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Phase 3a > Paeds 5 - Allergy, Infection, GU > Flashcards

Paeds 5 - Allergy, Infection, GU Flashcards

1
Q

From what do the testis form?

A

Urogenital ridge

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2
Q

What type of inguinal hernias occur in children and what is the cause?

A

Direct

Patent processus vaginalis

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3
Q

What are the symptoms of direct inguinal hernias?

A

Intermittent swelling in groin/scrotum, firm and tender lump

May become more obvious with increased intra-abdominal pressure

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4
Q

What is a hydrocele?

A

A transilluminating scrotal swelling

Accumulation of fluid secreted by the tunica vaginalis

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5
Q

What is a varicocele?

A

Varicosities of the testicular veins, usually left sided.

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6
Q

What is an undescended testis?

A

Cryptorchidism

A testis that has been arrested along its normal pathway of descent

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7
Q

What are the risk factors for undescended testis?

A

Pre term (descent through inguinal canal occurs in 3rd trimester)

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8
Q

What are the three types of undescended testis?

A

Retractile (pulled up by overactive cremasteric muscle)
Palpable
Impalpable

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9
Q

How is undescended testis investigated?

A

Ultrasound
Laparoscopy if bilateral
Orchidopexy

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10
Q

What are the symptoms of testicular torsion?

A

Severe testicular pain referred to groin or lower abdomen
Nausea and vomiting
Erythema and oedema, tenderness
Pain worsened by lifting up the testicle
Absence of cremasteric reflex on affected side

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11
Q

What are the medical indications of circumcision?

A

Phimosis/paraphimosis
Recurrent balanoposthitis
Recurrent UTIs

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12
Q

Define allergy

A

A hypersensitivity reaction initiated by specific immunological mechanisms

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13
Q

Define atopy

A

A personal or family tendency to produce IgE antibodies in response to ordinary exposures to potential allergens

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14
Q

What are the symptoms of food allergy?

A

Urticaria, angioedema, anaphylaxis

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15
Q

What are the symptoms of food intolerance?

A

Diarrhoea, vomiting, abdominal pain, failure to thrive, eczema

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16
Q

How is IgE food allergy diagnosed?

A

Skin prick tests and RAST test (measures specific IgE in blood)

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17
Q

How is lactose intolerance diagnosed?

A

Stool chromatography

Lactose hydrogen breath test

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18
Q

What are the forms of allergic rhinoconjunctivitis?

A

Seasonal and perennial

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19
Q

How is allergic rhinoconjunctivitis treated?

A 
2nd generation anti-histamines
Topical corticosteroids
Cromoglycate eye drops
Montelukast
Nasal decongestants
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20
Q

What is the treatment of anaphylaxis?

A

IM adrenaline

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21
Q

What is impetigo?

A

Bacterial infection of the skin

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22
Q

How does the treatment of uncomplicated impetigo and bullous impetigo differ?

A

Uncomplicated - fusidic acid

Bullous - PO flucloxacillin or clarithromycin

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23
Q

What is the main risk of melanocytic naevi?

A

Malignant transformation to melanoma

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24
Q

What causes albinism?

A

Defect in biosynthesis and distribution of melanin

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25
Q

What are the types of albinism?

A

Ocular, oculocutaneous, or partial

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26
Q

What is a consequence of lack of melanin in the iris, eyelids, and retina?

A

Failure to develop fixation reflex –> pendular nystagmus and photophobia

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27
Q

What occurs with epidermolysis bullosa?

A

Blistering of the skin and mucous membranes occurring spontaneously or with minor trauma

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28
Q

What are the complications of epidermolysis bullosa?

A

Contractures

Oral ulceration and oesophageal stenosis

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29
Q

Which condition is indicated by an erythematous, flexure sparing rash on lower abdomen, perineum, and buttocks?

A

Napkin rash

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30
Q

What is cradle cap?

A

Infantile seborrheic dermatitis

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31
Q

How is ISD treated?

A

Babies first line - shampoo and baby oil
Emollients
Clear scales with sulphur and salicylic acid ointment
Mild topical corticosteroids

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32
Q

What is the characteristic appearance of molluscum contagiosum?

A

Small skin coloured, pearly papules with central umbilication

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33
Q

Ringed annular lesions indicate infection with what?

A

Ringworm

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34
Q

What is the treatment of ringworm?

A

Topical/systemic antifungals dependent on severity

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35
Q

What causes scabies?

A

Infestation with the eight legged mite Sarcoptes Scabiei.

Mites burrow down the epidermis along the stratum corneum

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36
Q

What are the symptoms of scabies?

A

Burrows, papules, vesicles between the fingers and toes, axillae, buttocks, palms and soles

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37
Q

Which cream is used to treat scabies?

A

Permethrin

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38
Q

Which viral rash begins with a single round scale macule and spread in a fir tree pattern?

A

Pityriasis Rosea

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39
Q

Give three red flags for a febrile child

A 
Pale mottled blue colour
Altered consciousness
Neuro signs
Dehydration
Respiratory distress
Bile stained vomit
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40
Q

What organisms cause meningitis in the neonate?

A

Listeria, Group B strep

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41
Q

Which organisms cause meningitis in infants and children?

A

Neisseria, strep pneumoniae

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42
Q

What is Kernig’s sign?

A

Pain on leg straightening seen in meningitis

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43
Q

What is Brudzinki sign?

A

Flexion of the neck causes flexion of the knee and hip

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44
Q

What is Cushing’s triad of raised ICP?

A

Bradycardia
Hypertension
Abnormal breathing

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45
Q

What is the management of bacterial meningitis?

A

Under 16s: ceftriaxone
Under 3m: cefotaxime and amoxicillin
Neonate: benzylpenicillin and gentamycin
Dexamethasone beyond the neonatal period to prevent long term complications

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46
Q

Give three complications of meningitis?

A

Hearing loss from damage to hair cells
Cerebral abscess
Hydrocephalus from impaired CSF reabsorption

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47
Q

What are the symptoms of toxic shock syndrome?

A

Fever >39 degrees, hypotension, diffuse erythematous macular rash
Mucositis
Vomiting and diarrhoea

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48
Q

What organisms are implicated in TSS?

A

Staph aureus or Group A strep (must produce toxin)

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49
Q

Which antibiotics are given in TSS?

A

Cefotaxime or ceftriaxone

With clindamycin

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50
Q

What are the symptoms of glandular fever?

A

Fever, malaise, tonsillopharyngitis, lymphadenopathy
Soft palate petechiae
Jaundice

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51
Q

How is glandular fever diagnosed?

A

Large T cells on blood film

Positive monospot test (heterophile antibodies)

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52
Q

What is the treatment for herpes simplex infection?

A

Aciclovir

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53
Q

Which disease begins with a rash behind the ears, which spreads to the whole body?

A

Measles

54
Q

What are the characteristic white spots on buccal mucosa in measles called?

A

Koplick’s spots

55
Q

What are the complications of measles?

A

Encephalitis
Subacute sclerosing panencephalitis
Pneumonia

56
Q

What are the symptoms of mumps?

A

Fever, malaise, bilateral parotitis

57
Q

How is mumps diagnosed?

A

Increased plasma amylase

Clinical

58
Q

What are the complications of mumps?

A

Orchitis and oopheritis

59
Q

Rubella infection before 8 weeks gestation results in what?

A

Deafness, congenital heart disease, cataracts

60
Q

What are the symptoms of rubella?

A

Mild fever, maculopapular rash, suboccipital andnpost-auricular nodes

61
Q

Kawasaki disease is a vasculitis of what type of vessels?

A

Medium sized

62
Q

What are the symptoms of Kawasaki disease?

A 
High fever for more than 5 days
Conjunctivitis (no purulent)
Strawberry tongue
Lymphadenopathy (cervical)
Peeling of fingers, toes, and lips
Maculopapular rash
63
Q

What are the complications of Kawasaki disease?

A

Coronary artery stenosis or aneurysms

64
Q

What is the treatment of Kawasaki disease?

A

Aspirin and IVIG

65
Q

What is the cause of Acute respiratory distress syndrome?

A

Prematurity: lack of surfactant and lung hypoplasia

66
Q

What are the signs of ARDS?

A 
Grunting
Tachpnoea
Sternal and subcostal recession
Nasal flaring
Cyanosis
67
Q

What is seen on CXR in ARDS?

A

Ground glass appearance with obscured heart disorder

68
Q

What is the prevention and treatment of ARDS?

A

Prevention - antenatal glucocorticoids if preterm delivery is suspected
Treatment - surfactant therapy via tracheal tube
CPAP and oxygen

69
Q

When do infants have bronchopulmonary dysplasia?

A

Infants who still have an oxygen requirement at a gestational age of 36 weeks

70
Q

Which antibiotics should be used to treat staph/strep meningitis in the neonate?

A

Benzylpenicillin and gentamycin

71
Q

What is the virus in Measles?

A

Paramyxovirus

72
Q

What virus causes slapped cheek disease and what does it affect?

A

Parvovirus B19

Erythroblasts in bone marrow

73
Q

What are the symptoms of Turner syndrome?

A

Short stature, neck webbing, broad chest
Non-functioning ovaries
Coarctation of the aorta
LD

74
Q

Give three causes of a vesicular rash

A

Chicken pox
Hand foot and mouth disease
Herpes

75
Q

What is the difference between petechiae and purpura?

A

Well defined purple round lesions
Big - purpura
Small - petechiae

76
Q

What are three differentials of a non-blanching rash?

A 
Meningococcal septicaemia
ITP
ALL
HUS
HSP
77
Q

What is a strawberry naevus?

A

Cavernous haemangioma not present at birth

78
Q

What is bilateral absence of normal pupillary red reflex indicate?

A

Bilateral retinoblastoma

Congenital cataracts

79
Q

What are the antibiotics for Group B streptococcal infection?

A

Benzypenicillin and gentamycin

80
Q

When does ARDS present?

A

First 24 hours of life

81
Q

What are the symptoms of necrotizing enterocolitis and why?

A

Poor feed tolerance, abdo distension, bloody stools

Bowel ischaemic, inflammation, necrosis, and perforation

82
Q

What is seen on X-Ray in necrotizing enterocolitis?

A

Pneuomatosis intestinalis and free gas in perforation

Distended bowel loops

83
Q

What is the treatment of necrotizing enterocolitis?

A

NBM, TPN, antiobiotics

Surgical removal of perforated/necrotic bowel

84
Q

Define stillbirth

A

Baby delivered after 24 weeks with no signs of life

85
Q

Define early and late neonatal death

A

Baby days within 7 (early) and 7-28 (late) days

86
Q

Define low birth weight

A

<2000g

87
Q

What are the five serious congenital infections?

A 
T - Toxoplasmosis
Other - HIV, measles, hepatitis
R - Rubella
C - Cytomegalovirus
H - Herpes Simplex
88
Q

What are four complications of chicken pox?

A

Pneumonia
Encephalitis
Disseminated haemorrhagic chickenpox
Secondary bacterial infection

89
Q

When are umbilical hernias operated on?

A

Large and symptomatic - 2-3 years

Small and asymptomatic - 4-5 years

90
Q

When do babies first smile?

A

6 weeks

91
Q

When do babies first make eye contact?

A

8 weeks

92
Q

At what age do babies gain head control?

A

3 months

93
Q

What should a baby be able to do at 6 months old?

A

Roll over
Babble
Palmar grasp
Sit without support (7-8 months)

94
Q

When does a baby start crawling?

A

8-10 months

95
Q

What should a baby be able to do at 12 months old?

A

Walk with one hand held
Pincer grip
First word

96
Q

At what age should a baby be able to walk unsupported?

A

12-15 months (refer at 18 months)

97
Q

A tower of how many blocks is constructed at 15m, 18m, 24m, and 36m?

A

15 months - 2 blocks
18 months - 3 blocks
2 years - 6 blocks
3 years - 9 blocks

98
Q

What shapes should a baby be able to draw at 2 years, 3 years, and 4 years?

A

2 years - vertical line
3 years - copies circle
4 years - copies cross

99
Q

When should a baby be able to say 2 word sentences?

A

2 years

100
Q

When should a baby get a pincer grip?

A

12 months

101
Q

What is contained in the 6-in-1 vaccine?

A 
Tetanus
Diphtheria
Polio
Whooping cough
Hib
Hepatitis B
102
Q

When are the doses of the 6-in-1 vaccine given?

A

8 weeks
12 weeks
16 weeks

103
Q

Which vaccines are given at birth?

A

Hepatitis B/BCG if risk factors are present

104
Q

Which vaccines are given at 8 weeks?

A

6-in-1
Rotavirus
PPV (pneumococcal)
Men B

105
Q

When is the MMR vaccine given?

A

1 year

3 years and 4 months

106
Q

When are the doses of the rotavirus vaccine given?

A

8 weeks

12 weeks

107
Q

What vaccines are given at 16 weeks?

A

6 in 1 vaccine
PCV
Men B

108
Q

Which vaccine is given annually from the ages of 2-9 years

A

Flu

109
Q

Which vaccines are given at 1 year of age?

A

Hib/Men C
MMR
PCV
Men B

110
Q

What does the 4-in-1 pre-school booster contain?

A

Diphtheria, tetanus, whooping cough, polio

111
Q

When is the HPV vaccine given?

A

12-13 years; 2 vaccines given 6-12 months apart

112
Q

What is in the teenage booster and when is it given?

A

14 years
Diphtheria, tetanus, polio
Given with Men ACWY

113
Q

When is the shingles vaccine given?

A

70 years

114
Q

Which vitamin deficiency is associated with an increased risk of measles?

A

Vitamin A

115
Q

What is seen in impetigo?

A

Honey-coloured crusted skin lesions

116
Q

What is erythema migrans seen in?

A

Lyme disease

Bullseye

117
Q

Where are hypospadias seen?

A

Distal ventral surface

118
Q

What is first and second line pharmacological treatment of nocturnal enuresis (once star charts and enuresis alarms have been tried)?

A

Desmopressin

Imipramine

119
Q

Where do you measure temperature in a child <4 weeks?

A

Axilla or tympanic

120
Q

What is Perthes disease associated with?

A

Hyperactivity

Short stature

121
Q

Severe hypospadias are associated with what?

A

Chordee - ventral curvature of the penis

122
Q

What are the consequences of hypospadias?

A

Difficulty urinating whilst standing
Cosmetic appearance
Sexual function unaffected except if chordee is present

123
Q

How is a hypospadias treated?

A

Reconstruction of the urethra to the glans

Straightening of the chordee

124
Q

How common is cryptorchidism?

A

3% of full term newborn boys

125
Q

Where are palpable undescended testes found?

A

At the external inguinal ring

126
Q

Where are impalpable undescended testes found?

A

Intra-abdominal, inside the inguinal canal, or absent

127
Q

What are the risks of intra-abdominal impalpable undescended testes?

A

Malignant degeneration

128
Q

When should you refer a baby with undescended testes to a paediatric surgeon?

A

6 months

129
Q

When is the peak incidence of testicular torsion?

A

12 years

130
Q

What is the main cause of phimosis?

A

Balanitis xerotica obliterans (BXO, or lichen sclerosis)

Basically a scarring dermatitis

Phase 3a (18 decks)

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