Paeds 7B Flashcards
At what point in a child’s life would a squint be considered pathological?
3 months
Usually due to a refractive error
What are the limit ages for: Head control Sits unsupported Stands independently Walks independently
Head control - 4 months
Sits unsupported - 9 months
Stands independently - 12 months
Walks independently - 18 months
What are the limit ages for:
Fixes and follows
Pincer grip
Fixes and follows - 3 months
Pincer grip - 12 months
What are the limit ages for:
Saying 6 words with meaning
Joining words
3-word sentences
Saying 6 words with meaning - 18 months
Joining words - 2 years
3-word sentences - 2.5 years
Name the primitive reflexes.
Moro Grasp Rooting Stepping Asymmetrical tonic neck reflex
NOTE: these will be replaced by postural reflexes (e.g. parachute)
Which intelligence tests may be used in children?
WPPSI (2-7 years)
WISC (6-16 years)
How is meconium ileus treated?
Gastrograffin enema (or N-acetylcysteine)
How should a congenital diaphragmatic hernia be managed?
Insert a large NG tube and apply suction to prevent distension of the intrathoracic bowel
How should neonatal hypoglycaemia be managed?
Early and frequent milk feeding
IV dextrose in refractory cases (and consider glucagon and hydrocortisone)
Aim for blood glucose > 2 mmol/L
How is a Meckel’s diverticulum diagnosed?
Technetium 99 pertechnetate scan
Which causes of gastroenteritis should be reported to the health protection unit?
- Campylobacter
- Listeria
- Shigella
- Salmonella
Which blood tests may be considered at a coeliac disease review
Coeliac serology FBC TFT LFT Vitamin D, B12, folate and serum calcium U&E
Describe the clinical features of congenital varicella syndrome.
Dermatomal skin scarring Neurological defects IUGR Limb hypoplasia Hydrops fetalis
Describe the clinical features of congenital CMV infection.
Mental handicap
Visual impairment
Progressive hearing loss
Psychomotor retardation
At birth: hydrops, IUGR, exomphalos, microcephaly, hydrocephalus, hepatosplenomegaly, thrombocytopaenia
Which organism most commonly causes septic arthritis in children?
Staphylococcus aureus
NOTE: in sickle cell patients, salmonella is also common but S. aureus is still the most common
What is the most common site of septic arthritis in children?
Hip
NOTE: plain film changes are apparent after 2-3 weeks
At what age can babies roll over?
4 months
What does the child protection team do once they have been informed about a case of suspected NAI?
Convene a case conference (includes parents, police officer, paediatrician, GP, health visitor and social worker)
Place the child’s name on the child protection register
Give support to the parents
Ensure regular monitoring by health visitor/social worker
Arrange regular follow-up with paediatrician (especially growth and development)
What is the most common site of osteomyelitis in children?
Lower femur or upper tibia (around the knee)
Tends to affect the metaphysis
When should an MCUG and DMSA be performed in a child who has had an atypical UTI?
MCUG can be done as soon as the current infection is under control
DMSA should be performed 3-4 months after the infection
Outline the definitive management of VUR.
Often improves with time
May require surgical corrections
Patients may receive prophylactic antibiotics
Which investigations are used to identify DDH?
< 5-6 months = ultrasound
> 6 months = X-ray
What is the typical blood gas picture that is seen in congenital cyanotic heart disease?
Metabolic acidosis
Hypoxia
Describe the appearance of a rash caused by parvovirus in adults.
Lacey rash
What is Gaucher disease?
Glycogen storage disease that is prevalent in Ashkanazi jews
NOTE: Tay Sachs is also common in this population
