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FINALS > Paeds > Flashcards

Paeds Flashcards

gastroenteritis child Mx (need to do and gives advice on fluid Mx too)

1
Q

NICE Immediate referral criteria?

A
  • apnoea (observed or reported)
  • child looks seriously unwell to a healthcare professional
  • severe respiratory distress
  • a respiratory rate of over 70 breaths/minute
  • central cyanosis
  • persistent oxygen saturation of less than 92% when breathing air.
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2
Q

NICE consider referral criteria

A
  • a respiratory rate of over 60 breaths/minute
  • difficulty with breastfeeding or inadequate oral fluid intake (50–75% of usual volume, taking account of risk factors
  • clinical dehydration.
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3
Q

Management of Perthes disease in <6?

A

Observation

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4
Q

What is the management of umbilical hernias?

A
  • Usually self-resolve
  • If large/symptomatic, repair at 2-3 years
  • If small and asymptomatic, repair at 4-5 years
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5
Q

What is the management of meningitis in children < 3 months?

A

IV Cefotaxine plus IV Amoxicillin

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6
Q

progressive hip pain, limp and stiffness

A

Perthes disease

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7
Q

Brushfield spots in the iris are suggestive of which genetic condition?

A

Downs

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8
Q

painless rectal bleeding with no other acute abdominal signs?

A

Think Meckels Diverticulum

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9
Q

What should not be given to children <3 months with bacterial meningitis?

A

Corticosteroids

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10
Q

What should you do if there are no signs of breathing on initial assessment of a child?

A

Give 5 rescue breaths

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11
Q

Blue sclera is associated with what?

A

Osteogenesis imperfecta

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12
Q

What should be given to all children who have an asthma attack?

A

Oral prednisolone for 5 days

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13
Q

What criteria is used to assess the likelihood of septic arthritis in children?

A
  • Inability to weight bear
  • Fever > 38.5
  • WCC > 12
  • ESR > 40
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14
Q

Management of bow legs

A

If <3 - normal variant and usually resolves by 4 years old
If >3 - refer to paediatrics

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15
Q

Management of Children presenting with glue ear with a background of Down’s syndrome or cleft palate

A

Refer to ENT

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16
Q

When should a child be reviewed by a senior endocrinologist?

A

If ketonaemia and acidosis have not resolved within 24 hours of DKA

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17
Q

A lesion where causes finger abduction weakness

A

T1

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18
Q

What are risk factors for SUFE?

A
  • Obesity
  • Male
  • Local trauma
  • Hormone deficiencies: thyroid, GH
  • Chemo/Radio
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19
Q

What are examination findings for SUFE?

A

Limp on walking, external rotation of limb, hip motion is limited (flexion, abduction and medial rotation)

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20
Q

What are signs of decompensated congenital heart disease?

A

Poor feeding, dyspnoea, tachycardia, weak pulse, cold peripheries, hepatomegaly, engorged neck veins, gallop rhythm

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21
Q

What is Eisenmenger’s syndrome?

A

When a left-to -right shunt leads to pulmonary hypertension and shunt reversal, therefore turning an acyanotic heart defect into a cyanotic heart defect.

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22
Q

What are risk factors for respiratory distress syndrome?

A

Maternal diabetes, Caesarean sections, second twins, males, hypothermia, perinatal asphyxia, FH,prematurity

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23
Q

Which cells in the lung produce surfactant?

A

T2 Pnemocytes

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24
Q

What will be seen on CXR for RDS?

A

Ground glass appearance

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25
Q

Simple febrile convulsion vs complex

A

Complex - Focal, >15 minutes, Repeat seizure within 24 hours

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26
Q

What is cerebral palsy?

A

A chronic disorder of movement and posture due to non progressive brain abnormalities occurring before the brain is fully developed

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27
Q

What are non-motor signs of cerebral palsy?

A

Delayed milestones, failure to thrive, epilepsy, urinary
incontinence, constipation, drooling, sleep disturbance,
contractures

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28
Q

What are signs of intussception on abdo x ray?

A

Right lower quadrant opacity, dilated gas-filled proximal bowel with absence of gas distally, multiple fluid levels, perforation

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29
Q

What are indications for surgery with intussception?

A
  • Peritonitis
  • Failed enema
  • Perforation
  • Prolonged history
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30
Q

Murmur for ASD vs VSD

A

ASD - ejection systolic
VSD - pansystolic at left sternal border

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31
Q

What is Turners chromosomal abnormality?

A

XO karotype

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32
Q

What is the most common cardiac defect with Turners syndrome?

A

Bicuspid aortic valve

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33
Q

Slow movements of hand and feet with difficulty holding objects + drooling in a child?

A

Dyskinetic CP

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34
Q

Paeds BLS

A
  • 5 rescue breaths
  • 15:2 (3:1 for newborn) chest compressions on lower half of sternum with depth of 1/3 of chest
  • Use 2 thumb encircling technique for chest compression for infants
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35
Q

Where is the damage in dyskinetic cerebral palsy?

A

Basal ganglia and substantia nigra

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36
Q

Craniopharyngioma vs pituitary adenoma?

A

PA - bitemporal superior quadrantinopia
CP - bitemporal inferior quadrantinopia

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37
Q

What age do febrile convulsions normally stop?

A

5 years

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38
Q

Aplastic crisis vs sequestration crisis?

A

Aplastic - reduced reticulocytes
Sequestration - increased reticulocytes

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39
Q

What should not be given to patients with suspected meningococcal sepsis?

A

Dexamethasone

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40
Q

ALL can present with haemorrhage or thrombotic complications due to what?

A

DIC

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41
Q

How does TTP present?

A

FAT RN
Fever
Anaemia
Thrombocytopenia
Renal dysfunction
Neuro abnormalities

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42
Q

Cystic fibrosis associations?

A
  • Short stature
  • DM
  • Delayed puberty
  • Nasal polyps
  • Rectal prolapse
  • Male infertility
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43
Q

Swollen and retracted testicle

A

Testicular torsion

44
Q

What is the investigation for sickle cell anaemia?

A

Haemoglobin electrophoresis

45
Q

Which seizures appear in the morning after waking?

A

Myoclonic -> treat with sodium valproate/leviteracetam

46
Q

Infant <3 with suspected UTI?

A

Refer to Paeds

47
Q

What should be measured in patients with active HSP?

A
  • Blood pressure and urinalysis
48
Q

What is used for the longer term management of sickle cell anaemia?

A

Hydroxyurea -> increases levels of HbF

49
Q

Signs of tetralogy of fallot on examination?

A
  • Loud systolic murmur in pulmnary area
  • Ejection systolic murmur
50
Q

Sign of TOF on ECG?

A

Right axis deviation

51
Q

What conditions are screened for in NIPE?

A
  • Congenital cataracts
  • Congenital HD
  • Undescended testes
  • DHH
  • Newborn hearing
52
Q

What are signs of DDH on X-ray?

A

Reduced alpha and beta angles
Reduced bony coverage of femoral epiphysis

53
Q

What are complications of DDH?

A
  • Premature joint degeneration
  • Arthritis
  • Chronic lower back pain
  • Delay in walking
  • Avascular necrosis
54
Q

Treatment for muscle spams in CP?

A
  • Diazepam
  • Baclofen
  • Botox
55
Q

Vomiting vs Reflux

A

Vomiting - forceful and active, Reflux - sphincter incompetence

56
Q

Which organism causes hand, foot mouth/slapped cheek/roseola?

A

Coxsackie - HFM
Slapped Cheek - Parvovirus
Roseola - HH6

57
Q

steeple sign

A

Croup

58
Q

What is Eisenmenger’s syndrome?

A

Reversal of left-right shunt to a right-left shunt due to pulmonary HTN

59
Q

ADHD has reduced function of where?

A

Frontal lobe

60
Q

What is the most common small vessel vasculitis in children?

A

Henoch-Schonlein Purpura

61
Q

Meningitis + septic shock + massive adrenal haemorrhage?

A

Waterhouse-Friderichsen syndrome

62
Q

Rash organisms

A

Roseola - HH6
Slapped Cheek - Parvovirus
Hand, foot mouth - Coxsackie virus
Chickenpox - Varicella

63
Q

small round blue cells on histology

A

Think Wilms tumour

64
Q

What are the S of innocent murmurs?

A
  • Soft
  • Systolic
  • Sensitive
  • Short
  • Symptomless
65
Q

What is the treatment for epiglottitis?

A
  • Intubation
  • IV Cefuroxime
66
Q

What can be given to promote closure of the duct and what to keep the duct open?

A

Keep open - Prostaglandins
Promote closure - Ibuprofen/Indomethacin

67
Q

How long should patients be kept in for observation after anaphylactic reaction?

A

6 hours

68
Q

Components of Fraser guidelines

A

the patient cannot be persuaded to inform their parents or carers
the patient understands the advice or treatment
the patient’s physical and/or mental health will suffer if they do not receive the treatment/advice
the treatment/advice is in the patient’s best interest
the patient is likely to continue having sex with or without treatment

69
Q

Whooping cough is a risk factor for?

A

Bronchiectasis

70
Q

Which chromosome is Downs, Edwards, Patau?

A

Patau - 13
Edward - 18
Down - 21

71
Q

sensorineural deafness and a desquamating rash in a neonate?

A

Think congenital syphilis

72
Q

Rickets can present as what?

A

Widening of the joints

73
Q

Hearing tests in children

A

Newborn - otoacoustic emission test
If abnormal - auditory brainstem response test
3 years - Pure tone audiometry

74
Q

What is not a red flag referral criteria?

A

Nasal flaring

75
Q

grey spots on his buccal mucosa

A

Koplik spots -> measles

76
Q

Signs of Turners?

A
  • Short stature
  • Lymphoedema
  • Spoon shaped nails
  • Webbed neck
  • CHD
  • Delayed puberty
  • Wide spaced nipples
77
Q

What is intusseception?

A

Telescoping of a segment of proximal bowel into a distal one

78
Q

What is the management of intussusception?

A
  • Rectal air insufflation/air enema if stable
  • If unstable: laparoscopic reduction
79
Q

What is DDH?

A

Where the femoral head and acetabulum do not articulate correctly

80
Q

What are Barlow and Ortolani tests?

A

Barlow - attempt to dislocate the femoral head
Ortolani - attempt to relocate the dislocated femoral head

81
Q

Investigations for DDH?

A

If <4.5 months: US
If >4.5 months: X-ray

82
Q

When would you use correction for gestational age when assessing for milestones?

A

Until 2 years

83
Q

Features of Patau?

A
  • Microcephaly
  • Clef lip and palate
  • Polydactyly
84
Q

Features of Edwards?

A
  • Micrognathia
  • Low set ears
  • Rocker-bottom feet
  • Overlapping fingers
85
Q

What is the management of minimal change disease?

A
  • Prednisolone
  • Immunosuppressives such as ciclosporin
  • Fluid restrict and low salt
86
Q

Diffuse ‘lace-like’ rash develops across the body

A

Slapped cheek syndrome

87
Q

What is a big maternal risk factor for transposition of the great arteries?

A

Diabetes

88
Q

Triad of ADHD

A
  • Impulsivity
  • Inattention
  • Hyperactivity
89
Q

What must be performed before starting someone on methylphenidate?

A

ECG -> can be cardiotoxic

90
Q

What are signs of foetal alcohol syndrome?

A
  • Microcephaly
  • Short palpebral fissures
  • Absent philtrum
  • Reduced IQ
  • Cardiac abnormalities
91
Q

What causes a tet spell?

A

Reversal of the shunt across the VSD leading to a right to left shunt and exacerbated cyanosis

92
Q

Indications for tonsillectomy

A

seven or more episodes in a single year, five or more episodes/year in two years, or three or more episodes/year in three years

93
Q

Crampy abdo pain with sore throat and some lymphadenopathy?

A

Think mesenteric adenitis

94
Q

First line therapy for anorexia in kids?

A

Family therapy

95
Q

How long can maternal antibodies protect foetus?

A

Upto 6 months

96
Q

Dehydration, vomiting, hyponatraemia and hyperkalaemia shortly after birth?

A

Think Congenital adrenal hyperplasia

97
Q

Grunting, cyanosis with barrel chest and scaphoid abdomen?

A

Think congenital diaphragmatic hernia -> tinkling bowels sounds

98
Q

Yawning in a newborn baby that was previously well is a sign of what?

A

Opioid withdrawal

99
Q

sunburst appearance on x ray?

A

Osteosarcoma

100
Q

Gram negative coccobacillus?

A

Bordetella pertussis -> whooping cough

101
Q

Inheritance of DMD?

A

X-linked recessive

102
Q

recurrent otitis media in a girl?

A

Think Turners

103
Q

Cataracts, deafness, hepatosplenomegaly, heart mumur + rash?

A

Think congenital rubella

104
Q

Murmurs

A

ASD - Ejection systolic
VSD - pan systolic at lower left sternal edge
Pulmonary stenosis - Ejection systolic
Tricuspid regurg - pan systolic at lower left sternal edge

105
Q

Management of hydrocephalus?

A

VP shunt insertion

106
Q

What causes Kernicterus?

A

Toxic build up of unconjugated bilirubin

107
Q

What are the live vaccines?

A

MMR
Influenza

BCG
Oral polio
Oral rota
Typhoid
Yellow fever

FINALS (36 decks)

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