Paeds Flashcards
Differentials of stridor
ABCDEFGH A abscess B bacterial hypersensitivity C croup D diptheria E epiglottis F foreign body G gas H hypersensitivity
Cerebral palsy management
MDT Physiotherapy Occupational therapy Speech and language Psychological support Muscle relaxants (baclofen) Orthopaedic surgery
Turners
45, XO
Delayed puberty, subfertility Normal IQ Short stature, webbed neck, widely spaced nipples, cubitus valgus Cardiac abnormalities (co-arc, AS) Renal anomalies Non pitting lymphedema, hands and feet
Treatment: GH and oestrogen replacement
Klinefelters
XXY
Tall stature Delayed puberty Poor growth of facial and body hair Gynaecomastia Small testes Hypogonadism Infertility
Trisomy 21 clinical features
Round face, flat nasal bridge Upslanted palpebral fissues, Epicanthic fols Single palmar crease Wide sandal gap congenital heart defects duodenal atresia hirschsprungs protruding tongue
Trisomy 18
Edwards
IUGR, low birthweight
Prominent occiput, small mouth and sternum, short sternum, flexed overlapping fingers, rocker-bottom feet
Trisomy 13
Pataus
Hirchsprungs
Lack of innervation to myenteric plexus -> constriction of gut, prevents forward passage of stool
Slipped upper femoral epiphysis
10 - 15 years old
Obese children
Bilateral in 20%
Knee or distal thigh pain
loss of internal rotation of the leg in hip flexion
discrepancy between true and apparent leg lengths
Perthes disease
due to avascular necrosis of the femoral head
5 times more common in boys
10% of cases bilateral
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
Juvenile idiopathic arthritis
arthritis occurring in someone who is less than 16
>3 months
Pauciarticular JIA refers to cases where 4 or less joints are affected. It accounts for around 60% of cases of JIA
ANA may be positive
Hip pain differentials in children
SUFE Perthes JIA Septic arthritis Transient synovitis
Knee pain differentials in children
Chondromalacia patellae - anterior knee pain on walking up and down stairs –> Physio
Osgood-schlatter disease: (tibial apophysitis) - Pain, tenderness and swelling over the tibial tubercle. sporty teenagers
Osteochondritis dissecans - pain after exercise
Patellar subluxation
Child obesity interventions
NICE recommend
consider tailored clinical intervention if BMI at 91st centile or above.
consider assessing for comorbidities if BMI at 98th centile or above
Child obesity differentials
Cause of obesity in children growth hormone deficiency hypothyroidism Down's syndrome Cushing's syndrome Prader-Willi syndrome
Reyes syndrome
associated with aspirin use in children
around 2 years old
–> encephalopathy, fatty infiltration of liver, kidneys, pancreas
Px: supportive
Kawasakis disease
high grade fever >5days conjunctivitis red, cracked lips, strawberry tongue cervical lymphadenopathy Red palms, and soles
Rx: aspirin, IV immunoglobulin. Echo
Scarlet fever
Reaction to erythrogenic toxins from Group A haemolytic strep
Fever, malaise, tonsillitis, strawberry tongue
Rash
Rx: oral pen V.
notifiable
Complications of scarlet fever
otitis media
Rheumatic fever
Acute glomerulonephritis
