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PACES > Paeds > Flashcards

Paeds Flashcards

1
Q

most common tumour in posterior brain and cerebellum

A

medulloblastoma

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2
Q

Red flags febrile seizure

A

> 5 minutes
2 in 24 hours
Not resolve within an hour
Focal symptoms: weakness in left arm

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3
Q

Febrile seizures and epilepsy

A

1% normal lifetime risk
2% simple seizures
5% complex

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4
Q

LD criteria

A

IQ <70
Onset in early childhood
Reduced life/adaptation skills

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5
Q

Mx of infants >3 months with lower URTI

A

3 days Abx

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6
Q

Complications of sickle cell

A
  • Aplastic crisis (parvovirus, EBV)
  • Acute stroke
  • Infections (encapsulated due to hyposplenism)
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7
Q

Mx of new diagnosis of asthma

A

Give a SABA inhaler, consider a very low dose corticosteroid inhaler in new Dx

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8
Q

Role of health visitor

A

Health visitors work with parents who have new babies, offering support and informed advice from the ante-natal period until the child starts school at 5 years.

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9
Q

erythema nodosum and sore throat

A

group A strep

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10
Q

Complications of DM in children

A
  • Growth and puberty delay if poor control
  • Hypertension
  • Nephropathy
  • Infections
  • DKA
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11
Q

most common causes of erythema multiforme

A

herpes

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12
Q

Mx of anaphylaxis?

A

ABCDE.
Give intramuscular (IM) adrenaline 1:1000 - repeat the dose after 5 mins
Give oxygen at the highest concentration possible.
Obtain IV access and give a rapid fluid challenge (with Hartmann’s or normal saline) using 20 mL/kg in a child.
Monitor the ECG and pulse oximetry continuously, and the blood pressure and pulse every 5 minutes.

Following initial resuscitation:
Give slow IM or IV chlorphenamine.
Give slow IM or IV hydrocortisone 
Consider nebulized salbutamol or ipratropium if the person is wheezy 
All children under 16 should be admitted
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13
Q

Long term Mx of sickle cell

A 
Education; warning signs of crisis (e.g. tummy ache and splenic sequestration)
Immunise as normal
PCV every 5 years, influenza annually 
Life long antibiotics 
Folic acid

Hydroxycarbamide in repeated crises to prevent chest crises

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14
Q

pansystolic murmur at lower left sternal edge

A

VSD

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15
Q

Acute Mx of sickle cell crisis

A
  • Analgesia (strong opioids +/- anti emetics and laxatives) - - Fluids
  • Reassess often
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16
Q

inability to smell [anosmia], decrease in gonadotrophin-releasing hormone, developmental delay

A

Kallman syndrome

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17
Q

epileptic drug with side effects: transient hair loss, weight gain, liver damage and blood dyscrasias

A

sodium valproate

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18
Q

Regular screens in children with DM

A
  • Growth and development; BMI
  • BP
  • Renal disease
  • Feet
  • Annual flu jab
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19
Q

single best investigation for osteomyelitis

A

blood culture

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20
Q

Harmony test

A

analyses cell free DNA in maternal blood

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21
Q

Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

A

Patau syndrome (trisomy 13)

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22
Q

Mx of newly diagnosed T1DM

A
  • Education re injecting, BMs, diet, etc
  • Basal-bolus regime or pump
  • Aim for BM between 4 and 7, blood glucose diary
  • Carbohydrate counting
  • HbA1c checked 4x per year, <48mmol
  • Bio psycho social
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23
Q

physical features of Down syndrome

A

My CHILD HAS a PROBLEM

Congenital heart disease / Cataracts
Hypotonia / Hyperthyroidism
Increased sandal gap
Leukaemia
Duodenal atresia / Delayed development

Hirshsprung’s disease
Alzheimer’s disease / Alantoaxial instability
Short neck / Squint

Protruding tongue / Palmar crease
Roung face
Oblique eye fissure / Occiput flat
Behavioural difficulties
Low nasal bridge
Epicanthic folds
Mental retardation
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24
Q

tetralogy of fallot

A

large ventricular septal defect (VSD)
pulmonary stenosis
overriding aorta
right ventricular hypertrophy

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25
Q

Pattern in GH deficiency

A

Normal growth rate until 6-12 months of age, then growth velocity falls. Associated with neonatal hypoglycaemia and jaundice

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26
Q

By WHAT AGE would you refer the following kids if they haven’t achieve the following milestones

a. Sit without support
b. Walk
c. Hops on one leg
d. Pincer grip
e. Smiles

A

Sit without support – normally by 7-8m, refer by 8m

b. Walk – normally by 15m, refer by 18m
c. Hops on one leg – normally by 4y, refer by 5y
d. Pincer grip – normally by 12m, refer by 12m
e. Smiles – normally by 6w, refer by 8w

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27
Q

Diarrhoea following hospital admission for gastroenteritis

A

Lactose intolerance (transient)

28
Q

scaphoid abdomen and bilious vomiting

A

Intestinal malrotation

29
Q

continuous murmur heard loudest under the left clavicle

A

PDA

30
Q

Tx for Rickets

A

If vit D very low, give them D2 or D3 (ergo or cholcalciferol), otherwise advise on diet (Oily fish such as sardines, pilchards and mackerel, eggs, meat and milk)

31
Q

infant with UTI, <3 months old, what do you do?

A

Refer to paediatric specialist for urine analysis and treatment with parenteral Abx. If <6 months, refer for USS within 6 weeks

Septic Screen for any child <3 months with 38 degree fever

Abx: ceftriaxone and amoxicillin

32
Q

Responds to their own name

A

9-12 months

33
Q

When to refer undescended testes?

A

3 months

34
Q

Ricket’s causes

A

Inadequate nutritional intake of cholecalciferol
Intestinal malabsorption - Crohn’s, CF, coeliac disease
Defect in metabolism of vitamin D; liver disease, kidney disease

35
Q

When would you step up asthma management

A

If they have to use their “reliever” i.e. steroid inhaler more then 3X PER WEEK

36
Q

A 1-week-old infant is referred following episodes of vomiting, feeding intolerance , and abdominal distension. Examination reveals watery stools with specks of blood present within the nappy. An abdominal X-ray is requested which reveals gas cysts in the bowel wall.

A

NEC

37
Q

Croup scoring system

A

Westley

38
Q

Which booster vaccines do young people usually receive between the ages of 13 - 18 years?

A

‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)

Men ACWY

39
Q

Team members involved in child safeguarding

A

Hold a child protection conference, may have to do a court order to remove child if they are in immediate danger

Social services
GP
Health visitor

40
Q

Seen in sporty teenagers

Pain, tenderness and swelling over the tibial tubercle

A

Osgood-Schlatter disease

41
Q

investigation following FBC in suspected HSP?

A

urine dipstick; micro or macro haematuria

42
Q

Calculate fluid requirements

A

Total fluid requirement (24 hrs) = maintenance + deficit - boluses

Fluid deficit in ml = % dehydration x weight (kg) x 10

Maintenance =
100ml for first 10kg
50ml for 2nd 10kg
20 for subsequent kgs

43
Q

At what age would the average child start to say ‘mama’ and ‘dada’?

A

9-10 months

44
Q

Seizures usually nocturnal involving the mouth and face.

EEG often shows high amplitude spikes in the left centrotemporal region

A

Benign rolandic epilepsy

45
Q

Classification of LD

A

Mild, moderate, severe profound

46
Q

ejection systolic murmur in baby with split second heart sound

A

ASD

47
Q

What is the most common cardiac condition associated with Turners?

A

Bicuspid aortic valve
Aortic root dilatation
Coarctation of the aorta

48
Q

Vocabulary of 2-6 words

A

12-18 months

49
Q

continuous murmur that radiates to back

A

PDA

50
Q

APGAR score

A

HR, RR, reflex irritability, muscle tone, colour

Each scored out of 2, max score 10. Done after birth once baby is dried and warm

51
Q

It typically involves blue sclera, and bowing of the legs, recurrent fractures

A

osteogenesis imperfecta; autosomal recessive disorder of collagen synthesis

52
Q

Pain after exercise

Intermittent swelling and locking

A

Osteochondritis dissecans

53
Q

pan systolic murmur in apex

A

mitral regurgitation

54
Q

murmur at upper left sternal edge

A

pulmonary stenosis

55
Q

Harmony test

A

analyses cell free DNA in maternal blood

56
Q

Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing face

A

Scarlet fever (Group A strep)

57
Q 
Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis
A

Williams syndrome

58
Q

Mx of infants with recurrent UTI

A

USS within 6 weeks

59
Q

Contraindications to MMR

A

severe immunosuppression
allergy to neomycin
children who have received another live vaccine by injection within 4 weeks

60
Q

Criteria for moderate vs severe acute asthma

A

Moderate:
RR < 40 or <30 (<5yo and >5)
HR <140 or <125 (<5yo and >5)

Severe:
RR >40 or >30 (<5yo and >5)
HR >140 or >125 (<5yo and >5)

61
Q

When is the routine MenB vaccine given?

A

2, 4 and 12-13 months.

62
Q

unilateral occipital flattening, which pushes the ipsilateral forehead ear forwards producing a ‘parrallelogram’ appearance

A

Plagiocephaly

The vast majority improve by age 3-5 due to the adoption of a more upright posture.

63
Q

Cyanotic - most common causes

A

tetralogy of Fallot
transposition of the great arteries (TGA)
tricuspid atresia

64
Q

Tower of 3-4 blocks

A

18 months

65
Q

Asthma ladder

A

The following happens in GP
1. SABA
2. + Very low dose ICS
3. + LTRA (<5) or LABA (>5)
4. >5: If LABA not working, remove and add LTRA
If LABA working, keep and either up to low dose ICS or add LTRA
If <5, increase steroids
4. REFER TO SPECIALIST: Add medium dose ICS or oral theophylline
5. Oral steroids (maintain ICS)

66
Q

Mx of DKA

A
  1. ABCDE approach
  2. Give high flow oxygen, attach heart monitor
  3. Blood gas, glucose, measure ketones
  4. If shocked, fluid bolus 0.9% saline, 10ml/kg
  5. Fluids + KCl (over 48 hours, less than adult maintenance amounts)
  6. After 1hr, give insulin (0.05-1units/kg/hr) DO NOT correct glucose faster than 2mmol/hour. Stop any treatment they are on
  7. Once glucose <14mmol, give dextrose
  8. Once ketones fall to 1, resume normal insulin regime, wait 30 mins (if subcut) or 1 hour (insulin pump)

Monitor:

  • ECG
  • Neurological exam every hour
  • Urine monitoring
67
Q

Acyanotic - most common causes

A 
ventricular septal defects (VSD) - most common, accounts for 30%
atrial septal defect (ASD)
patent ductus arteriosus (PDA)
coarctation of the aorta
aortic valve stenosis

PACES (3 decks)

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