Paeds Flashcards
KFP: Steps in suspected NAI (5)
- Mandatory report of suspected child abuse
- Urgent paediatric admission via local ED
- Establish if patient in safe care
- Examine for further acute injuries
- Document findings
11mo brought in with 5 days of fever, cough, bilateral red eyesm runny nose. 2 days ago noticed red blotchy rash on face, then spread down neck + torso
Measles:
- start with fever+ cold like Sx: Couhg/Coryza/Conjuctivitis
- Rash appears head/neck, then spreads down to become confluent, over 3-4days
- Koplik spots - white spots
12mo with fevers + rhinorrhoea for 3/7. Settling but erupted in wide spread macpap rash ?
Roseola (or 6th disease)
- high fever 3-5days
- rash after fever, macpap rash initially trubk, then spreads out
Benign and self limiting, reassure
Kid comes in with a rash all over, face + body. Otherwise happy + well. Had a bit of a cold last week
Dx, usually timing of presentation
Slap cheek / Erythema Infectiosum / Parvovirus B19
- Cold like symptoms 7-10days prior
- 3 phase rash
-> slapped cheek -> mac-pap rash on proximal extremities -> relapses
Child with CAP on history. Analphylaxis to penicillin. Rx?
Oral azithromycin OD for 3/7
- 10mg/kg up to 500mg
- or clarithromycin BD for 3/7
ATSI child with OM - high risk features (5)
- living in remote communities
- <2yo
- first episode OM <6mo
- current ear pathology
- hearing loss or developmental delay
Child with sandpaper like rash
Scarlet fever
- acute exanthem + sore throat +- fever
- rash after 24hrs
KFP Question: what are your DDx for kid presenting with 5 days fever, rhinorrhoea, bilateral conjuctival injection, desquamating rash. Other than Kawasaki (5)
- Group A Strep/Scarlet fever
- EBV
- Systemic JIA
- Sepsis or Toxic Shock syndrome
- SJS
KFP: Management Actions for pt with HFM (4)
- Reassure self limiting disease
- Symptomatic treatment - paracetamol
- Careful hygiene at home
- Exclude until blisters have dried up
5wk old with new skin rash. Otherwise well.
Dx, and Rx if any?
Neonatal cephalic pustulosis
Will resolve within a few weeks
Can treat with Topical clotrimazole or ketoconazole BD
7yo presenting for their first ever flu shot? How to manage
Will need 2nd dose after 4wks
- first year flu needs 2 doses if <9yo
KFP: Cause of low milk supply in BF? (4+4)
Feed related
1. Poor attachment
2. Insufficient feeding/expressing regime
3. Mother-infant separation
4. Physical - tongue tie or oral cavity issue
Mother
1. Stress + illness
2. Medications
3. Medical conditions
4. Drug use +- smoking
Average weight gain of infant
- at 0-3mo
- at 3-6mo
0-3mo ~150-200g/wk
3-6mo ~100-150g/wk
UTI treatment in paed
eTG - Trimethorprim or bactrim 1st line, for 3/7
ceflex is 2nd line
3mo with umbilical hernia. Mx?
Reassure, can refer ~2yrs if still present for surgical management ~2-3yro
DDx for 8wk old baby who cries all night (1+6)
Unsettled or Crying baby (previous known as colic)
DDx
1. Raised ICP
2. Injury, NAI
3. Incarcerated inguinal hernia
4. UTI
5. Hair tourniquet
6. Corneal FB or abraison
12mo milestones (4)
Standing + cruising
Couple of words
Shared attention
Waves bye-bye
2 contra-indications to vaccination
Anaphylaxis to the vaccine
Immunodeficiency for live vaccines
Mild acne - comedomal - management
Topical retinoid (tretinoin)
Add BPO+retinoid if not effective
Mild acne - inflammatory/pustular - management
BPO + topical Abx (clindamycin)
Add oral abx if not working
KFP: DDx for un-witnessed collapse in adolescent, recovered without treatment (6)
- Seziure
- Psuedoseizure
- Conversion disorder
- Vasovagal
- Migraine syndrome (basilar migraine)
- Substance use (alcohol)
DDx for FTT (2+3+2)
- Problems with intake
- Neuro disorder affecting swallow - CP
- Structural - cleft palate - Problems absorbing
- Coeliac
- CF
- CMPI - Increased energy expenditure
- Congenital heart disease
- Hyperthyroid
Child with intermittent cold like symptoms and rash. Initially was around face/head, but now down his extremeties. Otherwise ok
Rubella
- Rash co-incides with mild cold like illness
- starts up high (like rubeus hagrid), then goes down
Key differentiating between paed rashs - Erythema infectiosum, roseola, measles + rubella?
Erythema infectiousum - cold, wk off, slap cheek, widespread
Roseola - high fever, settles, then rash trunk that spreads out
Measles - fever + 3Cs, then rash that spreads down
Rubella - mild could with rash that starts up, goes down
Dx + Mx
Naevus simplex “stork bite”
Resolve over 6-12months
New born, developed this in first few days.
Toxic erythema of newborn (erythema toxicum)
- spares palms+soles
- resolves in 1-2 days
