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3A > Paeds > Flashcards

Paeds Flashcards

1
Q

Causes of meningitis in neonates

A

Group B strep, E.coli and listeria monocytogenes

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2
Q

Causes of meningitis in 1 month-6 years

A

N. meningitidis, strep.pneumonia and Hib

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3
Q

Causes of meningitis > 6 years

A

N. meningitidis and strep. pneumoniae

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4
Q

History for meningitis

A

Fever, headache, photophobia, lethargy, vomiting, poor feeding, irritability, hypotonia, loss of consciousness/ drowsy and seizure
May be non-specific in young

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5
Q

Examination findings for meningitis

A

Fever, neck stiffness, purpuric rash, bulging fontanelle, opisthotonus, brudzinski and kernig signs, papilloedema, focal neurological signs, signs of shock

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6
Q

What is brudzinski sign

A

flexion of the neck when the child is supine causes flexion of the knees and hips

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7
Q

What is kernig’s sign

A

When the child is lying supine, and hips and knees are flexed there is back pain when the knee is extended

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8
Q

Investigations for meningitis

A

bloods, blood culture, throat swab, urine and stool culture, rapid antigen test for microorganisms, viral PCR, lumbar puncture, consider MRI/CT

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9
Q

When is lumbar puncture contraindicated

A

cardiorespiratory instability
focal neurological signs
signs of raised ICP (papilloedema)
coagulopathy
thrombocytopenia
local infection

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10
Q

LP findings for bacterial meningitis

A

Turbid appearance
raised polymorphs
raised protein
low glucose

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11
Q

LP findings for viral meningitis

A

Clear appearance
raised lymphocytes
normal/ raised protein
normal/ low glucose

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12
Q

LP findings for TB meningitis

A

turbid/clear
raised lymphocytes
very raised protein
very low glucose

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13
Q

Treatment of bacterial meningitis

A

IV ceftriaxone
supportive care
consider dexamethasone

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14
Q

prophylaxis of meningitis

A

rifampicin or ciprofloxacin for household contacts

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15
Q

viral causes of meningitis

A

enteroviruses, EBV, adenovirus and mumps

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16
Q

Complications of meningitis

A

hearing impairment
vasculitis
infarction
hydrocephalus
abscess
subdural effusion

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17
Q

Serious cause of encephalitis in children

A

HSV

18
Q

Treatment of encephalitis

A

High dose IV acyclovir

19
Q

Triad of toxic shock syndrome

A
  1. Fever >39
  2. hypotension
  3. diffuse erythematous, macular rash
20
Q

Cause of toxic shock syndrome

A

Toxin secreting staph aureus and group A streptococci

21
Q

Organ dysfunction in toxic shock syndrome

A
  • mucositis- of the conjunctivae and the oral and genital mucosa
  • GI dysfunction (D+V)
  • renal impairment
  • liver impairment
  • clotting abnormalities and thrombocytopenia
  • CNS: altered consciousness
22
Q

Treatment of Toxic shock syndrome

A
  • ICU
  • antibiotics: ceftriaxone and clindamycin
  • IV immunoglobulins to neutralise toxins
23
Q

What asthma treatment can cause nightmares in paediatrics

A

Montelukast

24
Q

What heart defect is common in Turner’s syndrome

A

Bicuspid aortic valve

25
Q

What is shown on a biopsy of Hirschsprung’s disease

A

Absence of ganglion cells

26
Q

What heart defect is common in Down’s syndrome

A

Atrial septal defect

27
Q

What is a halo sign on x ray of the oesophagus indicate

A

Ingestion of a button battery - requires immediate urgent endoscopy

28
Q

Management of febrile convulsion lasting > 5 mins

A

Buccal midazolam or rectal diazepam

29
Q

Treatment of Kawasaki disease

A

Iv immmunoglobulins and high dose aspirin

30
Q

Core feature of autism in children

A

Poor social interactions, narrow interests, language deficits, repetitive behaviours

31
Q

What is the most common abdominal tumour in children

A

Wilms tumour

32
Q

What are children with Down’s syndrome more likely to develop

A

Hirschsprung disease

33
Q

What is a risk factor for pyloric stenosis

A

Prematurity

34
Q

Signs of necrotising enterocolitis

A

Bilious vomiting
Bloody stools
Absent bowel sounds
Systemic compromise with metabolic acidosis

35
Q

What should an 18th month old be able to do

A

Use a cup and spoon to feed themselves

36
Q

Most common cause of late onset neonatal sepsis

A

Staph aureus

37
Q

What is the most common cause of congenital adrenal aplasia

A

21 - hydroxylase deficiency

38
Q

Order of management of chocking

A
  • cough encouragements
  • back slaps
  • Heimlich manoeuvre
39
Q

When should apgar scores be done

A

1 and 5 minutes post birth

40
Q

What are apgar scored

A

A- appearance
P- pulse
G- grimace
A- activity
R- respiration

41
Q

Long term complication of untreated vesicoureteric reflux

A

Renal scarring

42
Q

Sign of intussusxupetion on ultrasound

A

Target sign- concentric echogenic and hypotonic bands

3A (33 decks)

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