Paeds Flashcards
Why must you investigate EBV with a monospot before treating?
If treated with amoxicillin (as wrongly labelled as URTI), then can get a big rash!
Characteristics of necrotising enterocolitis on a Xray?
Thickened bowel wall, double ring (gas trapped in bowel wall).
This especially happens in formula milk- use donor breast!
Characteristic of E. coli 0157 ? And a complication of this?
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)
What is the concern with a Port Wine Stain?
Sturge-Weber’s!!
Can cause glaucoma, and intracranial changes on ipsilateral side which cause changes on contralateral side of body.
Management of Turner’s?
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!)
How do you test for Coeliac disease?
Tissue transglutaminase (positive in Coeliac)
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?
Coxsackie ! (causes hand, foot + mouth). Child usually presents with 3 day fever before other sx revealed.
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?
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)
5yr, positive Gower’s test.
What deficiency?
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.
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?
Aortic stenosis (which usually presents ~10yrs) (grade 4- shows a palpable murmur (thrill)- which automatically means it is not innocent.)
What is Kussmauls breathing?
Deep + laboured breathing pattern often associated with severe metabolic acidosis, particularly DKA but also kidney failure.
What do the following bloods indicate?
a) creatinine/urea/Na+
b) CRP/platelets
c) WCC/neutrophilia
a) high in dehydration
b) high in inflammation
c) high in infection
NB: Hb in babies is lower due to higher presence of HbF.
A portacath is usually fed into the subclavian or axillary vein.
Who might have them?
- CF (prolonged abx courses)
- Chemo pts
- Thalassaemic pts (require regular transfusions)
- Metabolic pts (require continuous infusions)
First-line relief from cows milk protein intolerance?
SMA Althera
or SMA Alfamino (most broken down)
What is a sternomastoid tumour associated with?
(pseudo-tumour) associated with hip dysplasia.
What is decorticate posture a sign of? And decerebrate?
Decorticate= raised IP. (flexed forearm)
Decerebrate (pronated forearm= usually more severe brain injury
What is the commonest surgical cause of acute respiratory distress in prem babies?
Diaphragmatic hernia!
Why is aspirin contraindicated in children?
Linked with Reye’s syndrome so contraindicated (especially if child recovering from a viral illness like chickenpox).
When may aspirin be specifically indicated in children?
Kawasaki disease
Why are children more prone to febrile fits?
Due to how quickly their temp jumps around- usually due to underdeveloped hypothalamus causing cytokine storm.
Why must you not give ibuprofen in chicken pox?
It is associated with secondary deep skin infections (+ therefore necrotising fasciitis).
