Paeds 4 Flashcards
Average age for running as a gross motor developmental milestone?
16m to 2y
Average age for riding a tricycle with pedals?
3y
How far apart should MMR vaccines be given (if not in routine schedule)?
3 months apart
What are the 2 most serious long term heakth problems for women with Turner’s?
1) aortic dissection
2) aortic dilatation
Why may patients with Turner’s syndrome develop X-linked recessive conditions?
As they only have 1 X chromosome
What imaging is 1st line for DDH in children >4.5 months?
Xray
Typical age that a child can pull to stand?
8-10 months
Typical age that a child can hop on one leg?
3-4y
Typical age that a child can squat to pick up a ball?
18 months
What murmur is heard in Ebstein’s anomaly?
The posterior leaflets of the tricuspid valve are displaced anteriorly towards the apex of the RV.
1) Tricuspid regurg –> pansystolic murmur
2) Tricuspid stenosis –> mid-diastolic murmur
There is also enlargement of the RA.
1st line Abx for pneumonia in children where Mycoplasma pneumonia is suspected?
A macrolide e.g. erythromycin
When should a c-section be planned for in exomphalos?
37 weeks
what term is used to describe the mode of inheritance for Prader-Willi syndrome?
Imprinting
For this disease to occur, the patient does not receive the gene from their father. The mother’s gene may be normal, but that does not prevent the phenotype occurring.
What 3 infections can cause HUS?
1) E. coli (Shiga toxin)
2) HIV
3) Pneumococcal
What is the criteria for a very urgent referral (for an appointment within 48 hours) in regard to Wilms’ tumour?
1) Palpable abdominal mass
2) Unexplained haematuria
3) Unexplained organomegaly
Referral time in suspected Wilm’s tumour?
<48h
What mutation is the cause of ARPKD?
Polycystic kidney and hepatic disease 1 (PKHD1) gene on chromosome 6.
What is the most common site of metastasis in Wilm’s tumour?
Lung
What is a posterior urethral valve?
Tissue at the proximal end of the urethra (nearest bladder) that causes obstruction of urine.
How can severe posterior urethral valve present in utero?
1) Bilateral hydronephrosis
2) Oligohydramnios –> lung hypoplasia (resp failure shortly after birth)
Give some risk factors for cryptorchidism
- prematurity
- low birth weight
- maternal smoking during pregnancy
- other abnormalities of genitalia e.g. hypospadias
- FH (1st degree)
What does the epididymis drain into?
Vas deferens
What are 2 key side effects of quinolones (e.g. ciprofloxacin)?
1) lowers seizure threshold
2) tendon damage & rupture (Achilles)
Should you wait for swab results before treating epididymo-orchitis?
No - treat empirically
How quickly should surgery occur in testicular torsion?
Within 4-6h of pain onset (due to risk of irreversible testicular necrosis).
What is epididymo-orchitis in individuals with a low STI risk usually due to?
Enteric organisms e.g. E. coli –> get MSU
What is Prehn’s sign?
Elevation of testicle does not ease pain (testicular torsion)
Mx of intermittent testicular torsion?
Consider bilateral orchiopexy (prophylactic)
What is paraphimosis?
When the foreskin cannot be returned to its original position after being retracted.
It causes the glans to become painful and swollen.
In severe cases, circumcision may be required to treat it.
When do hydroceles typically resolve by?
1-2 y/o
What is a varicocele a significant risk factor for?
Male infertility
What can a varicocele be a presenting feature of?
Renal cell carcinoma (due to compression of the renal vein between the abdominal aorta and the superior mesenteric artery) .
What is a epididymal cyst?
A cause of scrotal swelling which can be palpated as separate from the body of the testicle.
Found posterior to the testicle.
Give 3 associated conditions with epididymal cysts
1) polycystic kidney disease
2) cystic fibrosis
3) von Hippel-Lindau syndrome
Average age of diagnosis of retinoblastoma?
18m
Inheritance of retinoblastoma?
Autosomal dominant (around 10% of cases are hereditary)
Most common presenting symptom of retinoblastoma?
Absence of red reflex, replaced by white pupil (leukocoria)
Prognosis of retinoblastoma?
excellent, with >90% surviving into adulthood
3 key features of congenital rubella?
1) PDA
2) Sensorineural deafness
3) Congenital cataracts
When is bone marrow biopsy required in ITP?
Only if there is atypical features e.g. splenomegaly, failure to respond to treatment, lymph node enlargement
Mx of chickenpox?
Management is through supportive measures, including calamine lotion to soothe the itch and paracetamol to control the fever.
When is croup more common?
Autumn
Which childhood infection can cause suboccipital and postauricular lymphadenopathy?
Rubella
which antiepileptic can cause osteomalacia?
phenytoin - due to vitamin D deficiency
Which antiepileptic can cause megaloblastic anaemia?
phenytoin - due to vitamin D deficiency
What 2 medications are involved in mx of infantile spasms?
1) Vigabatrin
2) Prednisolone
What are infantile spasms usually 2ary to?
Usually secondary to serious neurological abnormality (e.g. tuberous sclerosis, encephalitis, birth asphyxia).
Can also be idiopathic.
What is the most common cause of a 1ary headache in children?
Migraine without aura
What condition have breath holding spells been associated with?
Iron deficiency anaemia
What can be used for excessive drooling in CP?
Glycopyrronium bromide or hyoscine hydrobromide
What 2 tests can be used to diagnose a squint?
1) cover test
2) Hirschberg’s test
Give 4 postnatal causes of CP
1) Hyperbilirubinaemia (kernicterus)
2) Intraventricular haemorrhage
3) Meningitis
4) Head trauma
What is a significant intrapartum risk factor for CP?
Prematurity
Give 4 intrapartum risk factors for CP
1) Birth asphyxia/trauma
2) Prematurity
3) Low birth weight
4) Neonatal sepsis