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