paeds Flashcards
difference in diagnosis of asthma in adults and children
adults: bronchoreversibilty and FeNO. children: bronchoreversibility and spirometry
What are the four steps in management of asthma
1) SABA, 2) ICS 3) ICS with LTRA under 5 years and LAMA over 5 years 4) theophyilline
If a child has symptoms three times a week or night waking what is the next step
prescribe ICS
When do you add LTRA
when using 200-400mg of ICS
What is the inheritance pattern of cystic fibrosis
autosomal recessive
What is the treatment for menconium ileus in neonates
gastrogaffin enema
recurrent chest infections, salty sweat, malabsorption and failure to thrive
cystic fibrosis
What do give in CF to thin mucus
dornase alfa
Diagnosis of cystic fibrosis in children
sweat test and raised trypsinogen levels
treatment of CF in absorption
creon
diet advice for CF
high calorie, high fat with pancreatic enzyme replacement with every meal
most common cause of tonsilitis
strep pneumoniae
Contents of the CENTOR criteria
1) tender anterior cervical lymphadenopathy
2) no cough
3) fever over 38 C
4) bacterial pus exudate
Treatment if Centor criteria is 3-4
penicillin V for 5 days or amoxcillin/erythromycin
when would you do a tonsilectomy
four infections a year within three years
Which is defined a drop in weight in the 9th decile
drop in one centile or more
Which is defined a drop in weight in the 9th- 91st decile
drop in 2 centiles or more
Which is defined a drop in weight above the 91st decile
drops in three centiles or more
flat nasal bridge, epicanthal folds, single palm creases, small ears, hearing loss, recurrent ear infections
downs syndrome
What is the chromosome at fault in downs
trisomy 21
prader-wili chromosome
18
short stature, low IQ, obese, excessive overeating, clenched fists and overlapping fingers
prader wili syndrome
cat cry, intellectual disability, wide spaced eyes, hypotonia and single palmar creases
cri-du-chat
what happens in cri-du-chat syndrome
deletion of P chromosome from chromosome 5
cardiac defects, extra fingers, hypotonia small eyes
patau syndrome
which chromosome is at fault in patau syndrome
13
most common mechanism that leads to down’s syndrome
genetic non-disjunction
increased risk of which cardiac abnormality in downs syndrome
atrial septal defect and increased risk of snoring
association between AFP and downs syndrome
increased AFP with lower risk
when are pregnant women screened for downs, patau and prader wili
10-14 weeks
demarcated itchy red plaques sparing the nappy region on flexors
atophic dermatitis
diagnosis for atophic dermatitis
itchy red plaques with atleast 3/5: history of itchy skin, history of flexural eczema, history of atopic tendency, visible flexural eczema and osnet below 2 years and on cheek before 18 months
features of conjunctivitis
red itchy eye, photophobia, excessive lacrimation and serous discharge not vision impairment
three types of conjunctivitis
allergic, viral and bacterial
which type of conjunctivitis is contagious
viral
Which type of conjunctivitis has eyelids feeling stuck together in the morning
bacterial
management of allergic conjunctivitis
conservative, artificial tears and antihistamines
management of viral conjunctivitis
conservative, artificial tears and avoid sharing towels for 2 weeks
management of bacterial conjunctivitis
conservative, artifical tears and chloramphenicol if severe
influenza vaccine in children with severe asthma
do not give nasal spray give IM as on oral steroids
auer rods on blood film
AML
blast cells on blood film
ALL
smudge cells on blood film
CLL.
interrupted aortic arch and cleft palate
digeorege syndrome
absence of a cardiac murmur, pes cavus foot deformity, motor weakness and scoliosis
frederick’s ataxia
inheritance of fredericks ataxia
autosomal recessive
10% of patients with hypospadias also have
cryptorchidism
