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Paeds Flashcards

1
Q

Inguinal hernia in infants management?

A

Urgent surgery

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2
Q

management of transposition of the great arteries?

A
  • maintenance of the ductus arteriosus with prostaglandins (e.g. alprostadil)
  • surgical correction is the definite treatment.
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3
Q

organism most commonly responsible for hand, foot and mouth disease?

A

coxsackie A16
enterovirus 71

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4
Q

Gold standard investigation for pyloric stenosis?

A

abdominal USS

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5
Q

management of pyloric stenosis?

A

pyloromyotomy (cut to pyloric sphincter to widen outlet)

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6
Q

investigation for intussusception?

A

USS - may show target like mass

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7
Q

management of intussusception?

A
  • reduction by air insufflation under radiology
  • if fails then surgery
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8
Q

What is Henoch-Schonlein Purpura?

A

Most common small vessel vasculitis in children. It most commonly affects children aged 3-5 years old.

presents after a viral illness with rash on buttocks and lower limbs associated with arthralgia and nephritis (haematuria + protein)

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9
Q

Management of Henoch-Schonlein Purpura?

A
  • NSAIDs for analgesia and their anti-inflammatory effect
  • Antihypertensives may be needed to control blood pressure
  • children should have regular urine dips for 12 months to check for renal impairment.
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10
Q

Female puberty - first sign?

A

breast development

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11
Q

What is complete androgen insensitivity syndrome?

A

X-linked recessive condition due to end-organ resistance to testosterone causing genotypically male children (46XY) to have a female phenotype

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12
Q

Joint pain + pink salmon rash + child = ?

A

idiopathic juvenile arthritis

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13
Q

umbilical hernia in child management?

A

conservative

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14
Q

Organism which causes scarlet fever?

A

Group A haemolytic streptococci (usually Streptococcus pyogenes)

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15
Q

How does scarlet fever usually present?

A
  • fever: typically lasts 24 to 48 hours
  • malaise, headache, nausea/vomiting
  • sore throat
  • ‘strawberry’ tongue
  • rash (pinhead, appears first on torso, palm/sole sparing, sandpaper texture)
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16
Q

Investigations for scarlet fever?

A

throat swab but start antibiotics immediately on suspicion

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17
Q

Management of scarlet fever?

A
  • oral penicillin V for 10 days ( penicillin allergy should be given azithromycin)
  • children can return to school 24 hours after commencing antibiotics
  • scarlet fever is a notifiable disease
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18
Q

Complications of scarlet fever?

A
  • otitis media (most common)
  • rheumatic fever: typically occurs 20 days after infection
  • acute glomerulonephritis: typically occurs 10 days after infection
  • invasive complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) are rare but may present acutely with life-threatening illness
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19
Q

Growth failure, tachycardia and tachypnoea in the context of weak femoral pulses = ?

A

coarctation of the aorta

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20
Q

what is coarctation of the aorta?

A

a congenital narrowing of the descending aorta

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21
Q

What is coarctation of the aorta associated with?

A

Turner’s syndrome
bicuspid aortic valve
berry aneurysms
neurofibromatosis

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22
Q

Management of coarctation of the aorta?

A

Prostaglandin E is used keep the ductus arteriosus open while waiting for surgery.

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23
Q

scoring system used to assess health of newborn baby + when is it used?

A

APGAR
At 1 and 5 minutes of age. If the score is low then it is again repeated at 10 minutes.

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24
Q

Diagnostic investigations for Pertussis?

A

per nasal swab culture for Bordetella pertussis
PCR and serology

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25
Management of whooping cough in infants?
admit to hospital
26
management of whooping cough (not in infants)?
oral macrolide (e.g. clarithromycin, azithromycin or erythromycin) - within first 21 days household contacts should be offered antibiotic prophylaxis notifiable disease school exclusion: 48 hours after commencing antibiotics (or 21 days from onset of symptoms if no antibiotics )
27
Delayed puberty + lack of smell in male = ?
Kallman syndrome
28
Kallman syndrome LH/FSH/testosterone pattern?
all low
29
Management of Kallman syndrome?
testosterone supplementation gonadotrophin supplementation may result in sperm production if fertility is desired later in life
30
Management of meningitis in <3m old baby?
IV amoxicillin (or ampicillin) + IV cefotaxime
31
Management of meningitis in >3m old child?
IV cefotaxime (or ceftriaxone)
32
Shaken baby syndrome triad?
Retinal haemorrhages + subdural haematoma + encephalopathy
33
CXR findings in transient tachypnoea of the newborn?
hyperinflation of the lungs and fluid in the horizontal fissure.
34
Management of transient tachypnoea of the newborn?
- observation, supportive care - supplementary oxygen may be required to maintain oxygen saturations -usually settles within 1-2 days
35
What is cerebral palsy?
A disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain.
36
Causes of cerebral palsy?
- Antenatal (80%): e.g. cerebral malformation and congenital infection (rubella, toxoplasmosis, CMV) - Intrapartum (10%): birth asphyxia/trauma - Postnatal (10%): intraventricular haemorrhage, meningitis, head-trauma
37
Clinical presentation of cerebral palsy?
- abnormal tone early infancy - delayed motor milestones - abnormal gait - feeding difficulties.
38
How can cerebral palsy be classified?
spastic (70%) dyskinetic ataxic mixed
39
Asthma guidelines in children 5-16years?
1. SABA 2. SABA + ICS 3. SABA + ICS + LTRA 4. SABA + ICS + LABA
40
Asthma guidelines in children <5years?
1. SABA 2. SABA + ICS (8 week trail) 3. SABA + ICS + LTRA 4. Asthma specialist
41
At what age are children usually affected with croup?
6 months - 6 years most commonly under 3 years
42
What causes croup?
parainfluenza - most common other viruses e.g. adenovirus, influenza, RSV can be bacterial - much more severe
43
Barking, seal like cough + stridor + fever in a child under 6years old = ?
Croup
44
Management of croup?
Dexamethasone - single dose if severe then hospital, oxygen, neb budesonide
45
Investigations for Hirschsprung's disease?
abdominal x-ray rectal biopsy - gold standard for diagnosis
46
management of Hirschsprung's disease?
initially - rectal washouts/bowel irrigation definitive management - surgery to affected segment of the colon
47
What is Hirschsprung's disease?
Where nerve cells of the myenteric plexus are absent in the distal bowel and rectum. No parasympathetic ganglion cells at the end of the colon = no peristalsis = constipation.
48
what is patent ductus arteriosus?
Congenital heart defect ('acyanotic') - connection between pulmonary trunk and descending aorta.
49
Causes of Patent ductus arteriosus?
- prematurity - maternal rubella infection in 1st trimester - born at high altitude
50
Features of PDA?
- left subclavicular thrill - continuous 'machinery' murmur - large volume, bounding, collapsing pulse - wide pulse pressure - heaving apex beat
51
Management of PDA?
indomethacin or ibuprofen
52
Infantile spasms first line management?
Vigabatrin
53
Childhood syndrome - microcephalic small eyes, cleft lip, polydactyly and scalp lesions - what is it?
Patau syndrome (trisomy 13)
54
Childhood syndrome - micrognathia, low set ears, rocker bottom feet and overlapping of fingers - what is it?
Edwards syndrome (trisomy 18)
55
Childhood syndrome - large testes, learning difficulties, long face, large ears and macrocephaly - what is it?
Fragile X syndrome
56
Childhood syndrome - webbed neck, pectus exacavatum, short and pulmonary stenosis - what is it?
Noonan syndrome
57
Investigation for NEC?
abdominal XRAY USS - if inconclusive
58
DDH screening in breach babies?
USS at 6 weeks
59
Red flag for RR in children?
>60
60
Which heart murmur is associated with turner's syndrome?
ejection systolic heard loudest over aortic valve - this is due to bicuspid aortic valve.

Finals (18 decks)

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