paeds Flashcards
Small testes in precocious puberty indicate_________________________
an adrenal cause of the symptoms
____________would cause unilateral enlargement of the affected testicle
A sex cord-gonadal stromal tumour
hypoglycaemia in neonates is defined as _____. what is a RF?
blood glucose level of less than 2.5 mmol/L
Maternal gestational diabetes
Perianal itching in children, possibly affecting other family members → which organism?
Enterobius vermicularis (threadworms)
‘Examination reveals a positive head impulse test’ –> ?
Vestibular neuritis
not typically seen in a posterior circulation stroke
_______________________ is the number one cause of painless massive GI bleeding requiring a transfusion in children between the ages of 1 and 2 years
Meckels diverticulum
CAH vs AIS - how to differentiate?
AIS causes primary amenorrhea while CAH causes precocious pubic hair
AIS: female presenting, firm palpable masses in groin (undescended testes)
CAH: ambiguous genetilia and virilisation (in F)
______________ is the triad of the shaken baby syndrome
Retinal haemorrhages, subdural haematoma and encephalopathy
distended abdomen and bilious vomiting =
intestinal malrotation
Pansystolic murmur in lower left sternal border
Ventricular septal defect
Crescendo-decrescendo murmur in the upper left sternal border
Coarctation of the aorta
Diastolic machinery murmur in the upper left sternal border
Patent ductus arteriosus
Ejection systolic murmur in the upper left sternal border
Pulmonary stenosis
which abdo condition is associated with fluid levels?
Hirchsprung’s
Infant with bilious vomiting & obstruction →
?intestinal malrotation
Parents should be advised to call an ambulance if a febrile convulsion lasts _____________
> 5 minutes
Exomphalos and diaphragmatic herniae are commonly associated with
malrotation
paeds seizures
1. generalised tonic-clonic seizures, myoclonic episodes in morning, 12-16 Y.O. occasional episodes of absence seizures:
- centrotemporal spikes on EEG, 3-13 Y.O. short seizures involving twitching and parraesthesia of one side of face and tongue:
- generalised tonic-clonic seizures, myoclonic episodes in morning, 12-16 Y.O. occasional episodes of absence seizures: juvenile myoclonic epilepsy
- centrotemporal spikes on EEG, 3-13 Y.O. short seizures involving twitching and parraesthesia of one side of face and tongue: benign rolandic epilepsy
Coronary artery aneurysms are a complication of Kawasaki disease and this should be screened for with an
echocardiogram
murmur in Turner’s syndrome
ejection systolic murmur due to bicuspid aortic valve
definitve Mx of SCFE
Refer to orthopaedics for in situ internal fixation with a cannulated screw
ITP vs TTP?
In TTP, schistocytes are often seen on blood smears.
____________ is used as prophylaxis for contacts of patients with meningococcal meningitis
Oral ciprofloxacin or rifampicin
Croup:_______________ is an indication for admission
audible stridor at rest
what causes roseola
HHV6
chickenpox rash vs roseola rash
roseola rash typically starts on the trunk and limbs (this is different to chickenpox which is typically a central rash)
Neonatal sepsis
- early onset cause:
- late onset cause:
- most characteristic feature:
- Tx:
- early onset cause: Group B Strep
- late onset cause: Staph epidermidis
- most characteristic feature: grunting/resp distreess
- Tx: IV benpen and gentamicin
ASD in children is associated with
- Downs
- FA
- Ebsteins anomaly
Live attenuated vaccines
BCG
MMR
oral polio
yellow fever
oral typhoid
adrenaline dose for children under 6 years
150mcg
6-12: 300mcg
adults: 500mcg
in cardiac arrest: 1mg
Ix for bronchiolitis?
immunofluorescence of nasopharyngeal secretions
emergency Tx for croup
dexamethasone, O2, adrenaline (nebulised)
CF-specific contraindication for lung transplantation
chronic infection with Burkholderia cepacia
referral points for milestones
Referral points
- doesn’t smile at 10 weeks
- cannot sit unsupported at 12 months
- cannot walk at 18 months
Fine motor skill problems
- hand preference before 12 months is abnormal and may indicate cerebral palsy
which infants need routine US examination for DDH
- 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
DDH Ix
US
XRAY if >4.5m
motor milestones
3 months = fix and follow
6 months = palmar grasp
9 months = points
12 months = pincer group
Play milestones
9m = peek a boo
12m = waves bye
18m = plays alone
2 years = plays near children
4 years = plays with children
inheritance of Duchenne’s muscular dystrophy
X-linked recessive
Definitive Ix for Duchenne’s muscular dystrophy
genetic testing
vaccination schedule
Ix of choice in NE and what does it show
Abdo XRAY: shows dilated bowel loops + pneumatosis intestinalis
do you treat whooping cough?
Whooping cough - azithromycin or clarithromycin if the onset of cough is within the previous 21 days
Newborn with intermittent grunting and nasal flaring, normal RR and O2 sats, born after C-section - Dx? Mx?
Dx: transient tachypnoea of the newborn
Mx: no further investivations just monitor
It is more common following caesarean sections, possibly due to the lung fluid not being ‘squeezed out’ during the passage through the birth canal
Chest x-ray may show hyperinflation of the lungs and fluid in the horizontal fissure.
For a child with a palpable abdominal mass or unexplained enlarged abdominal organ:
refer very urgently (<48hr) for specialist assessment for neuroblastoma and Wilms’ tumour
Unilateral undescended testicle -
review at 3 months - if persistent refer
bilateral - review in 24h
____ is associated with seborrhoeic dermatitis
HIV
increased nuchal thickness on combined scan =
- Down’s syndrome
- Congenital herat defects
