Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Specialties > Paeds > Flashcards

Paeds Flashcards

1
Q

Chickenpox

A

Fever initially
Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular
Systemic upset is usually mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Measles

A

Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots (‘grain of salt’) on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mumps

A

Fever, malaise, muscular pain

Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rubella

A

Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hand, foot and mouth

A

Caused by the coxsackie A16 virus
Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Erythema infectiosum

A

Also known as fifth disease or ‘slapped-cheek syndrome’
Caused by parvovirus B19
Lethargy, fever, headache
‘Slapped-cheek’ rash spreading to proximal arms and extensor surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Scarlet fever

A

Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Patau syndrome - trisomy 13

A

Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fragile X

A 
Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Vaccination schedule:

2 months

A

5in1 - DTaP/IPV(polio)/Hib
PCV (pneumococcal)
Rotavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Vaccination schedule:

3 months

A

5in1 - DTaP/IPV/Hib 2nd dose
Men C
Rotavirus 2nd dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Vaccination schedule:

4 months

A

5in1 - DTaP/IPV/Hib 3rd dose

PCV (pneumococcal) 2nd dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Vaccination schedule:

12-13 months

A

Hib/Men C booster
MMR
PCV (pneumococcal) 3rd dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Vaccination schedule:

2, 3, 4 yrs plus years 1 + 2 school

A

Flu vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vaccination schedule:

From 3 yrs 4 months up to year 1 school

A

MMR 2nd dose

4in1 pre-school booster - DTaP/IPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vaccination schedule:

12-13 years girls only

A

HPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Vaccination schedule:

13-18 years

A

3in1 booster - TD/IPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vaccination schedule:

13-15 years

A

Men C booster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pierre-Robin syndrome

A

Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Knee problems - children and young adults

Chondromalacia patellae

A

Softening of the cartilage of the patella
Common in teenage girls
Characteristically anterior knee pain on walking up and down stairs and rising from prolonged sitting
Usually responds to physiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Knee problems - children and young adults
Osgood-Schlatter disease
(tibial apophysitis)

A

Seen in sporty teenagers

Pain, tenderness and swelling over the tibial tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Knee problems - children and young adults

Osteochondritis dissecans

A

Pain after exercise

Intermittent swelling and locking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Knee problems - children and young adults

Patellar subluxation

A

Medial knee pain due to lateral subluxation of the patella

Knee may give way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Knee problems - children and young adults

Patellar tendonitis

A

More common in athletic teenage boys
Chronic anterior knee pain that worsens after running
Tender below the patella on examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Klinefelter’s syndrome - Primary hypogonadism

A

Klinefelter’s syndrome is associated with karyotype 47, XXY

Features
often taller than average
lack of secondary sexual characteristics
small, firm testes
infertile
gynaecomastia - increased incidence of breast cancer
elevated gonadotrophin levels

Diagnosis is by chromosomal analysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Kallman’s syndrome - Hypogonadotrophic hypogonadism

A

Kallman’s syndrome is a recognised cause of delayed puberty secondary to hypogonadotrophic hypogonadism. It is usually inherited as an X-linked recessive trait. Kallman’s syndrome is thought to be caused by failure of GnRH-secreting neurons to migrate to the hypothalamus.

The clue given in many questions is lack of smell (anosmia) in a boy with delayed puberty

Features
‘delayed puberty’
hypogonadism, cryptorchidism
anosmia
sex hormone levels are low
LH, FSH levels are inappropriately low/normal
patients are typically of normal or above average height

Cleft lip/palate and visual/hearing defects are also seen in some patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Androgen insensitivity syndrome

A

Androgen insensitivity syndrome is an X-linked recessive condition due to end-organ resistance to testosterone causing genotypically male children (46XY) to have a female phenotype. Complete androgen insensitivity syndrome is the new term for testicular feminisation syndrome

Features
‘primary amennorhoea’
undescended testes causing groin swellings
breast development may occur as a result of conversion of testosterone to oestradiol

Diagnosis
buccal smear or chromosomal analysis to reveal 46XY genotype

Management
counselling - raise child as female
bilateral orchidectomy (increased risk of testicular cancer due to undescended testes)
oestrogen therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Edwards syndrome - trisomy 18

A

Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Noonan syndrome

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Prader-Willi syndrome

A

Hypotonia
Hypogonadism
Obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

William’s syndrome

A 
Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Hip problems in children

DDH

A

Often picked up on newborn examination
Barlow’s test, Ortolani’s test are positive
Unequal skin folds/leg length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Hip problems in children

Transient synovitis

A

Typical age group = 2-10 years
Acute hip pain associated with viral infection
Commonest cause of hip pain in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Hip problems in children

Perthes disease

A

Perthes disease is a degenerative condition affecting the hip joints of children, typically between the ages of 4-8 years. It is due to avascular necrosis of the femoral head

Perthes disease is 5 times more common in boys. Around 10% of cases are bilateral

Features
hip pain: develops progressively over a few weeks
limp
stiffness and reduced range of hip movement
x-ray: early changes include widening of joint space, later changes include decreased femoral head size/flattening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Hip problems in children

SUFE

A

Typical age group = 10-15 years
More common in obese children and boys
Displacement of the femoral head epiphysis postero-inferiorly
Bilateral slip in 20% of cases
May present acutely following trauma or more commonly with chronic, persistent symptoms

Features
knee or distal thigh pain is common
loss of internal rotation of the leg in flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Hip problems in children

JIA

A

Preferred to the older term juvenile chronic arthritis, describes arthritis occurring in someone who is less than 16 years old that lasts for more than three months. Pauciarticular JIA refers to cases where 4 or less joints are affected. It accounts for around 60% of cases of JIA

Features of pauciarticular JIA
joint pain and swelling: usually medium sized joints e.g. knees, ankles, elbows
limp
ANA may be positive in JIA - associated with anterior uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Hip problems in children

Septic arthritis

A

Acute hip pain associated with systemic upset e.g. pyrexia. Inability/severe limitation of affected joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

6-year-old girl is investigated for precocious puberty. On examination she is noted to have cafe-au-lait spots predominately on one side of her body and a skull deformity

A

McCune-Albright syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Little or no head lag on being pulled to sit
Lying on abdomen, good head control
Held sitting, lumbar curve

A

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q 
Lying on abdomen, arms extended
Lying on back, lifts and grasps feet
Pulls self to sitting
Held sitting, back straight
Rolls front to back
A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Sits without support (refer at 12 months)

A

7-8 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Pulls to standing

Crawls

A

9 months

43
Q

Cruises

Walks with one hand held

A

12 months

44
Q

Walks unsupported (refer at 18 months)

A

13-15 months

45
Q

Squats to pick up a toy

A

18 months

46
Q

Runs

Walks upstairs and downstairs holding on to rail

A

2 years

47
Q

Rides a tricycle using pedals

Walks up stairs without holding on to rail

A

3 years

48
Q

Hops on one leg

A

4 years

49
Q

Intussusception

A

6-18 months

Features
paroxysmal abdominal colic pain
during paroxysm the infant will characteristically draw their knees up and turn pale
vomiting
blood stained stool - ‘red-currant jelly’
sausage-shaped mass in the abdomen

50
Q

Meningococcal disease

A

Non-blanching rash, particularly with 1 or more of the following:
ill-looking child
lesions larger than 2mm in diameter (purpura)
cap refill >3secs
neck stiffness

51
Q

Bacterial meningitis

A

Neck stiffness
bulging fontanelle
Decreased level of consciousness
Convulsive status epilepticus

52
Q

Herpes simplex encephalitis

A

Focal near signs
Focal seizures
Decreased level of consciousness

53
Q

Pneumonia

A 
Tachypnoea:
>60 breaths/min - 0-5months
>50 breaths/min - 6-12 months
>40 breaths/min - >12 months
Crackles in the chest
Nasal flaring
Chest indrawing
Cyanosis
O2 sats
54
Q

UTI

A 
Vomiting
Poor feeding
Lethargy
Irritability
Abdo pain or tenderness
Urinary frequency or dysuria
55
Q

Kawasaki disease

A 
Fever for > 5 days and at least 4 of:
bilateral conjunctival injection
change in mucous membranes
change in the extremities
polymorphous rash
cervical lymphadenopathy

Management:
high-dose aspirin*
intravenous immunoglobulin
echocardiogram (rather than angiography) is used as the initial screening test for coronary artery aneurysms

56
Q

Wilms’ tumour

A

Wilms’ nephroblastoma is one of the most common childhood malignancies. It typically presents in children under 5 years of age, with a median age of 3 years old.

Features:
Abdominal mass (most common presenting feature)
Painless haematuria
Flank pain
Other features: anorexia, fever
Unilateral in 95% of cases
Metastases are found in 20% of patients (most commonly lung)

Management:
nephrectomy
chemotherapy
radiotherapy if advanced disease
prognosis: good, 80% cure rate
57
Q

Pertussis

A

Gram negative bacterium Bordetella pertussis

Features, 2-3 days of coryza precede onset of:
coughing bouts: usually worse at night and after feeding, may be ended by vomiting & associated central cyanosis
inspiratory whoop: not always present (caused by forced inspiration against a closed glottis)
persistent coughing may cause subconjunctival haemorrhages or even anoxia leading to syncope & seizures
symptoms may last 10-14 weeks* and tend to be more severe in infants
marked lymphocytosis

Management - oral erythromycin to eradicate the organism and reduce spread

Women who are between 28-38 weeks pregnant will be offered the vaccine.

58
Q

Measles complications?

A 
Encephalitis: typically occurs 1-2 weeks following the onset of the illness)
Subacute sclerosing panencephalitis: very rare, may present 5-10 years following the illness
Febrile convulsions
Giant cell pneumonia
Keratoconjunctivitis, corneal Ulceration
Diarrhoea
Increased incidence of Appendicitis
Myocarditis
59
Q

Nephrotic syndrome triad

A

proteinuria (> 1 g/m^2 per 24 hours)

hypoalbuminaemia (

60
Q

Acute epiglottitis

A 
rapid onset
high temperature, generally unwell
sore throat
odynophagia (painful swallowing)
stridor
drooling of saliva

Do not attempt to examine the throat! Airway obstruction.

The incidence of epiglottitis has decreased since the introduction of the Hib vaccine

61
Q

Mild to moderate acute asthma treatment

A

Bronchodilator therapy:
Give a beta-2 agonist via a spacer
10 puffs every 10 secs
Repeat dose after 10-20 mins if necessary

Steroid therapy
To all children with an asthma exacerbation
Given for 3-5 days
Prednisolone - 2-5yrs - 20mg od
>5yrs 30-40mg od
62
Q

Retinoblastoma

A

The most common ocular malignancy found in children. The average age of diagnosis is 18 months. 10% hereditary.

absence of red-reflex, repalced by a white pupil (leukocoria) - the most common presenting symptom
strabismus
visual problems

Management
enucleation (removal of the eye) is not the only option
depending on how advanced the tumour is other options include external beam radiation therapy, chemotherapy and photocoagulation

Prognosis
excellent, with > 90% surviving into adulthood

63
Q

Heart rate - 110-160

Resp rate - 30-40

A
64
Q

Heart rate - 100-150

Resp rate - 25-35

A

1-2

65
Q

Heart rate - 90-140

Resp rate - 25-30

A

2-5

66
Q

Heart rate - 80-120

Resp rate - 20-25

A

5-12

67
Q

Heart rate - 60-100

Resp rate - 15-20

A

> 12

68
Q

Commonest cause of gastroenteritis in children in the UK?

A

Rotavirus

69
Q

Infantile colic

A

It typically occurs in infants less than 3 months old and is characterised by bouts of excessive crying and pulling-up of the legs, often worse in the evening

Infantile colic occurs in up to 20% of infants. The cause of infantile colic is unknown

70
Q

Pediculosis capitis

A

Head lice

Diagnosis
fine-toothed combing of wet or dry hair

Management
treatment is only if living lice are found
a choice of treatments should be offered - malathion, wet combing, dimeticone, isopropyl myristate and cyclomethicone

School exclusion is not advised for children with head lice

71
Q

Autism - associated conditions

A

Fragile X

Rett’s syndrome

72
Q

Hand, foot and mouth disease

A

It is caused by the intestinal viruses of the Picornaviridae family (most commonly coxsackie A16 and enterovirus 71). It is very contagious and typically occurs in outbreaks at nursery

Clinical features
mild systemic upset: sore throat, fever
oral ulcers
followed later by vesicles on the palms and soles of the feet

Management
self limiting
general advice about hydration and analgesia
reassurance no link to disease in cattle
children do not need to be excluded from school

73
Q

Bronchiolitis

A

respiratory syncytial virus (RSV) is the pathogen in 75-80% of cases
other causes: mycoplasma, adenoviruses
may be secondary bacterial infection
more serious if bronchopulmonary dysplasia (e.g. Premature), congenital heart disease or cystic fibrosis

Features
coryzal symptoms (including mild fever) precede:
dry cough
increasing breathlessness
wheezing, fine inspiratory crackles (not always present)
feeding difficulties associated with increasing dyspnoea are often the reason for hospital admission

SIGN suggested the following criteria for referral to hospital
poor feeding ( 70/min
nasal flaring or grunting
severe chest wall recession
cyanosis
oxygen saturation
74
Q

Roseola infantum

A

Roseola infantum (also known as exanthem subitum, occasionally sixth disease) is a common disease of infancy caused by the human herpes virus 6 (HHV6). It has an incubation period of 5-15 days and typically affects children aged 6 months to 2 years.

Features:
high fever: lasting a few days, followed by a
maculopapular rash
febrile convulsions occur in around 10-15%
diarrhoea and cough are also commonly seen

75
Q

Concomitant squint

A

Due to imbalance in extraocular muscles
Convergent is more common than divergent

Detection of a squint may be made by the corneal light reflection test - holding a light source 30cm from the child’s face to see if the light reflects symmetrically on the pupils

The cover test is used to identify the nature of the squint
ask the child to focus on a object
cover one eye
observe movement of uncovered eye
cover other eye and repeat test

Management
eye patches may help prevent amblyopia
referral to secondary care is appropriate

76
Q

Paralytic squint

A

Due to paralysis of extraocular muscles

Detection of a squint may be made by the corneal light reflection test - holding a light source 30cm from the child’s face to see if the light reflects symmetrically on the pupils

The cover test is used to identify the nature of the squint
ask the child to focus on a object
cover one eye
observe movement of uncovered eye
cover other eye and repeat test

Management
eye patches may help prevent amblyopia
referral to secondary care is appropriate

77
Q

UTI

A

Urinary tract infections (UTI) are more common in boys until 3 months of age (due to more congenital abnormalities) after which the incidence is substantially higher in girls. At least 8% of girls and 2% of boys will have a UTI in childhood

Management
Infants less than 3 months old should be referred immediately to a paediatrician

Children aged more than 3 months old with an upper UTI should be considered for admission to hospital. If not admitted oral antibiotics such as cephalosporin or co-amoxiclav should be given for 7-10 days

Children aged more than 3 months old with a lower UTI should be treated with oral antibiotics for 3 days according to local guidelines, usually trimethoprim, nitrofurantoin, cephalosporin or amoxicillin. Parents should be asked to bring the children back if they remain unwell after 24-48 hours

Antibiotic prophylaxis is not given after the first UTI but should be considered with recurrent UTIs

78
Q

Cradle cap

A

Seborrhoeic dermatitis is a relatively common skin disorder seen in children. It typically affects the scalp (‘Cradle cap’), nappy area, face and limb flexures.

It is characterised by an erythematous rash with coarse yellow scales.

Management depends on severity
mild-moderate: baby shampoo and baby oils
severe: mild topical steroids e.g. 1% hydrocortisone

79
Q

Asthma control

Children aged under 5 years

A

1 As-required reliever therapy: short-acting beta2-agonist

2 Regular preventer therapy: inhaled corticosteroids, 200-400mcg/day*
Or, if inhaled corticosteroids cannot be used, a leukotriene receptor antagonist

3 Children aged 2-5 years: trial of a leukotriene receptor antagonist. If already taking leukotriene receptor antagonist reconsider inhaled corticosteroids

Children aged under 2 years: refer to respiratory paediatrician

4 Refer to a respiratory paediatrician

80
Q

Asthma control

Children aged over 5 years

A

1 As-required reliever therapy: short-acting beta2-agonist

2 Regular preventer therapy: inhaled corticosteroids, 200-400mcg/day*

3 1. Add inhaled long-acting B2 agonist (LABA)

    2. Assess control of asthma: good response to LABA - continue LABA benefit from LABA but control still inadequate: continue LABA and increase inhaled steroid dose to 400 mcg/day* (if not already on this dose) no response to LABA: stop LABA and increase inhaled steroid to 400 mcg/ day.* If control still inadequate, institute trial of other therapies, leukotriene receptor antagonist or SR theophylline

4 Increase inhaled corticosteroids to high-dose, up to 800mcg/day*

5 Use daily steroid tablet at lowest dose providing control

Maintain inhaled corticosteroids at 800mcg/day

Refer to a paediatrician

81
Q

Sudden infant death syndrome

A

Sudden infant death syndrome is the commonest cause of death in the first year of life. It is most common at 3 months of age

Risk factors:
prematurity
parental smoking
hyperthermia (e.g. over-wrapping)
putting the baby to sleep prone
male sex
multiple births
bottle feeding
social classes IV and V
maternal drug use
incidence increases in winter
82
Q

Meningitis management

A
  1. Antibiotics:
    3 months: IV ceftriaxone
  2. Steroids: if > 1 month and Haemophilus influenzae then give dexamethasone
  3. Fluids: treat any shock, e.g. with colloid
  4. Cerebral monitoring: mechanical ventilation if respiratory impairment
  5. Public health notification and antibiotic prophylaxis of contacts - rifampicin
83
Q

Cerebral palsy: Associated non-motor problems

A 
Learning difficulties (60%)
Epilepsy (30%)
Squints (30%)
Hearing impairment (20%)
84
Q

Cerebral palsy: Causes

A

Antenatal (80%): e.g. cerebral malformation and congenital infection (rubella, toxoplasmosis, CMV)

Intrapartum (10%): birth asphyxia/trauma

Postnatal (10%): intraventricular haemorrhage, meningitis, head-trauma

85
Q

Cerebral palsy: classification

A

Spastic (70%): hemiplegia, diplegia or quadriplegia

Dyskinetic

Ataxic

Mixed

86
Q

Napkin rash:

Irritant dermatitis

A

The most common cause, due to irritant effect of urinary ammonia and faeces

Creases are characteristically spared

87
Q

Napkin rash:

Candida dermatitis

A

Typically an erythematous rash which involve the flexures

Characteristic satellite lesions

88
Q

Napkin rash:

Seborrhoeic dermatitis

A

Erythematous rash with flakes. May be coexistent scalp rash (cradle cap)

89
Q

Napkin rash:

Psoriasis

A

A less common cause characterised by an erythematous scaly rash also present elsewhere on the skin

90
Q

Napkin rash:

Atopic eczema

A

Other areas of the skin will also be affected

91
Q

Strawberry naevus

A

Usually not present at birth but may develop rapidly in the first month of life. They appear as erythematous, raised and multilobed tumours.

Typically they increase in size until around 6-9 months before regressing over the next few years (around 95% resolve before 10 years of age).

Common sites include the face, scalp and back. Rarely they may be present in the upper respiratory tract leading to potential airway obstruction

Capillary haemangiomas are present in around 10% of white infants. Female infants, premature infants and those of mothers who have undergone chorionic villous sampling are more likely to be affected

Potential complications:
mechanical e.g. Obstructing visual fields or airway
bleeding
ulceration
thrombocytopaenia

If treatment is required (e.g. Visual field obstruction) then systemic steroids are used

Cavernous haemangioma is a deep capillary haemangioma

92
Q

Membranous glomerulonephritis

A

Presentation: proteinuria / nephrotic syndrome / chronic kidney disease

Cause: infections, rheumatoid drugs, malignancy

1/3 resolve, 1/3 respond to cytotoxics, 1/3 develop chronic kidney disease

93
Q

Berger’s disease - IgA nephropathy

A

Typically young adult with haematuria following an URTI

94
Q

Diffuse proliferative glomerulonephritis

A

Classical post-streptococcal glomerulonephritis in child

Presents as nephritic syndrome / acute kidney injury

Most common form of renal disease in SLE

95
Q

Minimal change disease

A

Typically a child with nephrotic syndrome (accounts for 80%)

Causes: Hodgkin’s, NSAIDs

Good response to steroids

96
Q

Focal segmental glomerulosclerosis

A

May be idiopathic or secondary to HIV, heroin

Presentation: proteinuria / nephrotic syndrome / chronic kidney disease

97
Q

Rapidly progressive glomerulonephritis - aka crescentic glomerulonephritis

A

Rapid onset, often presenting as acute kidney injury

Causes include Goodpasture’s, ANCA positive vasculitis

98
Q

Mesangiocapillary glomerulonephritis (membranoproliferative)

A

Type 1: cryoglobulinaemia, hepatitis C

Type 2: partial lipodystrophy

99
Q

Absence seizures

A

Absence seizures (petit mal) are a form of generalised epilepsy that is mostly seen in children. The typical age of onset of 3-10 years old and girls are affected twice as commonly as boys

Features:
Absences last a few seconds and are associated with a quick recovery
Seizures may be provoked by hyperventilation or stress
The child is usually unaware of the seizure
They may occur many times a day
EEG: bilateral, symmetrical 3Hz spike and wave pattern

Management:
Sodium valproate and ethosuximide are first-line treatment
Good prognosis - 90-95% become seizure free in adolescence

100
Q

Live attenuated vaccines (5)?

A 
BCG
MMR
oral polio
yellow fever
oral typhoid
101
Q

Croup

A

Croup is a form of upper respiratory tract infection seen in infants and toddlers. It is characterised by stridor which is caused by a combination of laryngeal oedema and secretions. Parainfluenza viruses account for the majority of cases.

Epidemiology
peak incidence at 6 months - 3 years
more common in autumn

Features
stridor
barking cough (worse at night)
fever
coryzal symptoms

Management
CKS recommend giving a single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity
prednisolone is an alternative if dexamethasone is not available

Emergency treatment
high-flow oxygen
nebulised adrenaline

102
Q

Constipation treatment

A

NICE guidelines on management

If faecal impaction is present
polyethylene glycol 3350 + electrolytes (Movicol Paediatric Plain) using an escalating dose regimen as the first-line treatment
add a stimulant laxative if Movicol Paediatric Plain does not lead to disimpaction after 2 weeks
substitute a stimulant laxative singly or in combination with an osmotic laxative such as lactulose if Movicol Paediatric Plain is not tolerated
inform families that disimpaction treatment can initially increase symptoms of soiling and abdominal pain

Maintenance therapy
very similar to the above regime, with obvious adjustments to the starting dose, i.e.
first-line: Movicol Paediatric Plain
add a stimulant laxative if no response
substitute a stimulant laxative if Movicol Paediatric Plain is not tolerated. Add another laxative such as lactulose or docusate if stools are hard
continue medication at maintenance dose for several weeks after regular bowel habit is established, then reduce dose gradually

General points
do not use dietary interventions alone as first-line treatment although ensure child is having adequate fluid and fibre intake
consider regular toileting and non-punitive behavioural interventions
for all children consider asking the Health Visitor or Paediatric Continence Advisor to help support the parents.

103
Q

Nocturnal Enuresis management

A

Look for possible underlying causes/triggers (e.g. Constipation, diabetes mellitus, UTI if recent onset)

Advise on fluid intake, diet and toileting behaviour
reward systems (e.g. Star charts). NICE recommend these 'should be given for agreed behaviour rather than dry nights' e.g. Using the toilet to pass urine before sleep

NICE advise: ‘Consider whether alarm or drug treatment is appropriate, depending on the age, maturity and abilities of the child or young person, the frequency of bedwetting and the motivation and needs of the family’. Generally:
an enuresis alarm is first-line for children under the age of 7 years

Desmopressin may be used first-line for children over the ago 7 years, particularly if short-term control is needed or an enuresis alarm has been ineffective/is not acceptable to the family

Specialties (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions