PAEDS Flashcards
Bordetella Pertussis (Whooping cough) presentation
Afebrile, cough ,coryza, vomiting after cough
Pertussis investigation + management
Nasopharyngeal swab
Azithromycin or clarithromycin
Epiglottitis pathogen?
Hib
Epiglottitis ix + mx
Xray (avoid tongue depressor - elicit muscle spasm)
IV Ceftriaxone, intubation if severe resp distress
Rhinitis allergic vs non-allergic
Allergic: pollen, dust mites, mould
Non-allergic rhinitis: animals, food, drugs (aspirin), chemicals, infection, vasomotor (tobacco smoke, exercise, weather, perfume)
Rhinitis ix + mx
skin prick testing or IgE blood test
Mx: IN steroids (Beclamethasone, budenoside); antihistamines (loratidine, certirizine)
EBV presentation
Malaise, anorexia → fever, tonsillar exudate, generalised lymphadenopathy → fatigue
+/- hepatosplenomegaly, rash (amoxicillin-induced), arthritis
EBV ix + mx
Monospot test.
Supportive care.
Peritonsillar abscess clinical features
Unilateral sore throat, odynophagia, “hot potato” voice, drooling, fever, referred ear pain, trismus (lock jaw), contralateral deviation of uvula
Peritonsillar abscess mx
Penicillin + drainage
Retropharyngeal abscess
Torticollis (stiff neck), fever, odynophagia, drooling, palpable neck pain, stridor
Ix: CT with IV contrast
Mx: Antibiotics (Timentin IV)
Hand foot and mouth disease (coxsackie virus) presentation
high fever, fatigue, non-itchy blisters (side of tongue, palate, nappy area, soles, palms), sore throat
Rubella presentation
Respiratory symptoms + suboccipital adenopathy → maculopapular rash (initially face, then spread to entire body; pruritic), pink eye
Pregnancy + rubella. Complications and when to give vaccine?
Mother infected in first 4 months pregnancy may result in congenital rubella syndrome (deafness, blindness, heart disease).
Do not give rubella vaccine in pregnancy, or 1 month before
Mumps presentation and ix
Fever, headache, PAROTITIS (bilateral inflammation of parotid glands - pushes earlobes up and out; ear pain; pain on chewing), myalgia
Ix: urine or saliva viral serology
Measles clinical features. 3Cs
Cough, coryza, conjunctivitis.
Fever, eyelid oedema, Koplik spots.
Maculopapular rash spreads from face + hairline, in descending fashion
Varicella Zoster presentation.
Fever, resp symptoms → rash (pruritic, vesicles, erythematous) → vesicles burst + crust over
WHy should pregnant women be careful of VZV infection and what should be done?
Maternal infection in first trimester can cause congenital varicella syndrome (low birth weight, CNS abnormality, limb abnormality, eye defects). If mother develops VZV 2-5d after delivery, high risk of neonatal varicella = must give VZIg
Jones criteria of Rheumatic fever
SPACE: s/c nodules, pancarditis, arthritis, chorea, erythema marginatum
Antibiotics for Rheumatic fever
Penicillin
Scarlet fever clinical presentatoin
Acute onset fever (>38C), sore throat, strawberry tongue → pharyngitis, ‘sandpaper’ rash (perioral sparing, non-painful) → peeling
Scarlet fever pathogen + abx
GABHS - penicillin
CENTOR criteria for bacterial pharyngitis
No cough, tonsillar exudate, fever, cervical lymphadenopathy
What is glue ear and how to treat
persistent serous otitis media causing conductive hearing loss. can cause long term language deficits. Do not treat if hearing not affected. Grommets if fluid persists.
CSOM complications
hearing loss, mastoiditis, cholesteatoma, facial nerve paralysis, meningitis, brain abscess and sigmoid sinus thrombosis
CSOM management
Ciprofloxacin. Do not use aminoglycosides e.g. gentamicin (ototoxic)
Common cause of AOM
Viral, Strep pneumoniae, M. catarrhalis, H. influenzae
Management of impetigo
Staph aureus - mupirocin (bactroban) or cephalexin
Giardiasis
Metronidazole
Meningitis vs encephalitis management
Meninigitis: Ceftriaxone + Dexamethasone
Encephalitis: aciclovir
Danger signs of paediatric illness
Convulsions, poor feeding, poor social interaction, poor sleep, non-responsive, chest indrawing, non-blanching rash, RR >40, stiff neck
Croup presentation + mx
Barking cough + stridor. Consider prednisolone.
Signs and symptoms of meningitis
photophobia, purpura (non-blanching rash - may be HSP), neck stiffness, confusion, full fontanelle, Kernig’s sign, signs of encephalitis (focal neuro)
Bacterial meningitis pathogens
Strep pneumoniae (GP diplococci), Neisseria meningitides (GN diplococci), Hib (GN coccobacilli), Listeria monocytogenes (GP rods)
List 5 examinations and conditions to look for on 6 week GP check
1) Undescended testes
2) Hip dysplasia
3) Heart defects
4) Cerebral palsy
5) oral thrush/ cleft palate
What is blanitis + causal organism
Inflammation of glans penis resulting in rash over glans + under foreskin. May have discharge/odor.
Candida (not STI).
DDx for nappy rash
Threadworms
Seborrheic dermatitis - non-itchy, salmon pink flaky patches
Eczema, psoriasis
Zinc deficiency - sharply defined, red, anogenital rash. Perioral dermatitis, failure to thrive, alopecia, diarrhoea
Langerhan’s cell histiocytosis - chronic anogenital + scalp erosive rash unresponsive to treatment. Purpura, fever, hepatosplenomegaly, diarrhea, bone pain, pancytopenia.
Testicular torsion clinical features + mx
Discolouration of scrotum; tender and swollen testis, high riding. Cremasteric reflex absent.
Keep fasted. Urology referral for surgical consultation
Torsion of the appendix testis clinical features + mx
Focal tenderness at upper pole of testis; “blue dot” sign
Analgesia, rest.
Epididymoorchitis clinical features + mx
Onset may be insidious; fever, vomiting, irritative LUTS; penile discharge, dysuria. Red, tender, swollen hemiscrotum.
First-pass urine sample (first morning urine) for chlamydia and gonococcus PCR
Co-trimoxazole
Idiopathic scrotal oedema
clinical features
Rapid onset of painless but notable oedema
Hydrocele clinical features
Soft, non-tender swelling adjacent to testis; transilluminates (often self-resorbs)
Varicocele clinical features
Mass of varicose veins (“bag of worms”) above testicle, non-tender, more prominent when standing.
Henoch Schonlein purpura triad
1) purpura over butt + lower limbs extonsor surfaces, 2) arthralgia, 3) abdo pain with GI bleeding (4) haematuria)
What is dyschezia and is it normal in
Healthy infants (
Laxatives for paediatric constipation
Movicol or paraffin oil.
If
