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Revision all topics > Paeds > Flashcards

Paeds Flashcards

1
Q

“Kawasaki disease is a type of m____ - s___ v____ v____

A

“Kawasaki disease is a type of systemic, medium-sized vessel vasculitis”

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2
Q

What kind of ethnicity and gender does Kawasaki disease tend to affect?

A

Japanese and Korean boys

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3
Q

What is the most important investigation to do in Kawasaki disease? What does it screen for?

A

Echocardiogram to check for coronary artery aneurysm

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4
Q

What might trigger Kawasaki disease?

A

Infection

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5
Q

List the features of Kawasaki disease

A 
CRASH and BURN:
Conjunctivitis
Rash (non vesicular, peeling) on palms and soles
Adenopathy (cervical)
Strawberry tongue 
Hand and feet swelling 
Burn (fever) 
Other: dry red lips and mouth, pancarditis, coronary arteritis/aneurysm
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6
Q

What is the treatment for Kawasaki disease?

A
  • Single dose IV immunoglobulin

- Aspirin (after acute phase) is only given to children who have cracked hands, lips and strawberry tongue

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7
Q

What causes Scarlet Fever? Which organism is the most common cause?

A

Reaction to toxins from Group A haemolytic streptococci (streptococcus pyogenes)

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8
Q

What is the mode of transmission for Scarlet fever

A

Respiratory route via infected water droplets

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9
Q

What are the symptoms of Scarlet Fever?

A 
Fever 
Malaise, headache, N&V
Sore throat
Strawberry tongue
Sandpaper rash with circumoral sparing
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10
Q

Management for scarlet fever?

A

Oral penicillin V for 10 days

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11
Q

When can a child return to school after Scarlet fever infection?

A

24 hours after commencing antibiotics

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12
Q

Complications of scarlet fever?

A

Otitis media (most common)
Rheumatic fever
Acute glomerulonephritis

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13
Q

Symptoms of bone marrow failure in ALL?

A

Anaemia: lethargy and pallor

Neutropaenia: frequent and severe infection

Thrombocytopaenia: abnormal bleeding, easy bruising, petechiae

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14
Q

Non-bone marrow failure symptoms of ALL?

A

Hepatomegaly
Splenomegaly
Bone pain
Lymphadenopathy

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15
Q

What kind of vasculitis is Henoch Schonlein purpura?

A

IgA mediated small vessel vasculitis

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16
Q

Describe the pattern of rash seen in HSP

A

Palpable, purpuric rash over the buttocks and extensor surfaces of arms and legs

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17
Q

Features of HSP?

A

purpuric rash

abdominal pain

polyarthritis

Haematuria, renal failure

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18
Q

What is the treatment for HSP?

A

Analgesia for arthritis, otherwise treatment is supportive as it is a self limiting condition with good prognosis

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19
Q

What causes ITP?

A

Type 2 hypersensitivity reaction

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20
Q

Pathophysiology of ITP?

A

Production of antibodies target and destroy platelets

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21
Q

How does ITP timeline progress?

A

Often a history of recent viral illness and onset of symptoms after 24-48 hours. Most patients will remit spontaneously within 3 months

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22
Q

Symptoms of ITP?

A

Bleeding
Bruising
Petechial/purpuric non-blanching rash

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23
Q

What symptoms would make you consider a differential of ALL instead of ITP?

A

Hepatosplenomegaly, lymphadenopathy

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24
Q

What proteins are antibodies directed against in ITP?

A

glycoprotein 2b-3a or 1b complex

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25
Q

When would you treat ITP?

A

Only required if patient is actively bleeding or have a severe thrombocytopaenia

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26
Q

What treatments for ITP?

A

Prednisolone
IV immunoglobulins
Blood transfusion if needed
Platelet transfusions temporarily

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27
Q

Some non-medical/lifestyle advice for ITP?

A
  • Avoid contact sport
  • Avoid IM injections and procedures such as lumbar puncture
  • Avoid NSAIDs, aspirin and other anticoagulants
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28
Q

Name the types of cerebral palsy followed by symptoms and location of lesion

A

Spastic (70%) - tight and stiff muscles, hypertonia, scissor gait, toe walking - UMN

Dyskinetic (athetoid) - involuntary movements, dystonia, chorea - basal ganglia

Ataxic - shaky, uncoordinated, clumsy - cerebellum

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29
Q

General symptoms of cerebral palsy?

A 
Pain (tight muscles, stiff joints)
Sleep disorder 
Eating difficulties
Speech difficulty
Learning disability
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30
Q

Causes of jaundice in 1st 24 hours

A

This is ALWAYS pathological:

  • Rhesus haemolytic disease
  • ABO haemolytic disease
  • Hereditary spherocytosis
  • G6PD deficiency
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31
Q

How do blood test/film results differ between Rhesus haemolytic disease, hereditary spherocytosis and G6PD?

A
  • All 3 will have a normocytic anaemia with reticulocytosis and bilirubinaemia
  • blood film will show: nucleated RBCs, spherocytes, Heinz bodies/bite cells respectively
  • Direct and indirect Coombs strongly positive in Rhesus disease
  • Coombs test negative in spherocytosis and G6PD
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32
Q

What are the risks of prolonged and high levels of bilirubin?

A

Kernicterus - brain damage due to high bilirubin

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33
Q

How does breast milk jaundice occur?

A

Components of breast milk inhibit ability of liver to process bilirubin

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34
Q

After how long is jaundice considered “prolonged”?

A

> 14 weeks in full term babies

>21 weeks in premature babies

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35
Q

What are some causes of prolonged jaundice

A

Biliary atresia
Hypothyroidism
Breast milk jaundice
Prematurity

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36
Q

Speech and hearing milestones: 3 months, 9 months, 12 months, 2 years

A
  • Turns toward sound
  • Says mama and dada
  • Knows and responds to own name, knows 2-6 words, understands simple commands
  • Combines 2 words
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37
Q

At what stage would you refer a child for delay in speech and hearing milestones?

A

18 months and not knowing 2-6 words

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38
Q

Fine motor and vision milestones: 6 months, 12 months

A
  • Palmar grasp

- Good pincer grip

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39
Q

What symptom in a young child <12 months is abnormal and prompts investigation for cerebral palsy?

A

Hand preference seen <12 months

40
Q

Gross motor milestones: 7-8 months, 12 months, 13-15 months, 2 years, 4 years

A
  • Sits unsupported
  • Cruising
  • Walking unsupported
  • Runs
  • Hops
41
Q

Social behaviour and play milestones: 12 months, 18 months, 2 years, 4 years

A
  • Waves bye bye
  • Solitary play
  • Parallel play
  • Associative play
42
Q

At what age would you expect your child to be shy towards strangers?

A

9 months

43
Q

At what age would you refer for delay in gross motor milestones?

A

18 months still not walking unsupported

44
Q

Complications of measles?

A
  • Otitis media most common
  • Pneumonia most common cause of death
  • Encephalitis
45
Q

Features of measles?

A

Prodomal phase there is irritability, conjunctivitis, fever.

Koplik spots

Rash behind ears then spreads to whole body

46
Q

Doses of adrenaline for life support in:

  • Adult cardiac arrest
  • Adult anaphylaxis
A
  • Adult cardiac arrest
    1mg
  • Adult anaphylaxis 0.5ml 1:1,000 IM
47
Q

Paediatric compression:ventilation ratio? Rate?

A

15:2 at 100-120beats/min

48
Q

Estimated weight calculation for 0-12months?

A

(0.5*months)+4

49
Q

Estimated weight calculation for 1-5years?

A

(2*years)+8

50
Q

Estimated weight calculation for 6-12years?

A

(3*years)+7

51
Q

How many ml/kg of fluid for child in cases of trauma/DKA/cardiac pathology?

A

10ml/kg of 0.9% saline

52
Q

How many ml/kg of fluid for child in cases other than trauma/DKA/cardiac pathology?

A

20ml/kg of 0.9% saline

53
Q

How to calculate the daily fluid requirements for children?

A

100ml/kg for first 10kg
50ml/kg for next 10kg
20ml/kg thereafter

54
Q

Adrenaline dose for anaphylaxis in <6 month old?

A

0.1-0.15ml 1 in 1000

55
Q

Adrenaline dose for anaphylaxis in 6 month-6years

A

0.15ml 1 in 1000

56
Q

Adrenaline dose for anaphylaxis in 6-12 year old

A

0.3ml 1 in 1000

57
Q

Adrenaline dose for anaphylaxis in adults and children >12 years

A

0.5ml 1 in 1000

58
Q

Most common cause of meningitis in <3 months?

A

GBS from mother at birth

59
Q

Most common cause of meningitis in older children?

A

Neisseria meningitidis

60
Q

What is Kernig’s test

A

Flex a hip and knee to 90. Straighten the knee whilst hip is flexed. Positive test causes neck pain as it stretches the meninges

61
Q

What is Brudzinski’s test

A

Flex the patient’s chin to chest. causes an involuntary flexion of hip and knees

62
Q

Treatment of suspected meningitis in the community?

A

Stat dose of benzylpenicillin and transfer to hospital

63
Q

Treatment of meningitis in hospital setting? How does it differ in patients younger and older than 3 months?

A

Send for blood culture and lumbar puncture. Whilst waiting, administer empirical antibiotics.
< 3 months: cefotaxime + amoxicillin

> 3 months: ceftriaxone

64
Q

When is lumbar puncture contraindicated in meningitis? Why?

A

contraindicated if there is meningococcal sepsis due to risk of coning

65
Q

What pathology has a murmur in the mitral area?

A

Mitral regurgitation

66
Q

What pathology has murmur in the tricuspid area?

A

Tricuspid regurgitation

67
Q

Which pathology can be best heard in the left lower sternal border?

A

VSD

68
Q

Which pathology can be heard in aortic area?

A

aortic stenosis

69
Q

Which pathology can be heard in pulmonary area?

A

pulmonary stenosis

70
Q

What pathology can be heard at 4th intercostal space on the left sternal border?

A

hypertrophic obstructive cardiomyopathy

71
Q

Where can you hear VSD? How does the murmur sound

A

left lower sternal border, pan-systolic murmur

72
Q

Where can you hear ASD? How does the murmur sound?

A

heard at upper left sternal border. Mid-systolic crescendo-decrescendo murmur with fixed split 2nd heard sound

73
Q

Where can you hear PDA? How does the murmur sound?

A

heard under left clavicle. Machinery murmur with crescendo-decrescendo

74
Q

What murmur is heard in Tetralogy of Fallot?

A

Pulmonary stenosis - ejection systolic heard in pulmonary area

75
Q

Features of Patau syndrome (Trisomy 13?)

A 
Microcephaly
small eyes
Cleft lip/palate
Polydactyly
Scalp lesion
76
Q

Features of Edward’s syndrome (trisomy 18)?

A

Micognathia
Low set ears
Rocker bottom feet
Overlapping fingers

77
Q

What kind of genetic condition is Fragile X?

A

X linked, trinucleotide repeat of CGG

78
Q

Features of Fragile X?

A 
Learning difficulty
Macrocephaly
Large testes
Large face
Large ears
79
Q

Features of Noonan syndrome?

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

80
Q

Features of Prader-Willi syndrome

A

Hypotonia
Hypogonadism
Obesity

81
Q

Which is the most common primary malignant bone tumour?

A

osteosarcoma

82
Q

Where does osteosarcoma affect?

A

metaphyseal region of long bones (femur, tibia, humerus)

83
Q

What does x-ray of osteosarcoma show?

A

Sunburst pattern of Codman triangle

84
Q

Where does Ewing’s sarcoma occur?

A

pelvis and long bones

85
Q

What does x-ray of Ewing’s sarcoma show?

A

onion skin appearance

86
Q

What is osteochondroma

A

most common benign bone tumour at the cartilage-capped bony projection on the external surface of bone

87
Q

What is osteoma

A

Benign overgrowth of bone most typically occurring on skull

88
Q

What is the most common organism causing osteomyelitis?

A

Staph aureus

89
Q

What causes osteomyelitis in sickle cell patients?

A

Salmonella

90
Q

Features of Reyes syndrome?

A
  • Encephalopathy

- Liver failure

91
Q

Treatment of Reyes syndrome?

A

Supportive, may require ITU admission

92
Q

What murmur is heard in transposition of great arteries?

A

Loud S2

93
Q

How much weight can a baby lose before considering referral?

A

Up to 10% weight in 1st week of life

94
Q

Features of hand foot and mouth disease?

A
  • Vesicles in mouth
  • Blistering soles and palms
  • Blanching rash
  • Fever
95
Q

Treatment of hand foot and mouth disease?

A

-Supportive

96
Q

Difference between conjugated and unconjugated bilirubin?

A

Conjugated bilirubin is soluble so it appearance on urine. Unconjugated bilirubin has normal urine

97
Q

Give examples of unconjugated vs conjugated jaundice?

A

Conjugated: biliary atresia, CF, hepatitis
Unconjugated: G6PD, breast milk jaundice

Revision all topics (11 decks)

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