Paeds Flashcards
What causes acute epiglottitis and how is it treated
Is there a vaccination option?
Heamophilus Influenze B (A BACTERIA)
Treated with IV cephlasporins & airway protection (call anaesthetics/nebulised adrenaline)
Babies are immunised with the 6 in 1 vaccine at 8.12.16 weeks old and with the HiB/Men vaccine at 1 year
What causes croup and how is it treated
Is there a vaccination option
Parainfluenza virus
peak incidence at 6 months - 3 years
more common in autumn
Larygnotracheobronitis
Dexamethasone to treat
Emergency treatment
high-flow oxygen
nebulised adrenaline
No vaccine
What causes whooping cough and how is it treated
Is there a vaccine option
Bordatella pertussis (gram -ve)
Treated with an oral macrolide (e.g. clarithromycin, azithromycin or erythromycin) is indicated if the onset of the cough is within the previous 21 days
Infants <6 should be admitted
Notifiable disease - household contacts get prophylactic Abx
infants are routinely immunised at 2, 3, 4 months and 3-5 years. Newborn infants are particularly vulnerable, which is why the vaccination campaign for pregnant women was introduced - vaccines from 16-32 weeks
Features of croup
stridor
barking cough (worse at night)
fever
coryzal symptoms
Features of whooping cough
Paroxysmal cough.
Inspiratory whoop.
Post-tussive vomiting.
Undiagnosed apnoeic attacks in young infants.
catarrhal phase
symptoms are similar to a viral upper respiratory tract infection
lasts around 1-2 weeks
paroxysmal phase
the cough increases in severity
coughing bouts are usually worse at night and after feeding, may be ended by vomiting & associated central cyanosis
inspiratory whoop: not always present (caused by forced inspiration against a closed glottis)
infants may have spells of apnoea
persistent coughing may cause subconjunctival haemorrhages or even anoxia leading to syncope & seizures
lasts between 2-8 weeks
convalescent phase
the cough subsides over weeks to months
Features of acute epiglottitis
rapid onset
high temperature, generally unwell
stridor
drooling of saliva
‘tripod’ position: the patient finds it easier to breathe if they are leaning forward and extending their neck in a seated position
Features of DiGeorge Syndrome
CATCH-22
Cardiac defects
Abnormal Facies
Thymic hypoplasia
Cleft palate
Hypocaleamia
Deletions from Chromosome 22
What does parvovirus cause
Slapped cheek illness
i.e. fifth disease
“pablo gets slapped”
What does Coxsackie A16 cause
Hand, foot and mouth disease
‘C for cows: foot and mouth disease’
Features of Fragile X syndrome
X linked trinucleoside expansion
Features in males
learning difficulties
large low set ears, long thin face, high arched palate
macroorchidism
hypotonia
autism is more common
mitral valve prolapse
Seizures
Long face / large jaw
Features of williams syndrome
Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis
Deletion in ch 7
‘willy is the nice one’
Common organisms causing community acquired pneumonia in children and their Abx
Strep pneumoniae - amox
Mycoplasma pneumoniae - clari
Meningitis pathogen 2-5 year old
Nisseria meningitidis
Strep pneumnomiae
Focal seizures at night
Benign rolandic epilepsy
EEG centrotemporal spikes
Focal/partial seziures
Usually grow outof it by the time they are teenagers
Congential CMV infection
Intraventricular calcifications
Sensieonural deafness
Cerebral palsy
developmental delay
‘C for CMV and Calcifications’
Alports syndrome
X linked
Renal disease
Progressive hearing loss
Pendred syndrom
Childhood syndrome - goitre and hearing loss
Hypothyroidism
Buergers disease
IgA nephropathy
IgAt the same time as a resp infection
What is the most common cause of acute renal failure in children?
Heamolytic Ureamic syndrome
What is the triad of heamolytic uraemic syndrome and a traditional precipitent?
- Renal failure
- Thrombocytopenia
- Microscopic heamolytic anaemia
Triggered by exposure to e coli or shigella (bloody diarrhoea)
G6PD blood film
Hienz bodies
Complications of Mumps
Orchitis
Pancreatitis
Machinery murmur
Patent ductus ateriorisis
Mixed oxygenated & deoxygemated blood flow
Acyanotic
Treated with indamethacin/NSAIDs to stop prostglandin production - unless in a syndrome where the PDA is vital (eg transposition of the GA)
Features of Klinefleters
47 XXY or 48 XXXY
Gynaecomasteia
Small testes
Tall male
