Paeds 3 Flashcards
When is the risk of congenital rubella syndrome highest?
If contracted in first 3 months of pregnancy (earlier = more severe defects).
If contracted >20 weeks gestation –> NO additional risk.
Incubation period of rubella?
14-21 days
What are 3 key cardiac abnormalities that may be seen in congenital rubella syndrome?
1) PDA
2) Pulmonary stenosis
3) VSD
Management of varicella of the newborn?
VZIG +/- aciclovir
What is foetal varicella syndrome caused by?
reactivation of the virus in utero as herpes zoster.
this reactivation ONLY occurs when the foetus is infected with varicella <20 weeks gestation.
What is the most common virus transmitted to the fetus during pregnancy?
Cytomegalovirus
What are 6 key maternal infections that can have foetal complications?
1) Rubella
2) VZV
3) Herpes (HSV)
4) Cytomegalovirus
5) Toxoplasmosis
6) Zika
How can congenital rubella affect hearing?
Sensorineural hearing loss
How can congenital rubella affect eyesight?
Congenital cataracts & retinopathy
What is the biggest risk factor for varicella of the newborn?
Maternal infection occurs <4 weeks from birth (50% risk)
Management of maternal CMV infection in an immunocompetent woman?
No treatment
What are the 3 most commonly noted clinical features in congenital CMV?
1) jaundice
2) petechiae
3) hepatosplenomegaly
When is the risk of congenital toxoplasmosis higher in pregnancy?
The risk is higher LATER in pregnancy
How can foetal CMV be diagnosed prenatally?
Amniocentesis & PCR testing of amniotic sample
Must be carried out AFTER 21 weeks gestation, as functioning foetal kidneys are required for the virus to be excreted into the amniotic fluid.
Infections that can be passed to baby in pregnancy –> TORCH
What are they?
T - toxoplasmosis
O - others (syphillis, hep B, zika)
R - rubella
C - CMV
H - herpes simplex
When is sudden infant death syndrome (SIDS) most common?
At 3 months of age
Surgical mx of paediatric intestinal malrotation with volvulus?
Ladd’s procedure - includes division of Ladd bands and widening of the base of the mesentery.
Location of atopic eczema in infants?
Usually involves the face and flexural surfaces of the body (as opposed to its classical flexural distribution).
What is the only definitive treatment for biliary atresia?
Surgical intervention
Mx of SUFE?
Surgery –> internal fixation across the growth plate
What is used to screen newborns for hearing problems?
Automated otoacoustic emission test.
This involves putting a small soft-tipped earpiece in the outer part of a baby’s ear which sends clicking sounds down the ear. The presence of a soft echo indicates a healthy cochlea.
What further test can be done if the otoacoustic emission test is abnormal?
Auditory brainstem response test
Is oligo or polyhydramnios a risk factor for DDH?
Oligohydramnios –> as it restricts foetal movement and thus normal development of the hip joint.
What is the mx of any child presenting with a limp/hip pain + a fever?
Refer for same day hospital assessment (even if a diagnosis of transient synovitis is suspected) –> to rule out septic arthritis.