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Phase 3a > Paeds > Flashcards

Paeds Flashcards

1
Q

Summarise Vit K deficiency

A
  1. Ix - coag studies
  2. Tx: Prophylactic IM Vit K
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2
Q

Summarise APGAR scores

A
  1. Used to assess state of neonate quickly after birth
  2. Appearance (colour of baby)
    • 2 = pink
    • 1 = blue peripherally but pink centrally
    • 0 = baby blue all over
  3. Pulse
    • 2 = >100 bpm
    • 1 = <100 bpm
    • 0 = non detectable heart rate
  4. Grimace (response to stimuli)
    • 2 = crying on stim
    • 1 = grimace
    • 0 = no response
  5. Activity
    • 2 = flexed limbs that resist extension
    • 1 = some flexion
    • 0 = floppy baby
  6. Respiration
    • 2 = strong cry
    • 1 = weak cry
    • 0 = no resp. effort
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3
Q

Signs + Sx of different visual impairments in children

A
  1. Oculocutaneous albinism
    • No skin pigmentation
    • White hair
    • No pigment in the iris (red from light reflection)
    • Visual impairment
  2. Retinoblastoma
    • White eye reflex (loss of normal red reflex)
  3. Rentinopathy of prematurity
    • Visual impairment
  4. Cataracts
    • Absent red reflex
  5. Juvenile idiopathic arthritis
    • Chronic anterior uveitis
    • Visual loss
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4
Q

Summarise ventricular septal defect (VSD)

A
  1. Congenital cardiac defect
  2. Hole in septum that separates ventricles of the heart
  3. Small = often asymptomatic
  4. Large VSD = HF
  5. Ausc: loud, harsh, pansystolic murmur. Loudest at left lower sternal edge
  6. Ix: ECHO
  7. Self resolve or surgical intervention
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5
Q

Summarise T1DM

A
  1. Autoimmune
  2. Destruction of insulin-producing pancreatic cells
  3. Sx include:
    • Polyuria
    • Polydipsia
    • Weight loss
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6
Q

Summarise Turner syndrome

A
  1. 45, XO (just one X chromosome)
  2. Affects women only
  3. Sx include:
    • Short stature
    • Webbed neck
    • Primary amenorrhoea
    • Congenital cardiac defect in bicuspid aortic valve
  4. Tx: HGH during childhood + oestrogen replacement
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7
Q

Summarise the Trisomy disorders

A
  1. 21 - Down’s
    • Flat facial features
    • Upward slanting eyes
    • Small ears and hands
    • Hypotonia
    • Congenital heart defect
  2. 18 - Edward’s
    • Low set ears
    • Micrognathia (small lower jaw)
    • Microcephaly
    • Overlapping 4th and 5th finger
  3. 13 - Patau’s
    • Holoprosencephaly (failure of cerebral hemispheres to divide)
    • Microcephaly
    • Cleft lip/palate
    • Polydactyly (extra fingers)
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8
Q

Most common bacterium causing tonsillitis

A

Strep. pyogenes (Group A Strep)

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9
Q

Summarise tetralogy of fallot

A
  1. Cyanotic congenital heart defect
  2. Ventricular septal defect
  3. Overriding aorta
  4. Pulmonary stenosis (RV outflow tract obstruction)
  5. RV hypertrophy
  6. Sx: tet spells - acute episodes of deepened cyanosis
  7. Tx: O2, beta blockers, analgesia. Severe = phenylepinepherin
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10
Q

Summarise testicular torsion

A
  1. Twisting of testicle around spermatic cord due to inadequate tissue attachment
  2. Impaired blood flow
  3. Sx include:
    • Sudden severe unilateral testicular pain
    • High riding of testicle in scrotum
    • -ve Prehn’s sign
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11
Q

Summarise Rubella

A
  1. Sx include:
    • Fever
    • Coryza (nasaly)
    • Arthalgia
    • Rash
      • Begins on face and moves down trunk. LIMBS SPARED
  2. Rubella in unvaccinated pregnant women -> congenital rubella syndrome (birth defects)
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12
Q

Summarise roseola infantum

A
  1. Human herpes virus 6
  2. Macular rash as fever subsides
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13
Q

Summarise rickets

A
  1. Skeletal disorder
  2. Prolonged lack of sufficient Vit D -> impaired calcium + phosphorus absorption
  3. Sx include:
    • Bowed legs
    • Bone pain
    • Stunted growth
  4. Ix include:
    • Bloods: Calcium, phosphate and alkaline phosphatase
  5. Tx include:
    • Vit D + calcium supplement
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14
Q

Summarise red flag features of vomiting in children

A
  1. Projectile vomiting around 6-8w - Pyloric stenosis
  2. Bile stained vomit + abdo distension - intestinal obstruction
  3. Bloody stool + vomit - dysentery
  4. Paroxysmal coughing to the point of vomit - whooping cough
  5. Seizures +/- bulging fontanelle with vomiting - raised intracranial pressure
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15
Q

Summarise pyloric stenosis

A
  1. Hypertrophy of pyloric sphincter (end sphincter in stomach) in infants
  2. Projectile vomiting post feeding
  3. Dx: USS
  4. Tx: Surgery
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16
Q

Summarise epiglottitis

A
  1. Rapidly progressive infection
  2. Inflammation of epiglottis + surrounding tissue
  3. Abrupt blockage of upper airway + potential death
  4. Age 1-6
  5. Preventable by Hib vaccine (H. influenza B vaccine)
  6. Sx include:
    • Soft inspiratory stridor in upright position
  7. Tx include:
    • Secure airway
    • Endotracheal intubation
    • IV cefuroxime
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17
Q

Summarise the different rashes in children

A
  1. Slapped cheek syndrome
    • Rash on both cheeks
    • Fever
    • URTI
  2. Hand, foot and mouth disease
    • Blister on hands + feet
    • Grey ulceration in buccal cavity
    • Fever
    • Lethargy
  3. Scarlet fever
    • Coarse sandpaper texture red rash on cheeks
    • Sore throat
    • Headache
    • Fever
    • Bright red tongue
  4. Measles
    • Erythematous blanching maculopapular rash
    • Fever
    • Cough
    • Conjunctivitis
    • Koplik spots (white spots inside mouth)
  5. Urticaria
    • Raised itchy red rashes
    • No fever
  6. Chickenpox
    • Maculopapular vesicular rash
    • Crusts over + blister
  7. Roseola
    • Lace like red rash across whole body
    • High fever
  8. Rubella
    • Starts on head and spreads to trunk
    • Swollen lymph nodes behind ear
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18
Q

Summarise Whooping cough

A
  1. Severe URTI
  2. Bordetella pertussis
  3. Tx: Macrolides
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19
Q

Summarise Patent Ductus Arteriosus (PDA)

A
  1. DA (duct connecting aorta and pulmonary artery remains patent after 1st month of life
  2. Sx: Asymptomatic or signs of HF
  3. Machine-whirring continuous murmur
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20
Q

Summarise paeds BLS

A
  1. Open airway
  2. 5 rescue breaths
  3. 15 chest compressions + 2 rescue breaths:
    • Infant: 2 fingers (1/3 chest depth)
    • Small child: one hand
    • Large child: 2 hands (5cm)
  4. Airway position
    • Infants: Neutral
    • Young child: Slight extension of neck
    • Older child: head tilt, chin lift
21
Q

Summarise paeds obs

A
  1. Birth
    • 110-170bpm
    • 35-55rr
    • 50-70mmHg
  2. 12m
    • 80-140bpm
    • 30-40rr
    • 70-100mmHg
  3. 3-5y
    • 80-130bpm
    • 20-30rr
    • 70-110mmHg
  4. 6-11y
    • 70-120bpm
    • 16-25rr
    • 80-120mmHg
  5. 12-18y
    • 60-100bpm
    • 12-22rr
    • 100-120mmHg
22
Q

Summarise HEADSSSS screening for adolescent

A
  1. Home
  2. Education/employment
  3. Activities
  4. Drugs/drinking
  5. Sex
  6. Self-harm
  7. Suicide
  8. Safety
  9. Sleep
23
Q

Summarise the heel prick test

A

Blood screen on day 5 of life
Conditions screened for:
1. Sickle cell
2. Congenital hypothyroidism
3. CF
4. Phenylketonuria

24
Q

State the common microbes that cause early onset neonatal sepsis

A
  1. Group B Strep
  2. Listeria
  3. Toxoplasma
  4. Rubella
  5. CMV
25
Q

State the common microbes that cause late onset neonatal sepsis

A
  1. Staph. aureus
  2. Staph. epidermis
  3. E. coli
  4. Pseudomonas
  5. Klebsiella
26
Q

Define neonatal sepsis

A
  1. <90d age
  2. Early onset - within 72h of life
  3. Late onset - after 72h of life
27
Q

Summarise osteomyelitis

A
  1. Bact or fungal infection of the bone
  2. Sx include:
    • Usual
    • Swelling
    • Erythema
  3. Ix include:
    • Bone biopsy
    • Blood inflammatory markers
    • Imaging + cultures
  4. Tx include:
    • ABx 4-6w
    • Surgical debridement
28
Q

Summarise stillbirths and neonatal death

A
  1. Stillbirth death after:
    • 24w gestation
    • Before or during birth
  2. Neonatal death includes:
    • First 28d of life
29
Q

Summarise Neonatal Respiratory Distress Syndrome (NRDS)

A
  1. Deficiency of surfactant -> alveolar collapse
  2. Sx include:
    • Rapid laboured breathing
    • Ground glass CXR
  3. Dx: clinical + CXR
  4. Tx: artificial surfactant + glucocorticoids to mother of preterm delivery
30
Q

Summarise transient synovitis

A
  1. Benign cause of limping child
  2. Inflammation of synovial lining of hip joint
  3. 3-11yrs
  4. Sx incude:
    • Acute onset limp
    • Hip or referred knee pain
    • Low grade fever
  5. Tx: supportive management
31
Q

Summarise Duchenne’s muscular dystrophy

A
  1. Early childhood typically male
  2. Muscle wasting + weakness
  3. Wheelchair-bound before puberty + resp failure by 20’s (often fatal)
  4. Hypertrophic calves; degen muscles replaced by fat
  5. Key signs:
    • +ve Gower’s manoeuvre: use of hands to climb up legs when rising from floor
32
Q

Summarise difference between Duchenne’s and Becker’s muscular dystrophy

A
  1. Presents later in childhood
  2. Wheelchair-bound in teens but survive into their 30’s
33
Q

Summarise Juvenile Idiopathic Arthiritis (JIA)

A
  1. Chronic inflammatory disorder
  2. Persistent joint swelling >6w
  3. Key Sx:
    • Fever
    • Malaise
    • Salmon pink rash
    • Joint pain
  4. Dx: exclusion
  5. Tx:
    • NSAIDs
    • Steroids
    • Methotrexate
34
Q

Summarise minimal change disease

A
  1. Leading cause of nephrotic syndrome (increased permeability of renal glomerular basement membrane)
  2. Minimal change to nephrological structures on light microscopy
  3. Sx:
    • Oedema
    • Frothy urine
    • Follows from viral URTI
  4. Ix:
    • Urine tests
  5. Tx include:
    • Corticosteroids
    • Fluid restriction
    • Reduced salt
35
Q

Summarise meningitis Sx

A
  1. Fever
  2. Severe headache
  3. Neck stiffness
  4. Photophobia
  5. Confusion
36
Q

Summarise meconium ileus

A
  1. Meconium - first faeces by newborn, dark green
  2. Meconium ileus - bowel obstruction
  3. Indicates CF
  4. Failure to pass meconium within 24h
  5. Abdo distension
  6. Bilious vomiting
37
Q

Summarise intussusception

A
  1. Invagination of ileum (end of small intestine) into caecum (start of large intestine)
  2. Between 3m and 2y
  3. Sx:
    • Severe colicky pain
    • Vomiting
    • Blood stained mucus faeces
    • Abdo distension
  4. USS - ‘target’ sign
  5. Tx:
    • Rectal aur insufflation
38
Q

Summarise impetigo

A
  1. Highly infectious superficial epidermal infection
  2. Staph or Strep
  3. Infants and school-aged children
  4. Sx include:
    • Erythematous macules that vesiculate (fluid) or pustulate (pus)
    • Followed by superficial erosion + golden crust
  5. Tx include:
    • Fusidic acid or oral flucloxacillin
39
Q

What is immune thrombocytopenic purpura (ITP)

A
  1. Autoimmune disease
  2. Reduction in circulating platelets
40
Q

Summarise hydrocele

A
  1. Fluid collection around testicle
  2. Sx include:
    • Scrotal swelling + discomfort
  3. Dx: USS
  4. Tx|: resolve by 12m otherwise surgery
41
Q

Summarise Hodgkin’s lymphoma

A
  1. Reed-sternberg cells
  2. Young adults with cervical or supraclavicular non-tender lymphadenopathy
  3. Dx: lymph node biopsy
  4. Tx: Chemoradiotherapy
42
Q

Summarise glandular fever

A
  1. Viral infection from EBV
  2. Saliva transmittance
  3. Sx include:
    • Fever
    • Sore throat
    • Fatigue
    • Hepatomegaly/splenomegaly
  4. Dx:
      1. +ve Paul Bunnell test for presence of virus
43
Q

Summarise gastroenteritis

A
  1. Bact, viral or parasitic infections
  2. D+V
  3. Normal D+V management and Ix
44
Q

Summarise GOR in babies

A
  1. Immaturity of lower oesophageal sphincter
  2. Common in infants under 1y
  3. GORD Sx
45
Q

Summarise WETFLAG

A
  1. Weight:
    (Age + 4) x 2 (kg)
  2. Energy: 4 x weight (kg) = Joules
  3. Tube size: (Age/4) + 4 (cm)= mm endotracheal tube size
  4. Fluids: 10ml/kg normal saline bolus or another isotonic fluid
  5. Adrenaline: 10 micrograms/kg
  6. Glucose: 2ml/kg of 10% dextrose
46
Q

Summarise Ddx for vomiting in children

A
  1. GORD
    • After meals
    • Large volume regurg
  2. Gastroenteritis
    • Forceful vomit + D
  3. Pneumonia
    • Forceful vomit
    • pneumonia Sx
  4. Acute otitis media
    • Forceful vomit
    • Ear pain
  5. Tonsilitis
    • Throat Sx
  6. Meningitis
    • Forceful vomit
    • Meningitis Sx
  7. UTI
  8. Whooping cough
    • Vomiting + prolonged coughing
  9. Testicular torsion
  10. Pyloric stenosis
  11. GI obstruction
    • Bilious vomiting
  12. Appendicitis
47
Q

How is delayed puberty defined

A
  1. Absence of any pubertal development by 14M and 13F
48
Q

Factors for asthma to be considered life threatening

A

33,92 CHEST. Any one of the following:
PEF <33%
SO2 <92% or PO2 <8
Cyanosis
Hypotension
Exhaustion, altered consciousness
Silent chest
Tachyarrhythmias

49
Q

Factors for asthma to be considered life threatening

A

33,92 CHEST. Any one of the following:
PEF <33%
SO2 <92% or PO2 <8
Cyanosis
Hypotension
Exhaustion, altered consciousness
Silent chest
Tachyarrhythmias

Phase 3a (5 decks)

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