Paeds Flashcards
most common cause of croup
parainfluenza virus
most common cause of bronchiolitis
respiratory synctal virus (RSV)
most common cause of erythema infectiousum
parvovirus B19
slapped cheek syndrome
single palmar crease
down syndrome trisomy 21
when and who gives vitamin K
immediately after birth by a mid wife
neonate born very agitated
alcohol in pregnancy
neonate born very quiet and inactive
opiates used in pregnancy
sickly baby with intractable crying who has chronic hiccups
GORD
sand paper rash
scarlet fever
one side of body strength normal
cerebral palsy
when is a heel prick test done
day 5
when is the examination of the new born done
within first 72 hours
then again at 6-8 weeks by GP
what suggests a diagnosis of toddlers diarrhoea
food bits in the faeces
what is the first thing down in paediatric resus
5 rescue breaths
what position should infants and older children be put in
infants = neutral position
older children = “sniffing”
what should you cover when providing a rescue breath in an infant
nose and mouth
[normal mouth to mouth for child over 1]
what pulse should you feel in infants and children over 1
infants = brachial pulse
child over 1 = carotid pulse
can also use femoral pulse
how should chest compressions be given in an infant
Use two fingers for an infant < 1 year
[use one or two hands for a child over 1 year to achieve an adequate depth of compression]
what is the ratio of CPR in children
15:2
what should you do in a child that is choking - with effective cough
encourage to cough
what should you do in a child that is choking - with ineffective cough and conscious
5 back blows
5 thrusts [chest for infants, abdomen for > 1]
what should you do in a child that is choking - with ineffective cough and unconscious
open airway
5 rescue breaths
start CPR
what fluids should be used for resuscitation in children and why
ISOTONIC i.e. 0.9% saline
hypotonic will cause cerebral oedema and may cause coning - DO NOT USE DEXTROSE
Newborn Life Support - ABCDE
A = provide warmth, clear airway, dry, stimulate
B = if HR < 100 give Positive Pressure Ventilation
C = ensure effective lung inflation then add chest compressions
D = consider adrenaline
neutrapenia + sepsis
Piperacillin/Tazobactam
if pen allergic = Teicoplanin + Aztreonam
returning to attachment figure for comfort and safety in face of fear or threat
safe haven
attachment figure acts as a base of security from which a child can explore surroundings
secure base
anxiety that occurs in absence of the attachment figure
seperation distress
child readily explores, uses carer as secure base, cries infrequently when carer not present.
The carer has appropriate response to child being upset, encourages them to exploe and in tune to child needs
“child playing happily with mum in room but becomes upset when she leaves”
secure attachment
child avoid/ignores parent when they leave and come back. Treats parents same as strangers.
Carer is disinterested and uncomfortable with showing affection. Encourages separation/independence
anxious avoidant attachment
child explores little, wary of strangers, highly distressed when carer leaves.
Carer is inconsistent and has unpredictable response
anxious ambivalent attachment
baby, whose feeding pattern has always been irregular, is irritable and is difficult to settle
difficult temperament
DDx for NAI
NAI
ITP
Von Willbrand
Tx for meningitis
IV Ceftriaxone + Dexamethasone
IV Chloramphenicol if cef-allergic
+ gentamicin if E. coli
+ ampicillin if Listeria
difference in management of umbilical hernia and inguinal hernias in newborns
umbilical hernias = can be left alone to resolve
inguinal hernias = require surgery due to risk of strangulation [within 2 weeks]
2-month-old baby with noise breathing, particularly when feeding, and poor food intake and weight gain - Diagnosis ?
Laryngomalacia
child with Webbed neck, Pectus excavatum, Short stature and Pulmonary stenosis
Noonan syndrome
A baby is noted to have micrognathia [undersized jaw] and a cleft palate. See posterior displacement of the tongue. He is placed prone due to upper airway obstruction. There is no family history of similar problem.
Pierre-Robin syndrome
what is used to diagnose Vesicoureteric reflux
micturating cystourethrogram
what is used to check the kidney for renal scarring
DMSA
child with lump in anterior triangle
Branchial cyst
child with lump in posterior triangle
cystic hygroma
2 year old - On examination; a small smooth cyst is identified which is located above the hyoid bone. On ultrasound the lesion appears to be a heterogenous and multiloculated mas
dermoid cyst
milestones = gross motor
Head control - 3 months Sitting balance - 6 months Crawling - 9 months Standing - 12 months Runs - 18 months Stairs – 2 feet/tread - 24 months Stairs – alternate feet - 36 months Hops - 48 months
milestones = fine motor and vision
Hand regard in midline - 3 months Grasps toy - palmar - 6 months Scissor grasp - 9 months Pincer grasp - 12 months Tower of 3-4 bricks - 18 months Tower of 6-7/scribble - 24 months Tower of 9 bricks/copies circle - 3 years Draws simple man - 4 years Copies square and triangle - 5 years
milestones = hearing and language
Vocalises - 3 months
Babbles - 6 months
Imitates sounds - 9 months
Knows name - 12 months
2 body parts/5-20 words - 18 months
Simple instructions/50+ words - 24 months
Complex instructions/asks questions - 36 months
Can tell stories of experiences - 48 months
milestones = social behavior and play
Social smile - 6 weeks
Pleasure on friendly handling - 3 months
Plays with feet/friendly with strangers - 6 months
Plays peek-a-boo/stranger awareness - 9 months
Drinks from cup/waves bye-bye - 12 months
Feeds with spoon, plays alone - 18 months
Symbolic play/puts on some clothes - 2 years
Pretend interactive play/toilet-trained - 3 years
Understands turn-taking/dresses fully - 4 years
what are the live attenuated vaccines
BCG measles, mumps, rubella (MMR) influenza (intranasal) oral rotavirus oral polio yellow fever oral typhoid
what are the inactivated vaccines
rabies
hepatitis A
influenza
what are the toxoid [inactivated toxin] vaccines
tetanus
diphtheria
pertussis
what is child death between day 1 and 28 defined as
neonatal death
what should a child at 18 months be able to do
build a tower of 3 bricks, enjoy picture books, play alone, run, can say 5-20 words
what should a child at 12 months be able to do
fine motor = Pincer grasp
gross motor = standing
hearing and language = Knows name
play and social = Drinks from cup/waves bye-bye
what should a child at 3 years be able to do
fine motor =Tower of 9 bricks/copies circle
gross motor = Stairs – alternate feet
hearing and language = Complex instructions/asks questions
play and social = Pretend interactive play/toilet-trained
how do you work out milestones for a premature baby
corrected age is taken into consideration up to the age of 2
The child’s age minus how many weeks early from 40 weeks
vaccines given at 8 weeks
Diphtheria, tetanus, pertussis, polio, Hib, and Hep B
Pneumococcal [PCV]
MenB
Rotavirus
vaccines given at 12 weeks
Diphtheria, tetanus, pertussis, polio, Hib, and Hep B
rotavirus
vaccines given at 16 weeks
Diphtheria, tetanus, pertussis, polio, Hib, and Hep B
Men B
PCV
vaccines at 1 year old
Hib/MenC booster
PCV booster
Men B booster
MMR
vaccines at 3 years
Diptheria, tetanus, pertussis, and polio
MMR
vaccines at 12 to 18 year
HPV - course of two injections at least 6 months apart
vaccine at 14 years
Tetanus, diptheria and polio
Men ACWY
vaccine at 65 years old
Pneumococcal [PPV]
inactivated influenza
vaccine at 70 years old
shingles
what are contraindications to getting the MMR
severe immunosuppression
allergy to neomycin
children who have received another live vaccine by injection within 4 weeks
pregnancy should be avoided for at least 1 month following vaccination
immunoglobulin therapy within the past 3 month
contraindications to BCG
previous BCG vaccination a past history of tuberculosis HIV pregnancy positive tuberculin test
what vaccine was introduced in 2013
rotavirus
placenta artery = oxygenated or de-oxygenated
de-oxygenated
placenta vein = oxygenated or de-oxygenated
oxygenated
what needs to be monitored with methlyphenidate (ritalin)
height and weight every 6 months
what checks does a new borns get
Clinical examination of newborn
Newborn Hearing Screening Programme e.g. oto-acoustic emissions test
what checks does a baby get at 1 month
Heel-prick test day 5-9 - hypothyroidism, PKU, metabolic diseases, cystic fibrosis, medium-chain acyl Co-A dehydrogenase deficiency (MCADD)
Midwife visit up to 4 weeks*
what check does a baby get after 1 month
Health visitor input
GP examination at 6-8 weeks
Routine immunisations
