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Year 5 😊✌🏼 > Paeds 6 > Flashcards

Paeds 6 Flashcards

1
Q

What organism causes head lice?

A

pediculus capitis (obligate ectoparasite)

small insects that live only on humans and feed our blood

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2
Q

diagnosis of pediculosis capitis / head lice

A

fine toothed combing of wet or dry hair

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3
Q

What is the blood glucose cut-off when you should send to NICU and treat neonatal hypoglycaemia?

A

<1.5 mmol/L

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4
Q

What is the medical management of neonatal hypoglycaemia?

A

IV 10% dextrose 2ml/kg bolus

then infusion of 3.6 ml/kg/hr of 10% glucose

-> frequently check blood glucose until stable (aim 3-4 mmol/L)

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5
Q

What medication can be given to manage Mg sulfate induced respiratory depression?

A

calcium gluconate

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6
Q

Which of the following drugs should NOT be used in breastfeeding women?
1. aminophylline
2. carbamazepine
3. Sodium valproate
4. methyldopa
5. amiodarone

A
  1. Amiodarone (antiarrythmic)
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7
Q

What is the commonest heart defect in patientsb with down syndrome?

A

AVSD

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8
Q

How common are congenital heart defects in patients with down syndrome?

A

50% of pts have them

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9
Q

What does MCUG stand for?

A

micturating cystourethrogram

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10
Q

Mx of UTI in children

A

<3 months: admit, sepsis 6, give IV abx e.g. ampicillin or gentamycin or cefotaxime

3m - 15y: lower UTI give PO abx (trimethoprim, nitrofurantoin (if eGFR >/= 45ml/min); if upper UTI consider paeds referral and cephalexin/co-amoxiclav

if recurrent refer to paediatric specialist for USS, MCUG, DMSA

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11
Q

Medical management of migraines in children and adolescents

A
  1. simple analgesia
  2. nasal sumatriptan (oral triptans are not licensed in people under 16)
  3. combination therapy with nasal triptan and NSAID/Paracetamol; consider adding an anti-emetic, e.g. metoclopramide or chlorpromazine

F/U in 1 month or sooner if sx worsen

specialists can prescribe prophylactic treatment:
- topiramate (nb high risk of foetal malformations) or propranolol

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12
Q

What medication for bacterial tonsillitis in children

A

phenoxymethylpenicillin for 5-10 days

clarithromycin if penicillin allergy (macrolide, works by inhibiting 50s subunit in protein synthesis)

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13
Q

What centor / feverpain scores would prompt abx ?

A

FeverPAIN 4 or 5
CENTOR 3 or 4

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14
Q

What are the features seen in prader willi syndrome?

A

hyperphagia
obesity
muscular hypotonia
short stature
scoliosis
almond shaped eyes
thin upper lup
developmental delay
behavioural problems (e.g. temper tantrums, stubbornness)

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15
Q

Underlying pathology in Prader-Willi Syndrome?

A

genetic syndrome caused by a microdeletion at 15q11-q13 in combination with genomic imprinting

in PW-syndrome there is deletion or mutation of the paternal copy and the maternal gene is methylated (silenced)

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16
Q

What are the features of angelman syndrome?

A

delayed mental development and acquisition of motor skills
intellectual disability
microcephaly
in >80% there are pronounced epileptic seizures
ataxia
fascination with water
hyperexcitability, short attention span

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17
Q

When should children be able to draw a circle?

A

3 yo

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18
Q

When should children be able to draw a vertical and horizontal line?

A

veritcal: 2 yo
horizontal: 2.5 yo

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19
Q

When should children be able to draw a square and a triangle, person and cross?

A

cross: 4 yo

square: 4.5 yo

triangle/person: 5 yo

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20
Q

What is the first line chemotherapy option given in ovarian cancer?

A

combination of platinum compound and paclitaxel

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21
Q

What is the first line chemotherapy option given in ovarian cancer?

A

combination of platinum compound and paclitaxel

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22
Q

What are the chemotherpy cycles used in Ovarian cancer?

A

outpatient

3 weeks apart for 6 cycles

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23
Q

Follow up investigations in ovarian cancer

A

CT scan following completion of chemotherapy to review the response

clinical examination
Ca-125 (tends to rise before the onset of clinical signs of disease recurrence)

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24
Q

What is the management in recurrence of ovarian cancer?

A

mainly palliative

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25
Q

RFs for Ov Ca

A

age
FH
obesity
HRT
endometriosis
smoking
diabetes

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26
Q

what are protective factors for ovarian cancer?

A

COCP
pregnancy
breastfeeding
hysterectomy

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27
Q

What is the management of stage 1 ov ca?

A

total hysterectomy with bilateral salpingo-oophrectomy +/- chemo

if fertility needs to be preserved, only one ovary may be removed (only 1a)

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28
Q

What is the management of stage 2 ov ca?

A

debulking surgery to remove as much as possible

adjuvant or neo-adjuvant chemotherapy

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29
Q

What is the management of stage 3 ov ca?

A

debulking surgery to remove as much as possible

adjuvant or neo-adjuvant chemotherapy

+ targeted treatment bevacizumab (targets VEGF A)

if surgery not an option, platinum based chemo can be given as well as symptomatic treatment e.g. ascitic drain, mx of constipation

30
Q

What is the management of stage 4 ov ca?

A

like stage 3

but palliative care is more likely

31
Q

What are the components of the RMI for ovarian cancer?

A

Ca 125 (units/ml)
findings on TVUSS (0,1,2 depending if 0, 1 or 2+ features seen )
menopausal status (1 pre; 2 post)

RMI = U x M x Ca125 -> if >250 refer to gynae

32
Q

what is the cut off for RMI to refer to gynae?

How is RMI calculated?

A

if >250 refer to gynae

RMI = U x M x Ca125

33
Q

how does platinum based chemotherapy work?

A

causes cross-linkage of DNA strands leading to cell cycle arrest

34
Q

Which platinum based chemotherapy agent is mainly used in ov ca and why?

A

carboplatin

it is less nephrotoxic than e.g. cisplatin and causes less nausea

dose of carboplatin is calculated using the GFR

35
Q

How does Paclitaxel work?

A

causes microtubular damage

prevents replication and cell division

steroids can be given to reduce hypersensitivity reactions and reduce side effects

causes total loss of body hair

36
Q

what medication is used to treat threadworms?

A

mebendazole

everyone in the household should be treated.

37
Q

At what age does biliary atresia present?

A

a few weeks

38
Q

blood findings in biliary artresia

A

Conjugated hyperbilirubinemia
↑ Aminotransferases and alkaline phosphatase
↑ GGT

39
Q

What is the procedure called that is used to correct biliary artresia?

A

Kasai hepatoportoenterostomy

-> involves ligating the fibrous ducts above the join with the duodenum, dissecting proximally to the portal hepatis (from which the bile usually flows from the liver), facilitating bile duct drainage

40
Q

Complications of HSP

A

GI
- intussusception
- bowel ischaemia/perforation

Renal
- progressive kidney involvement (e.g. nephrotic syndrome)
- CKD

41
Q

What is the minimal acceptable level of observation in psychiatric inpatients?

A

every 60 minutes (Level 1)_

42
Q

What is the minimal acceptable level of observation in psychiatric inpatients?

A

every 60 minutes (Level 1)

43
Q

What are the different levels of observation in psychiatry?

A

Level 1 - General observation observation every 60 minutes (minimum required)
Level 2 - intermittent observation every 15-30 minutes
Level 3 - 1-2-1 within eyesight
Level 4 - 1-2-1 observation within arms reach. sometimes may need more than 1 person, people on Level 4 observation cannot go to the bathroom alone.

44
Q

What is the first line antibiotic used in PPROM?

A
  1. erythromycin 250 mg QDS for a max of 10d or until in established labour
  2. line: oral penicillin
45
Q

What is the risk of giving steroids in premature labour?

A

increased risk of learning difficulties
some research showing that there may be issues with wellbeing later on in life.

46
Q

what supplement should be prescribed in hyperemesis gravidarum?

A

thiamine (vitamin B1)

47
Q

What chronic infectious conditions are women screened for in early pregnancy?

A

HIV
Hep B
Syphilis

48
Q

A woman in her 1st pregnancy develops an itchy rash on her abdomen that spares the umbilical area - dx?

A

polymorphic eruption of pregnancy

a benign, inflammatory condition that most commonly affects primiparous women in the 3rd TM or immediately PP.

the lesions last for 4-6 weeks and then resolve spontaneously.

lesions spare the face, palms and soles.

49
Q

What site is most commonly affected by cephalohaematoma?

A

parietal bone

(does not cross suture lines)

50
Q

what is a cephalohaematoma?

A

swelling on newborns head

typically develops hours after birth

is due to bleeding between the periosteum and the skull

51
Q

What is a possible complication of cephaloheamatoma?

A

jaundice

52
Q

in what timeframe to cephalohaematoma and caput succedaneum develop?

A

cephalohaematoma: a few hours after delivery

caput succedaneum: generally present at birth

53
Q

where is caput succedaneum generally found?

A

over the vertex

crosses suture lines

54
Q

in what timeframe cephalohaematoma and caput succedaneum resolve?

A

cephalohematoma: can take up to 3 months

caput succedaneum: resolves within days

55
Q

What enzyme should be measured in children with ?muscular dytrophy?

A

creatine kinase (elevated in 50% cases)

but also elevated in 50% female carriers

56
Q

minimum duration to diagnose schizophrenia

A

1 month of sx

57
Q

What is pemphigoid gestationis

A

a rare skin blistering condition associated with pregnancy

usually presents in mid to late pregnancy (13-40w) with an itchy rash that develops into blisters

58
Q

What skin areas does pemphigoid gestationis affect?

A

commonly starts in the periumbilical region during the 2nd/3rd TM

pruritic, mostly non-blistering lesions

grouped vesicles with herpetiform appearance

59
Q

Management of pemphigoid gestationis

A

usually self-limiting

heals spontaneously after delivery

60
Q

what complications is pemphigoid gestationis associated with?

A

premature labour
increased lifetime risk of autoimmune disease

61
Q

What is the chance of developing T2DM in women who had GDM?

A

30% in 5 years

70% in 10 years

-> according to Chat GPT

62
Q

How long after LLETZ for CIN 1/2 should you have a smear?

A

6 months

(wait for discussion with girls before being sur ere this Q)

63
Q

When following a sensitising event should you give anti-D?

A

within 72h

64
Q

What are the cut-offs for iron supplementation in pregnancy?

A

<110 g/L in the 1st TM
<105 g/L in the 2nd/3rd TM
<100 g/L PP

65
Q

How does iron supplementation in pregnancy work?

A

100-200 mg oral iron (ferrous sulphate)

re-chech Hb in 2-3 weeks

once hb is normal, continue oral iron for 3 months or 6 weeks PP

give dietary advice (e.g. leafy greens, nuts, beans, seeds)

66
Q

Intrapartum advice for pregnant women with anaemia

A
  • give birth on LW
  • have a cannula
  • G&S on arrival
  • active management of the 3rd stage of labour
  • consider prophylactic syntocinon infusion in the 3rd stage of labour (to prevent PPH)

active mx of PPH if occurs

67
Q

Do you need scan confirmation for management of ?VTE in pregnancy

A

no

you should start LMWH management immediately (unless it is contraindicated)

68
Q

What location would prompt a GP to refer someone with molloscum contagiosum onwards

A

eye or eyelids

69
Q

What virus causes molloscum contagiosum?

A

molloscum contagiosum virus

70
Q

What is the scoring system used for croup?

A

Westley Croup Score

71
Q

What are the best opioid replacements to use in pregnancy?

A

methadone

or

buprenorphine

(double check this)

Year 5 😊✌🏼 (53 decks)

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