paeds Flashcards
In exomphalos (aka omphalocoele) the abdominal contents protrude through the anterior abdominal wall but are covered in …
amniotic sac
Exomphalos (omphalocoele) is the abdominal contents through the abdominal wall covered in amniotic sac. When it isn’t covered in a sac it is called
gastroschisis
- bowel contents outside of the abdominal wall
A child what age with fever >38 degrees needs to be referred urgently to pads ED
<3 months
Treatment for congenital hernias:
(a) inguinal
(b) umbilical
(a) repair urgently as risk of incarceration
(b) manage conservatively, reassure most resolve by 4-5 years.
What swelling due to bleeding between the periosteum and the skull. It is most commonly noted in the parietal region and is associated with instrumental deliveries. The swelling usually appears 2-3 days following delivery and does not cross suture lines. It gradually resolves over a number of weeks.
Cephalohaematoma
Scalp oedema swelling due to pressure of the presenting part of the cervix. Present from birth with poor margins and crosses suture lines
Caput succedaneum
n.b. cephalohaematoma does not cross suture lines
ventouse assisted deliveries are associated with which haematomas that present as a swelling 12-72 hours post-delivery
subgaleal haematoma
Child aged <5 years with asthma not controlled by a SABA + low-dose ICS, what should be added next
Leukotriene receptor antagonist
if this doesn’t work <5 years, refer to paeds specialist
if this doesn’t work >5 years, then next step is SABA + ICS + LABA
What X-ray changes are seen with Perthes disease (age 4-8years)
Early changes = widening of joint space
Late changes = decreased femoral head size or flattening
risk of avascular necrosis
Centor 4 criteria for streptococci tonsillitis
- tonsil exudate
- fever
- tender lymphadenopathy
- absence of cough
0-2 - low chance
3 or 4 - high chance - treat with 7 or 10 days phenoxymethylpenicillin or clarithromycin if pen allergic
Contraindications to MMR
- Severe immunosuppression
- Immunoglobulin Rx in the past 3 months
- Allergy to neomycin
- Child who had another live vaccine within 4 weeks
- Pregnancy should be avoided for at least 1 month post-vax
Children in the UK receive two doses of the Measles, Mumps and Rubella (MMR) vaccine before entry to primary school. When is the schedule?
12-15 months
3-4 years
Short stature Learning difficulties Friendly, extrovert personality Transient neonatal hypercalcaemia Supravalvular aortic stenosis
What condition
William’s syndrome
Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis
What condition
Noonan syndrome
Learning difficulties Macrocephaly Long face Large ears Macro-orchidism
What condition?
Fragile X syndrome
When does tetralogy of fallot (VSD, pulmonary stenosis, RVH, overriding aorta) typically present?
1-2 months
The nitrogen washout test (aka hyperoxia test) differentiates cardiac from non-cardiac causes. Baby is given 100% oxygen for 10 mins then ABG is done. pO2 of less than what value indicates cyanotic congenital heart disease?
pO2 <15 kPa
What is the most common heart defect with Down’s syndrome
Atrioventricular septal defect
What condition presents in the first 24-48 hours of life with abdominal distension and bilious vomiting, more common in cystic fibrosis
Meconium ileus
Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers
What condition?
Edwards syndrome
Chr 18
A baby is born with microcephaly, small eyes, low-set ears, cleft lip and polydactyl. What syndrome
Patau syndrome
Chr 13
Fever initially
Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular
Systemic upset is usually mild
What childhood infection?
Chickenpox
Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots (‘grain of salt’) on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent
What childhood infection?
Measles
Fever, malaise, muscular pain
Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%
What childhood infection?
Mumps
Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular
What childhood infection?
Rubella
Also known as fifth disease or ‘slapped-cheek syndrome’
Lethargy, fever, headache
‘Slapped-cheek’ rash spreading to proximal arms and extensor surfaces
What childhood infection?
Erythema infectiosum
caused by parvovirus B19
Reaction to erythrogenic toxins produced by pathogen
Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)
What childhood infection?
Scarlet fever
Caused by Group A haemolytic streptococci
Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet
What childhood infection?
Hand, foot and mouth disease
Caused by Coxsackie A16 virus
Child has:
- micrognathia (small jaw)
- posterior displacement of the tongue (can lead to upper airway obstruction)
- cleft palate
what is the congenital syndrome
Pierre Robin syndrome
Child has:
- characteristic cry due to larynx and neurological problems
- feeding difficulties and poor weight gain
- learning difficulties
- microcephaly and micrognathism
- hypertelorism
what is the congenital syndrome?
cri du chat syndrome
i.e. Chr 5p deletion syndrome
