Paeds Flashcards
What conditions are associated with pulmonary hypoplasia
- congenital diaphragmatic hernia
- oligohydraminos
Why should you avoid hypotonic (0.45%) saline in paeds
risk of hyponatremic encephalopathy
monitoring for HUS
BP and urinalysis to look for renal involvement
IV fluid bolus in children
20ml/kg over less than 10 mins
Whirlpool sign
malrotation
treatment of malrotation
Ladd procedure
what can trigger an aplastic crisis in children with hereditary spherocytosis
parvovirus
paediatric HIV
Low risk babies, where mums viral load is < 50 copies per ml, should be given zidovudine for 4 weeks
High risk babies, where mums viral load is > 50 copies / ml, should be given zidovudine, lamivudine and nevirapine for 4 weeks
initial vs definitive management of hirschprungs
initial: bowel irrigation
definitive: anorectal pullthrough
neonatal hypoglycaemia treatment
asymptomatic
- encourage normal feeding (breast or bottle)
-monitor blood glucose
symptomatic or very low blood glucose
- vadmit to the neonatal unit
- intravenous infusion of 10% dextrose
partial seizures during sleep
benign rolandic epilepsy
centrotemporal spikes
features of PDA
left subclavicular thrill
continuous ‘machinery’ murmur
large volume, bounding, collapsing pulse
wide pulse pressure
heaving apex beat
which congential infection can cause PDA
rubella in first trimester
how to differentiate TGA and TOF
Cyanotic congenital heart disease presenting within the first days of life is TGA.
Cyanotic congenital heart disease presenting at 1-2 months of age is TOF
cystic fibrosis treatment
Lumacaftor/Ivacaftor (Orkambi) c
impetigo treatment
localised non-bullous impetigo = hydrogen peroxide
widespread = fusidic acid 2%
how to differentiate caput succedaneum and cephalohematoma
Caput Succedaneum
successfully Crosses Sutures
moderate asthma attack
Oral prednisolone and salbutamol via a spacer: one puff every 30-60 seconds to a maximum of 10 puffs
acute epiglottis cause
Haemophilus influenzae type B
VSD murmur
pansystolic murmur
bow legs in children
resolves by 4 years
umbilical hernias
Usually self-resolve, but if large or symptomatic perform elective repair at 2-3 years of age. If small and asymptomatic peform elective repair at 4-5 years of age.
dex dosage for croup
150mcg/kg PO
congenital adrenal hyperplasia cause
partial deficiency of 21 hydroxylase and results in a reduction in aldosterone and cortisol. This can present with irregular or absent periods accompanied by early onset pubic hair, acne and hirsutism. A high level of 17-hydroxyprogesterone is associated with this diagnosis
serious complication of turners
aortic root dissection
what class of antibiotic for whooping cough
macrolide: azithromycin/clarithromycin
whooping cough symptoms
Paroxysmal cough.
Inspiratory whoop.
Post-tussive vomiting.
Undiagnosed apnoeic attacks in young infants.
NRDs chest x-ray
diffuse ground glass lungs with low volumes and a bell-shaped thorax
APGAR
Pulse, respiratory effort, colour, muscle tone, reflex irritability
70%
williams heart defect
supravalvular aortic stenosis
SUPER cos theyre HAPPY
oligo or poly for DDH
oligo due to restricted movement
what murmur do you get with ebsteins abnormality
pansystolic due to tricuspid regurg
Vesicoureteric reflux investigation
VUR is normally diagnosed following a micturating cystourethrogram
a DMSA scan may also be performed to look for renal scarring
Heel prick results with down syndrome
raised level of immunoreactive trypsinogen (IRT).
when does infantile colic resolve by
6 months
chest x-ray with ttn
hyperinflation of the lungs and fluid in the horizontal fissure.
malignant bone tumour x-ray
Codman’s Triangle - as tumours enlarges raising the periosteum sunray calcification - new
bone breaches the cortex & radiates outwards into adjacent soft tissue
how do you check visual acuity in children
cardiff cards
2 tests for intusucception
US → target lesion/donut sign
AXR → might show edge of intussusception
3 complications of intusucception
Intestinal Perforation and/or Ischaemia and/or Necrosis
Hypovolemic Shock
Sepsis
6 features of down syndrome
- single palmar crease
- epicanthic folds
- brushfield spots on iris
- Wide space between 1st/2nd toes
- flat occiput
gastro abnormalities associated with downs
Duodenal/ anal stenosis
Duodenal/ anal atresia
Hirschsprung disease
Tracheoesophageal fistula
potential risk of not treating jaundice
kernicterus
clinical signs of appendicitis
Tachycardia
Rovsing sign - RIF pain when palpating LIF
Psoas sign - RIF pain on hyperextension of R hip
Obturator sign - RIF on internal rotation of flexed right hip
McBurney’s sign - RIF over appendix
important investigation after febrile convulsion
urinalysis
febrile convulsion prognosis
~33% of patients will have another febrile seizure, while 10-20% will have ≥3 further
episodes with most occurring within 2 years of the initial presentation
There is also a 2-5% risk of developing Epilepsy depending on the type of febrile seizure
leukaemia definition
Haematological Malignancy
Presence of neoplastic haemopoietic cells in the bone marrow +/- peripheral circulation
methods for uncontaminated urine sample
Catheter specimen
Supra-pubic aspiration
Clean-catch midstream specimen
diagnosis of UTI standards
Pyuria
Bacteriuria
radiological investigation following UTI
Within 6 weeks of UTI an US of the urinary tract should be performed to identify structural
abnormalities
alternative to methylphenidate
dexafetamine
signs that support ruptured appendix
Air under the diaphragm on erect CXR
Rigid, board-like abdomen on palpation
differential diagnosis for swelling in forearm
Cellulitis
Ewing’s Sarcoma / Osteosarcoma
Trauma (fracture with possible compartment syndrome)
initial management of osteomtelitis
Analgesia e.g. paracetamol → to reduce distress,
Arrange admission and referral to orthopaedics for possible surgical drainage if initially
unresponsive
Empirical Antibiotics e.g. Flucloxacillin and Benzylpenicillin → to treat infection and prevent
bone necrosis, chronic infection with discharging sinus, limb deformity and amyloidosis
ENT paeds difficulty hearing and ear pain
Acute Otitis Media with Effusion (aka glue ear)
Recurrent Acute Otitis Media
Adenoid Hypertrophy
Foreign Body
Allergic Rhinitis
treatment of glue ear
Grommet facilitates improved hearing via ↑ conduction of sound
Adenoidectomy improved nasal obstruction
guthrie heel prick test findings
- Guthrie Assay (identifies Phenylketonuria)
- Immunoreactive Trypsin (Cystic Fibrosis)
- Thyroid Function Tests (Hypothyroidism)
- Sickle Cell Disease
x-ray with NEC
Dilated Bowel Loops, Bowel wall oedema, Pneumotitis Intestinalis:
what screening is offered with JIA
anterior uveitis: eye testing every 3 months
centor criteria
- presence of tonsillar exudate
- tender anterior cervical lymphadenopathy or lymphadenitis
- history of fever
- absence of cough
EBV symptoms triad
sore throat, pyrexia and lymphadenopathy
perths disease what do you see on x-ray
avascular necrosis
- osteopenia and microfractures
- collapse of the articular surface may result in the crescent sign
- osteosclerosis
- flattening or femoral head
how to calculate fluid deficit
Fluid deficit (mL) = % dehydration x weight (kg) x 10
constipation
- movicol
- stimulant (senna)
- osmotic (lactulose)
complication of not treating exotropia
amblyopia
cause of necrotising fasciitis after chicken pox
group a strep
threadworm organism
Enterobius vermicularis
what should be checked for in active kids with down syndrome
atlantoaxial instability
