paeds Flashcards
what are the features of benign rolandic epilepsy?
- form of childhood epilepsy characterised by partial seizures (usually) during sleep.
- hemifacial paraesthesias, oropharyngeal manifestations (e.g. strange noises) and hypersalivation.
- occasionally progress to generalised tonic-clonic seizures.
-usually fhx of the condition and are usually seizure-free during the day.
At what age would the average child start to play alongside, but not interacting with, other children?
2 years
how would a baby with congenital rubella syndrome present?
- sensorineural deafness
- congenital cataracts
how does congenital CMV present?
- hearing loss
- low birthweight
- petechial rash
- microcephaly
- seizures
how is duchenne muscular dystrophy diagnosed?
genetic analysis
how should a child with an unexplained enlarged abdo mass be referred?
urgent paeds review within 48h
what is the probability that a man with haemophilia A’s daughter’s son will have the disease?
XhY -> XhX -> either XhY or XY
so 50%
how do infantile spasms present?
- repeated flexion of head/arms/trunk
- followed by extension of arms
when do children usually grow out of feb cons?
5 years
(occur 6mo-5y)
what are the features of an innocent murmur?
8 S
- soft
- short
- systolic
- sounds s1 and s2 normal
- symptomless
- special tests normal (XR, ECG)
- standing/sitting (varies with posture)
- sternal depression
what are the causes of jaundice in the first 24 hours?
- rhesus haemolytic disease
- ABO haemolytic disease
- hereditary spherocytosis
- G6PD
After confirming cardiac arrest and following paediatric BLS protocol, what is the rate you should perform chest compressions at?
100-120 compressions/min
how does transposition of the great arteries present?
- no murmur
- loud single S2
- prominent right ventricular impulse palpable
what is fragile X?
trinucleotide repeat disorder of the x chromosome
how does fragile x present in males?
learning difficulties
large low set ears, long thin face, high arched palate
macroorchidism
hypotonia
autism is more common
mitral valve prolapse
how does fragile x present in females?
normal to mild symptoms of males
autism
how is slipped capital femoral epiphysis managed?
orthopaedics - in situ fixation with cannulated screw
how to remember gross motor milestones in first year of life?
3 6 9 12 head shoulders knees and toes
3 - head control
6 - sitting
9 - crawling
12 - walking
what is the most common cause of pulmonary hypoplasia?
CDH
what are the 4Hs of cardiac arrest?
- hypoxia
- hypothermia
- hypovolaemia
- hypo/hyper - kalaemia, glycaemia, calcaemia, H+
what are the 4 Ts of cardiac arrest?
- tension pneumothorax
- tamponade
- thromboembolism
- toxicity (digoxin, local anaesthetics, insecticides)
what is ebstein’s anomaly?
atrialisation of the right ventricle
- echo: low insertion of tricuspid valve, large RA, small RV, tricuspid incompetence
what type of antibiotics are given in pertussis/whooping cough?
macrolides - azithromycin or clarithromycin (if within 21 days)
how does ITP present?
- bruising
- petechial or purpuric rash
- bleeding less common and typically presents as epistaxis or gingival bleeding
- may follow infection or vaccination
how does meckel’s diverticulum present?
painless massive GI bleeding requiring transfusion in child 1-2 years
how is neonatal hypoglycaemia managed?
> 1mmol and asymptomatic - encourage early breastfeeding and monitor
<1mmol or >1mmol and symptomatic - IV 10% dextrose
dietary advice for patient with CF?
- high calorie
- high fat
- pancreatic enzyme supplementation for every meal
which virus causes slapped cheek syndrome? (erythema infectiosum)
parvovirus b19
what are the features of cephalohaematoma?
- several hours after birth
- doesn’t cross suture lines
- can take months to resolve
cephalOH my gosh this wasn’t here a few hours ago
what are the features of caput succedaneum?
present at birth
typically forms over vertex and crosses suture lines
resolves within days
caPUT a hat on this baby to hide the swelling it was born with
what is wests syndrome?
(infantile spasms)
4-8mo
M>F
salaam attacks - flexion of head, trunk, arms then ext of arms
1-2 seconds, repeated
progressive mental handicap
what is shown on eeg in wests syndrome?
hypsarrhythmia (2/30)
CT - diffuse or localised brain disease in 70%
- eg tuberous sclerosis
what heart defect is associated with fragile X?
mitral valve prolapse
what type of laxative is movicol/macrogol?
osmotic
what type of laxative is senna?
stimulant
what type of laxative is lactulose?
osmotic
what type of laxative is fybogel?
bulk forming
what is the most common complication of measles?
otitis media
what is the mode of inheritance for prader willi syndrome?
imprinting
what are the features of prader willi syndrome?
- hypotonia during infancy
- dysmorphic features
- short stature
- hypogonadism and infertility
- learning difficulties
- childhood obesity
- behavioural problems in adolescence
what is weak femoral pulses a sign of in an infant?
coarctation of the aorta
-> SAME DAY discussion with paeds
what is a risk factor for the development of surfactant deficient lung disease in the newborn?
maternal diabetes mellitus
what are the features of atypical UTI in children?
- seriously ill
- poor urine flow
- abdo or bladder mass
- raised creatinine
- septicaemia
- failure to respond to treatment within 48h
- infection with non-e.coli organisms
what resp rate is a red flag according to NICE paeds traffic light system?
> 60 in any age
what is in the 6 in 1 vaccine?
Parents Will Immunise Toddlers Because Death
Polio
Whooping cough (pertussis)
Influenzae (haemophilus type b)
Tetanus
B (hepatitis)
Diphtheria
what are trident hands a feature of?
achondroplasia
what are poor prognostic factors in ALL?
- age <2y or >10y
- WBC >20 at dx
- T or B cell surface markers
- non-caucasian
- male sex
how is a moderate asthma attack managed?
oral pred
salbutamol via spacer - 1 puff every 30-60 seconds to max 10 puffs
how is scarlet fever managed?
oral pen V 10 days and return to school after 24h of starting abx
what does VSD increase the risk of?
endocarditis, aneurysm of the ventricular septum, pulmonary htn
asthma mgt in child under 5?
- saba
- moderate dose ICS
- LTRA
- stop LTRA and refer to specialist
asthma mgt in child 5-16?
- SABA
- low dose ICS
- LTRA
- stop LTRA, + LABA
- SABA + MART (inc low dose ICS)
- SABA + moderate dose ICS MART
- SABA + one of inc ICS, add theophylline, seek expert advice
how does biliary atresia present?
first few weeks of life
- jaundice over 2wks
- dark urine and pale stools
- appetite and growth disturbance
- hepatosplenomegaly
- associated cardiac murmurs
what are the risk factors for ddh?
fat
female
first born
foot first
family hx
fair (caucasian)
fluid (oligohydramnios)
what heart defect is associated with turners syndrome and what murmur does it cause?
bicuspid aortic valve
> ejection systolic murmur
how to remember patau syndrome
trisomy 13 - 13 fingers
how to remember patau syndrome
trisomy 13 - 13 fingers
paTau - Thirteen
how to remember edwards syndrome
trisomy 18 - age at rock bottom Eighteen - Edwards
what is the most common cause of childhood hypothyroidism in the uk?
autoimmune thyroiditis
what is the most likely dx in a 14 month old with a loss of red reflex?
retinoblastoma
(10% hereditary)
what are the causes of snoring in children?
- obesity
- nasal problems (polyps, dev sept, hypertrophic nasal turbinates)
- recurrent tonsillitis
- downs
- hypothyroidism
when is newborn blood spot screening test performed?
5th-9th day of life
how do growing pains present?
never present at waking
no limp
no limitation of physical activity
systemically well
normal examination
motor milestones normal
sx often intermittent and worse after activity
leg pain
how far apart do you give mmr vaccines in a prev unvaxxed child?
3mo
what is the management for bacterial meningitis in a 2 month old?
iv amoxicillin and cefotaxime
what is a venous hum?
benign murmur in children
continuous blowing noise
below clavicles
what is a stills murmur?
benign
low pitched sound
lower left sternal edge
what is a pulmonary flow murmur?
benign
upper left sternal border
what is the best predictor of clinical severity in tetralogy of fallot?
degree of pulmonary stenosis
what is the typical distribution of atopic eczema in a 10-month-old child?
face and trunk
(and extensor surfaces)
nappy area usually spared
when can a child with chickenpox return to school?
when all lesions have crusted over
what is the recommended compression: ventilation ratio for the newborn?
3:1
what features are seen in hypernatraemic dehydration?
- jittery movts
- inc muscle tone
- hyperreflexia
- convulsions
- drowsiness or coma
when should a child be able to hop on one leg?
3-4y
what are the features of osteochondritis dissecans?
pain after exercise
intermittent swelling and locking
what proportion of roseola infantum cases do febrile convulsions occur in?
10-15%
which TWO heart defects are associated with turners syndrome?
coarctation of the aorta
bicuspid aortic valve
