get your 6-1 vaccine?
2 months, 3 months, 4 months
66
What is in your 6-1 vaccine?
1. diptheria
2. tetanus
3. whooping cough
4. polio
5. Hib
6. hepatitis B
67
When do you get your oral rotavirus vaccine?
3 months
68
What is the most common presentation of neonatal sepsis?
Respiratory distress
69
What are the key features of patent ductus arteriosus?
1. L subclavicular thrill
2. continuous 'machinery' murmur
3. large volume, bounding, collapsing pulse
4. heaving apex beat
70
How is patent ductus arteriosus managed?
Indomethacin given to neonate postnatally
71
Which structural abnormality causes patent ductus arteriosus?
Failure of ductus arteriosus between pulmonary trunk and descending aorta to close
