Paeds 5 - Allergy, Infection, GU Flashcards
1
Q
From what do the testis form?
A
Urogenital ridge
2
Q
What type of inguinal hernias occur in children and what is the cause?
A
Direct
Patent processus vaginalis
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
4
Q
What is a hydrocele?
A
A transilluminating scrotal swelling
Accumulation of fluid secreted by the tunica vaginalis
5
Q
What is a varicocele?
A
Varicosities of the testicular veins, usually left sided.
6
Q
What is an undescended testis?
A
Cryptorchidism
A testis that has been arrested along its normal pathway of descent
7
Q
What are the risk factors for undescended testis?
A
Pre term (descent through inguinal canal occurs in 3rd trimester)
8
Q
What are the three types of undescended testis?
A
Retractile (pulled up by overactive cremasteric muscle)
Palpable
Impalpable
9
Q
How is undescended testis investigated?
A
Ultrasound
Laparoscopy if bilateral
Orchidopexy
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
11
Q
What are the medical indications of circumcision?
A
Phimosis/paraphimosis
Recurrent balanoposthitis
Recurrent UTIs
12
Q
Define allergy
A
A hypersensitivity reaction initiated by specific immunological mechanisms
13
Q
Define atopy
A
A personal or family tendency to produce IgE antibodies in response to ordinary exposures to potential allergens
14
Q
What are the symptoms of food allergy?
A
Urticaria, angioedema, anaphylaxis
15
Q
What are the symptoms of food intolerance?
A
Diarrhoea, vomiting, abdominal pain, failure to thrive, eczema
16
Q
How is IgE food allergy diagnosed?
A
Skin prick tests and RAST test (measures specific IgE in blood)
17
Q
How is lactose intolerance diagnosed?
A
Stool chromatography
Lactose hydrogen breath test
18
Q
What are the forms of allergic rhinoconjunctivitis?
A
Seasonal and perennial
19
Q
How is allergic rhinoconjunctivitis treated?
A
2nd generation anti-histamines Topical corticosteroids Cromoglycate eye drops Montelukast Nasal decongestants
20
Q
What is the treatment of anaphylaxis?
A
IM adrenaline
21
Q
What is impetigo?
A
Bacterial infection of the skin
22
Q
How does the treatment of uncomplicated impetigo and bullous impetigo differ?
A
Uncomplicated - fusidic acid
Bullous - PO flucloxacillin or clarithromycin
23
Q
What is the main risk of melanocytic naevi?
A
Malignant transformation to melanoma
24
Q
What causes albinism?
A
Defect in biosynthesis and distribution of melanin
25
What are the types of albinism?
Ocular, oculocutaneous, or partial
26
What is a consequence of lack of melanin in the iris, eyelids, and retina?
Failure to develop fixation reflex --> pendular nystagmus and photophobia
27
What occurs with epidermolysis bullosa?
Blistering of the skin and mucous membranes occurring spontaneously or with minor trauma
28
What are the complications of epidermolysis bullosa?
Contractures
| Oral ulceration and oesophageal stenosis
29
Which condition is indicated by an erythematous, flexure sparing rash on lower abdomen, perineum, and buttocks?
Napkin rash
30
What is cradle cap?
Infantile seborrheic dermatitis
31
How is ISD treated?
Babies first line - shampoo and baby oil
Emollients
Clear scales with sulphur and salicylic acid ointment
Mild topical corticosteroids
32
What is the characteristic appearance of molluscum contagiosum?
Small skin coloured, pearly papules with central umbilication
33
Ringed annular lesions indicate infection with what?
Ringworm
34
What is the treatment of ringworm?
Topical/systemic antifungals dependent on severity
35
What causes scabies?
Infestation with the eight legged mite Sarcoptes Scabiei.
| Mites burrow down the epidermis along the stratum corneum
36
What are the symptoms of scabies?
Burrows, papules, vesicles between the fingers and toes, axillae, buttocks, palms and soles
37
Which cream is used to treat scabies?
Permethrin
38
Which viral rash begins with a single round scale macule and spread in a fir tree pattern?
Pityriasis Rosea
39
Give three red flags for a febrile child
```
Pale mottled blue colour
Altered consciousness
Neuro signs
Dehydration
Respiratory distress
Bile stained vomit
```
40
What organisms cause meningitis in the neonate?
Listeria, Group B strep
41
Which organisms cause meningitis in infants and children?
Neisseria, strep pneumoniae
42
What is Kernig's sign?
Pain on leg straightening seen in meningitis
43
What is Brudzinki sign?
Flexion of the neck causes flexion of the knee and hip
44
What is Cushing's triad of raised ICP?
Bradycardia
Hypertension
Abnormal breathing
45
What is the management of bacterial meningitis?
Under 16s: ceftriaxone
Under 3m: cefotaxime and amoxicillin
Neonate: benzylpenicillin and gentamycin
Dexamethasone beyond the neonatal period to prevent long term complications
46
Give three complications of meningitis?
Hearing loss from damage to hair cells
Cerebral abscess
Hydrocephalus from impaired CSF reabsorption
47
What are the symptoms of toxic shock syndrome?
Fever >39 degrees, hypotension, diffuse erythematous macular rash
Mucositis
Vomiting and diarrhoea
48
What organisms are implicated in TSS?
Staph aureus or Group A strep (must produce toxin)
49
Which antibiotics are given in TSS?
Cefotaxime or ceftriaxone
| With clindamycin
50
What are the symptoms of glandular fever?
Fever, malaise, tonsillopharyngitis, lymphadenopathy
Soft palate petechiae
Jaundice
51
How is glandular fever diagnosed?
Large T cells on blood film
| Positive monospot test (heterophile antibodies)
52
What is the treatment for herpes simplex infection?
Aciclovir
53
Which disease begins with a rash behind the ears, which spreads to the whole body?
Measles
54
What are the characteristic white spots on buccal mucosa in measles called?
Koplick's spots
55
What are the complications of measles?
Encephalitis
Subacute sclerosing panencephalitis
Pneumonia
56
What are the symptoms of mumps?
Fever, malaise, bilateral parotitis
57
How is mumps diagnosed?
Increased plasma amylase
| Clinical
58
What are the complications of mumps?
Orchitis and oopheritis
59
Rubella infection before 8 weeks gestation results in what?
Deafness, congenital heart disease, cataracts
60
What are the symptoms of rubella?
Mild fever, maculopapular rash, suboccipital andnpost-auricular nodes
61
Kawasaki disease is a vasculitis of what type of vessels?
Medium sized
62
What are the symptoms of Kawasaki disease?
```
High fever for more than 5 days
Conjunctivitis (no purulent)
Strawberry tongue
Lymphadenopathy (cervical)
Peeling of fingers, toes, and lips
Maculopapular rash
```
63
What are the complications of Kawasaki disease?
Coronary artery stenosis or aneurysms
64
What is the treatment of Kawasaki disease?
Aspirin and IVIG
65
What is the cause of Acute respiratory distress syndrome?
Prematurity: lack of surfactant and lung hypoplasia
66
What are the signs of ARDS?
```
Grunting
Tachpnoea
Sternal and subcostal recession
Nasal flaring
Cyanosis
```
67
What is seen on CXR in ARDS?
Ground glass appearance with obscured heart disorder
68
What is the prevention and treatment of ARDS?
Prevention - antenatal glucocorticoids if preterm delivery is suspected
Treatment - surfactant therapy via tracheal tube
CPAP and oxygen
69
When do infants have bronchopulmonary dysplasia?
Infants who still have an oxygen requirement at a gestational age of 36 weeks
70
Which antibiotics should be used to treat staph/strep meningitis in the neonate?
Benzylpenicillin and gentamycin
71
What is the virus in Measles?
Paramyxovirus
72
What virus causes slapped cheek disease and what does it affect?
Parvovirus B19
| Erythroblasts in bone marrow
73
What are the symptoms of Turner syndrome?
Short stature, neck webbing, broad chest
Non-functioning ovaries
Coarctation of the aorta
LD
74
Give three causes of a vesicular rash
Chicken pox
Hand foot and mouth disease
Herpes
75
What is the difference between petechiae and purpura?
Well defined purple round lesions
Big - purpura
Small - petechiae
76
What are three differentials of a non-blanching rash?
```
Meningococcal septicaemia
ITP
ALL
HUS
HSP
```
77
What is a strawberry naevus?
Cavernous haemangioma not present at birth
78
What is bilateral absence of normal pupillary red reflex indicate?
Bilateral retinoblastoma
| Congenital cataracts
79
What are the antibiotics for Group B streptococcal infection?
Benzypenicillin and gentamycin
80
When does ARDS present?
First 24 hours of life
81
What are the symptoms of necrotizing enterocolitis and why?
Poor feed tolerance, abdo distension, bloody stools
| Bowel ischaemic, inflammation, necrosis, and perforation
82
What is seen on X-Ray in necrotizing enterocolitis?
Pneuomatosis intestinalis and free gas in perforation
| Distended bowel loops
83
What is the treatment of necrotizing enterocolitis?
NBM, TPN, antiobiotics
| Surgical removal of perforated/necrotic bowel
84
Define stillbirth
Baby delivered after 24 weeks with no signs of life
85
Define early and late neonatal death
Baby days within 7 (early) and 7-28 (late) days
86
Define low birth weight
<2000g
87
What are the five serious congenital infections?
```
T - Toxoplasmosis
Other - HIV, measles, hepatitis
R - Rubella
C - Cytomegalovirus
H - Herpes Simplex
```
88
What are four complications of chicken pox?
Pneumonia
Encephalitis
Disseminated haemorrhagic chickenpox
Secondary bacterial infection
89
When are umbilical hernias operated on?
Large and symptomatic - 2-3 years
| Small and asymptomatic - 4-5 years
90
When do babies first smile?
6 weeks
91
When do babies first make eye contact?
8 weeks
92
At what age do babies gain head control?
3 months
93
What should a baby be able to do at 6 months old?
Roll over
Babble
Palmar grasp
Sit without support (7-8 months)
94
When does a baby start crawling?
8-10 months
95
What should a baby be able to do at 12 months old?
Walk with one hand held
Pincer grip
First word
96
At what age should a baby be able to walk unsupported?
12-15 months (refer at 18 months)
97
A tower of how many blocks is constructed at 15m, 18m, 24m, and 36m?
15 months - 2 blocks
18 months - 3 blocks
2 years - 6 blocks
3 years - 9 blocks
98
What shapes should a baby be able to draw at 2 years, 3 years, and 4 years?
2 years - vertical line
3 years - copies circle
4 years - copies cross
99
When should a baby be able to say 2 word sentences?
2 years
100
When should a baby get a pincer grip?
12 months
101
What is contained in the 6-in-1 vaccine?
```
Tetanus
Diphtheria
Polio
Whooping cough
Hib
Hepatitis B
```
102
When are the doses of the 6-in-1 vaccine given?
8 weeks
12 weeks
16 weeks
103
Which vaccines are given at birth?
Hepatitis B/BCG if risk factors are present
104
Which vaccines are given at 8 weeks?
6-in-1
Rotavirus
PPV (pneumococcal)
Men B
105
When is the MMR vaccine given?
1 year
| 3 years and 4 months
106
When are the doses of the rotavirus vaccine given?
8 weeks
| 12 weeks
107
What vaccines are given at 16 weeks?
6 in 1 vaccine
PCV
Men B
108
Which vaccine is given annually from the ages of 2-9 years
Flu
109
Which vaccines are given at 1 year of age?
Hib/Men C
MMR
PCV
Men B
110
What does the 4-in-1 pre-school booster contain?
Diphtheria, tetanus, whooping cough, polio
111
When is the HPV vaccine given?
12-13 years; 2 vaccines given 6-12 months apart
112
What is in the teenage booster and when is it given?
14 years
Diphtheria, tetanus, polio
Given with Men ACWY
113
When is the shingles vaccine given?
70 years
114
Which vitamin deficiency is associated with an increased risk of measles?
Vitamin A
115
What is seen in impetigo?
Honey-coloured crusted skin lesions
116
What is erythema migrans seen in?
Lyme disease
| Bullseye
117
Where are hypospadias seen?
Distal ventral surface
118
What is first and second line pharmacological treatment of nocturnal enuresis (once star charts and enuresis alarms have been tried)?
Desmopressin
| Imipramine
119
Where do you measure temperature in a child <4 weeks?
Axilla or tympanic
120
What is Perthes disease associated with?
Hyperactivity
| Short stature
121
Severe hypospadias are associated with what?
Chordee - ventral curvature of the penis
122
What are the consequences of hypospadias?
Difficulty urinating whilst standing
Cosmetic appearance
Sexual function unaffected except if chordee is present
123
How is a hypospadias treated?
Reconstruction of the urethra to the glans
| Straightening of the chordee
124
How common is cryptorchidism?
3% of full term newborn boys
125
Where are palpable undescended testes found?
At the external inguinal ring
126
Where are impalpable undescended testes found?
Intra-abdominal, inside the inguinal canal, or absent
127
What are the risks of intra-abdominal impalpable undescended testes?
Malignant degeneration
128
When should you refer a baby with undescended testes to a paediatric surgeon?
6 months
129
When is the peak incidence of testicular torsion?
12 years
130
What is the main cause of phimosis?
Balanitis xerotica obliterans (BXO, or lichen sclerosis)
| Basically a scarring dermatitis
