PAEDS Flashcards
Acute epiglottitis is caused by
Haemophilus influenzae type B
features of measles
prodromal phase
irritable
conjunctivitis
fever
Koplik spots white spots (‘grain of salt’) on the buccal mucosa
rash
causes of acyanotic congenital heart disease
ventricular septal defects (VSD) - mostcommon, accounts for 30%
atrial septal defect(ASD)
patent ductus arteriosus (PDA)
coarctation of the aorta
aortic valve stenosis
causes of cyanotic heart disease
tetralogy of Fallot
transposition of the great arteries(TGA)
tricuspid atresia
Hand, foot and mouth disease features
Caused by the coxsackie A16 virus
Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet
Scarlet fever features
Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)
Erythema infectionsum features
known as fifth disease or ‘slapped-cheek syndrome’
Caused by parvovirus B19
Lethargy, fever, headache
‘Slapped-cheek’ rash spreading to proximal arms and extensor surfaces
Rubella features
Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular
mumps features
Fever, malaise, muscular pain
Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%
Kawasaki features
high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel
Roseala
infantum features
human herpes virus 6(HHV6). It has an incubation period of 5-15 days and typically affects children aged 6 months to 2 years.
Features
high fever: lasting a few days,followed laterby a
maculopapular rash
Nagayama spots: papular enanthem on the uvula and soft palate
febrile convulsions occur in around 10-15%
diarrhoea and cough are also commonly seen
Patau syndrome(trisomy 13)
Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions
Edward’s syndrome(trisomy 18)
Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers
fragile X
Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism
Noonan syndrome
Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis
Pierre-Robin syndrome*
Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate
Prader-Willi syndrome
Hypotonia
Hypogonadism
Obesity
William’s syndrome
Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis
Whooping cough diagnostic criteria
Whooping cough should be suspected if a person has an acute cough that has lasted for 14 days or more without another apparent cause, and has one or more of the following features:
Paroxysmal cough.
Inspiratory whoop.
Post-tussive vomiting.
Undiagnosed apnoeic attacks in young infants.
management of whooping cough
infants under 6 months with suspect pertussis should be admitted
in the UK pertussis is anotifiabledisease
an oralmacrolide(e.g. clarithromycin, azithromycin or erythromycin) is indicated if the onset of the cough is within the previous21 daysto eradicate the organism and reduce the spread
household contacts should be offered antibiotic prophylaxis
antibiotic therapy has not been shown to alter the course of the illness
school exclusion:48 hoursafter commencing antibiotics (or 21 days from onset of symptoms if no antibiotics )
Measles features
Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots (‘grain of salt’) on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent
Scarlet fever features
Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)
Which infants require routine US exam ddh risk
first-degree family history of hip problems in early life
breech presentation at or after 36 weeks gestation, irrespective of presentation at birth or mode of delivery
multiple pregnancy
Risk factors for DDH
female sex: 6 times greater risk
breech presentation
positive family history
firstborn children
oligohydramnios
birth weight > 5 kg
congenital calcaneovalgus foot deformity
Mild vs moderate vs severe croup
Mild croup:
Occasional barking cough with no stridor at rest
No or mild recessions
Well looking child
Moderate croup:
Frequent barking cough and stridor at rest
Recessions at rest
No distress
Severe croup:
Prominent inspiratory stridor at rest
Marked recessions
Distress, agitation or lethargy
Tachycardia
Croup when to admit?
Admission to hospital is only considered for moderate or severe croup
Croup mx
single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity
Emergency treatment
high-flow oxygen
nebulised adrenaline
Necrotising enterocolitis features
risks increased in prematurity and inter-current illness
Dilated bowel loops on AXR, pneumatosis and portal venous air
Whooping cough cause
Gram-negative bacterium Bordetella pertussis
Whooping cough mx
azithromycin or clarithromycin if the onset of cough is within the previous 21 days
Undescended testicles are associated with an increased risk of
infertility, torsion and testicular cancer
