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Paeds Flashcards

1
Q 
Trisomy 21 
Cardiac - VSD, AVSD, ToF
Endocrine - HypoThy, Addisons, T1DM
Ocular - cataracts
Malignancy - Leukaemia
GI -duodenal atresia, Hirschprungs
Musk - Atlanto-axial instability
Neuro - Alzheimers
A

Down’s (complications)

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2
Q

Genetic imprinting - Loss of some of paternal chromosome 15

Px -Hypotonia, hypogonadism, obesity

A

Prader-Willi

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3
Q

X linked.

Px - Long face, big ears, macroorchidism, LD’s

A

Fragile x

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4
Q 
CATCH 22
Cardiac
Abnormal facies
Thymic aplasia
Cleft lip
HypoCa
A

DiGeorge

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5
Q

Ax - Trisomy 13

Px - Microcephalic, small eyes, cleft lip/palate, polydactyly, scalp lesions (progression of features?)

A

Patau’s

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6
Q

Ax - Trisomy 18

Px - Micrognathia (overbite)/small chin, low ears, rocker bottom feet, overlapping of fingers

A

Edwards

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7
Q

Ax - Def in galactose-1-phosphate uridyl transferase

Px - Illness with lactose containg milks. Vomiting, cataracts and recurrent E.coli infx

A

Galactosaemia

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8
Q

Ax - Autosomal dominant

Px - Tall, arm span>Ht, Long thin fingers, scoliosis, pectus excavatum.

A

Marfan’s

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9
Q

Ax - Autosomal recessive. Def phenylalinine hydroxylase

Ix - newborn bld spot screening

A

Phenylketonuria

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10
Q

Ax - Dystrophin gene abnormality. X-linked

Px - delayed development+walking

A

Duchennes’

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11
Q

Ax- def in hormones that convert sex hormones to cortisol
Px - ambiguous genitalia (accumulation of sex hormones), Salt losing crisis (lack of cortisol) i.e. low glucose and vomiting, hirsuitism, early menarche, large stature
Tx - IV dextrose and hydrocortisone

A

Congenital adrenal hyperplasia

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12
Q

Ax - Autosomal dominant

Px - Webbed neck, Pec Excav, short, pulmonary stenosis

A

Noonan’s

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13
Q

Px - micrognathia, cleft palate

A

Pierre-Robin

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14
Q

Px - Short, LD’s, friendly, aortic stenosis, neonatal hyperCa

A

William’s

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15
Q

Jaundice <24hrs

A

Px -
Immune: Rheus/ABO incompatibility
RBC defect: G6PD def, pyruvate kindse def, hered sphere
Infx

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16
Q

Jaundice 24hrs-2wks

A

Physiological, breast milk, infx, excess haemolysis

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17
Q

Persitant jaundice >2wks

A

Unconjugated: breast mil, infx, ABO incompatibility, hypothyroidism, galactosaemia
Conjugated: biliary atresia, neonatal hepatitis

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18
Q

Biliary atresia

A

Px - prolonged jaundice >2ks dark urine, pale stools
Mx - surgical
NB diagnoses after 6wks compromises outcome

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19
Q

Group B strep

A

can colonize reproductive tract and can infx baby

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20
Q

Px - respiratory distress syndrome, ground glass CXR
Ax - immature T2 pneumocytes
Mx - artificial surfactant, venti

A

Surfactant def

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21
Q

Ax - Parvovirus B19

Px - lethargy, fever, headache, slapped-cheek spreading to proximal arms and extensor sufaces

A

erythema infectiosum/slapped cheek/fifth disease

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22
Q

Ax - VZV

Px - Multistaged mac/pap/vesicular rash starting on head/trunk before spreading globally

A

Chicken pox

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23
Q

Ax - measles virus
Px - prodrome of fever, irritability, conjunctivitis, rash starting behind ears and spreading globally, macpap to confluent
NB Kopliks spots

A

Measles

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24
Q

Ax - mumps

Px - fever, muscle pain, pain on eating/earache, parotitis, unilateral and becoming bilateral in 70%

A

Mumps

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25
Q

Ax - Rubella virus

Px - macpap rash spreading globally and usually fades by day 3-5, suboccipital and postauricular LN’s

A

Rubella

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26
Q

Ax - toxins produced by GAS
Px - fever, malaise, tonsilitis (strep throat), fine punctate rash sparing peri-oral area (sandpaper texture), strawberry tongue

A

Scarlet fever

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27
Q

Ax - Coxsackie A16

Px - Vesicles on mouth, hand and feet

A

Hand, foot and mouth disease

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28
Q

Down’s diagnosis

A

karyotyping

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29
Q

VACTERL

A

Vertebral, anal imperforation, cardiac, tracheo-oesophageal fistula, renal, limb anomalies

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30
Q

Neonatal cardiology

A

Cyanotic: transposition of the great arteries, tetralogy of fallot,
Acyanotic: VSD, Aortic stenosis, AVSD, coarction of the aorta

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31
Q

Tetralogy of Fallot

A

VSD, Rt ventricular outflow obstruction, RV hypertrophy, overriding aorta

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32
Q

Transposition of the great arteries

A

PDA sustaining life

Mx - prostaglandin infusion and surgical intervention

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33
Q

Autoimmune hepatitis

A

Ax - anti -smooth muscle Abs

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34
Q

Coeliac’s

A

Px - diarrhoea, malabsorption (buttocks wasting)

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35
Q

Acute epiglottitis

A

Ax - HiB infx

Px - rapid onset, fever, toxic look, stridor, drooling of saliva

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36
Q

Ax - Human herpes virus 6

Px - 3-5 day high fever, 2 day macpap rash on chest and limbs, cough, D, febrile convulsions

A

Roseola infantum

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37
Q

Meningitis <3mnths

A

GBS (low birth wt+Prolonged ROM)

also E.coli+Listeria

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38
Q

Meningitis 1mnth-6yrs

A

N.men
Strep.pneu
Haemophilus.inf

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39
Q

Menigitis >6yrs

A

N.men

Strep.p

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40
Q

Autosomal recessive

A

Metabolic

exceptions=inherited ataxia’s

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41
Q

Autosomal dominant

A

structural

exceptions=Gilbert’s

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42
Q

Ax - parainfluenza infx
Epx - 6mnths-3yrs
Px - Stridor, barking cough, fever, coryzal Sx
Mx - PO dexamethasone, O2+adrenaline in emergency

A

Croup

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43
Q

Adrenaline for anaphylaxis ages and doses

A 
<6yrs = 150mcg
6-12 = 300mcg
>12yrs = 500mcg
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44
Q

Ax - IgA mediated small vessel vasculitis

Px - Palpable purpuric rash, abdo pain, usually following infx, polyarthritis, haematuria, renal failure

A

Henoch-Schonlein purpura

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45
Q

Develpmental dysplasia of the hip

A

RF: female, breech, FHx, oligohydramnios, macrosomaly
Ix - Barlow + Ortolani, US
Mx - Spont stabilise by 3-6wks, Pavliks harness, Surgery

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46
Q

Rose spots in non bloody diarrhoea

A

Salmonella typhi

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47
Q

BCG vaccine

A

At birth

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48
Q

Hepatitis B

A

At birth if rsk factors

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49
Q

DTap/IPV/Hib

Diptheria, tetanus, acellular pertussis/inactivated polio vaccine/Haemophilus influenza B vaccine

A

2mnths
3mnths
4mnths

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50
Q

PCV

Pneumococcal conjugate vaccine

A

2mnths
4mnths
12-13mnths

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51
Q

Oral rotavirus vaccine

A

2mnths

3mnths

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52
Q

Men B

A

2mnths
4mnths
12-13mnths

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53
Q

Hib

A

2mnths
3mnths
4mnths
12-13mnths

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54
Q

Men C

A

12-13mnths

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55
Q

Flu vaccine

A

2-7yrs

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56
Q

MMR

A

12-13mnths

3-4yrs

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57
Q

DTaP/IPV

A 
2mnths
3mnths
4mnths
3-4yrs
13-18yrs
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58
Q

HPV vaccination

A

12-13yrs

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59
Q

Thx for impetigo

A

Fusidic acid

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60
Q

Grey coating on tonsils and cervical lymphadenopathy

A

Diphtheria

61
Q

Irritability and convulsion in premmie w/ no head trauma or swelling

A

Intraventeicular haemorrhage

62
Q

Methods of catching urine sample

A

Adhesive bags
Clean catch
Catheter insertion
Suprapubic aspiration

63
Q

Px - Tall, obese, hirsute, high LH, high insulin, subfertility, menstrual abnormalities, acanthosis nigracans (Hyperpig skin folds)

A

PCOS

64
Q

Pansytolic left 4th ICS

A

VSD most common congenital heart abnormality

65
Q

Diastolic apex

A

Mitral stenosis

66
Q

Howell-Jolly bodies

A

Splectomy, splenic atrophy

67
Q

Auer rods

A

AML

68
Q

Infants intake mL/kg/day

A

150-180mL/kg/day

69
Q

2 feet proximal to ileo-caecal valve, 2 inches in length , 2% of ppln
Painless PRB

A

Meckel’s diverticulum

70
Q

Px - Obese, tall adolescents, shortened and externally rotated, referred pain to knee
Ax - Posterolateral displacement of the femoral head

A

Silpped upper femoral epiphysis

71
Q

Ax - degenerative disease of the hip
Epidx - 2-10yo, boys,
Px - Insidious-onset hip pain, limp,

A

Perthe’s disease

Legg-Calve-Perthes disease

72
Q

Px - Acute hip pain following viral infx, no pain at rest, reduced ROM
Epix - Most common cause of acute hip pain 3-8yo,

A

Transient synovitis

73
Q

Px - Neonate w/ swollen hands and feet, difficult to palpate femoral artery, short stature, wide carrying angle, widely spaced nipples, coarction of aorta

A

Turner’s syndrome 45XO

74
Q

Px - Delayed puberty, tall for age, small firm testes, shy

A

Klinefelter’s 47XXY

75
Q

Major Duckett Jones criteria for Rheumatoid fever (5)

A

Pancarditis, Polyarthritis, Erythema marginatum, nodules, Chorea

76
Q

Minor Duckett Jones criteria for Rheumatoid fever (4)

A

Fever, arthralgia, high ESR/WCC, heart block

77
Q

HTN, renal impairment, wt loss reduced appetitie, lethargy, abdo mass, haematuria

A

Wilm’s tumour

78
Q

Purpruic non blanching rash, arthralgia, abdo pain, renal involvement (nephrotic syndrome), +/-vomiting
Usually following viral illness

A

Henoch-Schonlein purpura

79
Q

Tx of ITP

A

Conservative, ITP is self limiting

80
Q

Tx of AML prevention

A

Tumour lysis syndrome
Ax - large number of cells break down
Px - HyperK, fluid overload, raised urea

81
Q

Complications of childhood oncological disease (4)

A

Secondary malignancies, LD, growth problems, infertility

82
Q

Causes of erythema nodosum (4)

A

OCP, TB, strep infx, sarcoidosis

83
Q

3wo baby, floppy, jaundice, large tongue hoarse cry no dysmorphic features

A

Congenital hypothyroidism

84
Q

Graves Tx

A

Optimize carbimazole

Add propanolol for Sx relief

85
Q

Corticosteroids SE (4)

A

HTN, glucose intolerance (hyperglycaemia), wt gain, short, osteoporosis

86
Q

Delayed puberty

A

No pubertal development by 15yo

87
Q

Tall, gynaecomastia, microorchidism, delayed puberty

A

Klinefelter’s 47XXY

88
Q 
Age 2-13
Pain symmetrical in lower limbs and not limited to joints
Pains never present at start of day
Physical activities not limited 
No limp
Examination normal
A

Rules of growing pains

89
Q

Immobile child, apyrexial, following URTI (1-2wks), normal xray, joint may be red/hot/swollen

A

Reactive arthritis

90
Q

Limp, apyrexial, accompanied by viral infx, referred knee pain, reduced ROM internal rotation

A

Transient synovitis

91
Q

Px - obese boys, shortened externally rotated

Mx - internal fixation

A

Slipped femoral epiphysis

92
Q

Acute illness, daily fevers, malaise, failure to thrive, rash, muscle/joint aches, >6wk duration, raised inflammatory markers

A

Juvenile idiopathic arthritis

93
Q

Erythematous, warm, acutely tender joint, reduced ROM, febrile child, <2yo

A

Septic arthritis

94
Q

Immobile limb, acute febrile illness, distal femur, proximal tibia

A

Osteomyelitis

95
Q

Clumsy, quadriceps wasting, Gower’s sign, waddling gait, raised CK

A

Muscular dystrophy

96
Q

Maternal haemorrhage, poor feeding, altered tone, seizure activity in neonate

A

Hypoxic ischaemic encephalopathy (moderate)

97
Q

Hyperintense, inflammatory white matter lesions

A

MS

98
Q

UMN lesion signs (4)

A

Increased reflexes
Decreased power
Increased Tone
Up going plantar reflexes

99
Q

Leg weakness in SCCC

A

Stroke

100
Q

SE profile:

Inc appetite, wt gain, hair loss, liver failure

A

Sodium valproate

101
Q

SE profile:

dizziness, visual distrubance, lupus erythematosus syndrome

A

Carbemazipine

102
Q

SE profile:

Behavioural change, irritability rash

A

Lamotrigine

103
Q

SE profile:

Behavioural changes, retinopathy, sleep disturbance, wt gain

A

Vigabatrin

104
Q

SE profile:

Anorexia, abdo pain, vomiting, diarrhoea,

A

Levetiracetam (Keppra)

105
Q

Ash leaf macule under Wood’s light, subendymal nodules, hypsarrythmia on EEG

A

Tuberous sclerosis

106
Q

Port wine stain

A

Sturge-Weber syndrome

107
Q 
Status epilepticus Mx
0min
5min
15min
25min
45min
A

0mins: ABC + glucose. O2
5mins:
IV access = lorazepam
No IV buccal midazolam/rectal diazepam
15mins: Lorazepam IV/IO senior help, prepare phenytoin
25mins: Rectal paraldehyde, phenytoin infusion
45mins: Rapid sequence induction of anaesthesia w/ thiopental and intubation, transfer to PICU

108
Q

GORD Mx

A

Cons: Feed thickeners, positioning
Med: Antacids, PPI, hypermotility drugs (metoclopramide)
Surg: fundoplication

109
Q

PDA Mx

A

Cath lab plugging

110
Q

Exercise + haematuria

A

Stress haematuria

111
Q

OCP + red urine, bld -ve

A

Porphyria

112
Q

Fluid maintenance

A 
0-10kg = 100ml/kg
10-20kg = 50ml/kg
>20kg = 20ml/kg
113
Q

Undigested food w/ diarrhoea, healthy child

A

Toddler’s diarrhoea/chronic non specific

114
Q

IDA, polyps, pigmented palms and soles

A

Peutz-Jeghers

115
Q

Small red growth in centre of umbilicus, covered w/ clear mucous

A

Umbilical granuloma
Salt the wound
resolve by 2

116
Q

Boot shaped heart

A

ToF

117
Q

Frequent yawning, irritable, no fever

A

Maternal opiod use

118
Q

Becwith-Wiedemann

A

Macrosomaly, large tongue hypoglycaemia

119
Q

Resp rate infants

A

30-40

120
Q

Resp rate young children

A

25-35

121
Q

Resp rate older children

A

20-25

122
Q

HR infants

A

110-160

123
Q

HR young children

A

95-150

124
Q

Older children

A

80-120

125
Q

Systolic BP infants

A

80-90

126
Q

Systolic BP young children

A

85-100

127
Q

Systolic BP Older children

A

90-110

128
Q

Neonate

A

<4wks

129
Q

Infant

A

<1yr

130
Q

Young child

A

2-5

131
Q

Older child

A

6-12

132
Q

Severe asthma assessment

O2 sats

A

O2: <92% for <12yo

133
Q

Severe asthma assessment

Resp rate

A

Resp rate:
>40 (2-5)
>30 (5-12)
>25 (12-18)

134
Q

Severe asthma assessment

Peak flow

A

Peak flow:33-50%

135
Q

Severe asthma assessment

HR

A

> 140 (2-5)
125 (5-12)
110 (12-18)

136
Q

Px - Generalised abdo pain, fever, recent viral URTI

Ax - Inflammation of mesenteric lymph nodes that occur following a viral URTI

A

Mesenteric adenitis

137
Q

RF for hypoglycaemia

A

<37wks, <2.5kg

138
Q

Acquired vs congenital hypothyroidism

A

Congenital presents earlier in life w/ coarse facial features, macroglossitis, umbilical hernia

139
Q

Sever dehydration (Wt)

A

> 10% wt loss

140
Q

Juvenile idiopathic arthritis. Define:
Monoarticular
Pauciarticular
Multiarticular

A

Single joint
<4
>4

141
Q

Supravalvular aortic stenosis

A

Williams

142
Q

UTI Mx:
<3mnths
Upper UTI >3mnths
Lower UTI <3mnths

A

<3mnths = Referred immediately to specialist. Admitted IV Abx
>3mnths Upper = Considered for admission. If not admitted PO Abx for 7-10 days (cephalosporin/co-amox)
>3mnths Lower = PO Abx for 3 days (Trimethoprim/nitro)

143
Q

CF Mx at birth

A

Gastrograffin enema - diagnostic and therapeutic

Prophylactic flucloxacillin and sweat test at 6wks

144
Q

Anaphylaxis

A

PO antihistamines (chlorphenamine)
IV Adrenaline
IV hydrocortisone

145
Q

Risk of hydrops feotalis

A

Parvovirus B19

146
Q

Simple nappy rash Tx

A

Castor oil, zinc

147
Q

Threadworm Tx

A

Mebendazole

148
Q

Impetigo Tx

A

Fusidic acid

149
Q

Kid w/ acne, topical Abx don’t work

A

Benzoyl peroxide

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