Paeds 2 Flashcards
At what age would the average child acquire the ability to sit without support?
6-8 months
At what age would the average child start to play alongside, but not interacting with, other children?
2 years
What scan can be done to look for renal scarring in VUR?
DMSA scan
1st line in paeds BLS if there are no signs of breathing on initial assessment?
Give 5 rescue breaths
Follow this with CPR 15:2
At what age would the average child acquire a good pincer grip?
12 months
Describe rash in chickenpox
The rash starts as a macular rash before quickly developing into vesicular lesions which later scab over and heal.
The rash is itchy and associated with constitutional symptoms such as a fever, headache, and general malaise.
Gastroschisis vs omphalocele?
Both are examples of congenital visceral malformations.
Gastroschisis –> refers to a defect lateral to the umbilicus
Omphalocele –> refers to a defect in the umbilicus instead
What can be provided to parents for prophylaxis of febrile seizures? (2)
1) Rectal diazepam
2) Buccal midazolam
In what situations would Abx be indicated in otitis media?
1) >4 days of illness
2) Systemically unwell
3) Perforation of TM
4) Bilateral otitis media ≤2 y/o
Mx of otitis media (if no indications for Abx)?
Supportive
Safetynetting advice –> if temperature rises in the next few days, the child deteriorates, or swelling behind the ear develops.
What are the complications of otitis media?
1) Perforation of TM
2) Mastoiditis
3) Meningitis
What is the most common cause of ambiguous genitalia in newborns?
Congenital adrenal hyperplasia
Head size in fragile X syndrome?
Typically larger than normal
What is a reflex anoxic seizure?
A syncopal episode (or presyncope) that occurs in response to pain or emotional stimuli.
Features of a reflex anoxic seizure?
- child goes very pale
- falls to floor
- 2ary anoxic seizures are common
- rapid recovery
What class of medication is alprostadil?
Prostaglandin E1
Cause of congenital adrenal hyperplasia (CAH)?
Absence of 21-hydroxylase enzyme.
This results in the underproduction of cortisol & aldosterone, and overproduction of androgens.
What is the role of 21-hydroxylase?
Responsible for converting progesterone into aldosterone and cortisol.
Progesterone is also used to create testosterone, but this conversion does NOT rely on the 21-hydroxylase enzyme.
Therefore, because there is extra progesterone floating about that cannot be converted to aldosterone or cortisol, it gets converted to testosterone instead.
How do females with CAH typically present?
Ambiguous genitalia
How do males with CAH typically present?
Salt losing:
- hyponatraemia
- vomiting
- excessive dehydration
- hypotension
- hypoglycaemia
How is a diagnosis of CAH made?
1) Elevated cortisone precursors (17-hydroxyprogsterone)
2) Steroid profile
Mx of early onset vs late onset sepsis?
Early onset –> IV benzylpenicillin + gentamicin
Late onset –> IV flucloxacillin or vancomycin + gentamicin
What is the most common organism causing late onset neonatal sepsis?
Coagulase-negative Staphylococci e.g. Staph. epidermidis
What are 2 ABSOLUTE contraindications to lumbar puncture in neonates?
1) GCS <8
2) Raised ICP e.g. bulging fontanelle