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Tomakesense 2 > Paeds > Flashcards

Paeds Flashcards

1
Q

All live vaccines can be given at any time before and after each other except which?

A

Vaccination with yellow fever or varicella/zoster requires a 4 week minimum between giving MMR.

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2
Q

Normocytic normochromic anaemia + arthralgia + raised ESR + fine “salmon pink” rash

Dx and Rx

A

JIA

Rx: NSAIDs
Consider DMARD eg. methotrexate if severe

RF+ve associated with worse prognosis

NB. Rash distinguishes JIA from other causes

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3
Q

Definition of SGA births

A

Birth weight <10th centile for gestational age

50-70% physiological; 30-50% IUGR

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4
Q

Post-partum complications of SGA babies

A

Hypoglycaemia (low glycogen stores)
NEC (bowel hypoxia)
Polycythaemia + thrombocythaemia
Hypocalcaemia (delayed vD pathway development)

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5
Q

Maternal IUGR RFs

A

Substance abuse eg. smoking
Congenital infection
Maternal age >40

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6
Q

10 year old boy with marble like swellings in neck and armpit

A

Lymphoma
NON-Hodgkins most common

Usual px: painless lymphadenopathy
B symptoms if more severe

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7
Q

10 year old with visual impairment and brown patches on skin

A

Optic glioma as manifestation of NF1 (cafeaulait spots)

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8
Q

Most common paed malignancy

Px?

A

ALL 2-5yo

Rash, anaemia, infections, HSM, LNopathy

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9
Q

CF complications

A

DM
Recurrent chest infection
Infertility
NASAL POLYPS

(not CKD)

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10
Q

Initial Rx of acute apiglottitis

A

Neb adrenaline

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11
Q

Headache -> chest infection Sx

Dx and Rx

A

Mycoplasma pneumonia

PO Erythromycin

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12
Q

DiGeorge S features

A 
CATCH22
Cardiac anomalies
Abnormal facies
Thymic hypoplasia
Cleft palate
Hypocalcaemia + hypoPTH
c22 deletion

IE. poor immunity to infection
NB. also get cognitive/behavioural/psych problems

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13
Q

When can a child:

  1. copy a cross
  2. copy a circle
  3. copy a square
  4. copy a triangle
A
  1. 3 years
  2. 4 years
  3. 4.5 years
  4. 5 years
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14
Q

How old can tell their age?

A

3 years

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15
Q

How old can enjoy symbolic play?

A

18-24months

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16
Q

Laryngotracheobronchiolitis Rx

A

aka. Croup

Rx: oral dex

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17
Q

Age for febrile convulsions

A

6mo-3yo

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18
Q

HSP features and Rx

A

Colicky abdo pain + palpable pruritic rash + arthritis
+/- haematuria, proteinuria
Rx: NSAIDs, roids

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19
Q

Asian/AfroCarrib
dark blue lesion on back/buttocks
present from birth

Dx and prognosis

A

Mongolian blue spot/slate grey nevus

Slowly resolve over first few years

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20
Q

Itchy annular lesions with central clearing

A

Tinea

Ddx: annular psoriasis

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21
Q 
Immunodeficiency presdispositions:
NP defect?
T-cell defect?
B-cell defect?
Leukocyte defect?
Complement/MAC defect?
A

NP defect: recurrent abscess and fungals
T-cell defect: severe or atypical viral/fungal
B-cell defect: severe bacterial, but not Neisseria meningitidis
Leukocyte defect: poor wound healing, skin ulcers
Complement/MAC defect: Recurrent Meningococcal disease

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22
Q

EEG centrotemporal spikes

A

Benign rolandic epilepsy of childhood

most common cause of childhood seizures

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23
Q

Hearing loss, developmental delay, CT intracranial calcificaiton

A

Congenital CMV

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24
Q

Hearing loss and prog renal disease

A

Alport’s sydrome

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25
Q

Hearing loss and goitre

A

Pendred syndryome (~hypothyroid)

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26
Q

What gestation at risk of RDS due to surfactant deficiency

A

<34/40

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27
Q

haematuria + resp infections at same time

A

IgA(t same time) nephropathy

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28
Q

6 week old with jaundice, umbilical hernia, dry skin

A

Hypothyroidism

often non-uk residents

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29
Q

First day new born jaundice. negative Coombs. Heinz bodies present

A

G6PD deficiency

Middle East/SE Asian/Mediterranean

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30
Q

Complications of cleft palate

A 
Feeding
Speech
Hearing
Ear infections
Jaw development eg. displaced teeth
(no ocular association)
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31
Q

Features of salicylate poisoning and sources

A

N+V
lethargy
Dizzy + tinnitus

Severe: hyperventilation, deafness

Sources:
aspirin
wintergreen oil eg. tiger balm, deep heat

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32
Q

Clumsiness
Poor coordination
Headache worse in morning

A

intracranial tumour

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33
Q

What is Reye’s syndrome

A

Life-threatening complication of viral infection, associated with use of aspirin

Fever, hypoglycaemia, hepatomegaly, deranged LFTs
(no jaundice)

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34
Q

Imaging in UTI guidelines

A

<6mo + recurrent or atypical UTI = USS during infection
<6mo and typical UTI = 6 week USS
<3mo = refer to paeds urgently

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35
Q

Newborn ALS compressions:breath ratio

A

3:1

36
Q

FTT
Unwilling to breastfeed
Became blue on bottle

A

Congenital cyanotic heart disease

37
Q

Most common organism of pneumonia in >2yo

A

Strep pneumoniae

38
Q

APGAR score description

A

0/1/2
Appearance: cyanotic/peripheral cyanosis/pink
Pulse: 0/100/140
Grimace: No response/weak cry/cry
Activity: Floppy/some flexion/well flexed and resisting extension
RR: Apneic/slow irregular/strong cry

39
Q

Paeds ALS - how to assess circulation?

A

Check brachial or femoral (not carotid) pulse for TEN seconds

40
Q

Most common cause of NEWBORN intestinal obstruction

A

Hirschsprungs disease

41
Q

3 days old, unable to feed, vomiting bile, “scaphoid abdomen”

A

Duodenal atresia - requires radiology to Dx

42
Q

3 days old. Abdo mass, distension, passing meconium regularly, now blood PR

Dx, usual age, late signs

A

Intussusception
6-18mo but can present earlier
Bleeding per rectum: suggests mucosal necrosis “redcurrant jelly”

43
Q

Sudden infant death:

  • Major RFs:
  • Other RFs:
A

Major RFs:

  • Parental smoking
  • Bed sharing
  • Sleeping prone
  • hyperthermia
  • prematurity

Other RFs:

  • winter
  • multiple birth
  • male
  • maternal drug use
  • social class IV or V
44
Q

Commonest cause of death in 1st year

A

SIDS ~3months

NB. Screen all siblings for sepsis or inborn errors of metabolism

45
Q

DDH RFs, Ix, Rx

A

RFs:

  • FH
  • Female
  • First born
  • Breech
  • Oligohydramnios
  • Birth weight <5kg

Ix: urgent hip USS

Rx:

  • Usually spontaneously resolve in 3-6 weeks
  • Pavlik harness if <5mo
  • Consider surgery if older
46
Q

Labial adhesions:

  • age of presentation
  • Rx
A

3mo-3yo

Rx:

  • usually spontaneously regress around puberty
  • if multi UTI, trial TOP Oes cream
  • if fails, consider surgical
47
Q

Nocturnal enuresis:

  • age of presentation
  • Rx
A

Should achieve incontinence at 3-4yo ie. abnormal if 5+

Rx:
- Look for possible cause eg. constipation, UTI, DM
- Advise on diet and toileting behaviour (do not restrict fluids)
- Trial reward system eg. star chart
- If fails:
• <7yo = enuresis alarm
• >7yo = trial of oral desmopressin (esp. if need short term control)

48
Q

Who is offered HPV Vaccine (Gardasil) and when?

A

All boys and girls aged 12-13yo

2 doses

49
Q

Kawasaki features + Rx

A 
Fever >5 days
Conjunctivitis
Red, cracked lips
Strawberry tongue
Cervical LNopathy
Red, peeling hands and soles

Rx: high dose aspirin, IVIg, Echo (to r/v coronary aneurysms)

50
Q

Paediatric marks features

A

Strawberry naevus/capillary haemangioma:
o Small red patch develops in first month and increasing in size until around 9 months
o Rx: first line = propranolol

Mongolian blue spots: blue spots on buttocks and lower back, resolve by 1yo

Port wine stains: purplish/red macule with irregular contours – do not resolve ie. Cosmetics or laser therapy

Stork mark/salmon patch: vascular birthmark, self resolves

51
Q

Carrier rate in CF

A

1/25

52
Q

Perthe’s disease:

  • age of presentation
  • Rx
A

~4-8 yo

Rx:

  • Keep femoral head in acetabulum ie. Cast, braces
  • <6yo = conservative, unless severe deformity
  • > 6yo = surgical
53
Q

Paediatric BLS:

A

Start with 5 rescue breaths ->
Check for circulation ->
15:2 compressions

54
Q

AR inheritance rule of thumb

A

Metabolic EXCEPT ataxias too

55
Q

AD inheritance

A

Structural EXCEPT Gilbert’s, hyperlipidaemia type II

56
Q

Responds to own name

A

9-12mo

57
Q

Most common cardiac congenital abnormality in Downs Syndrome

A

AVSD

58
Q

Presentation of HF in neonates

A

poor feeding/FTT
hepatomegaly
SOB

59
Q

Paeds Px of hereditary spherocytosis

A

Jaundice, gall stones
Hepatomegaly
Splenomegaly
Aplastic crisis

60
Q

Vitamin supplementation in paeds, what ages? what replace?

A

Vit A, C, D from 6mo-5yo

61
Q

Headbanging. When concern? What may it suggest?

A

Normal up to 2yo

>3yo ?autism

62
Q

Which metabolic disease does neonatal blood spot not test for?

A

galactosaemia

63
Q

First line pharm Rx for paeds constipation

A

Movicol

64
Q

Indication for admission for NG feed

A

Child feeding <50%

65
Q

Scarlet fever features

A

o Fever
o Sore throat
o Strawberry tongue
o Rash: punctate/pinhead erythema on torso, spares palms and soles

66
Q

Bowed legs in child should resolve when?

A

by 4yo

67
Q

Risk of Downs Syndrome in pregancy depends on mother of age, how?

A

1/1000 at mother 30yo, divide by 3 for every 5 years

68
Q

<3mo + >38 deg ?action

A

same day paeds assessment (do not Px Abx w/o source)

69
Q

Coxsackie A16 ftrs

A

~hand, foot, mouth disease + mild systemic upset

70
Q

Parvovirus B19

A

~Erythema infectiosum aka 5th disease aka slapped cheek syndrome
+ fever

71
Q

Rubella ftrs

A

pink maculopapular rash on face then spreads + LNopathy

72
Q

Child with squint ?action

A

Refer all children with squints to Ophthal

o UNLESS <3mo old

73
Q

“mama/dada”

A

9-10/12

74
Q

Overlapping bones and positional head moulding in newborn ?Action

A

Normal in newborn but document clearly for GP

75
Q

Non-IgE mediated cows milk protein allergy ?Rx

A

initiate milk ladder with malted milk biscuits first

76
Q

When should not have head lag?

A

~3mo

77
Q

When crawl

A

8-10mo

78
Q

Roseola infantum Px

A

Fever -> settles -> rash

79
Q

Jaundice in first 24h DDx

A

Always pathological

  • ABO/Rh haemolysis
  • G6PD
  • Hereditary spherocytosis
80
Q

Jaundice in first 2-14/7 DDx

A

Common and physiological

- investigate if persists

81
Q

Prolonged jaundice DDx

A 
o	Biliary atresia
o	Hypothyroid
o	Galactosemia
o	UTI
o	Breast milk
o	Congenital infection
82
Q

Sit without support, when able? when refer if not able?

A

7-8mo

12mo

83
Q

Noonan syndrome ftrs

A 
o	Pulmonary stenosis
o	Pectus excavatum
o	Ptosis
o	Short
o	Webbed neck
84
Q

Pierre-Robin ftrs

A

o Cleft palate
o Posterior displacement of tongue
o Micrognathia

85
Q

Recurrent sticky eye in neonates Dx and Rx

A

Congenital tear duct obstruction

Self resolves by 1yo ie. reassure

86
Q

Tuberous sclerosis features

A

adenoma sebaceum

epilepsy

87
Q

FGM and police

A

Refer all to police if <18yo

- does not apply for over 18s

Tomakesense 2 (18 decks)

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