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MSRA > Paeds > Flashcards

Paeds Flashcards

1
Q

Breastmilk jaundice can last until? Rx?

A

Up to 12 weeks
Phototherapy if above the treatment line

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2
Q

2 types of criggler-naijarr

A

Type 1 - severe and will lead to bilirubin encephalopathy + brain damage
2 - less severe

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3
Q

Colicky abdo pain, constipation, vomiting, headache, drowsiness + papilloedema

A

Lead poisoning
-> GI symptoms and raised ICP

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4
Q

Severe vomiting and GI bleed, then CV compromise and drowsiness

A

Iron toxicity

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5
Q

2 week old suddenly drowsy with tense fontanelle. Raised PT on bloods? Why has this happened and who does it usually happen to?

A

Intracerebral haemorrhage due to vit K deficiency
-Lack of vit K in breast milk. Doesn’t occur in bottle-fed as fortified

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6
Q

Life-threatening asthma exacerbation pneumonic

A

CHEST
Cyanosis
Hypotension
Exhaustion
Silent chest OR spO2 <92%
Threatening peak flow <33%

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7
Q

BTS asthma steps

A

SABA (if infrequently needed) + Low dose ICS
-Add LABA
-Add LTRA (or increase ICS)

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8
Q

Most common hearing loss in children. When does it occur? Usual Rx?

A

Otitis media with effusion (glue ear)
Usually following acute otitis media
Monitor - usually resolves in 6-12 weeks (may then need referral)

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9
Q

Difference between Otitis media with effusion and Chronic suppurative otitis media ? Extra risk of?

A

Inflammation present in CSOM
-Risk of cholesteatoma

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10
Q

Bed wetting in kids ix? when management? When pharma

A

Urine culture/dip
-Also check for psych issues Eg school performance

Not until at least 6
Can use alarms/star charts

Could use intranasal desmopressin if off to friend’s house for sleepover etc

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11
Q

Cyanosed newborn with oligaemic lung fields

A

Pulmonary atresia
-Need to maintain open PDA

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12
Q

Tetralogy falot what are the bits

A

Overriding aorta
VSD
R ventricular outflow tract obstruction
-> RVH (Boot shaped heart)

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13
Q

Perthes disease in who? What is it and how does it present?

A

Boys 3-10
AVN of the femoral epiphysis
Gradual onset limp / pain (may be Knee pain as referred)

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14
Q

Who gets SUFE and what is it? Rx?

A

Teenage obese boys
Fracture through growth plate -> leg length discrepancy / limp / groin pain
Surgical Rx to prevent permanent deformity

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15
Q

6-9m most common cause of GI obstruction

A

Intussusception (red jelly poo)

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16
Q

Hypertropic pyloric stenosis presents at what age with what

A

3 weeks
Vomiting + olive mass in abdo

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17
Q

GI obstruction and ‘double bubble’ on XR in neonate

A

duodenal atresia

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18
Q

Meconium obstruction 1st line rx

A

Radiocontrast enema

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19
Q

Unconjugated hyperbilirubin in first 24hrs

A

Haemolytic disease - usually ABO incompatibility

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20
Q

Well newborn has progressive conjugated hyperbilirubin with pale stools and dark urine

A

Biliary atresia

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21
Q

Jaundiced at birth with microcephaly and abdo distention with organomegaly ? When else microcephaly

A

CMV infection
Microcephaly also in rubella / toxoplasmosis

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22
Q

5m irritability, cyanosis and episodes of LOC
CXR - right-sided aortic arch + oligaemic lung fields

A

Tetralogy of fallot

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23
Q

When is tachy really tachy in <5

A

> 140

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24
Q

Colicky Abdo pain in ‘paroxysms’ with sausage-shaped mass in RUQ

A

intussusception
- Especially <1yr

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25
Q

Teenage girl monthly pain has worsened this month. No constipation. preg negative. Palpable mass in lower abdo

A

Haematocolpus (retained blood during menstruation.
-Usually due to abnormality eg imperforate hymen

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26
Q

Viral illness and now crampy Abdo pain and tenderness on palpation

A

Mesenteric adenitis
[often mistaken for appendicitis]

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27
Q

9m spasmic abdo pain, vomiting and bloody stools

A

Intussusception

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28
Q

<1 wheeze, cough, fever, tachypnea =

A

Bronchiolitis

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29
Q

6y painless limp XR - flattened and fragmented femoral head

A

Perthes = AVN
[XR may be initially normal]

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30
Q

Infantile colic rx

A

Can keep upright after feeds
-Gaviscon / others not first line and no evidence base

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31
Q

Normal age range - heart rates

A

<1: 100-160
1-2: 100-150
2-5: 95-140
5-12: 80-120
>12: 60-100

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32
Q

Poisoning - GI symptoms and raised ICP / haemolysis

A

Lead

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33
Q

poisoning - tachycardia, hallucinations, breathing difficulty

A

tricyclics

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34
Q

poisoning - drowsy vomiting and jaundice

A

paracetamol

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35
Q

posioning - tinnitus, acidocis and hypoglycaemia

A

salicilates

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36
Q

Vomiting and GI bleed -> drowsy and CV collapse

A

Iron

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37
Q

Who needs the US of hips as a newborn for DDH and by when? Rx?

A

Any breech presentation after 36 weeks
-can screen with Barlow / Ortolani
US within 6 weeks

Palvik harness

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38
Q

Pyloric stenosis acid base typical? Rx?

A

HypoK, HypoCl metabolic alkalosis

Ramsted’s pyloromyotomy

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39
Q

Rockerbottom feet? Which genetic?

A

Edwards
Triosmy 18

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40
Q

Key blood test duchennes? Diagnosis?

A

CK
MPLA
[genetic testing if above not conclusive]

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41
Q

Key new drug for duchennes ? What does it do? In who?

A

Ataluren - restores the synthesis of dystrophin

Children >5 who can still walk

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42
Q

When refer straight to paeds with a child with fever?

A

if under 3m and fever needs referral

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43
Q

Croup bug? Rx?

A

Parainfluenza
0.15mg/kg oral dex

-Second line budenoside nebuliser
+/- neb adrenaline

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44
Q

Child complains episode of tingling LIPS/mouth.
May get twitching of face / drooling / disturbed speech?

A

Benign rolandic epilepsy

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45
Q

Maternal age for chance of downs 1:100

A

40

20= 1:1500
30= 1:800
35 = 1:270

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46
Q

Double bubble on xr? linked to?

A

Duodenal atresia
Downs

47
Q

Baby / maternal risk factors for SIDS

A

Prone sleeping, winter, respiratory Sx

Young, high parity, smoking

48
Q

22q11 deletion called?

A

DiGeorge
[absent thymus, hypoCa/PTH]

49
Q

Severe exacerbation asthma
PO2?
RR?
PEFR?
HR?

A

PO2 <92%
RR >30
PEFR 33-50%
HR >125

50
Q

Sickle cell
Abdo pain, hyperSpleen, anaemic with raised reticulocyte and jaundice =
Assoc with?
Differentiate to aplastic crisis on bloods?

A

Splenic sequestration crisis
[infarcts in spleen]

Parovirus b19

Aplastic crisis = low reticulocytes

51
Q

Abdo pain and obstruction in sickle cell

A

Girdle mesenteric syndrome

52
Q

Turner-like syndrome

A

Noonan

53
Q

Most common cardiac defect in fragile X

A

MR

54
Q

Small tongue which is pushed back and micrognathia

A

Pierre-robin

55
Q

When oral rehydration solution in kid with normal obs and exam who has D&V?

A

Vomit >2x in 24hrs
Diarrhoea >5x in 24hrs
Age <1year

56
Q

What mediates cows milk protein allergy?

A

IgE
[Remeber this can occur in breast fed if mum drinking cows milk]

57
Q

Which vaccines MUST be given 4 weeks apart

A

Yellow fever +

MMR/Varicella

58
Q

Insidious onset of limping child with sore hip? What is it?

A

Perthes disease
Avascualr necrosis of femoral head

59
Q

Kid with sore jount with Fine rash with raised ESR and normocyctc normochromic anaemia ? Rx?

A

Juvenile idiopathic arthritis
[Rash often salmon pink]

Nsaids -> dmards

60
Q

3 year old painless limp with asymmetric hip creases

A

Developmental dysplasia of the hip

61
Q

Kid with swellings in neck and armpits that are not painful

A

NHL
(It’s more common than hodgkins)

62
Q

Flat light brown skin patches and visual issues?

A

Neurofibromatosis
- optic glioma causes visual issues

63
Q

Most common Haem malignancy in kids

A

ALL
[There’s Loads]

64
Q

Kid with stridor working hard 1st line rx

A

Nebulised adrenaline

65
Q

6m with wheeze and crackles, subcostal ressession and been snuffly for couple days =? 1st line rx

A

Bronchiolitis
O2

[No evidence for salbutamol]

66
Q

Kid with headache -> cough and now patchy intisicial unilateral pneumonia rx?

A

Clary

[Headache -> pneumonia is leigonella ]

67
Q

Kids absence epilepsy 1st line? 2nd?

A

Ethosuxamide

Valproate

68
Q

Cardiac abnormalities and immune issues + hypocalcaemia ?

A

Di George syndrome

Hypoparathyroidism -> hypoCa

69
Q

Sort stature, overly friendly with cardiac abnormalities and a little bit slow

A

William syndrome

70
Q

When is peak age for febrile convulsions? Usual cause? Risk of epilepsy?

A

18 months

Viral infections.

2% risk epilepsy

71
Q

Croup name? UsuL cause?

A

Laryngotracheobronchitis

Parainfouenza virus

72
Q

Usual cause of acute epiglotitis

A

Haemophylis Influenza

73
Q

<6m and has UTI what Ix is required

A

If responds to abx in <48 hrs -> US within 6 weeks

If doesnt respond
DSMA / MCUG

74
Q
A
75
Q

7-9years old migrane rx

A

Ibuprofen 200mg

76
Q

Known heartfailure and develops hearing loss due to which drug

A

Furosemide

77
Q

Pyelonephritis in kids orally rx?

A

Cefalexen 500mg BD 7 days

78
Q

Abx for sinusitis which causes oesophagitis

A

Droxycycline

79
Q

Tonsillitis given abx and now thrombocytopenia

A

Penicillin V

80
Q

Which type of infection in:

Neutrophil defects->

T cell defects->

B cell defects ->

Leukocyte defects ->

Complement defects ->

A

Neutrophil defects-> Abscesses + fungal

T cell defects-> viral and fungal

B cell defects -> Severe bacterial but not menigococcal

Leukocyte defects -> Delayed wound healing + ulcers

Complement defects -> recurrent meningococcal

81
Q

Kid walking and jerking in night unable to talk =? seen on eeg?

A

benign rolandic epilepsy
[usually resolves by teens]

EEG -> centrotemopral spikes

82
Q

10 keeps falling and cant run anymore with pes cavus

A

charot marie tooth

83
Q

Mum had multiple miscarriages and now baby has jaundice at 4 weeks with failure to thrive

A

Resus haemolytic disease

[Likely exposed to Rh in prev pregnancies]

84
Q

18 month with poor head growth and intracranial calcification on CT

A

Congenital CMV

85
Q

sensoryneural hearing loss and goitre =

A

Pentad syndrome - SN loss and Hypothyroidism

86
Q

1w old develops rash with pin point papules on erythematous base ?

A

erythema toxicum

87
Q
A
88
Q

What sign for DDH

A

Ortolanis sign - abducting a flexed hip and knee to check for dislocation

Barlow - backward pressure on hip to subluxation

Galeazzi sign - one leg shorter than other at 3 months

89
Q

Most common primary bone tumour

A

Osteosarcoma

90
Q

Baby with absent red reflex and white pupil

A

Retinoblastoma

91
Q

Eye deviating out is called? When present all the time called?
What if patient has a squint that deviates out on cover/uncover test?

A

eye deviating out is called ‘exo-‘
When present all the time called ‘-tropia’

Exophoria

92
Q

girl <3 hits puberty ?

A

Hamartoma (usually hypothalamus)

93
Q

Infant with central cyanosis who keeps squating

A

tetralogy of fallot

94
Q

kartanger syndrome features

A

dextrocardia
sinusitis and bronchiectasis due to impaired ciliary function

95
Q

2yo with slow-rising pulse and ejection systolic murmur rx?

A

Balloon angioplasty (for AS)
Surgical valve replacement if fails

96
Q

Infant hearing test use

A

otoacoustic emissions

97
Q

Reyes syndrome usual presentation in infants

A

Post viral illness
[especially following aspirin use]

Impaired liver function WITHOUT jaundice

Infants - Respiratory symptoms, hypoglycaemia and hepatomegaly

98
Q

Atypical uti eg pseudomonas plan in kids?

A

Antibiotics and US during acute illness

99
Q

When US in paeds UTI

A

<6 months - US in 6 weeks
>6 months and recurrent infections

Atypical UTI - US during admission

100
Q

Neonatal ALS basics

A

Assess HR every 30 seconds
-If no pulse

CPR 3:1 per breaths

101
Q

Most common pneumonia in kids

A

Strep pneumo

102
Q

Start of PALS

A

5 rescue breaths
15:2 CPR

103
Q

psoriasis rx in kids

A

<6 - topical steroids
>6 - vid d analogue eg calcipotriol

104
Q

kid with abnormal facial movements that start at finger tip and move to face + and a funny taste in the mouth but retais consciousness? rx?

A

Partial sezuire / peti mal / jacksonian

Lamotrigine / carbamazepine
[valproate second line]

105
Q

Kid seizing with no IV access

A

Buccal midazolam
[IV loraz if access]

106
Q

All babies born to HIV positive mothers should have HIV antibody test when? [Even if multiple negative HIV viral DNA tests perinatally]

A

18 months

107
Q

What is anterograde amnesia

A

Unable to create new memories following injury

108
Q

19 purulent urethral discharge and urethritis? rx?

A

Gonnorea
Azithro

109
Q

When immunosuppression in polycythaemia

A

Organomegally
Weight loss / night sweats
thrombocytosis

110
Q

Kid with unilateral proptosis progressing over weeks

A

rhabdomyosarcoma

111
Q

kid with diabetes + optic atrophy

A

wolfram syndrome

112
Q

Cows milk protein allergy - what type of milk can they have?

A

Breast
extensively hydrolyzed [milk proteins broken down]

113
Q
A

MSRA (8 decks)

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