Paeds Flashcards
Abdominal wall defects
Omphacoele- sealed in a sac
Gastrochisis- no peritoneal sac, lots of fluid loss
What is the diagnosis of a preterm 2 week old which is crying, abdo distension, bloody stool?
Necrotising enterocolitis
What Ix do you do for NEC?
Cultures, FBC, blood gas
CRP
Diagnosis is made by AXR
What is the management of NEC
Frrd
Causes of LBO in a newborn?
Rectal atresia
Hirschsprungs
What is hirschsprungs disease?
How do you diagnose?
How do you treat?
Absence of ganglion cells from the myenteric and submucosal plexuses
Occurs in 1/5000 births
Full thickness rectal biopsy for diagnosos
Delayed passage of meconium and abdo distension
Treatment is with rectal washouts followed by anorectal pull through procedure
How would you manage suspected haematological malignancy?
Any of the following features in a person aged 0-24 years should prompt a very urgent full blood count (within 48 hours) to investigate for leukaemia: Pallor Persistent fatigue Unexplained fever Unexplained persistent infections Generalised lymphadenopathy Persistent or unexplained bone pain Unexplained bruising Unexplained bleeding
What is a cephalohaematoma?
Swelling due to birth
doesnt cross suture lines
what is caput succedaum?
swelling, crosses suture lines
What is turners associated with?
Bicuspid aortic valve causing aortic stenosis and ejection systolic murmur
What does croup present with?
Stridor
Barking cough
Mild pyrexia
Coryzal sx
What is the cause of croup?
URTI caused by parainfluenza virus
Peak incidence 6 months- 3 years
When should a child be admitted with croup?
<6months of age
Known upper airway abnormalities- laryngomalacia, downs
uncertainty about diagnosis
Moderate or severe croup
How do you treat croup?
CKS recommend giving a single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity
Prednisolone is an alternative if dex is not available
Emergency treatment; high flow oxygen, nebulised adrenaline
When should you never examine a childs throat?
In croup!
What should you do if a baby is jaundice in the first 24 hours of life?
You have to urgently measure and record the serum bilirubin level urgently (within 2 hours) in all babies with suspected or obvious jaundice as this is likely to be pathological rather than physiological jaundice
What are the causes of jaundice in the first 24 hours of life?
Rhesus haemolytic disease
ABO haemolytic disease
Glucose 6 phosphodehydrogenase
hereditary spherocytosis
What are the causes of jaundice from 2-14 days?
usually physiological
less developed liver, more RBC, fragile RBC
more common in breastfed babies
What Ix to do in prolonged jaundice (>14 days?)
14 days or 21 days premature, a perolonged jaundice screen is performed
Conjugated and unconjugated bilirubin (very improtant as raised conjugated bilirubin could indicate biliary atresia which requires urgent surgical intervention)
Coombs test (Direct antithyroglobulin test)
FBC
TFTS
Urine for MC+s and reducing sugars
UES
LFTS
What are the causes of prolonged jaundice?
Biliary atresia Hypothyroidism Galactosaemia UTI breast milk jaundice Prematurity CMV/Toxoplasmosis
What is scarlet fever?
A reaction to erythrogenic toxins produced by group A haemolytic streptococci (Staph pyogenes)
Spread via. the resp route by inhaling/ingesting resp droplets
Fever, malaise, headache, nausea, vomiting, sore throat, strawberry tongue, sandpaper rach
How do you manage scarlet fever?
Oral pen V for ten days
Azithromycin for pen allergy
Children can return to school 24 hours after commencing abx
Scarlet fever is a notifiable disease
What is the no.1 cause of painless massive GI bleeding requiring a transfusion in children aged 1-2?
Meckles diverticulum
What is VUR diagnosed by?
MCUG