Paeds Flashcards

1
Q

Why must you investigate EBV with a monospot before treating?

A

If treated with amoxicillin (as wrongly labelled as URTI), then can get a big rash!

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2
Q

Characteristics of necrotising enterocolitis on a Xray?

A

Thickened bowel wall, double ring (gas trapped in bowel wall).
This especially happens in formula milk- use donor breast!

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3
Q

Characteristic of E. coli 0157 ? And a complication of this?

A

Quick onset of bloody diarrhoea,
Complication= haemolytic uraemic syndrome (one of most common causes of acute renal failure- so warn pts of reduced urine output)

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4
Q

What is the concern with a Port Wine Stain?

A

Sturge-Weber’s!!

Can cause glaucoma, and intracranial changes on ipsilateral side which cause changes on contralateral side of body.

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5
Q

Management of Turner’s?

A

ECHO and US kidneys (as ^risk coarctation, + kidney problems).
Plot on Turner’s growth chart.
Growth hormone ! (Turner’s is rare time can use it!)

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6
Q

How do you test for Coeliac disease?

A

Tissue transglutaminase (positive in Coeliac)

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7
Q

3yr girl, 3 day Hx of fever. Oral ulceration and papular-vesicular rash on palms/soles (characteristically linear lesions). What is the pathogen most likely responsible?

A

Coxsackie ! (causes hand, foot + mouth). Child usually presents with 3 day fever before other sx revealed.

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8
Q

6yr boy, pyrexia 38.5C, upper abdo pain and headache. Persistent slowly worsening dry cough for 3 days, associated with vomiting over 24hrs. Abdo exam normal, CRP 80, WCC 31.
Most likely DDx?

A

Pneumonia ! This shows how pneumonia in children can present in many non-specific ways, including abdo pain if lower lobe infection.
(DDx- whooping cough, but the inflammatory markers would be even higher and +++lymphocytes)

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9
Q

5yr, positive Gower’s test.

What deficiency?

A

Creatinine kinase! (because this shows they have Duchenne’s muscular dystrophy).
Positive Gower’s shows they have proximal muscle weakness.
Wouldn’t karyotype, as wouldn’t show up.

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10
Q

10yr, episodes of dizziness on exercise over last 3 months. Harsh grade 4/6 ejection systolic murmur, loudest in 2nd right intercostal space. There is an ejection click.
Most likely diagnosis?

A
Aortic stenosis (which usually presents ~10yrs)
(grade 4- shows a palpable murmur (thrill)- which automatically means it is not innocent.)
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11
Q

What is Kussmauls breathing?

A

Deep + laboured breathing pattern often associated with severe metabolic acidosis, particularly DKA but also kidney failure.

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12
Q

What do the following bloods indicate?

a) creatinine/urea/Na+
b) CRP/platelets
c) WCC/neutrophilia

A

a) high in dehydration
b) high in inflammation
c) high in infection

NB: Hb in babies is lower due to higher presence of HbF.

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13
Q

A portacath is usually fed into the subclavian or axillary vein.
Who might have them?

A
  • CF (prolonged abx courses)
  • Chemo pts
  • Thalassaemic pts (require regular transfusions)
  • Metabolic pts (require continuous infusions)
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14
Q

First-line relief from cows milk protein intolerance?

A

SMA Althera

or SMA Alfamino (most broken down)

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15
Q

What is a sternomastoid tumour associated with?

A

(pseudo-tumour) associated with hip dysplasia.

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16
Q

What is decorticate posture a sign of? And decerebrate?

A

Decorticate= raised IP. (flexed forearm)

Decerebrate (pronated forearm= usually more severe brain injury

17
Q

What is the commonest surgical cause of acute respiratory distress in prem babies?

A

Diaphragmatic hernia!

18
Q

Why is aspirin contraindicated in children?

A

Linked with Reye’s syndrome so contraindicated (especially if child recovering from a viral illness like chickenpox).

19
Q

When may aspirin be specifically indicated in children?

A

Kawasaki disease

20
Q

Why are children more prone to febrile fits?

A

Due to how quickly their temp jumps around- usually due to underdeveloped hypothalamus causing cytokine storm.

21
Q

Why must you not give ibuprofen in chicken pox?

A

It is associated with secondary deep skin infections (+ therefore necrotising fasciitis).