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Phase 3a > Paeds > Flashcards

Paeds Flashcards

1
Q

1st Line Treatment for Pneumonia

A

Amoxicillin

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2
Q

2nd Line Treatment for Pneumonia

A

Clarithromycin (If Allergy for Amox.)

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3
Q

Commonest cause for Neonatal Conjunctivitis

A

Blocked Lacrimal Duct

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4
Q

Organisms Causing Neonatal Conjunctivitis

A

Birth Canal:
Chlamydia
Gonorrhea

Other:
Haemophilus Influenza
Staph. aureus
Strep pneumonia
HSV
Adenovirus
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5
Q

Treatment for Chlamydia

A

Erythromycin (4x daily, 14 days)

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6
Q

Treatment for Gonorrhoea

A

Cefotaxime (IV)

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7
Q

Treatment for Meningitis

A
  1. IM Benzylpenicillin (in community)
  2. Cefotaxime
  3. Amoxicillin (if <3months for listeria cover)
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8
Q

Meningitis Prophylaxis

A
  1. Ciprofloxacin ( 1 dose)
    or
  2. Rifampicin (BD, 2 days)
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9
Q

Vesicoureteral Reflux Management

A
  1. Treat acute episode: IV abx, Fluids, Analgesia
  2. MCUG
  3. DMSA - 3-4 months post acute infection
  4. Prophylaxis Abx
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10
Q

Causes of Significant Hypoxia

A
  1. Tetralogy of Fallot

2. Transposition of Great Arteries

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11
Q

What can help keep ductus arteriosus open?

A

Prostaglandins

optimise oxygenation

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12
Q

Signs of Coarctation of aorta

A

absent femoral pulse

lower O2 sats in leg compared to r. arm

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13
Q

Diagnosis Triad of CF

A

Pulmonary/GI manifestations
Family history
positive sweat test (Cl conc.)

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14
Q

Common Organisms causing resp infections in a patient with CF

A

staph aureus
psuedomonas aeruginosa
burkholderia cepacia

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15
Q

CF Chest XR findings

A 
bronchial wall thickening
bronchiectasis
hyperinflation
lobar atelectasis (obstruction by mucus plug)
large hilar
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16
Q

What is Gaucher’s Disease.

Name 2 signs

A

lysosomal storage disorder
(missing an enzyme that breaks down lipids)

Signs: hepatomegaly & splenomegaly
(lipids build up in organs)

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17
Q

What group does Gaucher’s Disease particularly affect?

A

Ashkenazi Jews

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18
Q

What Organism common causes: Epiglottitis

A

Haemophilus Influenza type B

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19
Q

What Organism common causes: Croup

A

Parainfluenza Virus type 1&2

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20
Q

What Organism common causes: URTI

A

RSV (Respiratory Syncytial Virus)

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21
Q

What Organisms (5) common causes: Otitis Media

A 
RSV
Pneumococcus
Haemophilus
Group A Strep
Moraxella
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22
Q

What Organism common causes: Sinusitis

A

Pneumococcus

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23
Q

What Organisms common causes: Pneumonia

A 
Pneumococcus
Haemophilus Influenzae
Staph aureus
Klebsiella pneumoniae
Mycobacterium tuberculosis
Strep A
TB

RSV
Influenza
Parainfluenza
Adenovirus

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24
Q

What Organism common causes: Bronchiolitis

A

RSV

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25
Q

What Organism common causes: Infective Endocarditis

A

Strep. viridans

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26
Q

What Organism common causes: Rheumatic Fever

A

Group A B-haemolytic Strep.

Strep throat, scarlet fever

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27
Q

What Organism common causes: Pharyngitis/Tonsilitis

A

Group A Strep.
Adenovirus
EBV

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28
Q

What Organism common causes: Diarrhoea

A

Rotavirus
Calcivirus
Astrovirus

Campylobacter jejuni
Salmonella
E. Coli

Giardia

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29
Q

What Organism common causes: UTI

A

E. Coli
Proteus (structural abnormality)
Psuedomonas

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30
Q

What Organism common causes: Meningitis in <3 months

A

Group B Strep.
E. Coli
Listeria

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31
Q

What Organism common causes: Meningitis in >3 months

A

Neisseria meningitidis
Haemophilus Influenzae
Strep. pneumoniae

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32
Q

What Organism common causes: Encephalitis

A 
Enterovirus
Varicella
HSV
HIV
Measles
Mycoplasma
Borrelia burgdorferi
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33
Q

What Organism common causes: Lyme Disease

A

Borrelia Burgdorferi

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34
Q

What Organism common causes: Whooping Cough

A

Bordetella Pertussis

gram -ve cocobacilli

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35
Q

What Organism common causes: Chickenpox

A

Varicella Zoster Virus

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36
Q

What Organism common causes: Glandular fever

A

EBV

Cytomegalovirus

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37
Q

What Organism common causes: Slapped Cheek Syndrome

A

Paravirus B19

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38
Q

What Organism common causes: Impetigo

A

Staphylococcus

Group A Strep.

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39
Q

What Organism common causes: Scalded Skin Syndrome

A

Staphylococcus

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40
Q

What Organism common causes: Typhoid

A

Salmonella

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41
Q

What Organism common causes: Osteomyelitis

A

Staph aureus
Strep.
Haemophilus Influenza

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42
Q

What Organism common causes: Septic Arthritis

A

Staph. aureus

Haemophilus Influenza

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43
Q

What Organism common causes: Septicaemia

A

Pneumococcus
Group B Strep.
Meningococcus

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44
Q

What Organism common causes: Scarlet Fever

A

Strep. pyogenes

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45
Q

If few dilated loops of bowel seen on abdo XR;

  1. where is the obstruction?
  2. give 2 causes
A
  1. proximal obstruction
  2. malrotation,
    jejunal atresia
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46
Q

If multiple dilated loops of bowel seen on abdo XR;

  1. where is the obstruction?
  2. give 4 causes
A
  1. distal obstruction
  2. ileal atresia
    meconium ileus or plug
    Hirschsprung’s
    anal atresia
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47
Q

What does a “double-bubble” finding on Abdo XR signify?

A

Duodenal Stenosis

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48
Q

Name 2 GI complications those with Down’s syndrome are at increased risk of having

A

Duodenal stenosis

Hirshsprung’s disease

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49
Q

What is Hirschsprung’s Disease?

A

absence of parasympathetic ganglion cells in myenteric & submucosal plexus of rectum

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50
Q

How do you diagnose Hirschsprung’s?

A 
Rectal Biopsy
Barium enema (avoid if systemically unwell- perforation likely, enema will make peritonitis worse)
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51
Q

Complications of Hirshsprung’s

A

Perforation

Toxic Megacolon

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52
Q

Management of Toxic Megacolon

A
  1. fluids
  2. decompression
  3. Surgery
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53
Q

Treatment for Hirschsprung’s

A

Surgery

Swenson Procedure

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54
Q

What 2 plexuses are absent in Hirschsprung’s?

A

Meissner’s

Auerbach’s

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55
Q

What Triad makes up Haemolytic Uraemic Syndrome

A

AKI
Thrombocytopenia
Normocytic anaemia

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56
Q

What is Infectious Mononucleosis also known as?

A

Glandular fever

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57
Q

What should not be given in Glandular fever? Why?

A

Amoxicillin - develop maculopapular pruritis rash

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58
Q

Investigations for ALL

A

blood film

bone marrow biopsy

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59
Q

What is the inheritance pattern of Congenital Adrenal Hyperplasia?

A

Autosomal Recessive

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60
Q

What hormones are affected in Congenital Adrenal Hyperplasia? are they high or low?

A

Cortisol & Aldosterone

both low

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61
Q

What electrolyte imbalances are associated with Congenital Adrenal Hyperplasia?

A

hyponatraemia
hyperkalaemia
metabolic acidosis

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62
Q

Presentation of Oculomotor (CN3) Nerve Palsy

A

ptosis

“down & out” eye

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63
Q

Presentation of Abducens (CN6) Nerve Palsy

A

adducted eye (towards eye)

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64
Q

Name 2 sanctuary sites in Chemotherapy

A

CNS

Testes

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65
Q

What is Wilson’s Disease?

A

high levels of copper deposited in body- problem with excretion

Affects:
liver - jaundice
kidneys
eyes - Kayser-Fleischer Ring
brain - parkinsonism, psychosis
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66
Q

Management of Wilson’s Disease

A
  1. Copper Chelating agent - Penicillamine

2. Zinc Pyridoxine - for neuro

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67
Q

Management of Sickle Cell Disease

A
  1. Hydroxycarbamine
  2. Transfusions
  3. Stem cell transplant (curative)
  4. Penicillin (prophylaxis treatment after splenectomy)
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68
Q

Which age group is Hodgkin’s Lymphoma more common associated with?

A

Teens

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69
Q

Which age group is Non-Hodgkin’s Lymphoma more common associated with?

A

Kids

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70
Q

How do you monitor Treatment for Hodgkin’s lymphoma?

A

PET

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71
Q

What are the B Symptoms of Lymphoma?

A

unexplained fever
unexplained weight loss
night sweats

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72
Q

What causes Stephen-Johnson Syndrome?

A

adverse reaction to meds

infection (viral)

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73
Q

Presentation of Stephen-Johnson Syndrome

A

Start: flu-like symptoms
Later: red rash that spreads and blisters (target-like)
Affected skin dies and peels off

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74
Q

Viral Causes of Stephen-Johnson Syndrome

A 
Mumps
Flu
HSV
EBV
Coxsackie virus
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75
Q

Medication Causes of Stephen-Johnson Syndrome (10)

A 
Allopurinol
Carbamazepine
Lamotrigine
Nevirapine
Meloxicam (all oxicams)
Phenobarbitol
Phenytoin
Sertaline
Sulfasalazine
Sulfamethoxazole
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76
Q

Complications of Chickenpox

A

Bacterial superinfection
Cerebelitis
DIC
Progressive disseminated disease

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77
Q

Presentation of Scarlett fever

A 
fever
sore throat
maculopapular rash - sandpaper like
strawberry tongue
cervical lymphadenopathy
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78
Q

Treatment of Scarlett fever

A

Phenoxymethylpenicillin

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79
Q

If Scarlett Fever a Notifiable Disease?

A

Yes

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80
Q

When can a child return to school after being diagnosed with Scarlett Fever?

A

24hrs after starting Abx

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81
Q

Management of GORD

A 
1. Carobel (feed thickener)
    \+ Gaviscon (alginate therapy
2. Ranitidine (H2 receptor antagonist)
    or. Omeprazole
3. Donperidone (D2 antagonist)
4. Surgery - if resistant to meds. 
   (Nissen Funndoplication)
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82
Q

Treatment for Tonsilitis

A

Phenoxymethylpenicillin

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83
Q

Management for Faecal Impaction

A
  1. Polyethylene (macrogol laxative) or osmotic laxative if macrogol intolerated
    + electrolytes
  2. Senna (stimulant)
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84
Q

Management of ITP

A

majority resolve spontaneously within 6-8 weeks
if need to raise platelets: 1st Line- Prednisolone

avoid NSAIDs and Aspirin - impair platelet function

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85
Q

Treatment for Otitis Media

A

1st Line: Amoxicillin

2nd Line: Clarithromycin ( if allergic to Amox.)

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86
Q

What murmur is heard with VSD?

A

Pansystolic

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87
Q

What murmur is heard with Patent ductus arteriosus

A

Continuous Machinery sounding

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88
Q

What murmur is heard with ASD?

A

Ejection systolic

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89
Q

What murmur is heard with Tetralogy of Fallot

A

Harsh Ejection Systolic

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90
Q

What murmur is heard with Coarctation of aorta?

A

heard on back between scapula

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91
Q

What makes up Tetralogy of Fallot?

A

Right ventricular hypertrophy
VSD
Pulmonary Stenosis
Misplaced aorta

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92
Q

Which Heart defects cause cyanosis?

A

Tetralogy of Fallot

Transposition of great arteries

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93
Q

What does ITP common follow after?

A

Viral Infection

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94
Q

What Inheritance pattern if Haemophilia?

A

X-linked Recessive

boys affected

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95
Q

What deficiency if found in Haemophilia A?

A

Factor VIII

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96
Q

What deficiency if found in Haemophilia B?

A

Factor IX

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97
Q

Complications of haemophilia

A 
Haemarthrosis
Chronic arthropathy
Compartment Syndrome (bleeding into muscles)
Haematuria
Hep B infections (due to blood products)
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98
Q

What Abx can be used in Penicillin allergy?

A

Clarithromycin

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99
Q

Causes of Physiological Jaundice

A

breast milk feeding
dehydration
biliary atresia

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100
Q

What is a complication of severe neonatal jaundice?

A

Kernicterus

high levels of unconjugated bilirubin cross blood-brain barrier- collect in basal ganglia & brainstem

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101
Q

What can Kernicterus cause?

A 
cerebral palsy
hearing loss
convulsions
lethargy
poor feeding
learning difficulties
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102
Q

Presentation of HSP

A

Rash - raised, palpable purpura. buttocks and legs
abdo pain
athritis/arthralgia
glomerulonephritis

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103
Q

Complications of HSP

A

Intussusception
Arthritis
Pancreatitis
Acute Renal Impairment

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104
Q

Organisma that cause bloody diarrhoea

A

E. Coli

Salmonella

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105
Q

Who is immune to Slapped Cheek Syndrome?

A

Those lacking P anigen

Parovirus replicates in red cell precusor cells expressing P antigens

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106
Q

Describe the Rash associated with Slapped Cheek Syndrome

A

cheeks

trunk & arms - lace-like (adults)

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107
Q

Name a complication of a Parovirus infection in pregnancy

A

Hydrops fetalis

fetal bone marrow aplasia– anaemia

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108
Q

Name a complication of a Varicella infection in pregnancy

A

Limb defects

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109
Q

Name a complication of a Rubella infection in pregnancy

A

cataracts

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110
Q

Name a complication of a CMV infection in pregnancy

A

cerebal palsy

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111
Q

Name a complication of a Toxoplasmosis infection in pregnancy

A

choroidoretinitis

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112
Q

What is Toxic Megacolon

A

Complication of hirschsprung’s

  • proximal colonic dilation secondary to obstruction
  • thining of colonic wall
  • bacterial overgrowth
  • translocation of gut bacteria
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113
Q

Symptoms of Pyloric Stenosis

A

non-bilious vomit

  • immediately after feeding
  • projectile
114
Q

Signs of Pyloric Stenosis

A

wave of peristalsis (L-R)
RUQ mass - firm, mobile, olive-shaped (hypertrophied pylorus)
Depressed fontanelle (dehydration)
Abdo distension

115
Q

Pyloric Stenosis electrolyte pattern

A

low Cl
low K
metabolic alkalosis

116
Q

Primitive Reflexes

A 
Moro
Grasp
Crawl
Step
Tonic Neck
117
Q

Causes of jaundice if <24hrs old

A

Always BAD - unconjugated bilirubin

  • Haemolytic
  • Congenital
118
Q

Causes of jaundice if 24hrs-3 wks old

A 
Haemolysis
Infection
Polycythemia
Physiological
Biliary Atresia
119
Q

Causes of jaundice if >3wks

A

Infection - UTI
Physiological
Hypothyroidism
Liver- Gilbert’s Syndrome

120
Q

What can Haemolytic Uraemic Syndrome be secondary to?

A

GI infection- bloody diarrhoea

E.coli, Shigella

121
Q

Signs of Nephrotic Syndrome

A

Proteinuria
Hypoalbuminaemia
Oedema

122
Q

Treatment for nephrotic Syndrome

A

Prednisolone (if steroid sensitive)
fluid balance
low salt diet

123
Q

What usually causes Nephrotic Syndrome?

A

minimal change disease

124
Q

What can nephrotic syndrome be secondary to?

A

HSP
SLE
Infection
Allergens

125
Q

Complications of Nephrotic Syndrome

A

Hypovolaemia
Infection (Pneumococcus) – due to loss of
immunoglobulins
Thromosis
Hypercholesterolaemia

126
Q

Presentation of Glomerulonephritis

A 
-Haematuria
proteinuria
impaired GFR
-Hypertension
-Oedema
127
Q

What can Glomerulonephritis be secondary to?

A

Strep. Infection (Group A)

128
Q

Investigations of UTI

A

Renal US
MCUG –VU reflux
DMSA

129
Q

Management of Glue Ear

A 
Resolve itself (take up to 3 months)
Grommets
130
Q

Causes of a Wheeze

A

Viral Induced
Bronchiolitis
Pneumonia
Asthma

131
Q

Causes of Stridor

A 
Croup
Epiglottitis
Bacterial Tracheitis
Diptheria
Inhaled Foreign Body
Angioedema/ Anaphylaxis
Laryngomalacia
132
Q

Signs of Resp distress

A 
cyanosis
hypoxia
subcostal recessions
tracheal tug
wheeze on auscultation
head bobbing
133
Q

Inheritance pattern of CF

A

autosomal recessive

134
Q

Chromosome and gene affected in CF

A

chrom 7
delta F508
codes for chloride channels

135
Q

CF gold standard diagnosis

A

sweat test

136
Q

What viral organisms commonly cause: gastroenteritis

A

Rotavirus
Enterovirus
Norovirus
Adenovirus

137
Q

What bacterial organisms commonly cause: gastroenteritis

A

Campylobacter jejuni
E. Coli
Shigella
Salmonella

138
Q

Managmemt of gastroenteritis

A

Oral Rehydration Solutions

139
Q

When should stool sample be taken?

A 
diagnostic doubt
sepsis
bloody diarrhoea
diarrhoea >2 wks
immunocompromised
140
Q

Live Vaccines

A

Rotavirus
MMR
Shingles/chicken pox
BCG

141
Q

When is Amoxicillin prescribed in Meningitis treatment

A

under 3 months - Listeria cover

142
Q

ADHD Management

A
  1. Methylphenidate

2. Lisdexamfetamine

143
Q

ADHD

DSM-V6 Criteria

A

answers Qs prematurely
always on the go, spontaneous moving around
losing important things, forgetful
can’t play quietly

144
Q

Viral Induced Wheeze Management

A
  1. Inhaled Salbutamol
  2. O2
  3. ICS
  4. Montelukast
145
Q

Resp Red flags

A 
central cyanosis
floppy
tracheal tug
costal recessions
too breathless to feed/ speak in full sentences
146
Q

NEC Presentation

A 
abdo distension
(absent bowel sounds)
vomit- bilious
rectal bleeding
lethargy
feed intolerance
visible intestine loops lacking peristalsis
147
Q

NEC Diagnosis and Findings

A

Abdo XR

  • dilated bowel loops
  • bowel wall oedema
  • pneumonitis intestinalis
148
Q

NEC Management

A

broad spec. Abx

149
Q

Cyanotic Heart Defects

A

Tetralogy of Fallot
Transposition of great arteries
Tricuspid Atresia

(TTT)

150
Q

Acute Exacerbation of Asthma Management

A
  1. high flow O2 (if Sp02<94%)
  2. Oral Prednisolone
  3. Nebulised Ipratropium
  4. Nebulised Salbutamol
    (5. Nebulised Mg if Sp02<92%)

2nd Line

  1. IV Salbutamol
  2. IV aminophylline
  3. IV Mg
151
Q

Chronic Asthma management in under 5s

A
  1. Salbutamol
  2. Beclomethasone
  3. Montelukast
152
Q

Name 2 Gram -ve Diplocci

A

Neisseria Meningitidis

Neisseria Gonorrhoea

153
Q

Viral Meningitis Treatment

A

Aciclovir

154
Q

How can you group Cryptorchidism

A
  1. Retractable
  2. Palpable
  3. Unpalable
155
Q

When does testes descent usually occur?

A

3rd Trimester

156
Q

Who is cryptorchidism more common in

A

Premature

157
Q

Cryptorchidism Management

A
  1. Repeat testicular exam at 8wk check
  2. refer if undescended by 3 months
  3. Surgery - Orchidopexy
158
Q

What surgery is performed for cryptorchidism

A

Orchidopexy

159
Q

Presentaion of Intussusception

A 
paroxysmal episodes of colicky pain
redcurrent jelly stool / blood in stool
draw legs up to chest
distension
vomit
constipation
RUQ mass- sausage shape
160
Q

Most common site of intussusception

A

ileum into caecum

161
Q

What age is intussusception most common cause of obstruction

A

3 months to 2 yrs

162
Q

Investigation of Intussusception and result

A

US Abdo

- target sign/doughnut sign – proximal bowel in distal bowel

163
Q

Intussusception Management

A
  1. fluids

2. Rectal air insufflation

164
Q

Causes for: bile-stained vomit

A

obstruction

NEC

165
Q

Causes for: haematemesis

A

peptic ulcer
gastritis
oesophageal varices

166
Q

Causes for: Projectile Vomit

A

pyloric stenosis

167
Q

Causes for: abdo pain on movement

A

appendicitis

168
Q

Causes for: blood in stool and vomit

A

intussusception
gastroenteritis
intolerance

169
Q

Causes for: severe dehydration and vomit

A

severe gastroenteritis
DKA
systemic infection

170
Q

Causes for: Headache and vomit

A

increase intracranial pressure

171
Q

Causes for: failure to thrive and vomit

A

GORD

Coeliac’s

172
Q

Pyloric Stenosis Investigations

A

Bloods- FBC, U&Es, blood gases

Test feed - NG tube insertion

173
Q

Pyloric Stenosis Management

A
  1. Fluids
  2. Surgery - after fluids/electrolytes normalised
    • Ramstedt’s pyloromyotomy
174
Q

Side Effects of Salbutamol

A

tachycardia
hypokalaemia
tremor

175
Q

Chronic Asthma management for 5-12 year olds

A
  1. Salbutamol
    • ICS
    • Salmeterol (LABA)
  4. increase ICS
    • montelukast
176
Q

Anaphylaxis Management

A
  1. ABCDE
  2. O2
  3. Fluids IV
  4. IM Adrenaline (repeat after 5 mins)
  5. IV hydrocortisone (+2 further doses)
  6. Oral Chlorphenamine

measure tryptase

177
Q

Who should receive Palivizumab

A

CF
Premature
Chronic Lung Disease
Immunodeficiency

178
Q

What is Palivizumab and what is it for

A

Monoclonal antibody against RSV

once monthly vaccine

179
Q

Croup Management

A
  1. Dexamethasone
  2. O2
  3. Nebulised Budesonide
  4. Neb. Adrenaline
180
Q

Epiglottitis Management

A
  1. ITU - intubate
  2. IV Cefotriaxone
    + Dexamethasone
181
Q

Epiglottitis Prophylaxis

A

close contact

Rifampicin

182
Q

IBD Investigations

A

Colonoscopy

183
Q

Crohn’s Presentation

A

RLQ pain/mass - terminal ileum disease
Perianal disease
Gallstones
mouth to anua

184
Q

Ulcerative Colitis Presentation

A

bloody diarrhoea
LLQ tenderness
from anus

185
Q

Crohn’s Macroscopic findings

A

skip lesions
cobblestone mucosa
strictures

186
Q

Crohn’s Microscopic Findings

A

non-caseating granulomas

transmural inflammation

187
Q

Ulcerative Collitis Macroscopic Findings

A

continuous

mucosal ulceration

188
Q

Ulcerative Collitis Microscopic Findings

A

no granulomas

mucosal & submucosal inflammation

189
Q

Crohn’s Induction of Remission

A
  1. Enteral nutrition (Modulen) - liquid feed for 6-8 wks

2. Glucocorticosteroids

190
Q

Crohn’s Maintenance of remission

A
  1. Azathioprine or. Mercaptopurine
191
Q

Ulcerative Colitis Induction of Remission

A
  1. Glucocorticosteroids or Aminosalicylates (Mesalazine)
192
Q

Ulcerative Collitis Maintenance of Remission

A
  1. Aminosalicylates eg. Mesalazine
193
Q

What Antibodies are associated with Coeliac’s Disease

A

ETG
Endomysial cells
gliadin

194
Q

Coeliac’s Disease Investigations

A

Antibodies- tTG testing

  • If +ve = endoscopy & biopsy
  • If -ve = serum IgA
195
Q

Histological findings of Coeliac’s Disease

A

crypt hyperplasia
villi atrophy
intraepithelial lymphocytes

196
Q

What can develop in Post-Gastroenteritis Syndrome

A

Lactose Intolerance

197
Q

What do the lines on Bilirubin Chart represent

A

Phototherapy

Exchange Transfusion

198
Q

Presentation of Biliary Atresia

A

severe jaundice 2 days post birth
pale stool
dark urine

199
Q

Risk Factors for Biliary Atresia

A

Down’s

CFC1 mutation

200
Q

Management of Biliary Atresia

A
  1. US - gallbladder & bile duct
  2. TBIDA scan - show no excretion
  3. Surgery - Kasai Procedure
201
Q

Inheritance Pattern of Hereditary Spherocytosis

A

Autosomal Dominant

202
Q

Hereditary Spherocytosis Investigations

A

FBC - increase MCHC & reticulocytes
Blood Film - sphere RBC
Coomb’s Test

203
Q

Hereditary Spherocytosis Management

A

Splenectomy
Cholecystectomy
Penicillin prophylaxis
Folate supplements

204
Q

Inheritance Pattern of G6PD

A

X-linked recessive

205
Q

G6PD Presentation

A

splenomegaly

gallstones

206
Q

Triggers for G6PD symptoms

A

infection
medication
fava beans

207
Q

G6PD Investigations

A

Blood Film - heinz bodies

208
Q

What will Liver biopsy show in Neonatal Hepatitis

A

mulitnucleated giant cells

Rosette formation

209
Q

Neonatal Hypothyroidism Presentation

A

prolonged neonatal jaundice
hypotonia
large tongue

210
Q

Causes of Hypothyroidism

A

UK- hormonal dysgenesis, ectopic thyroid

Later in childhood- autoimmune thyroiditis

211
Q

Galactosaemia Presentation

A

cataracts
hepatomegaly
shock from E.Coli sepsis

212
Q

Galactosaemia Management

A

mum and baby dairy free diet

213
Q

Wilson’s Disease inheritance pattern & chromosome affected

A

Autosomal Recessive

Chrom. 13

214
Q

Management of Fitting Child

A
  1. high flow O2
  2. capillary blood glucose
  3. gain IV access
  4. bloods - FBC, U&Es, gases, Ca, Mg

IV Lorazepam

215
Q

What is Sandifer Syndrome

A

neurological signs associated with feeding

eg. Gord - dystonic posturing of head, neck, back
- can cause apnoea

216
Q

What is the APGAR Scoring System

A 
for neonates
A- activity
P- pulse
G- grimmace
A- apperance
R- Resp
217
Q

What is the Guthrie Card

A

Heel Prick test

218
Q

What is looked for in the Guthrie Card

A

Hypothyroidism
CF
Sick-cell
Phenylketonuria

219
Q

Neonatal Infections

A 
TORCHS:
Toxoplasmosis
Rubella
CMV
Herpes Simplex
Syphilis
220
Q

Toxoplasmosis Presentation

A

hydrocephalus
microcephaly
cerebral palsy

221
Q

Rubella Presentation

A

sensorineural deafness
congenital cataracts
glaucoma
cerebral palsy

222
Q

CMV Infection Presentation

A 
sensorineural deafness
growth retardation
jaundice
cerebral palsy
purpuric skin lesion
223
Q

Herpes Simplex Neonatal Presentation

A

limp hypoplasia
corticol atrophy

give Zaricella Zoster IgG

224
Q

What is Transient Tachypnoea of Newborn

A

Physiological pulmonary oedema

  • following emergency C-section
  • not had time to absorb amniotic fluid in lungs
225
Q

Transient Tachypnoea of Newborn Management

A

Resolve spontaneously by 48hrs

O2 + CPAP

226
Q

Respiratory Distress in Neonates CXR findings

A

‘ground-glass’
indistinct heart border
air bronchograms

227
Q

Complication of O2 and ventilation in Neonates

A

retinopathy

pneumothorax

228
Q

Meconium Aspirate Syndrome Presentation

A

term baby
meconium/dark green staining of amniotic fluid
resp distress

229
Q

Meconium Aspirate Syndrome CXR Findings

A

patchy infiltrates
atelectasis
coarse streaking

230
Q

Meconium Aspirate Syndrome Management

A

suctioning

O2

231
Q

Common Organism causing neonatal Sepsis

A

Group B strep

232
Q

Management of Neonatal Sepsis

A
  1. Benzylpenicillin + Gentamycin

2. blood cultures, CRP, LP

233
Q

Risk Factors for Persistent Pulmonary Hypertension in Newborns

A 
Meconium aspirate syndrome
Resp. distress syndrome
Sepsis
Congenital diaphragmatic hernia
Maternal NSAID use - 3rd Trimester
Maternal SSRI use
234
Q

Apnoea of Prematurity Management

A

IV Caffeine

Tactile Stimulation

235
Q

Brain Haemorrhage Treatment

A

Vit. K

236
Q

Hypoxic Ischaemia Encephalopathy Complications

A

cerebral palsy

seizures

237
Q

Hypoxic Ischaemia Encephalopathy Management

A

therapeutic hypothermia

238
Q

NEC Risk Factors

A 
formula feeding
resp distress
low birth weight
prematurity
Abx
anti-acid meds
239
Q

How does retinopathy of Prematurity come about?

A

retinal blood vessel formation is stimulated by hypoxia

exposure to high O2 prevents this from happening–retinal damage

240
Q

Management of Retinopathy of Prematurity

A

Screen for in <32wks and <1.5kg

Transpupillary diode laser therapy

241
Q

Management of Kawasaki’s

A

Aspirin
IV Immunoglobulins
Routine Echos

242
Q

Complication of Kawasaki’s

A

Coronary artery aneurysms

243
Q

Management of Meningococcal Septicaemia

A

Meningococcal PCR

Dexamethasone - reduce frequency and severity of hearing loss and neuro damage

244
Q

What should not be used in Chickenpox management

A

NSAIDs- increase risk of secondary infections

245
Q

Impetigo Management

A
  1. swabs
  2. topical fusidic acid
  3. flucloxacillin
246
Q

Slipped Upper Femoral Epiphysis Management

A

Immobilisation
Analgesia
Screw fixation

247
Q

Septic Arthritis Pathogens for neonates and older children

A

neonates: strep.
older: staph. aureus

248
Q

septic arthritis management

A 
joint aspiration
blood cultures
splint
IV Abx
surgical drainage
249
Q

sickle cell disease inheritance pattern

A

autosomal recessive

  • chrom 11
  • single nucleotide mutation
250
Q

DKA Management

A

Fluids
IV insulin - start 1-2 hrs after fluids
KCl

251
Q

Corticosteroids Side Effects

A

acne
striae
telangiectasia
skin thinning

252
Q

Sepsis 6

A 
Blood cultures
Urine output
Fluids IV
Abx
Lactate measurement
O2
253
Q

4 key drivers for Failure to thrive

A

Inadequate intake
Inadequate retention
Malabsorption
Increased requirements

254
Q

Whooping Cough Treatment

A

Erythromycin

255
Q

ALL Presentation

A

Hepatosplenomegaly

high WCC – high K, Phospate, Uric Acid, LDH

256
Q

ALL Management

A
  1. Allopurinol + Hyperhydration
  2. Crossmatch + Platelet Transfusion
  3. Bone Marrow Aspirate
  4. Chemo
257
Q

Phenylketonuria Inheritance pattern

A

Autosomal Recessive

Metabolic Disorder

258
Q

Phenylketonuria Management

A

Low phenylketonuria diet + amino acid supplements

Lifelong

259
Q

Child has bloody diarrhoea then develops jaundiced and oedema

A

Haemolytic Uraemic Syndrome

260
Q

Haemolytic Uraemic Syndrome Investigations

A

Stool culture (E.Coli, Salmonella)
FBC
Blood Film
Renal function + electrolytes

261
Q

HSP Presentation

A

rash
abdo pain
arthralgia
glomerulonephritis

262
Q

HSP Investigations

A

FBC
Clotting screen
Renal Function
Urine dipstick

263
Q

HSP Complications

A

Intussusception
Renal Impairment
Pancreatitis
Arthritis

264
Q

Haemolytic Jaundice Investigations

A 
FBC
Blood film
serum bilirubin
bllod group
coomb's test
265
Q

What replacements do those with haemolytic jaundice require?

A

Folic Acid

266
Q

When is the MMR vaccine given?

A

1 yr

3 yr 4 months

267
Q

When is the DTaP vaccine given?

A 
8 wks
12 wks
16 wks
3 yrs 4 months
DT- 13-18 yrs
268
Q

When is the Hib vaccine given?

A

8 wks
12 wks
16wks
1 yr

269
Q

When is the IPV vaccine given?

A 
8 wks
12 wks
16 wks
3 yrs 4 months
13-18 yrs
270
Q

When is the HepB vaccine given?

A

8 wks
12 wks
16 wks

271
Q

When is the Rotavirus vaccine given?

A

8 wks

12 wks

272
Q

When is the PCV vaccine given?

A

12 wks

1 yr

273
Q

When is the MenB vaccine given?

A

8 wks
16 wks
1 yr

274
Q

What vaccines do at risk neonates get?

A

BCG

Hep B

275
Q

What diseases does the DTap Vaccine cover?

A

diptheria
tetanus
pertussis

276
Q

What vaccines are given at 8 wks?

A

DTaP/IPV/Hib/HepB
MenB
Rotavirus

277
Q

What vaccines are given at 12 wks?

A

DTaP/IPV/Hib/HepB
PCV
Rotavirus

278
Q

What vaccines are given at 16 wks?

A

DTaP/IPV/Hib/HepB

MenB

279
Q

What vaccines are given at 1 yr?

A

MMR
MenB
PCV
Hib/MenC

280
Q

What vaccines are given at 3 yrs 4 months (start of school)

A

DTaP/IPV

MMR

281
Q

When is the HPV vaccine given?

A

11-14 yrs

second dose 6-24 months later

282
Q

What vaccines are given at 13-15?

A

HPV
MenACWY
DT/IPV

Phase 3a (1 decks)

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