Paeds Flashcards
What is the order of Laxatives you should give in kids? (3 things)
- Movicol
- Stimulant (Senna)
- Osmotic (lactulose)
When should males have corrective surgery for Hypospadius?
@ 12 months
What are INNOCENT murmurs that may be heard in kids? (3 things)
- Ejection murmurs
- Venous hums
- StiLL’s murmur (Low pitched @ LL sternal edge)
What condition is it when a child has partial seizures at night?
Benign Rolandic Epilepsy
What is the Medical Tx for ADHD?
Methylphenidate (stimulant)
What should you monitor when you give Methylphenidate for ADHD?
Weight + Height every 6 months
(bc can cause LOA + Growth impairment)
What is the Dx when a child has perianal itching?
Threadworms (Enterobius vermicularis)
What do you need to be aware of with Threadworms (Enterobius vermicularis)?
Can possibly be affecting whole household so prescribe meds for everyone
What is the Meds Tx for Threadworms (Enterobius vermicularis)?
Mebendazole (single dose)
What are the causes of Snoring in children? (5 things)
- Downs
- Nasal problems (e.g nasal turbinates)
- Recurrent tonsillitis
- Hypothyroidism
- Obesity
What abx should you give for Meningitis UNDER 3 months? (2 things)
- IV amoxicillin
- IV cefotaxime
What abx should you give for Meningitis OVER 3 months?
IV cefotaxime
What developmental problem can Breech presentation lead to?
Hip dysplasia
What are the RF for developmental hip dysplasia? (2 things)
- Breech
- Female (6x)
How should you investigate developmental hip dysplasia?
US hip
What is the Mx for developmental hip dysplasia? (3 things)
- Most will self fix by 3-6 wks
- 4-5 months old: Pavlik harness (dynamic flexion-abduction orthosis)
- Older kids: Surgery
What are the CF of GORD in babies?
Vomiting after being laid flat after being breastfed
What is the Mx of GORD in babies?
Keep baby upright after breastfeeding
What is the Dx when you can hear bowel sounds in a Resp exam of a neonate (in resp distress)?
Diaphragmatic hernia
Why do some kids get Rickets, esp refugee kids?
Bc inexposure to sun light vit D
What are the CF of Rickets? (4 things)
- Forehead bossing
- Kyphoscoliosis of spine
- Widening of joints
- Bowing of legs
What should you sus if a girl has short stature and Primary amenorrhea (aka no menarche)?
Turners syndrome
What are the stages of diagnosing CF at birth? (2 steps)
- Routine heel prick test @ day 5: raised IRT
- Sent for sweat test: raised = CF
How long should you refer before referring a undescended testicle?
3 months
What system is the most common cause of cardiac arrests in kids?
Resp (e.g bronchiolitis)
What is the Dx of a kid who has a persistent cough (worse @ night), which is assoc w vomiting?
Whooping cough
What are the Mx options for Whooping cough? (3 things)
- Azithromycin (or others Macs) (if cough onset within last 21 days)
- Abx prophylaxis for household
- Stay off from school for 2 days after starting Abx
What is Roseola infantum aka?
Sixth disease
What are the CF of Roseola? (2 things)
- High grade fever (for few days) which resolves then..
- Maculopapular rash (trunk –> limbs)
Do kids with Roseola infantum need to stay off school?
No
What are the only 3 CYANOTIC congenital HD? (3 things)
- TOF
- Transposition of the Great Arteries (TGA)
- Tricuspid atresia
What is the initial Mx of Transposition of the Great Arteries (TGA)?
Prostaglandins
(keeps PDA open so allows L-R shunting)
Apart from salbutamol, what should all kids having an asthma attack be given?
Steroids (oral prednisolone)
If a child has hip pain, what should you exclude with an XR?
Slipped Upper Femoral Epiphysis (SUFE) (medical emergency)
Why is a Slipped Upper Femoral Epiphysis (SUFE) a medical emergency?
Risk of AVN
What is the Mx of Slipped Upper Femoral Epiphysis (SUFE) (medical emergency)?
Internal fixation
What are the CF of Chickenpox? (3 things)
Fever (initially)
Itchy rash (head / trunk –> limbs) (Macular –> Papular –> Vesicular)
Systemic upset (usually mild)
What are the CF of Measles? (3 things)
- Before inf: Fever / Conjunctivitis / Irritable
- Koplik spots (white salty spots in mouth)
- Rash (behind ears –> body) (Maculopapular –> blotchy)
What are the CF of Measles? (3 things)
- Before inf: Fever / Conjunctivitis / Irritable
- Koplik spots (white salty spots in mouth)
- Rash (behind ears –> body) (Maculopapular –> blotchy)
What are the CF of Measles? (3 things)
- Before inf: Fever / Conjunctivitis / Irritable
- Koplik spots (white salty spots in mouth)
- Rash (behind ears –> body) (Maculopapular –> blotchy)
What are the CF of Mumps? (3 things)
- Fever
- Muscle pain
- Parotitis (earache / pain @ eating) (unilateral –> bilateral)
What are the CF of Rubella? (2 things)
- Rash (face –> body) (pink maculopapular) (fades by 3-5 days)
- Lymphadenopathy (behind ears n suboccipital)
What are the Erythema Infectiosum (aka 5th disease) of Rubella? (4 things)
- Headache
- Fever
- Lethargy
- Slapped cheek rash (cheek –> arms)
What organism is Erythema Infectiosum (aka 5th disease) caused by?
Parvovirus B19
What are the CF of Kawasaki disease? (3 things)
- High grade fever (5+ days)
- Red palms
- Strawberry tongue (red with white coating)
What type of disease is Kawasaki disease?
Systemic vasculitis
What is the Tx for Kawasaki disease?
High dose aspirin
What are the CF of Scarlet Fever? (5 things)
- Headache
- Fever
- Sore throat (tonsillitis)
- Strawberry red tongue
- Rash (coarse like sandpaper + red around mouth)
What is the Tx for Scarlet Fever?
Oral penicillin V for 10 days
What are the CF of Hand, Foot, and Mouth Disease in kids? (2 things)
- Sore throat / fever (systemic CF)
- Vesicles in mouth (ulcers), palms n feet
What organism is Hand, Foot, and Mouth Disease caused by?
Coxsackie A16 virus
Does the kid need to stay off school with Hand, Foot, and Mouth Disease?
No
What is used to screen newborns for Hearing problems?
Otoacoustic emission test
What follow up test is done if Otoacoustic emission test results come back as abnormal?
Auditory brainstem response test
What should you sus in a boy over 4 presenting with a limp?
Perthes’ disease
How should you investigate Perthe’s disease? (2 things)
- XR (but can miss dx so move onto MRI)
- MRI
What are the CF of PDA? (5 things)
- Continous machinery murmur
- Collapsing pulse
- Wide pulse pressure
- Apex beat
- L subclavian thrill
What is the Tx for PDA?
Indomethacin (in postnatal period)
(give kids indomie)
What are the CF of Idiopathic thrombocytopenic purpura (IPR)? (3 things)
- Bruising
- Petechial rash
- Bleeding (epistaxis / gingival)
What will Idiopathic thrombocytopenic purpura (IPR) be preceded by?
Glandular fever
What is the day cut off point for Neonatal death?
Baby dies in 0-28 days
What does weak femoral pulses at 6-8 week check of baby suggest?
Coarctation of aorta (refer to paeds on same day)
What is the Dx if a neonate hasn’t passed stool for 24+ hours after birth?
Hirschprungs disease
How do you Dx Hirschprungs disease?
Rectal biopsy (GOLD)
What is the initial Mx for Hirschprungs disease?
Bowel irrigation
What is the rate of compression to breaths in children CPR?
15:2
What are the CF of Fetal Alcohol syndrome? (5 things)
- IUGR
- Microcephaly
- Thin upper lip
- Irritability
- ADHD
What is the most common cause of Nappy rash?
Irritant dermatitis
How should babies born prematurely be given their vaccines?
According to their chronological age, aka DO NOT correct for prematurity
What is Intussusception?
Invagination of part of bowel into lumen of adjacent bowel
What age does Intussusception most commonly affect?
6-18 months
What gender does Intussusception most commonly affect?
Boys (2x)
What are the CF of Intussusception? (6 things)
- Crying beh
- D+V
- Sever crampy abd pain
- Sausage mass in RUQ
- Draw knees up to chest
- Bloody stool
What is the investigation for Intussusception and what will you see?
US (will see Target like mass)
What is the Mx option for Intussusception?
Reduction by air insufflation (air khartoosh colonscopy thing)
What usually comes before Mesenteric adenitis?
Viral infection
Does Mesenteric adenitis need any Tx?
No
What is a very common benign cause of noisy breathing in infants?
Laryngomalacia
(self resolves by 2 yrs)
What size head do Fragile X syndrome babies have?
Massive head
What is the very first step of newborn baby resus? (3 things)
- Dry baby
- Maintain temperature
- Start clock
What score is use to assess health of a newborn baby?
Apgar score
What are the CF of Meconium aspiration syndrome? (5 things)
- Cyanosis
- Tachypnoea
- Chest wall retraction
- Patchy infiltrations (on CXR)
- Atelectasis (on CXR)
What should you do if neonate (aka 1 hour old) baby has BG of 2.2?
Nothing, bc transient hypoglycaemia in first few hours of birth is normal
What age should babies be able to palmar grasp?
5 months
(5 fingers on a hand)
What age should kids be able to draw a circle?
3 years
What age should a kid be able to build a tower of 3-4 blocks?
18 months
When do umbilical hernias usually resolve by?
3 years
What is a POOR prognosis factor for Acute Lymphoblastic Leukaemia (ALL)?
Being male :(
What can you give a child to stop them from wetting the bed in the short term (aka for a sleepover)?
Desmopressin
What underlying condition can hand preference before 12 months indicate?
Cerebral palsy
What is the causative organism of Epiglottitis?
H influenza (type B)
What is the Dx?
Congenital diaphragmatic hernia (bowel loops seen in thoracic cavity)
What is a common complication of Chickenpox?
Secondary bac infection
What can increase risk of developing Secondary bac inf in Chickenpox?
NSAIDs
What are less common complications of Chickenpox? (3 things)
- Pneumonia
- Encephalitis
- Disseminated haemorrhagic chickenpox
What is the number 1 cause of painless massive GI bleeding needing transfusion in 1-2 year olds?
Meckel’s diverticulum
What are the CF of Meckels diverticulum? (3 things)
- Asymptomatic (usually)
- RIF pain / tenderness (mimics appendicitis)
- Bloody poo
How do you reduce the chance of severe brain damage in neonate w Hypoxic injury?
Therapeutic cooling @ 33-35 degrees
What is the Dx of a swelling on a newborns head that crosses sutures?
Caput Succedaneum
(CS = Crosses Sutures)
What is the Dx of a swelling on a newborns head that is caused by Suction?
Caput Succedaneum
(SUCC)
How long does Caput Succedaneum take to resolve?
Few days
What is the Dx of a swelling on a newborns head that develops few hours after birth?
Cephalohaematoma
(does NOT cross sutures)
How long does Cephalohaematoma take to resolve?
Few months
What Resp rate is a RED flag according to NICE paeds traffic light scoring?
RR over 60
Why should you not give NSAIDs to kids with chickenpox?
Risk of Necrotising fasciitis
What is first line for Nocturnal Enuresis (aka bed wetting)?
Enuresis alarm
What are the Abx TX for Meningitis in kids?
- Under 3 months: IV amoxicillin + IV cefotaxime
- Over 3 months: IV cefotaxime (or ceftriaxone)
What helps you remember Dev Milestones for walking?
Head, shoulders, knees and toes, 3 6 9 12
* 3 months = Control head
* 6 months = Sitting up
* 9 months = Crawling
* 12 months = Walking
What will happen to most kids diagnosed with non-IgE mediated cows milk allergy?
They will become tolerant by 3 yrs (aka they can drink it)
What Prostaglandin can you give to keep PDA open in Cyanotic congenital heart disease?
Alprostadil
What kid should you never examine their throat and why?
Croup kids, bc risk of airway obstruction
What is the Dx when a kid has Intestinal rotation?
Paediatric intestinal malrotation w volvulus
What is the Tx for Paediatric intestinal malrotation w volvulus?
Ladds procedure
What epilepsy is characterised by partial seizures at night (or when they just wake up)?
Benign Rolandic epilepsy
(Ronaldo having partial seizures as a kid at night bc hes too good to sleep)
What is the Mx of Pyloric stenosis in a newborn?
Ramstedt pyloromyotomy
(cut it basically)
What are the Stepwise approach for Asthma Mx in UNDER 5’s? (4 steps)
- Step 1: SABA
- Step 2: MODERATE dose ICS (8 wk trial)
- Step 3: SABA + Low dose ICS + LTRA
- Step 4: Stop LTRA n refer
What are the Stepwise approach for Asthma Mx in OVER 5’s?
Same as adults pretty much
