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MSRA > Paeds > Flashcards

Paeds Flashcards

1
Q

Live attenuated Viruses (7)

A

BCG (CI if prev TB/+ve tuberculin test)
Oral tphoid
Yellow fever
Varicella
Oral rotavirus
Nasal influenza
Oral Polio

Live attenuated Ci if pred live attenuated within 4w

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2
Q

Rotavirus Vaccine schedule

A

2 doses - 1st at 2 mo, 2nd at 3 mo

Oal live attenuated

Should not give 1st dose after 14+6w or second after 23+6 due to risk of intussusception

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3
Q

Men B vaccine schedule

A

three doses - 2mo, 4 mo, 12mo

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4
Q

Adrenaline doses paeds anaphylaxis

A

<6y - 150mic (0.15ml 1:1000)
6-12 300 mic
12+ = 500 mic

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5
Q

Fever ,swollen knee, pain on movement - systemic onset
Fine macular rash
uveitis

A

Stills disease (JIA)
Salmon pink rash
+ lymphadenopathy, arthritis, weight loss,
Raised ESR, normochromic normocytic anemia

Tx = NSAIDs, DMARDs (methotrex)

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6
Q

Postpartum comp of IUGR

A

Hypogly (dec glycogen stores)
NEC (chronic bowel hypoxia)
decreased O2 levels
Polycythaemia

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7
Q

RF for IUGR

A

Maternal substance abuse
Congen infection
Maternal age >40

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8
Q

Tx for ADHD in paeds

A

1 -= psychological intervention
2 - Psychostimulants - methylphenidate, lisdexamfetamine

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9
Q

Cafe-au lait spots, axilary/groin freckles, vision trouble

A

NF1
Also - learning difficulties + eplipsy

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10
Q

Bilateral vestibular schwannomas

A

NF2

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11
Q

Tired child, frequent infections, easy bruising

A

ALL - incidence peaks 2-5

Also; bone pain, spleno/hepatomeg, fever, testicular swelling

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12
Q

Presenting features CF

A

Meconium ileus, prolonged jaundice, recurrent chest inf
malabs (greasy poos that float)

Failure to thrive

Later symptoms -Short stature, DM, delayed puberty, rectal prolapse, nasal polyps, infertility

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13
Q

Features of innocent murmurs

A

Systolic (commonly EJS), may vary with posture, no radiation
no added sounds or diastolic component
Asymptomatic

Venous hum - turbulent flow - continuous blowing noise below clav

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14
Q

Ft of acute epiglottitis

A

Rapid onset, high temp, stridor, drooling, tripod position

Cause - Haemophilus influenza
Dx - by direct visualisation #

Tx - IV Abx (cefutaxime, Neb adrenaline if severe DIB

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15
Q

Congenital heart defects, short stature, lack of infections resistance, cleft palate (abn facies), cognitive/behavioural issues, hypocal

A

Di George syndrome

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16
Q

Child, short stature, cardiac malformations, mild mental retardation, overly friendly, Supravalvular aortic stenosis

A

Williams syndrome

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17
Q

Small jaw, Low-set ears
Overlapping of fingers
Abnormal feet

A

Edwards syndrome (trisomy 18)

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18
Q

Learning difficulties, large, long face, large testes

A

Fragile X

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19
Q

Webbedn neck, outgoing chest, short, pulmonary stenosis

A

Noonan syndrome

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20
Q

Small jaw, posterior displacement of tongue (recurrent upper airway obstruction), cleaft pallate

A

Pierre robin syndrome

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21
Q

Floppy baby, hypogionadism
appetite driven obersity

A

Prader-willi syndrome

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22
Q

Key gross motor milestones

A

6 months: Sits without support (refer at 12mo)
9-12 months: Crawls and pulls to stand.
12-18 months: Walks independently. (refer at 18mo)
2-3 years: Runs and walks up stairs with help.
3-4 years: Hops on one foot and walks up/down stairs alternating feet.

NB - hand preference before 12 mo is abnormal (?CP)

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23
Q

Key social developmental milestones

A

6 weeks - smiles (refer at 10w)
9-12 months: Stranger anxiety/shy
18 months - plays contentedly alone
2 years - plays near others
4 - plays with others

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24
Q

Key speech milestones

A

3mo - turns to sound
9mo - mama/dada
12 mo - knows own name
2 yr - combines 2 words
3 yr - short sentences (3-5words)

25
CMPA
Presents in first 3 mo of life Vom/diarrhea, irritability, colic, rash Tx - extensively hydrolyzed formula
26
Kawasaki
High grade fever, not responsive, >5d non-purulent conjunctiva Bright red lips + cracked tongue Cervical lymphadenopathy Tx - high dose aspirin, IVIG, echo (coronary artery aneurysms
27
Whooping cough- ft + Tx
Paroxysmal cough, insp whoop, coughing fits + vom Bordetella pertussis Tx - macrolide (clari/azi/erythromycin) if <21 days since starts Exclude from school 2 days after abx started or 21 days from onset if no abx Paeds vaccine - 2, 3, 4mo and 3-5yr NB women between 16 and 32 w pregnant - offer the vaccine
28
Opportunistic org in CF
Staph A, Pseudomonas aureg Aspergillus
29
Jaundice in first 24 hrs
rhesus / ABO haemolytic disease hereditary spherocytosis G6PD def
30
Child, fever w/ headache + N/V Red tongue, sore throat Fine punctate erythema on torso, rough
Scarlet fever (Group A strep (strep pyogenes)) Tx - Oral penicillin V 10/7 If pen allergy - Azithro 24 hr school exclusion after starting abx notifiable disease Comp - otitis media
31
X-linked recessive inheritance
Affected males can only have unaffected sons and carrier daughters Hetrozygous mum - 50% chance carrier/ affected
32
Acyanotic congenital heart disease (5)
VSD - most common ASD PDA coarctation of the aorta aortic valve stenosis
33
Cyanotic congen heart disease (3)
Tetralogy of fallot (presents at 1-2mo) Transposition of GA (present at birth) Tricuspid atresia
34
Red - risk stratification for feverish child: Colour Activity Resp Circulation Other
Colour - mottled/ashen/blue Activity - no response to social cues, weak, high pitched or continuous cry, does not wake Resp - grunting, RR>60, mod/sev chest indrawing Circulation - reduced skin turgor Other - Age<3 with temp >38, non-blanching rash, bulging fontanelle, neck stiffness, focal neurological signs
35
Teenage girl, anterior knee pain when walking up/down stairs
Chondromalacia patellae - softening of the cartilage of the patella Responds to physiotherapy
36
Sporty teenager with pain/tenderness in knee
Osgood schlatter disease
37
Knee pain after exercise, intermittent locking and swelling
Osteochondritis dissecans
38
Teenager - medial knee pain Knee may give way
Patellar subluxation
39
Irritable/feverish child, Conjunctivitis rash that starts behind ears then spreads to the whole body
Measles Prodrome - irritable, feverish, conjunctivitis Koplic spots (grain of salt on buccal mucosa) Rash - discrete maculopapular rash that starts behind ears then spread, becomes blotchy and confluent, desquamation Tx = supportive If non-vacc child comes into contact - offer MMR withing 72hrs
40
Complications for maesles
Otitis media Pneumonia (most common cause of death) encephalitis, febrile convulsions Diarrhoea Subacute sclerosing panencephalitis
41
Classic presentation Roseola Infantum
Caused by HHV6 High fever for few days then maculopapular rash Febrile convulsions common Nil need for exclusion
42
Risk factors and presentation of RDS
RDS = surfactant deficient lung disease RFs - premature, male sex, diabetic mum, C-sec Give maternal corticosteroids in premature delivery CXR - ground glass appearance
43
Features of Turnurs syndrome
Short stature, wide space nipples, bicuspid aortic valve, webbed neck, horseshoe kidney, hypothyroidism, aortic stenosis primary amenorrhea with elevated gonadotrophins
44
Tx for umbilical hernia
Watch and wait - most resolve by 3yrs age
45
Features of life-threatening asthma attack in paeds
PEF <33%, silent chest, poor resp effort, agitation, altered consciousness, cyanosis
46
Cyanosis around mouth and extremities immediately from birth, otherwise healthy infact
Acrocyanosis
47
Taller child, lack of secondary sexual characteristics, small firm testes
Primary hypogonadism (klinefelters) High LH, low testosterone
48
Delayed puberty, hypogonadism, anosmia
Kallmans syndrome (hypogonadotropic hypogonadism) Low LH, low testosterone
49
Girl with primary amenorrhoea, groin swellings
Androgen insensitivity syndrome High LH, normal/high testosterone
50
Failure/delay to pass meconium
? Hirschsprungs disease Asso with downs syndrome Ix - AXR, rectal biopsy Tx - rectal washouts/bowel irrigation
51
easy bruising, petechia/purpiric rash#Recent infection/vaccination
ITP Tx - conservative, if very low Plt count (corticosteroids, IVIG)
52
Men B Vaccine
(bexsero) Given at 2 mo, 4 mo, 12 mo
53
Proteinuria, oedema, low albumin
Nephrotic syndrome - peak 2-5yr - Minimal change glomerulonephritis Tx high dose oral steroids
54
Newborn eye infection
Opthalmia neonatorum (Chlam t, N Gonorr) # Refer for same day opthal
55
baby - retinal haemorrhages, subdural haematoma, encephalopathy
Shaken baby syndrome
56
SUFE tx and comp
Tx - internal fixation Comp - osteoarth, avasc nec, leg length discrepoancy
57
Ts for transposition of great arteries
Maintain the PDA with prostaglandins while awaiting surgery
58
When to refer undescended testes
unilat - refer at 3 mo Bilat - rv by snr paediatrician within 24hrs
59
Child, painless haematuria, abdominal mass
Wilms tumour (nephroblastoma)

MSRA (21 decks)

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