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Finals > Paeds > Flashcards

Paeds Flashcards

1
Q

ITP Mx:

A
  • Management is usually oral prednisolone (corticosteroid) however if platelet count is not less than 10 and there is no active bleeding, then NO management is required.
  • usually self resolves in 6 months without any management
    -advice to avoid activities that could result in trauma
    -
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2
Q

Turner’s syndrome: associations ?

A
  • is linked with Bicuspid Aortic Valve (ejection-systolic murmur)
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3
Q

Reflux Nephropathy(vesico-ureteric reflex): (in neonates)

A
  • Gold standard investigation: Micturating Cystography
    -Presents as: recurrent UTIs since very young age and raised creatinine
    -Pathophys: ureters are placed laterally, entering bladder at more perpendicular angle
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4
Q

Noonan Syndrome:

A

young boy presenting with: short stature, webbed neck, pulmonary stenosis, ptosis: is a Autosomal Dominant Disorder, pectus excavatum (sunken chest) is likely.

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5
Q

risk factor for DDH:

A
  • Oligohydramnios
  • Female
  • Breech presentation
    -positive family history
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6
Q

Hand preference before 12 months of age is ABNORMAL: what to do?

A
  • Refer urgently to paediatrician as could be a sign of cerebral palsy.
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7
Q

shaken baby syndrome:

A

Presents with triad of: retinal haemorrhage, encephalopathy, subdural haematoma

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8
Q

Indication of a Atypical UTI:

A
  • Poor urine flow
    -severely ill
    -abdominal/bladder mass
    -raised creatinine
    -septicaemia
    -failure to respond to treatment with suitable abx within 48 hours
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9
Q

Roseola Infantum rash:

A

Fever followed later by rash
- febrile seizures common
-is common in 6 months to 2 years

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10
Q

Retinoblastoma:

A
  • loss of red reflex in neonates= detected at birth, strabismus, visual problems
  • is autosomal dominant
    ddx: congenital cataract but this would not present at Newborn check
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11
Q

Rota Virus vaccine (oral)- when given?

A

at 2 and 3 months
- is an oral, live attenuated vaccine

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12
Q

Indication for admission:

A

Audible stridor at rest

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13
Q

Perthe’s Disease: Mx- be careful with age of child:

A
  • if child is LESS than 6 yrs-good prognosis, therefore reassurance and follow up only, if more than 6 years, then do splinting of the limb.
  • Presents with hip pain, limping and reduced range of movement of hip
    -pathophys: due to avascular necrosis of femoral head
    -xray changes: early changes= widening of joint space
    -diagnosis done by Xray
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14
Q

if child has limp+fever:

A

Refer for same day urgent assessment even if the diagnosis is Transient Synovitis as do not want to miss septic arthritis.

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15
Q

in neonates: which haemorrhage is common until 72 hours of birth?

A
  • Intraventricular Haemorrhage
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16
Q

cardiac defect associated with Duchenne Muscular Dystrophy:

A

Dilated Cardiomyopathy

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17
Q

GI: malrotation classical presentation

A

associated with exomphalos(baby’s abdo wall does not fully develop in utero) and congenital diaphragmatic hernia

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18
Q

croup causative organism:

A

Parainfluenza virus
- presents in autumn months with barking cough and inspiratory stridor

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19
Q

Bronchiolitis causative organism:

A
  • Respiratory Syncytial Virus
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20
Q

Escalation plan for children less than 3 months: (eg. for a suspected UTI):

A

admit SAME day to paeds ward for assesment

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21
Q

Meningitis management for children less than 3 months:

A
  • IV Cefotaxime and IV amoxicillin, if more than 3 months, just Cefotaxime.
  • Do not give steroids eg. dexamethasone in less than 3 months old.
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22
Q

Toddler’s diarrhoea:

A
  • Benign condition that causes child no problems, happens due to fast transit through digestive system resulting in undigested food.
    Mx: reassure and self-resolve
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23
Q

Asthma Mx: (look carefully at age of child, if less than 5 or more than 5)

A
  • less than 5: Salbutamol, ICS, LABA
  • More than 5- same as adult management: Salbutamol, ICS, Monteluklast (Leukotrine receptor antagonist)
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24
Q

Paeds life support resus:

A

1) if no signs of breathing: first give 5 rescue breaths.
2) check for signs of circulation
3) Chest compressions 15:2 ratio for children at a rate of 100-120/minute, otherwise 30:2

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25
Q

AVERAGE child walking age:

A

13-15 months but can often walk quicker than that.

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26
Q

Hand foot and mouth disease caused by:

A

Coxsackie A16 and enterovirus
- requires only symptomatic treatment.
- is very contagious, typically spreads in nursery.
-children DO NOT need to be excluded from school.

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27
Q

Roseola(also known as 6th disease) causative organism:

A
  • Caused by Human Herpes Virus 6(remember because also called 6th disease).
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28
Q

Intussusception Inv:

A
  • Ultrasound= would show a target-like mass
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29
Q

Transposition of great arteries:

A

-Is a medical emergency, presents with cyanosis and loud S2 sound and systolic murmur heard on auscultation
- Mx: Prostaglandin to keep ductus arteriosus open.

NB: Indomethacin is used to close the duct (is a NSAID)

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30
Q

Pyloric Stenosis:

A
  • presents with forceful projectile vomiting about 30 minutes after feeding.
  • hypochloride hypokalaemia metabolic alkalosis
    -diagnosis is made by Ultrasound
    -Mx: Ramstedt Pyloromyotomy
31
Q

Neonatal Hypoglycaemia (risk factor):

A
  • born preterm(before 37 week)at 35 weeks gestation.
  • Presentation: Jittery, irritable, poor feeding and tachypnoea(abnormally rapid breathing)
32
Q

Contraindication for a Lumbar Puncture:

A

Meningococcal Septicaemia (purpura rash alongside meningitis infection)
- others: signs of raised ICP(papilloedema, bulging of fontanelle, DIC)

33
Q

Meningitis prophylaxis:

A

Abx= Ciprofloxacin and public health notify about disease and contacts

34
Q

Biliary Atresia:

A
  • Jaundice presenting after first 2 weeks
  • Dark urine and pale stools
    -Appetite and growth disturbance

Mx: Surgical treatment is the only definitive treatment

35
Q

Escalation pathway of a child presenting with limp+fever(even if diagnosis of Transient Synovitis is suspected)

A

refer for SAME day assessment as need to exclude septic arthritis

36
Q

Necrotising Enterocolitis:

A
  • presents often in premature neonates with: feeding intolerance, abdominals distension, bloody stools.
  • Abdo xray: shows dilated bowel loops, often asymmetrical in distribution, pneumatosis intestinalis(gas)
37
Q

Test for NEWBORNS with hearing problems:

A

Otoacoustic emission test

38
Q

DDH(developmental dysplasia of hip) Mx:

A
  • Less than 6 months old= 1st line) Pavlik harness
  • if more than 6 months or 2nd line if Pavlik Harness has not worked= Spica cast in flexion and abduction
39
Q

DDH Inv: (Age is relevant)

A
  • Ultrasound
    NB:
  • if more than 4.5 months= then xray=1st line
40
Q

Kawasaki disease complication investigation:

A

Coronary artery aneurysm- Echocardiogram

41
Q

Gonadotrophin INDEPENDENT precocious puberty:

A

FSH and LH levels are LOW

42
Q

Gonadotrophin DEPENDENT precocious puberty(puberty starting before 8 years of age):

A

FSH and LH levels are HIGH
- more common in females

43
Q

Threadworms pathogenic name:

A

Enterobius Vermicularis

44
Q

Threadworms:

A

Mx: Mebendazole- is used 1st line for children
Sx: Perianal itching at night

45
Q

Slipped capital femoral epiphysis:

A
  • Loss of internal rotation of leg in flexion
  • Obese 10 year old classical picture
46
Q

Haemophilia A mode of inheritance:

A
  • X linked recessive
47
Q

Transient Tachypnoea of the newborn:

A
  • Presents with Respiratory Distress.
  • Condition is: rapid breathing, grunting, mild intercostal recession.
  • Occurs due to delayed clearance of lung fluid.
  • Usually presents within 24-48 hours after birth
    CXR: shows hyperinflation of the lungs and fliud

Ddx: Persistent pulmonary hypertension of the newborn: occurs when there is a failure to transition from foetal circulation to postnatal circulation.

48
Q

Nasal polyps, recurrent respiratory infections and weight loss are associated with which condition?

A
  • Cystic Fibrosis
49
Q

1st line for enuresis(bed wetting) management:

A

Enuresis alarm

50
Q

Important ethics (paeds specific-under 16yrs):
A child can consent to but NOT refuse treatment, even if they are in full capacity, example:

A

If a patient has appendicitis, and wants to refuse treatment, even if they have full capacity, they cannot!

51
Q

SUFE (slipped capital femoral epiphysis) definitive mx:

A

Refer to Orthopaedics= for in-situ fixation with a cannulated screw
Presentation: obese boy with groin/thigh/knee pain
Investigation(diagnostic)= AP(Antero=posterior; beams pass from front to back) view and lateral view(typically frog leg views)

52
Q

Roseola Infantum:

A
  • Caused by Human herpes virus 6
  • Presentation:first fever, then followed by rash(painless, non-pruritic)
    Mx: No treatment is required and long term complications are rare.
53
Q

Infantile spasms is also known as?

A

West Syndrome:
- is a childhood epilepsy syndrome
-‘salaam’ attacks
Investigation: EEG(electroencephalogram) shows hypsarrhythmia in 2/3rds of infants
- has a poor prognosis
-Vigabatrin is now considered 1st line

54
Q

Female Puberty signs in order:

A
  • 1st) Breast development at 11.5 years
    -2nd) Height spurt reaches max at 12 years before menarche
    -3rd) Menarche at 13
55
Q

Asthma management for less than 5 years:

A

1st) Salbutamol
2nd) Beclometasone (low dose steroid)
3) Leukotriene receptor antagonist

56
Q

Mx: for febrile convulsions in children that last longer than 5 minutes?

A
  • Call ambulance immediately
57
Q

DDH investigations:

A
  • Ultrasound is generally used to confirm
    -If infant is more than 4.5 months, then x-ray is 1st line investigation.
58
Q

Jaundice in newborn period:

A

Within the first 24 hours is pathological jaundice
- needs paeds assessment
-causes of jaundice in first 24 hours: rhesus haemolytic disease, ABO haemolytic disease, hereditary spherocytosis.

  • From day 2-14: physiological jaundice= Breastfed babies

-After 14 days= means prolonged jaundice: causes- biliary atresia, hypothyroidism, galactosaemia

59
Q

Pyloric Stenosis Management:

A

Ramstedt Pyloromyotomy (surgical management)

  • Diagnosis is made by ultrasound

-Presents as: Projectile vomiting, typically 30 minutes after feed, hypochloraemic hypokalaemic acidosis due to persistent vomiting.

60
Q

Cerebral Palsy Presentation:

A
  • Affects the Basal Ganglia and Substantia Niagra
  • Presents: slow, twisting, repetitive movements of the arms that can be noticed and is accompanied by rapid involuntary movements.
61
Q

Bronchiolitis management:

A

admit to hospital; but for supportive treatment.

62
Q

Bow legs in children less than 3 is normal:

A

Normally resolves by the age of 4 years, reassure parent.

63
Q

Notifiable infectious disease in children:

A
  • Scarlet Fever : need to notify Public Health England.
64
Q

Mitochondrial DNA inheritance pattern:

A

-Is only passed down to children through mother, so if father has condition, not necessary that mother has it too.
-None of male’s children will inherit disease (0%)
- All of female’s children will inherit the disease (100%)

65
Q

Cystic Fibrosis inheritance pattern:

A

Autosomal Recessive

66
Q

Head lice (Pediculus Capitis): household contacts treatment?

A

Household contacts DO NOT need treating unless they too have head lice, no need for prophylactic management.

Mx: Malathion, fine-tooth combing of wet/dry hair.
- School exclusion is not advised.

67
Q

Difference between Reflex Anoxic Seizures and Epilepsy:

A
  • Reflex Anoxic seizure= has a faster recovery after seizure unlike epilepsy(post-ictal effect)
  • there is no significant treatment and has a good prognosis.
68
Q

Congenital Rubella Presentation:

A
  • Sensorineural deafness
  • Congenital cataracts
69
Q

Red flag for children:

A
  • Resp rate of more than 60, manage: by immediately admitting to hospital
  • then give antibiotics.
  • be careful in feverish children who are less than 3 years of age.
70
Q

Consider neonatal sepsis when presenting with vague symptoms like:

A

-Poor feeding, grunting, lethargy

71
Q

Primary Amenorrhoea cause? (first period has not come yet)

A
  • Complete Androgen Insensitivity
72
Q

Causes of secondary amenorrhoea:

A
  • PCOS (typically in patients with a high BMI)
  • Pregnancy
  • Prolactinoma
73
Q

Ethics for Jehovah’s witness and child refusing treatment (blood transfusion)

A

In an emergency, you can provide treatment that is immediately necessary to save life or prevent deterioration in health without consent or, in exceptional circumstances, against the wishes of a person with parental responsibilitym

Finals (38 decks)

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