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Paeds PACES > Paeds > Flashcards

Paeds Flashcards

1
Q

APGAR

A

Appearance - Colour - (Blue or pale/extremities blue/completely pink)
Pulse - HR - 0/1/2 (Below/above 100)
Grimace - Reflex - 0/1/2 (Grimace/Cough or sneeze)
Activity - Muscle tone - 0/1/2 (Limp/Some flexion/Active motion)
Respiration - Resp effort - 0/1/2 (Slow, irregular/good crying)

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2
Q

2 month/8 week vaccines

A

6 in 1, Rotavirus, Men B

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3
Q

3 month vaccines

A

6 in 1, Rotavirus, PCV

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4
Q

4 month vaccines

A

6 in 1, Men B

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5
Q

1 year vaccines

A

HiB/Men C, PCV, Men B, MMR

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6
Q

2-10 year vaccines

A

Flu annually

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7
Q

3 years 4 months vaccine

A

4 in 1 booster - DTaP/IPV, MMR

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8
Q

12-13 year vaccines

A

HPV

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9
Q

14 year vaccines

A

3 in 1 booster T/D/aP, Men ACWY

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10
Q

Normal urine output

A

> 2ml/kg/hr if <2yrs

>1ml/kg/hr if >2yrs

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11
Q

Fluid resus bolus

A

0.9% NaCl STAT
20ml/kg under 10 mins - children
10ml/kg under 10 mins - neonates

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12
Q

Fluid deficit

A

% deficit x weight x 10

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13
Q

Maintenance fluid

A

0.9% NaCl + 500ml 10% dextrose + 40mmol KCl

<10kg 100ml/kg/day (4/hr)
next 10-20kg 50ml/kg/day (2/hr)
>20kg 20ml/kg/day (1/hr)

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14
Q

DKA bolus

A

10ml/kg over 30 mins and subtract from fluid deficit

If shocked 20ml/kg and don’t subtract

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15
Q

Febrile convulsions

A

Mx - offer fluids and paracetamol
Next seizure - note when it starts, protect from injury but do not restrain, 5 min rule for ambulance and buccal midazolam (rpt at 10 mins)

NOT epilepsy

1 in 3 will have repeat febrile seizure

Safety net - non-blanching rash, reduced GCS, dehydration, fever >5 days

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16
Q

Sepsis Abx

A

Meningococcal - IM benpen in community, IV ceftriaxone in hospital

Neonates - IV benpen + gentamicin

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17
Q

Sepsis possible CNS infection or <1mth old

A

High risk: meropenem + amikacin + ampicillin

Moderate risk: cefotaxime + amikacin + ampicillin

18
Q

T1DM

A

Body does not produce enough insulin - can lead to kidney damage, visual problems, skin ulcers

Mx: teach how to self-inject insulin into tummy/thigh before meals, teach how to finger prick - advise re continuous subcut insulin

High protien/low-fat diet, exercise

Regular GP review

If tired, dizzy, shaky, lips tingling, heart pounding - sugary energy drink - if not getting better 999

19
Q

Epilepsy

A

Brain condition causing seizures - aetiology not known - lifelong, can get better over time

Ix: ECG, MRI/CT EEG (will only support diagnosis)

Mx: carbamazepine/lamotrigine, avoid sodium valproate in girls, go for levetiracetam
Buccal midazolam for future seizures

Advise avoiding swimming/bathing unsupervised

Care team, epilepsy society

20
Q

West Syndrome

A

Infantile spasms

Mx: pred or vigabatrin (if due to tuberous sclerosis)

Refer to tertiary epilepsy specialist

21
Q

Childhood absence seizures

A

Mx: ethosuximide (or valproate for boys)

22
Q

Asthma (under 5)

A

Ix: clinical, spirometry (FEV1/FVC < 70%)

23
Q

Asthma (under 5)

A

Ix: clinical, spirometry (FEV1/FVC < 70%), bronchodilator reversibility test, fractional exhaled nitric oxide, PFR, asthma control questionnaire

Mx:
- SABA reliever
- 8wk trial moderate dose ICS, stop then monitor - if resolved then remit:
within 4wks low dose
after 4wks moderate 8wk
- Consider LTRA to ICS maintenance therapy
- Specialist

24
Q

Asthma (over 5)

A

Ix: clinical

Mx:

  • SABA reliever
  • Low dose ICS
  • Consider adding LTRA and review in 4-8wks
  • Stop LTRA, start LABA
  • Change ICS and LABA to MART w/ low dose ICS and SABA
  • Increase ICS to moderate dose
  • Specialist

Itchywheezysneezy.co.uk

25
Q

Bronchiolitis/croup safety net

A

111

Less than half usual amount of feed in last 3

Dry nappy 12 hrs

38 persistently

Drowsy, irritable

999

Cyanosed

Lots of work of breathing

Pauses in breathing

26
Q

Whooping Cough

A

Ix: NPA or swab

Mx: if <21 days of cough - macrolide

  • <1 m - clarithromycin
  • > 1 m or not pregnant - azithro/clarithromycin
  • Pregnant - erythromycin

Do not use co-trimoxazole

27
Q

Cystic Fibrosis

A

Ix: Guthrie
Sweat
Karyotyping

Mx: 
High fat diet
Don't meet other CF kids
antibiotic cover prophylactically
Inhalers
Creon
?steroids oral
rhDNase

Cystic fibrosis trust

28
Q

Measles

A

Mx: School exclusion for 4d after rash develops

MMR

29
Q

Mumps

A

Ix: saliva swab

Mx: School exclusion for 5 days after onset

30
Q

Rubella

A

Ix: Saliva swab
B19 testing if pregnant

Mx: 5d exclusion

31
Q

Rheumatic fever

A

Ix: Jones Criteria, Throat Culture rapid antigen testing for GAS, Anto-streptolysin O titre

Mx: if unconfirmed - paracetamol
confirmed - benpen IM or penV - ?NSAIDs
If HF - furosemide/spironolactone or enalapril
AF - steroids, amoidarone/digoxin
If chorea - emergency valve surgery - carbamazepine (LFTs)

Long-term IM benpen monthly for 10 yrs or until age of 21 yrs

Regular check-ups

32
Q

Infective Endocarditis

A

Ix: Follow up with cardiologist

Mx: abx for 6 weeks (started IV inpatient)

Penicillin-susceptible streptococcus - beta-lactam + gentamicin OR vanc

Penicillin-resistant streptococcus - beta-lactam + gentamicin OR vanc + gent

MSSA - beta-lactam/vancomycin/daptomycin/co-trimaxole + clindamycin

MRSA - vanco/dapto/co-trim + clindamycin

Penicillin-sensitive enterococci: beta-lactam/van + gent

Penicillin-resistant enterococci: ampicillin/vancomycin + gentamicin

HACEK: ceftriaxone + gent

Fungal: surgery + antifungal

33
Q

Scarlet Fever

A

Ix: Clinical, consider throat swab GAS

Mx: penV / amoxicillin

School exclusion 24hrs post-abx start

34
Q

Urticaria

A

Ix: Urticaria Activity Score (UAS7)

Mx: Antihistamines, prednisolone if severe

Antipruritic treatment (calamine lotion, topical menthol in aqueous cream), chlorphenamine at night

Montelukast, cyclosporin, omalizumab, mycophenolate mofetil

35
Q

Eczema

A

Ix: Swabs if infected, CDLQI questionnaire

Mx: Emollients

Hydrocortisone 1% –> Betamethasone valerate 0.025% or clobetasone butyrate 0.05% –> betamethasone valerate 0.1%

36
Q

Nappy Rash

A

Mx: High absorbency, leave nappies off, clean skin and change nappies every 3-4 hrs, change nappies ASAP after soiling or wetting, fragrance-free, alcohol-free, dry gently, avoid excessive bathing

Barrier preparation to protect the skin - Diprobase

Topical hydrocort up to 7 days

37
Q

KDIGO/RIFLE/AKIN criteria for AKI

A
  • Rise of serum creatinine of 26micromol/L or more within 48 hours
  • 50%+ rise in creatinine in 7 days
  • UO decreases to less than 0.5ml/kg/hr for more than 6hrs in adults, 8 in children
  • 25% or greater fall in eGFR in children within 7 days
38
Q

Iron-rich foods

A

dark green vegetables, iron-fortified bread, meat, aprcots, prunes, raisins

39
Q

Hodgkin Lymphoma

A

Doxorubicin, bleomycin, vinblastine, dacarbazine

40
Q

Septic arthritis

A

Ix: Synovial fluid joint aspiration

Mx: G+ fluclox + joint aspirate OR clindamycin OR vanc

G- ceftriaxone + joint aspirate OR ciprofloxacin

Paeds PACES (1 decks)

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