Paeds 1A Flashcards
When is the 6 in 1 vaccine given?
2, 3 and 4 months
When is the pneumococcus vaccine given?
2, 4 and 12 months
When is the Men B vaccine given?
2, 4 and 12 months
When is the rotavirus vaccine given?
2 and 3 months
When is the Hib/MenC booster given?
1 year
When is the MMR given?
1 year and 3 years 4 months
When is the HPV vaccine given?
12-13 years
When is the Men ACWY vaccine given?
14 years
New university students aged 19-25
Outline the management of DDH.
If < 2 months, observation and serial examination and ultrasound is recommended (every months)
If it persists/worsens, hip abduction orthosis (splint) or Pavlik harness are recommended (serial follow-up and plain X-ray at 6 months)
Outline how hearing is tested in the neonate.
1st: evoked otoacoustic emission (EOEA) testing
If this is abnormal –> automated auditory brain stem (AABR) audiometry
Briefly outline the steps in the management of necrotising enterocolitis.
Stop oral feeding
Broad spectrum antibiotics (ceftriaxone and vancomycin)
Surgery if perforation/necrosis
TPN
What can be used to close a PDA?
IV indomethacin
Prostacyclin synthetase inhibitor
Ibuprofen
How is the bilirubin concentration measured in neonatal jaundice?
If < 24 hours or < 35 weeks gestation = serum bilirubin
If > 24 hours or > 35 weeks gestation = transcutaneous bilirubin (if this is > 250 µmol/L - check serum bilirubin)
What serum bilirubin levels suggests increased risk of developing kernicterus?
> 340 µmol/L in babies > 37 weeks
or rising rapidly > 8.5 µmol/L/hr
How often should serum bilirubin be measured in a neonate with jaundice?
Every 6 hours until it drops below the treatment threshold
Which investigations should be performed in a neonate who developed jaundice within 24 hours of birth?
Haematocrit Blood group of mother and baby DAT test FBC and blood film Blood G6PD level Blood/urine/CSF culture
Which antibiotics are used to treat meconium aspiration?
IV ampicillin and gentamicin
Which antibiotics may be used in the treatment of early-onset sepsis?
Benzylpenicillin and gentamicin
Which organism most commonly causes late-onset sepsis?
Coagulase-negative staphylococcus (e.g. Staphylococcus epidermidis)
How is neonatal meningitis treated?
3rd generation cephalosporin + amoxicillin/ampicillin
What is the paediatric sepsis 6?
- Supplemental oxygen
- Gain IV or IO access and order blood cultures, blood glucose and arterial/capillary/venous gasses
- IV/IO broad-spectrum antibiotics
- IV fluids (be cautious about fluid overload)
- Experienced senior clinicians should be involved early
- Vasoactive inotropic support (e.g. adrenaline) should be considered early
a. Considered if normal physiological parameters are NOT achieved after > 40 ml/kg of fluid resuscitation
How should neonatal conjunctivitis be treated?
Mild bacterial = chloramphenicol
Serious ones require systemic abx:
Gonococcus - single dose 3rd generation cephalosporin eg cefotaxime/ceftriaxone
Chlamydia - oral erythromycin (2 weeks)
Pseudomonas - gentamicin eye drops + systemic abx
What should babies at risk of vertical hepatitis B transmission receive?
Hepatitis B immunoglobulin AND Hep B vaccine
How is gastro-oesophageal reflux in a breastfed infant treated?
1st line: Breastfeeding assessment
2nd line: trial of alginate therapy for 1-2 weeks
How is gastro-oesophageal reflux in a formula fed infant treated?
1st line: review feeding history (check for overfeeding)
2nd line: offer trial of smaller more frequent feeds
3rd line: offer trial of thickened formula
4th line: offer trial of alginate therapy
If conservative measures to treat GORD in an infant fail, what should you do?
Consider a 4-week trial of a PPI or histamine antagonist
