Paeds Flashcards
indications for abx otitis media paeds
tympanic membrane perforated
< 3-months old
<2 years & infection bilateral
symptoms present >= 4 days
anaphylaxis adrenaline doses for children < & >6
150 microgram 1:1000
3000 microgram
CIs lumbar puncture (coning risk)
men sept
raised ICP
focal neurological signs
coagulation disorders
cardiovascular instability
delay abx deliver
jaundice with a conjugated hyperbilirubinaemia
biliary atresia
dark urine and chalky white stool
cause of prolonged jaundice in infants.
Clinical features include dry skin, constipation, coarse facial features including a large tongue as in the figure, umbilical hernia and a hoarse cry.
In the UK it is usually identified on newborn biochemical screening (Guthrie test).
Hypothyroidism
whilst neonatal hypoglycaemia is often under ….
it’s often treated if under …
2.5
1 (10% dextrose)
most common finding of neonatal sepsis
respiratory distress
when are bowed legs normal and when do they resolve
<3
by 4
prem babies immunisation changes
as per chronological age
if <28 –> 1st set in hospital due to apnoea risk
airway suction should not be performed in neonates unless there is …. because it can cause …..
meconium
reflex bradycardia
initial Ix for febrile child
Full blood count
Blood culture
C-reactive protein
Urine testing for urinary tract infection
Chest radiograph only if respiratory signs are present
Stool culture, if diarrhoea is present
intesessuption is often associated with (2)
exophalos
diaphragmatic hernia
what is seen on blood films in TTP
schistocytes
mx limp in <3
urgent paeds assessment
milestone calculation in prem baby
normal milestone - (40 - gestational age)
in child with fever remember
NICE traffic light system
threadworms name
Enterobius vermicularis
ix if FTT baby
FBC // TFTs // coeliac screen // sweat test
key facts on each type of idiopathic arthritis
oligo - <=4 joints // girls<6
poly - 5>= // +ve RF
systemic - fever // rash
chest compressions on a child can also be commenced if
bradycardic (<30)
parkland formula for paeds fluid for 1st 24hrs after a burn
4mL/kg/%BSA burn of Hartmann’s
give half in 1st 8 hours (other half in remaining 16hrs)
most common cause pathological neonatal jaundice
biliary atresia
tx vs prevention choices for NEC
prevention erythromycin
tx BSAbx
Pancreatitis and infertility may follow … infection
mumps
loud single S2 is audible and a prominent right ventricular impulse
TGAs
differentiate infantile spasm from colic
In infantile spasms the child will become distressed between spasms, whereas in colic the child will become distressed during the ‘spasms’
common transient problem post gastroenteritis
lactose intolerance
Removal of lactose from the diet for a few months followed by a gradual reintroduction
intracranial haemorrhages in neonates
Subarachnoid: common // irritability + convulsions over the first 2 days of life
Subdural: following use of forceps
Intraventricular: pre-term infants // ultrasound
undescended testes vs hyposdpadias mx
undescended: in 3m (ideally operation <6)
hypospadias: 12m
undescended testes vs hyposdpadias complications
undescended: infertility & testicular torsion
hypospadias: cryptochidism & inguinal hernia
The major risk factors for SIDS are:
prone sleeping
parental smoking
bed sharing
hyperthermia and head covering
prematurity
if NEC deteriorates then manage with
laparotomy
fluid levels in meconium ileus vs Hirschsprung
meconium –> no fluid levels
maternal partum ICS use ++ risk of
DDH (lol!)
when is PDA closed
1 week post delivery
give abx in otitis media if
systemically unwell // immunocompromised
DDx thalassaemia & sickle cell
- first year of life with severe anemia and failure to thrive. Extramedullary haemopoiesis results in frontal bossing of the skull. Haemolysis results in hepatosplenomegaly
- later in line, recurrent bone & chest pain, proliferative retinopathy
gold standard test for streptococcal pharyngitis
Throat cultures (since centor isnt good enough)
why do we defer giving antibiotics in the community if men sept is suspected (unless hospital tx is gonna be delayed or px is too sick)
abx can interfere with LP results
freidrich’s ataxia inheritance pattern
autosomal recessive
genetic disease common in children with consanguineous parents characterised by fatty substances, gangliosides, build up to toxic levels in the brain and spinal cord and affect the function of the nerve cells
Tay-Sachs disease
immunisation associated with febrile convulsions
menB
bruising that is more pronounced over bony prominences
ITP
A 10 year old presents to his GP with several
episodes of dizziness which have occurred on
exercise over the past 3 months. On examination,
he has a harsh grade 4/6 ejection systolic murmur
which is loudest in the second right intercostal
space. There is an ejection click. From the list below
which is the most likely diagnosis?
aortic stenosis
- What is the most common symptom of a UTI in a child aged <2 years?
unexplained fever
UTI abx duration for boys and girls
boys - 7days
girls - 3days
x-linked recessive conditions
haemophilia
DMD
G6PD deficiency
x-linked dominant condition
fragile x (CGG // huntington’s GAG)
autosomal dominant
marfan
ehler’s danlos syndrome
ryanodine deficiency
autosomal recessive
cystic fibrosis sickle cell
MMR vaccine is contraindicated in what allergy
neomycin
