Paeds Flashcards
What is a common condition that patients with measles get?
otitis media
When should an undescended testis be referred?
3 months
What are the common symptoms of Croup?
Barking cough - worse at night
Stridor
coryzal symptoms
fever
What is the causative organism for croup?
Parainfluenza viruses
What is the most common cause of stridor?
Laryngomalacia
Where can a still’s murmur be heard?
left sternal edge
Why should a child with downs syndrome be warned about taking part in physical activities?
They have atlanto-axial instability
What is the management for meningitis?
> 3 months - IV cefotaxime
<3months - + IV amoxicillin
What is the cause of perthe’s disease?
Avascular necrosis of femoral head
What scores 2 points in the APGAR test?
pink all over
HR>100
cries on stimulation/sneezes
Flexion that resists extension
strong crying
What is the most common presentation of neonatal sepsis?
Grunting or other signs of respiratory distress
Describe the progression of chicken pox?
High temp - rash in face and torso - macular - vesicular
What are some poor prognostic factors of ALL?
Male sex
non-caucasian
WBC > 20x10^9
Age <2 or >10
T or B cell surface markers
What are the 4 characteristics of tetralogy of fallot?
VSD
RVH
Pulmonary stenosis, right ventricular outflow tract obstruction
Overriding aorta
What is the management of ITP in a pt with petichae and purpura only?
No management - usually self limiting
What is the name of the manovuere where a physician attempts to dislocate the femoral head?
Barlow manoeuvre for DDH
What are the LH and FSH levels like in gonadotrophin dependant precocius puberty?
high
What is the main characteristic of hypospadias?
Ventral urethral meatus
What are the features of life-threatening asthma?
<92% o2 sats
silent chest
<33% PEF
poor resp effort
agitation
altered consciousness
cyanosis
What is the management of an umbilical hernia in a newborn?
Watch and wait - they typically resolve between 12 months and 3 years
Tell pt to present again at 2 years
Coryzal symptoms followed by bouts of coughing that can turn infants red and cause them to vomit it characteristic of which condition?
Pertussis - Whooping cough
What is Osgood-Schlatter syndrome?
Type of osteochondrosis (self limiting developmental derangement of normal bone growth) - inflammation of tibial tuberosity
What condition are these features characteristic of: bouts of excessive crying, pulling up of the legs and worse in the evening?
Infantile colic
What does the shaken baby syndrome triad consist of?
retinal haemorrhages
Subdural haematoma
encephalopathy
What is the average age for a child being able to pull themselves up to standing?
8-10 months
What is the typical distribution of eczema in a 10 month year old?
Face and trunk
When and how long should steroids be given to children with an asthma attack?
Always
3-5 days 2-5 yrs 20mg OD >5 40mg OD
What is the management for slipped capital femoral epiphysis?
Internal fixation
What sort of diet is recommended in CF?
High calorie and high fat
What is the chance of a father with haemophilia A passing it to his son when his mother has no FHx?
0% as it is an X-linked recessive condition
How long should a child with Hand, foot and mouth disease take off school?
It is not needed to take time off school if they are well
What is the most important investigation for suspected orbital cellulitis?
CT orbit
How does HSP present?
Purpura or petechiae, primarily located on the buttocks and lower limbs
Abdominal pain
Arthralgia or arthritis, predominantly in the knees and ankles
Renal involvement - Nephritis (hematuria and/or proteinuria)
Patients may present with a fever
Often, a history of a recent upper respiratory tract infection
What are risk factors for DDH
FHx
Female
Breech
Restricted intrauterine space
Postural deformity
How does Wilm’s tumour (nephroblastoma) present? And what other conditions are associated with it?
A palpable abdominal mass that does not cross the midline, although it may be bilateral in up to 5% of cases.
Abdominal distension
Haematuria
Hypertension
Often asymptomatic unless the tumour grows sufficiently large to cause pain or disrupt other abdominal structures.
WAGR syndrome (Wilms’ tumour, Aniridia, Genitourinary anomalies, and mental Retardation)
Beckwith-Wiedemann syndrome - Hemi hypertrophy of the body
Denys-Drash syndrome
What is the management of meningitis in children younger than 3 months old?
- Antibiotics
< 3 months: IV amoxicillin (or ampicillin) + IV cefotaxime
> 3 months: IV cefotaxime (or ceftriaxone) - Steroids
NICE advise against giving corticosteroids in children younger than 3 months
dexamethsone should be considered if the lumbar puncture reveals any of the following:
frankly purulent CSF
CSF white blood cell count greater than 1000/microlitre
raised CSF white blood cell count with protein concentration greater than 1 g/litre
bacteria on Gram stain - Fluids
treat any shock, e.g. with colloid - Cerebral monitoring
mechanical ventilation if respiratory impairment - Public health notification and antibiotic prophylaxis of contacts
ciprofloxacin is now preferred over rifampicin
Which Abx are cautioned in breastfeeding mothers?
ciprofloxacin (potential joint problems),
nitrofurantoin (G6PD deficiency),
teicoplanin,
clindamycin (antibiotic-associated colitis),
co-trimoxazole.
How does a Ewing sarcoma present in imaging and histology?
X-ray: lamellated (onion skinning) periosteal reaction
MRI: large mass with necrosis
Histology: small blue round cells with clear cytoplasms on H&E staining
How does an osteosarcoma present on a radiograph?
sunburst pattern and codman’s triangle
How do you differentiate between TGA and Tetralogy of Fallot?
TGA: first 24hrs and loud S2
TOF: 1-2 months and ejection systolic murmur (pulmonary stenosis)
What congenital heart defects are associated with turner’s syndrome?
bicuspid aortic valve (15%)
Co-arctation of the aorta
aortic dilatation and dissection are the most serious long term health problems
What cardiac defects are associated with Down’s syndrome?
multiple cardiac problems may be present:
endocardial cushion defect (most common, 40%, also known as atrioventricular septal canal defects)
ventricular septal defect (c. 30%)
secundum atrial septal defect (c. 10%)
tetralogy of Fallot (c. 5%)
isolated patent ductus arteriosus (c. 5%)
What are some associated conditions and long term complications of Down’s syndrome?
congenital heart defects (40-50%)
duodenal atresia
Hirschsprung’s disease
subfertility: males are almost always infertile due to impaired spermatogenesis. Females are usually subfertile, and have an increased incidence of problems with pregnancy and labour
learning difficulties
short stature
repeated respiratory infections (+hearing impairment from glue ear)
AML>acute lymphoblastic leukaemia
hypothyroidism
Alzheimer’s disease
atlantoaxial instability
What is a positive gower’s sign and in which condition does it present?
Patient uses hands to climb up legs to stand up
Duchenne muscular dystrophy
What is the gold standard investigation for Duchenne muscular dystrophy?
Genetic testing
What is the difference in presentation between duchenne’s and becker’s?
Duchenne’s presents in early childhood whereas becker’s presents in later in childhood
What is the most likely mode of inheritance of Trisomy 21
Meiotic non-disjunction
How do you investigate and manage Eisenmenger syndrome?
Echo
Pulmonary function tests
Cardiac catheterisation - GOLD STANDRARD
Heart lung transplant
Palliative
How do you investigate and manage malrotation?
Upper GI contrast study - corkscrew appearance
Urgent laparotomy (ladd’s procedure)
What is the dose of IM adrenaline given to children under the age of 12?
300ug
500ug for 12+ and adults