Paeds Flashcards
Necrotising enterocolitis
Features (3)
feeding intolerance, abdominal distension and bloody stools
More common in prem babies
Acute epiglottitis cause
Haemophillus influenzae B
Transient tachypnoea of the newborn
CXR
Mx
CXR: hyperinflation, fluid in horizontal fissure
Mx: supportive
Loss of red light reflex ?cause
retinoblastoma
Roseola infantum F
fever first then a rash
whooping cough (pertusis) Mx
azithromycin
shaken baby syndrome (3)
encephalopathy
subdural haematoma (on ct)
retinal haemorrhages
Down’s most common cardiac abnormality
arterioventricular septal defect
cerebral palsy suspicious milestones requiring urgent referral
Not sitting by 8 month
Not walking by 18 month
Hand preference <1 yr
Persistent toe-walking
scarlet fever cause
group A haemolytic strep (pyogenes)
scarlet fever Fx
fever 24-48hrs
sore throat
strawberry tongue
rash (pinhead erythema) torso spares hands/ feet
malaise, headache
otitis media (most common complixcation)
scarlet fever Mx
oral pen V (azithromycin if pen allergy)
gastro-oesophageal reflux in children Mx
1 - conservative
2 - alginates/ thickened feed
3 - PPI (only if poor feeds, faltering growth)
long term asthma Mx age 5-16
1 - SABA
2 - SABA + ICS
3 - SABA + ICS + LABA/ LTRA
4 - SABA + MART (maintenance and reliever therapy)
edwards syndrome (trisomy 18) Fx
rocker bottom feet
low set ears
patau syndrome (trisomy 13) Fx
microcephalic, small eyes
cleft palate
scalp lesions
Fragile X Fx
macrocephaly
macroorchidism
learning difficulty
Noonan Fx
short stature
webbed neck
pulmonary stenosis
Croup (parainfluenza viruses) Fx
stridor
barking cough (worse at night)
fever
coryza
croup Mx
admit if moderate/ severe
PO dexamethasone
if emergency - HFNO, Neb adrenaline
williams syndrome Fx
short stature
learning difficulty
friendly, extrovert personality
supravalvular aortic stenosis
chondromalacia patella Fx
anterior knee pain walking up and down stairs
osgood schattler (tibial apophysitis)
pain, swelling tibial tubercle
sports teens
osteochondritis dissecans
knee pain after exercise
intermittent swelling and locking
cyanotic congenital heart disease and when they present (2)
Tetralogy of fallot (most common) - 1-2 months
Transposition of great arteries - <24 hours
shaken baby syndrome CT findings (3)
retinal haemorrhage
subdural haematoma
encephalopathy
IM Benzylpenicillin doses for Meningococcal septicaemia
< 1 year
1 - 10 years
> 10 years
< 1 year 300 mg
1 - 10 years 600 mg
> 10 years 1200 mg
roseola infantum Fx (3) caused by human herpes virus 6
6 month - 2 years
fever followed by rash
febrile seizures common
haemophillia A inheritance
X-linked recessive
- daughters are carriers to affected parents
- no male to male
ADHD Mx
1st - lifestyle modification
2nd - methylphenidate
slipped capital femoral epiphysis Mx
cannulated screw for in situ fixation
acute epiglottitis cause
haemophilus influenza type B
Kawasaki disease Mx
aspirin
echo - ?coronary artery aneurysm
labial adhesions Mx
usually self resolves by puberty
if recurrent UTI - give oestrogen cream
meningitis B vaccine dates
2, 4, 12 months
cow’s milk protein allergy/ intolerance Mx
1st - extensive hydrolysed formula
2nd - amino acid based formula
hand, foot and mouth disease
viral infection (coxsackie A16)
<10 years old
fever, sore throat, mouth ulcers, rash palms/ soles feet/ legs
self resolves
benign rolandic epilepsy Fx
partial seizures at night (eg facial paraesthesia, facial twitching)
self resolve by adolesence
present between 4- 12 yrs
Age < 3months + temp > 38 C Mx
refer to paeds emergency
reflux nephropathy (vesicoureteic reflux) Ix
1st micturating cystography
Dimercaptosuccinic acid (DMSA) scan - useful for renal scarring
congenital heart disease
cyanotic vs acyanotic
cyanotic - TGA most common at birth, TOF most common overall
acyanotic - VSD most common
sit without support milestone
7-8 months (refer if unable at 12)
precocious puberty definition
secondary sexual features before 8 in girls and 9 in boys
precocious puberty classifications in females
Gonadotrophin dependent (central/ true) - premature activation of hypothalamus. FSH/ LH raised
Gonadotrophin independent (psudo/ fake) - excess sex hormones. FSH/ LH low
precocious puberty in males
testes evaluation
bilateral enlargement - intracranial lesion (gonadotrophin release)
unilateral enlargement - gonadal (testicular) tumour
small testes - adrenal (tumour/ hyperplasia)
Turners syndrome Fx (5)
short stature
short fourth metacarpal
primary amenorrhea
poorly developed secondary sexual characteristics
bicuspid aortic valve (crescendo-decrescendo murmur)
Rubella Fx
rash - pink maculopapular, face spread to body
sensorineural hearing loss
cataracts
congenital heart - patent ductus arteriosus, pulmonary artery stenosis
Scarlett fever Fx
(group A haemolytic strep)
fever, tonsilitis
strawberry tongue
rash - fine punctate, sparing the mouth
Erythema infectisoum (slapped cheek/ fifth disease) Fx
parvovirus B19
“slapped cheek” rash spread to arms
lethargy, fever, headache
Acute asthma Mx in community
Bronchodilator (B agonist)
Oral Steroid 3-5 days
constipation in children Mx
1st - macrogol (movicol)
2nd - senna
3rd - docusate/ lactulose
newborn baby head swelling
caput succedaneum - crosses suture line
cephalohaematoma - parietal region, does not cross
measles complication (1)
pneumonia
neonatal respiratoru distress syndrome Mx
maternal dexamethasone
lack of red light reflex cause + Investigation
retinoblastoma
urgent ophthalmology
Downs syndrome risk
1/1000 at 30 years
divide by 3 for every 5 years
Downs syndrome cardiac complication
atrioventricular septal defect (most common)
pertussis vaccine dates (whooping cough)
16-32 weeks of pregnancy
threadworm Fx
asymptomatic in 90% cases
perianal itching (particularly at night)
vulval irritation
threadworm Mx
Mebendazole stat
hygeine measures for all household
umbilical hernia Mx
self resolve by 3 yrs old
complications of chickenpox (4)
disseminated haemorrhagic chickenpox
secondary bacterial infection
encephalitis
pneumonia (mililary)
patent ductus arteriosis Mx
indomethacin or ibuprofen
prostaglandin is useful to keep the duct open, until surgical repair of another congenital heart defect
bow legs (genu varum) <3 yrs Mx
self resolve by 4 yrs old
age able to crawl
9 months
live vaccines
MMR
BCG
oral polio
yellow fever
oral typhoid
Hirschsprung disease
< 2 yrs old
delayed passage of meconium
constipation and vomiting
Nappy rash Mx
Commonly Candida colonisation
Topical imidazole (anti fungal)
Topical hydrocortisone (if discomfort)
Impetigo Mx
Hydrogen peroxide 1% cream
- fusidic acid/ mupiron cream if required
Epiglottitis neck xray finding
thumbprint
duodenal atresia Fx
vomiting within hours of life (day 1)
intestinal obstruction
double bubble sign on US
impetigo Mx
1st - hydrogen peroxide 1% cream
2nd - fusidic acid 2%
