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Paeds Flashcards

1
Q

What to check at well child visit

A

vaccinations
growing ie head lenght wt
abuse/neglect
development milestones

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2
Q

Failure to thrive organic reasons

A

genetic ie CF
heart disease
pyloric stenosis
GORD

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3
Q

Developmental milestones gross motor

2mo
4mo
6mo

1yr
2yr
3yr
4yr
5yr

A

lift head
roll over
sit up

walk
steps
tricycle
hop
skip

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4
Q

Developmental milestones fine motor

3yr
4yr
5yr

A

circle
cross
triangle

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5
Q

Developmental milestones social

6 weeks
6mo

1yr

A

social smile

stranger anxiety

1 year separation anxiety

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6
Q

path of acute allergic reaction

A

IGE-mediated type 1 hypersen

trigger = cross linking of mast cells which degranulate = histamine release

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7
Q

anaphylaxis presentation n tx

A

urticaria (rash)
hypotension
wheeze

from trigger

remove cause
adrenaline IM 0.5ml 1:1000
fluids
chlorphenamine IV
steroids

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8
Q

Urticaria presentation n tx

A

wheal
whelt
erythema

No hypotension

check not anaphylaxis
Self limiting
non sedating anti hist ie loratidine,cetrizine

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9
Q

angioedema present n mx

A

swelling all over but esp airway
post acei
no rash no hypotension

secure airway
anti hist
steroids

if c1 esterase deficiency = give FFP

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10
Q

allergic rhinitis presentation n mx

A

shiners (runny eyes)
Salute sign (pushing nose up to wipe)
Pale boggy mucosa
nasal polyps
cobblestining bc post nasal drip

avoid trigger
intranasal steroids

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11
Q

Allergic conjuctiv present n mx

A

shiners runny eyes
conjunct injection
chemosis (swelling)

h2 antihisatmines
LTA

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12
Q

Food allergies cause n presentation n management

A

wheat soy milk eggs
Nuts shellfish (anaphylaxis)

N&V&D
and associated with atopic dermatitis

Clx dx but maybe foot trial to narrow down trigger

tx avoid trigger and carry epi pen if anaphylaxis

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13
Q

Tx for milk protein allergy

n cause

A

MC cause soy formula

tx cows milk
breatfeed
hydrolysed formula

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14
Q

What is BRUE

A

brief resolved unexplained event

<1yo + <1min duration of;

change in;
colour
tone
breathing
responsiveness

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15
Q

Low risk Brue criteria

A

Age
term baby> 60 days
pre term >32GA or >45Post conception

No hx to suggest any of causes
no physical findings
no cpr for episode
1st time episode

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16
Q

Things that might want to rule out w brue

A

gord
LRTI
seizure (eye move.jerk)

sepsis (fever)
heart disease (FTT &murmur)
abuse (mult injuries)

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17
Q

SIDS prevention

A

sleep on back (flattens occiput)

dont share bed

smoking cessation

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18
Q

vaccine CI egg allergy

A

yellow fever

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19
Q

Vaccines CI if immunocomp

A

Live attenuated ie

MMRV
influenza if live (intranasal) - (IM Flu is ok)

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20
Q

Mom hep B +ve (chronic or acute during preg)

baby mx?

A

Hep B vaccine course now

+ Hep B ig

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21
Q

DTaP vaccine schedule

A

5 doses
3x in 1st year, 1x 3-5, 1x 13-18

2mo,3mo,4mo

3-5yrs

13-18yrs

= full lifetime course

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22
Q

wound
pt had full tetanus course
last dose<10yrs

A

regardless of would severity

no vaccine
no tet immunoglob(Tig)

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23
Q

Pt full course of tetanus vaccines last dose >10 years

A

Tetanus prone wound (dirty) = Vaccine booster?

High risk would ie
compound frac, delayed surg intervention , large degree devitalised tissue = vaccine boost + Tig

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24
Q

unknown tetanus hx

A

vaccine booster

if high risk/tetanus prone would = also Tig

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25
hiB vacciine for
epiglottisis
26
mmrv course and CI
12-15mo 3-4years CI pregnanct women severe immunocomp ie transplant, AIDs, biologics
27
Tetanus presentation how does Vaccine n Tig work tx
dirty wound, lockjaw, spasms lethal dose
28
Diptheria presentation n mx
High fever, sob, dysphagia grey pseudomembranious in oropharynx (do not touch) secure airway, abx, antitoxin
29
Pertussis presentation 3 phases Tx
vague catarrhal stage -infectious days of rinorhea, cough and low grade fever Paraxysmal phase - coughiing spells interspersed with insp. whoop Resolution phase supportive ie secure airway if need erythromcin Iv abx
30
Common cause of otitis externa
swimmers ear pseudomonas staph. aureus seb dermatitis (fungal) contact dermatitis (allergiccor irritatnt)
31
Otitus media causing bugs presentation and Dx
Resp bugs - strep.pneum, h.influ, moraxella painful ear - relief on tugging Pneumatic insufflation ie air on eardrum = stiff
32
common cold causing pathogen
rhinovirus
33
choanal atresia
connection between mouth and nose Unilat and bi(emergency) Blue baby at rest (nose breather ie breastfeeding) Pink when crying catheter cant get through if complete atresia
34
erthyema infectiosum virus pt: tx complications
PARVOVIRUS 19 'slapped cheek' fever and rash supportive aplastic crisis in sickle cell thalasemia and sperocytosis hydrops fetalis
35
time off school slapped cheek
infectious for 10 days before rash so once it comes no time off
36
roseola infantum virus
HHV 6
37
roseola infantum sx tx and comps
High fever then rash AFter fever Starts on trunk and spreads outwards supportive tx febrile seizures
38
measles prodrome and spread
4 Cs cough corzya conjunctivitus Coplik spots (white small spots in mouth) fever and rash spreads from face (behind ears ) to whole body inc palms n soles
38
measles virus
paramyxovirus
39
later in life complication of measles
subacute sclerosing panencephalitis
40
rubella prodrome and spread
generalised tender lymphadenopathy fever and macular rash from face spread to trunk itchy
41
measles infectious period
4 days before and after rash
42
rubela infecious spread
7 days before and after sx
43
varicella zoster sx
rash difuse vesicles on erthyematous base diff stages of healing NO fever starts on head back trunk then peripheries
44
varicella zoster (VZV) infectious period
2 days before and 5 days after sx start which is usually when lesions crust over
45
mumps presentation complication
pubertal males parotiditis orchiditis infertility
46
hand foot and mouth disease virus and presentation
coxsackie a16 vesicular rash on mouth (1st) then feet and hand
47
Kochers criteria
Septic arthritis in kids
48
sickle cell path
glutamate swapped for valine 6th space on chromosome 16
49
definitive ddx sickle cell
HB electrophoresis
50
sickle cell crisis mx
opiates iv fluids oxygen abx if infection blood transfusion
51
when to use exchange transfusion sickle cell
neuro acute chest ie chest pain sob pul. oedema
52
sickle cell crisis prophylaxis
hydroxyurea pneum vaccine every 5 yrs
53
check if pt in sickle crisis
change from their baseline low hb higher bili higher retic count pain sickle cells on smear
54
what can happen with transfusion in sickle pt
iron overload = give deferoxamine
55
chronic consequences of sickle
too much haemolysis = chronic anaemia -> kidney release epo -> bone marrow constantly stimulated to make more RBCs = inc retic count = high levels of unconjugated bilirubin -> pigmented gallstones & jaundice (cholecyst) organ autoinfarct ie spleen, avascular necrosis of hip, brain lungs etc risk of osteomyelitis
56
MC cause osteomyelitis
staph aureus
57
pt osteomyelitis with salmonella organism
= pt has sickle cell
58
Aplastic crisis
sudden drop in hb post parvovirus pancytopenia but mostly Hb
59
meconium ileus in cystic fibrosis presentation and findings
no bowel movement since birth distended abdo abdo XR - dilated bowel loops proximal to an impaction rectal biopsy negative
60
cystic fibrosis fx
short stature Diabetes delayed puberty rectal prolapse (bulky stools) nasal polyps male infert, female subfert
61
uni undescended testes at birth bilateral
review at 3mths if persist - refer review senior paeditrician in 24hrs
62
whooping cough tx
azithromycin/clarithromycin if cough within 21 days
63
Tetralogy of fallot (TOF) features what determines degree of cyanosis and clinical severity
VSD Right vent hypertrophy right vent outflow obstruction - pulmonary stenosis Overriding Aorta severity of right ventricular outflow obstruction ie pul stenosis
64
Croup cause age group and diagnosis/ xray
viral - parainfluenza 3mo-3yrs dx = clx Xray PA= steeple sign lateral = thumb sign
65
Steeple sign on xray
subglottic narrowing
66
Thumb sign on xray
swelling of epiglottis
67
Bacterial tracheitis cause presenttaion mx
staph aureus MC post viral URTI bc mucosal damage and local immune changes Stridor high fever purulent secretions musosal necrsis and sloughing Iv abx
68
Retropharyngeal abscess defining features
anterior chain unilateral lymph nodes tender neck mass
69
peritonsillar abscess defining features
uvular deviation to unaffected side
70
foreign body airway obstruction (FBAO) extrathoracic
inspiratory stridor
71
foreign body airway obstruction intrathoracic
exp wheeze
72
FBAO xray findings
-ve coin sign AP +coin sign lateral = in trachea
73
bronchiolitis bug and presentation
RSV <2 yo coryzal sx precede wheeze SOB cough feeding difficulties sx peak 3-4 days
74
cystic fibrosis pneumonia bug and pancreas mx
pseudomonas pancreatic enzyme supplements with meals vitamins ADEK
75
NEC pt & sign
premature bby xray = peumatosis intestinalis
76
intussusception age, ix, mx
3months- 3 years USS = target sign tx = air enema surgery if peritonitis, perforation, or enema fail
77
meckels diverticulum presntation ddx and tx
vitelline duct remenant painless GI bright red bleeding ddx = technicium -99 scna tx = resection
78
indicator of cerebral palsy
Not sitting by 8 months (corrected for gestational age) Not walking by 18 months (corrected for gestational age) Early asymmetry of hand function (hand preference) before 1 year (corrected for gestational age) Persistent toe-walking
79
school exclusion rubella
5 days onset of rash
80
school exclusion scarlet fever
24hrs after startiing abx
81
school exclusion whooping cough
2 days after abx or 21 days from sx starting if no abx
82
school exclusion measles
4 days from onset of rash
83
school exclusion chickepox
all lesions crutsed over
84
school exclusion mumps
5 days from onset of swollen glands
85
school exclusion gastroentritis
48hrs sx settles
86
school exclusion impetigo
until lesions crusted and healed or started 48hrs since starting abx
87
recurrent febrile seizures management
Rectal diazepam buccal midazolam
88
cystic fibrosis homoozygous for delta F508 mutation tx
lumacaftor/Ivacaftor (Orkambi)
89
threadworm organism
enterobius vermicularis
90
chronic management of CF
chest physio and postural drainage twice a day high calorie diet including high fat intake
91
fever traffic light system red
colour - pale, mottled, ashen, blue activity - appears ill to professional, no response social cues, doest wake when aroused, weak high pitches continuous cry resp - grunting, RR>60, mod/sev chest indrawing circ - reduced skin turgor other = age <3 w temp>38
92
peads bls
5 rescue breaths 15 compressions (rate 100-120permin) : 2 breaths depth of compressions = 1/3 of the chest
93
stills disease
systemic juvenile arthritis subtle salmon pink rash high swinging fevers enlarged LN weight loss joint inflammation splenomegaly muscle pain pleurtitis pericarditis raised inflam markers
94
stills disease complications
macrophage activation syndrome (MAS) ie kid with DIC and low ESR
95
which JIA may have +ve ANA
oligoarticular JIA RF -ve in JIA
96
chicken pox medication CI
NSAIDs increase risk of necrotising faciitis in pt w chicken pox
97
whooping cough tx
macrolide ie azithromycin
98
what age should stop having febrile seizures
usually lasts happens from 6mths to 5 years
99
klumpke paralyisis
damage to t1 due to traction loss of intrinsic hand muscles (thmb adductions and finger abduction) and sensory loss over medical epicondyle
100
bronchiolitis ix
nasopharyngeal asp immunofloresence shows rsv
101
bronchiolitis refereal to hosp criteria
apnoea (observed or reported) child looks seriously unwell to a healthcare professional severe respiratory distress, for example grunting, marked chest recession, or a respiratory rate of over 70 breaths/minute central cyanosis persistent oxygen saturation of less than 92% when breathing air.
102
bronchiolitis mx in hosp
o2 nasal suction ng feeing
103
bronchiolitis on chest xr
hyperinflation
104
croup sx
barking cough hoarseness stridor
105
croup causes
parainfluenza rsv measles influenza a n b
106
croup differentials
acute epiglottitis, bacterial tracheitis, peritonsillar abscess foreign body inhalation
107
croup who to admit
moderate or severe croup < 3 months of age known upper airway abnormalities (e.g. Laryngomalacia, Down's syndrome) uncertainty about diagnosis (important differentials include acute epiglottitis, bacterial tracheitis, peritonsillar abscess and foreign body inhalation)
108

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