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Year 3 > Paeds > Flashcards

Paeds Flashcards

1
Q

Milestone: mature pincer grip

A

9-12 months

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2
Q

Milestone: walking

A

18mo (red flag age)

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3
Q

Which food comes with a risk of infant botulism and therefore should be avoided before 12months?

A

Honey

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4
Q

Milestone: hop

A

4yr

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5
Q

Symptoms of lactose intolerance

A

Loose stools which can be foamy or watery
Painful poos - burn due to acidity
Abdominal bloating
Gurgling stomach

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6
Q

Characteristics and genetics of Kleinfelters

A

47XXY

Tall stature
Sparse facial/body hair
Gynaecomastia
Infertility
Learning difficulties
Small testicles (due to hypogonadism)
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7
Q

Vaccines at 8 weeks

A

6 in 1: DTaP, polio, HiB, hepatitis B
Meningitis B
Pneumococcal conjugate (PCV)
Rotavirus (oral)

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8
Q

Vaccines at 12 weeks

A

6 in 1: DTaP, polio, HiB, hepatitis B

Rotavirus (oral)

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9
Q

Vaccines at 16 weeks

A

6 in 1: DTaP, polio, HiB, hepatitis B
Pneumococcal (PCV)
Meningitis B

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10
Q

Vaccines at 1 yr

A

HiB and MenC
Pneumococcal (PCV)
MMR
Meningitis B booster

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11
Q

Vaccines at 3yr 4mo

A

DTaP + polio

MMR

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12
Q

Vaccines at 14yr

A

Diphtheria, tetanus and polio

MenACWY

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13
Q

Vaccines offered to 65yr

A

Influenza - inactivated

Pneumococcal polysaccharide vaccine (PPV)

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14
Q

Vaccines offered at 70yo

A

Shingles

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15
Q

Two types of pneumococcal vaccine and when they are given

A

Pneumococcal conjugate vaccine (PCV) - 8wk, 16wk, 1yr

Pneumococcal polysaccharide vaccine (PPV) - 65yr

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16
Q

Contents of 6-in-1 vaccine and when it is given

A

DTaP - diphtheria, tetanus and pertussis
Polio
Hepatitis B
HiB

given at 8wk, 12wk, 16wk

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17
Q

When is temperature concerning in children?

A

> 38 degrees in <3mo
3-6mo and >39 degrees
Temperature for more than 5 days
Temperature under 36 degrees and checked 3 times

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18
Q

Age range most affected by croup?

A

6mo-6yr

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19
Q

Acute Epiglottitis age range

A

1-6yr

20
Q

FeverPAIN score components and interpretation

A 
Fever - in past 24h
Purulent Tonsils 
Attend within 3 days 
Inflamed tonsils
No cough/coryza

1 for each
0-1 = no abx
2-3 = consider delayed prescription
4-5 = consider ab

21
Q

3 drugs used in anaphylaxis

A

Adrenaline
Chlorphenamine
Hydrocortisone

22
Q

2 tests for DDH

A

Barlow’s test = flex hip and knee, push posteriorly to dislocate
Ortolani test = attempt to reduce the dislocation

23
Q

Newborn exam: describe findings that may be present when examining the genitalia

A

Female = clitoromegaly in congenital adrenal hyperplasia

Male - epispadia = defect on dorsal surface, hypospadia = defect on the ventral surface
Undescended testes

24
Q

Craniofacial abnormalities in Down’s Syndrome

A 
Round face
Epicanthic folds
Flat nasal bridge
Flat occiput and third fontanelle
Upslanted palpebral fissures
Small ears
Brushfield spots in the iris
Protruding tongue
25
Q

Non-craniofacial abnormalities in Down’s Syndrome

A 
Short neck
Single palmar creases
Incurved and short 5th finger
Sandal gap between 1st and 2nd toe
Congenital heart defects
Duodenal atresia
26
Q

Most common pathogens in neonatal sepsis

A

<5 days = maternal floria e.g. E.coli, GBS

>5 days = above plus S. aureus

27
Q

Define early and late neonatal sepsis

A

Early - 0-7 days

Late - 7-28 days

28
Q

Management of neonatal sepsis

A

<5 days = benzypenicillin (covers GBS), gentamicin (covers E. coli)
> 5 days = as above but plus flucloxacillin for s aureus

29
Q

Stages of HIE

A

Stage 1 / Mild –> irritability, hyperventilation, overstimulated, hypertonic
Stage 2 / Moderate –> movement abnormalities, hypotonia, seizures
Stage 3 / Severe –> no spontaneous movements, fluctuating hypo/hypertonia, seizures, multi-organ failure

30
Q

Management of HIE

A

Resuscitation
Anticonvulsant
Cooling - to reduce brain damage, especially for moderate-severe HIE

31
Q

Which babies are at risk of intraventricular haemorrhage?

A

Preterm babies, especially <30 weeks

32
Q

How does intraventricular haemorrhage lead to hydrocephalus?

A 
Bleeding into ventricles
Ventriculomegaly
Blood products block the arachnoid granulations
Build up of fluid
Hydrocephalus
33
Q

Aetiology of ARDS

A

Surfactant deficiency as this is not made until 34 weeks gestation, so significantly preterm babies are affected
Leads to alveolar collapse and prevents gas exchange

34
Q

Diagnosis of ARDS

A

Clinical signs

Ground glass CXR

35
Q

Management of ARDS

A

Respiratory support e.g. CPAP
Surfactant therapy
Maternal steroids before delivery - prevention

36
Q

Which babies are affected by transient tachypnoea of the newborn

A
  • C sectioned babies
  • Fast delivery

This is due to reduced stress hormones during the delivery which are needed to help the baby clear its lungs

37
Q

Diagnosis of TTN

A

Tachypnoea - >60breaths/min

CXR - lung hyperinflation, fluid in horizontal fissure of R lung

38
Q

When should TTN resolve by?

A

Within 3 days

39
Q

Clinical features of necrotising enterocolitis

A
  • Intolerance to feeding
  • Vomiting bile
  • Bloody stools
  • Shiny distended abdomen
  • Shock
40
Q

Maintenance fluid in children

A

100ml/kg for first 10kg
50ml/kg for next 10kg
20ml/kg for every kg after

0.9% saline with 5% glucose +/- 20mmol/L KCl

41
Q

Deficit/replacement fluid calculation in children

A

Weight x % dehydration x 10

42
Q

Fluid bolus calculation in children

A

20ml/kg - sepsis/shock

10ml/kg trauma /DKA

43
Q

Genetic pattern and pathophysiology of Duchennes muscular dystrophy

A

X-linked recessive (so mainly affects men) mutation of dystrophin gene which forms part of muscle cell cytoskeleton, leading to myofibre necrosis (hence raised CK)

44
Q

Symptoms and signs of Duchennes muscular dystrophy

A 
Waddling gait
Slow running 
Delayed walking
Pseudohypertrophy if calves
Learning difficulties

Growers sign - difficulty getting up from floor, children roll prone and walk up their legs

45
Q

Diagnosis of Duchennes

A
  • CK raised - should be done on every boy not walking by 18 months
  • genetic testing
46
Q

Heelprick test is for…

A
  1. Sickle cell disease
  2. Cystic fibrosis
  3. Congenital hypothyroidism

Then 6 inherited metabolic disorders

  1. Phenylketonuria
  2. MCADD
  3. Maple syrup urine disease
  4. Isovaleric acidaemia (IVA)
  5. Glutaric Aciduria type 1 (GA1)
  6. Homocysteinuria

Year 3 (7 decks)

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