Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 3a > Paeds > Flashcards

Paeds Flashcards

1
Q

name 5 conditions tested for by the guthrie test?

A 
sickle cell
hypothyroidism 
CF
maple syrup urine disease
phenylketonuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does the APGAR score test for?

A 
Appearance- colour 
Pulse 
Grimace 
Activity - muscle tone
Respiratory effort

7-10 good
0-3 low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some complications of premature birth?

A 
NEC
RDS- surfactant deficiency 
retinopathy of prematurity 
PDA
jaudince- liver immaturity
intraventricular haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the ways to categorise neonatal jaundice?

A

present at birth/appears in first 24 hours- pathological
appears after 24 hours and resolves by 14 days - physiological
continues after 14 days- prolonged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

causes of pathological jaundice?

A

rhesus d incompatibility/ABO
G6PD-deficiency
Infection - congenital (CMV, syphilis, rubella, toxoplasmosis, herpes)
Spherocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the pathophysiology of rhesus/ABO incompatibility?

A

mother is rhesus -ve, baby is rhesus +ve (due to rhesus +ve father), sensitisation event occurs where mother is exposed to foetal blood -> causes body to produces auto-antibodies against rhesus +ve RBC’s, which then cross the placenta and destroy the foetal RBC’s leading to physiological jaundice. The same occurs if a mothers blood type is O and the foetus is either A or B.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

investigations of suspected rhesus incompatibility?

A

rhesus negative mothers and O blood group - indirect coombs test
foetal blood sampling/doppler USS- can show foetal anaemia + increased reticulocyte
direct coomb test after birth to check

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

management of incompatbility ABO or rhesus?

A

transfusion with group O negative blood

anti-D immunoglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the danger of prolonged jaundice in neonates?

A

can develop kernicterus - bilirubin crosses blood/brain barrier which can lead to cerebral palsy (non-progressive permanent cerebral insult)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

mode of inheritance of G6PD deficiency?

A

X-linked recessive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pathophysiology of G6PD deficiency?

A

reduced G6PD leads to reduction in glutathione which causes increased susceptibility of RBC to oxidative stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

management of G6PD deficiency in neonates?

A

exchange transfusion

phototherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

causes of physiological jaundice in neonate?

A

immature hepatic bilirubin conjugation
infection: sepsis/UTI
haemolytic disorders
breast milk jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

management of neonatal jaundice?

A

blue light phototherapy

exchange transfusion if very high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

investigations of neonatal jaundice?

A

serum bilirubin to monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

causes of prolonged neonatal jaundice?

A

unconjugated:
-infection
-breast milk
-haemolytic anaemia
-hypothyroidism
conjugated:
-bile duct obstruction - biliary atresia
neonatal hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is biliary atresia?

A

complete or partial obstruction of the extrahepatic biliary tree within the first 3 months of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

signs and symptoms of biliary atresia?

A 
neonatal prolonged jaundice - often 8 weeks after birth (can have an episode of transient jaundice at birth which then resolves, followed by further jaundice 8 weeks later) 
pale stools
dark urine
failure to thrive 
hepatomegaly + splenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

investigations of biliary atresia?

A 
serum bilirubin - normal 
conjugated bilirubin- abnormally high
serum alpha-1-antitrypsin 
CF sweat test 
USS of biliary tree
percutaneous liver biopsy with intraoperative cholangioscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

management of biliary atresia?

A

surgical intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pathophysiology of neonatal respiratory distress syndrome?

A

widespread alveolar collapse due to surfactant deficiency (immature lungs in neonate- surfactant starts to be produced at 24 weeks). This leads to inadequate gas exchange.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

RF for RDS?

A

premature birth
C-section delivery
maternal diabetes
past hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

presentation of RDS?

A 
nasal flaring
grunting 
tachypnoea 
tracheal tug 
intercostal recession
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

investigations and findings in RDS?

A

CXR: bilateral diffuse ground glass appearance, reduced lung volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

management of RDS?

A 
surfactant administration (intra-thecal) 
oxygen via nasal cannula (CPAP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

prevention of RDS?

A

corticosteroids (betamethasone/dexamethasone) 1-7 days before birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

presentation of PDA?

A

if large- poor growth, difficulty feeding and breathing

continous machinery murmur at upper L sternal border radiating to the back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

investigations of PDA?

A

CXR- cardiomegaly

ECHO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

management of PDA?

A

indomethacin - to close

surgical closure if fails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

likely diagnosis in neonate who is vomiting and has distended abdomen with fresh blood in stool?

A

NEC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

pathophysiology of NEC?

A

bacterial invasion of ischaemic bowel wall typically seen in premature infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

symptoms of NEC?

A 
vomiting - may become billous 
poor feeding 
distended abdomen 
fresh blood in stools 
shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

investigations of NEC?

A

XRAY: distended bowel loops, thickening of bowel wall with intramural gas, bowel wall oedema, RIGLER SIGN- air inside and out of bowel, FOOTBALL SIGN- air outlining the falciform ligament

FBC- ESR/CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

management of NEC?

A

stop oral feed
broad spec abx IV
total parenteral nutrition
surgery if necrotic or perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is retinopathy of prematurity?

A

hyperoxic insult (i.e. O2 therapy in premature infant), causes neovascularization -> retinal haemorrhage, fibrosis and reintal detachment, ultimately leading to blidness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

genetics of downs syndrome?

A 
chr 21 trisomy 
due to:
meiotic non-disjunction
translocation 
mosaicism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what some non-physical features of downs syndrome?

A 
hirschsprungs
duodenal atresia 
septal defect (VSD)
alzheimers
ALL
tetralogy of fallot 
PDA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are some physical features of downs syndrome?

A 
epicanthial fold 
simian crease/single palmar crease
low set ears
flat nasal bridge 
protruding tongue 
sandal gap
short stature 
flat occiput 
hypotonia when born
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

diagnosis of down syndrome?

A

combined test at 10-14 weeks
Quadruple test at 15-20 weeks
Amniocentesis from 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what does the combined test look for?

A

nuchal translucency
B-HCG
PAPPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what does the quadruple test test for?

A

alpha fetoprotein
oestriol
B-HCG
Inhibin A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what are the risks of amniocentesis?

A

miscarriage
chorioamnionitis
amniotic fluid embolism
injury to foetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is the genetic defect in patau syndrome and how does it present?

A

trisomy 13

small eyes
cleft lip
rocker bottom feet
polydactyly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is the genetic defect in edwards syndrome and how does it present?

A

Trisomy 18

small mouth and chin
rocker bottom feet
overlapping fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is genetic defect in turners syndrome and features?

A

45, XO

short stature
webbed neck
infertility
absence of secondary sex characteristics
bicuspid aortic valve -> ejection systolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is the definition of cerebral palsy?

A

permanent non-progressive cerebral insult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

causes of cerebral palsy?

A 
TORCH infections 
hypoxic-ischaemia injury
kernicterus 
traumatic delivery 
meningitis/encephality
hydrocephalus/head trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what are the types of cerebral palsy and some of their defining features?

A

spastic = UMN damage (spasticity, hyperreflexia, stiff muscles, clonus, pain, tight muscles)

dyskinetic/athetoid= basal ganglia damage (involuntary uncontrolled movements- chorea, athetosis, dystonia)

ataxic/hypotonic= cerebellum damage (hypotonia, poor balance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

key features of ASD?

A

persistent communication and social interaction impairement (poor communication, eye contact, reduced emotional response)
restricted, stereotyped pattern of behaviour, interests and activities (repetitive movements, fixation etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

features of foetal alcohol syndrome?

A 
thin upper lip
epithcanthic folds
microcephaly 
short nose 
short palpabral fissure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

likely diagnosis in child with conjunctivities, cough and coryzal symptoms followed by a maculopapular rash that starts behind the ears and white spots in the mouth?

A

measles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

causes of measles

A

paramyoxovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

feautres of measles?

A

prodrome: coryza, conjunctivitis, cough
koplik spots: white spots on buccal mucosa
maculopapular rash that starts behind the ears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

complications of measles?

A 
encephalitis
febrile seizures 
DEAFNESS
hemiplegia
learning difficulties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

likely diagnosis in child aged 5-9 with fever, malaise and large swelling of parotids?

A

mumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

complications of mumps?

A

orchitis + infertility
pancreatitis
meningitis/encephalitis
deafness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

how does rubella present?

A

maculopapular rash that starts on face

suboccipital and postauricular lymphadenompathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what is the presentation of chicken pox?

A

rash- starts as macules, then papules appear as crops, then vesicles that start on head and trunk and progress to peripheries, then crusts over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what medication should be avoided in chicken pox?

A

NSAID!

increases risk of necrotising disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what virus causes shingles?

A

VZV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

management of shingles?

A

aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

presentation of infecitous mononucleosis?

A 
tonsillitis 
cervical lymphadenopathy 
fever
malaise 
petechiae on soft palate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

likely diagnosis in child with fever and malaise, who a week later develops a erythematous rash on the face?

A

Parvovirus B19 (slapped cheek)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what are the features of slapped cheek?

A

viraemic phase- fever, headache, malaise

1 week later- erythematous maculopapular (often described as lace) rash on face which spreads to extremities and trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

likely diagnosis in child with honey crusted plaques on chin?

A

impetigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what is impetigo?

A

staph aureus or strep pyogenes infection (very infectious)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

management of impetigo?

A

topical fusidic acid

systemic flucoloxacillin if severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what is the likely diagnosis in a child with a sand paper like rash that started on the neck and spreads to body, and strawberry tongue?

A

scarlet fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what is scarlet fever

A

infection with group A strep- strep pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

features of scarlet fever?

A 
sore throat 
vomiting 
headache
sand paper like rash
strawberry tongue 
enlarged tonsils
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

management of scarlet fever?

A

phenoxymethylpenicillin for 7 days
self isolate for 24 hours after starting antibiotics (can return to work after that)
notify public health england

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

likely diagnosis in patient with purpura on back of legs and buttocks?

A

Henoch-schonlein purpura (HSP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

what is HSP?

A

autoimmune IgA mediated small vessel vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

presentation of HSP

A

often preceded by URTI 1-3 weeks earlier
symmetrical palpable purpura rash on lower back legs and buttocks
joint pain
abdominal pain
renal involvement
rash, GI upset, arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

investigations of HSP?

A

check renal function - U+E
serum IgA level
skin biopsy - small vessel vasculitis
urinalysis (should always be performed)- haematuria if renal involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

management of HSP?

A

self limiting

paracetamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

management of bacterial meningitis?

A

IM benzylpenicillin in GP

IV ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

organisms that cause bacterial meningitis in children?

A 
GBS
E.coli
listeria monocytogenes
Neisseria meningitidis 
HiB
strep pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what are the cyanotic congenital cardiac conditions?

A

tetralogy of fallot

transposition of the great vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what are the non-cyanotic cardiac conditions?

A

PDA
VSD
ASD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

pansystolic murmur best heard at the left lower sternal edge?

A

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

feautres of VSD?

A 
hepatomegaly 
poor feeding 
failure to thrive 
tachypnoea 
can be asymptomatic 
PANSYSTOLIC murmur at left sternal edge radiating to the axilla/back (VSD, VIP= Pansystolic)
active precodrium 
thrill
gallop rhythm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

complications of VSD?

A

eisenmengers syndrome

heart failure

84
Q

management of VSD?

A

usually self limiting
diuretics with captopril (ACE-I) - if symptoms of heart failure
if symptomatic - surgery

85
Q

machinery murmur best heard over left clavicle?

A

PDA

86
Q

when does the PDA usually close?

A

3-4 days after birth

87
Q

features of PDA?

A 
poor feeding 
failure to thrive
continous machinery murmur in left pulmonary/sub clavicular area
wide pulse pressure
bounding peripheral pulse
88
Q

management of PDA?

A

self-limiting
NSAID treatment (indomethacin) - inhibits prostaglandins
closure with a catheter at 1yr

89
Q

systolic ejection murmur in the pulmonary area?

A

ASD (A+E-> ejection)

90
Q

pathophysiology of ASD?

A

patent foramen ovale

91
Q

feautres of ASD?

A

systolic ejection murmur in pulmonary area

mostly asymptomatic

92
Q

what is eisenmengers syndrome?

A

L-R shunt causing increased pulmonary resistance and remodelling of the pulmonary vessels. This causes RV hypertrophy, which causes increase in pressure in the right ventricle. This pressure surpasses the pressure in the left ventricle, causing reversal of the shunt, creating a R-> L shunt which is associated with cyanosis

93
Q

features of eisenmenger syndrome?

A

cyanosis on excersise/exertion

94
Q

management of eisenmengers sydrome?

A

heart-lung transplant

95
Q

radial-radial delay and systolic murmur?

A

coarctation of the aorta

96
Q

what are the two types of coarctation of the aorta and how does coarctation present?

A

ascending aorta - narrowing before the DA
descending aorta - narrowing after the DA

2 days after delivery (closure of DA)- presents as heart failure, systolic murmur, radio-femoral delay, absent femoral pulses

97
Q

signs specific to coarctation of the descending aorta?

A

radio-femoral delay
absent femoral pulses
systolic murmur

98
Q

signs specific to coarctation of the ascending aorta?

A

radial radial delay

99
Q

management of coarctation of the aorta?

A

resus and early surgical intervention

100
Q

diagnosis in infant not cyanosed at birth, but develops cyanosis and tachypnoea?

A

tetralogy of fallot

101
Q

4 cardinal features of tetralogy of fallot?

A

largeVSD
overriding aorta
RVH
pulmonary stenosis

102
Q

investigations of tetralogy of fallot?

A

CXR- boot shaped heart

ECHO

103
Q

management of tetralogy of fallot?

A

IV prostaglandin E infusion to keep DA open

surgery

104
Q

diagnosis in baby born severely cyanosed and tacypnoeic?

A

transposition of the great arteries

105
Q

what is transposition of the great arteries?

A

aorta and pulmonary artery are the wrong way round therefore RV goes into the aorta, creating two closed parallel circuits = medical emergency

106
Q

management of transposition of the great arteries?

A

maintain PDA with IV prostaglandin infusion

correction of metabolic acidosis and hypoglycaemia `

107
Q

diagnosis in child with high grade fever who then develops strawberry tongue and peeling fingers and toes?

A

kawasaki disease

108
Q

features of kawasaki?

A 
MY HEART: 
Mucosal involvement
Hands and feet desquamination 
Eyes bilateral non-purulent conjunctivities
Adenopathy 
Rash
Temperature - high and non-remitting
109
Q

pathophysiology of kawaski disease?

A

systemic vasculitis

110
Q

investigations of kawasaki disease?

A 
FBC
ECHO- look for aneurysms 
leucocytosis 
ESR increased
LFTS increased
111
Q

management of kawasaki disease?

A

IV immunoglobulin 2g/kg over 12hrs as single infusion to lower aneurysm risk
aspirin to lower thrombosis risk

112
Q

criteria for rheumatic rever?

A 
JONES-
joints
O- heart
nodules subcutaneous
erythema marginatum 
sydenham chorea
113
Q

management of rheumatic fever?

A

aspirin
ACE-I and diuretics if heart failure
anti-inflammatory agents

114
Q

likely diagnosis in 6 months- 6 year old child with coryza that is followed by a barking cough and stridor?

A

croup (laryngotracheobronchitis)

115
Q

which organism causes croup?

A

parainfluenza virus

116
Q

features of croup?

A

coryzal symptoms followed by
barking cough
stridor - worse at night
hoarseness

117
Q

investigations of croup?

A

O2 sats

AVOID THROAT EXAM

118
Q

management of croup?

A

corticosteroids - PO dexamethasone or neb budesonide
O2 therapy
intubation if airway obstruction
neb adrenaline if necessary

119
Q

likely diagnosis in 6 month old child with breathing difficulties and coryzal symptoms?

A

bronchiolitis

120
Q

which organism causes bronchiolitis?

A

RSV -> most common
can be para-influenza
adenovirus
rhinovirus

121
Q

Ix of bronchiolitis?

A

RSV swab- nasopharyngeal swab for imunofluroescent rapid antigen testing
O2 sats

122
Q

management of bronchiolitis?

A

supportive

123
Q

vaccinations for bronchiolitis?

A

palivizumab - monoclonal antibody given to preterm and oxygen dependent infants at high risk

124
Q

likely diagnosis in child 1-6 year old who has a high grade fever and soft stidor- sitting upright to optimise airway?

A

epiglottitis

125
Q

what is the organism responsible for epiglottitis?

A

HiB

126
Q

management of epiglottitis?

A

intubation under GA
cultures
antitbiotics-> cefotaxime + ampicillin

127
Q

likely diagnosis in child <4months with week of coryzal symptoms followed by paroxysmal coughing and whooping?

A

whooping cough (pertussis)

128
Q

organism responsible for whooping cough?

A

bordatella pertussis

129
Q

investigations of whooping cough?

A

nasal swab

130
Q

management of whooping cough?

A

erythromycin
isolation
close monitoring as risk of seizures, encephalopathy and death

131
Q

features of whooping cough?

A

1-2 weeks: mild fever, cough, coryza

2-6 weeks: severe paroxysmal cough with inspiratory whoop

132
Q

features of bronchiolitis?

A

coryza
inspiratory distress: tracheal tug, intercostal recession, nasal flaring, grunting
hyperinflation of chest
fine-end inspiratory crackles expiratory wheeze

133
Q

indications for hospital referral in bronchiolitis?

A 
< 50% normal feed
Hx of apnoea
increased resp effort 
cyanosis
RR >70 
sats < 94%
134
Q

organisms that cause pneumonia in neonates, infants, and school age children?

A

neonates: GBS, e.coli, staph aureus
infants: strep pneu., chlamydia
school: strep penu., staph aureus, mycoplasma

135
Q

likely diagnosis in 3 month old male infant with progressively worsening non-billous projectile vomiting after feeds + weight loss?

A

pyloric stenosis

136
Q

what is pyloric stenosis?

A

pylorus is normal at birth but then undergoes progressive hypertrophy of the muscle surrounding the pylorus causing gastric outlet obstruction

137
Q

features of pyloric stenosis?

A 
vomiting during/after feeds
progressive
projectile 
non-billous vomiting 
hunger
weight loss 
dehydration (skin turgor, sunken eyes, dry mucous membranes, reduced urine output)
hard palpable mass -> olive shaped in UQ
138
Q

investigations of pyloric stenosis?

A

ABG: hypochloraemic hyokalaemic metabolic alkalosis + hyponatraemia
USS: olive shaped mass in RUQ

139
Q

management of pyloric stenosis?

A

stabilise with fluids (saline + dextrose)
stop oral feeds
surgery- pyloromyotomy (Ramstedts procedure)

140
Q

likely diagnosis in baby that has recurrent regurgitation following meals, failure to thrive and holds neck extended?

A

GORD

141
Q

pathophysiology of GORD in infants?

A

inappropriate relaxation of LOS due to immaturity and reduced peristalsis leads to increased flow of gastric contents into oesophagus

142
Q

investigations of GORD?

A

24 hr pH study

imagining of upper GIT

143
Q

management of GORD?

A 
reassure 
resolves usually by 12 months 
smaller more frequent feeds
thickened feeds 
PPI
144
Q

likely diagnosis in child (<1yr) who has screaming episodes of pain with legs drawn up, and passing redcurrent jelly stool?

A

intersussception

145
Q

which part of the bowel does intersussception most commonly occur?

A

ileum passing into the caecum through the ileocaecal valve

146
Q

sign of intersussception on examination?

A

palpable sausage shaped mass in RUQ

147
Q

investigations of intersussception?

A

USS: target sign/doughnut sign
AXR: distended bowel and absence of gas distal to colon/rectum
contrast enema: GOLD STANDARD -> sausage shaped mass

148
Q

management of intersussception?

A

IV fluids
NG tube
rectal air insufflation

149
Q

clinical features of malrotation?

A

bilious vomiting
scaphoid abdomen
abdominal pain/tenderness

150
Q

investigations of malrotation/volvulus?

A

urgent upper GI contrast study
abdo XR/CT= whirl sign
barium enema = birds beak sign

151
Q

management of malrotations?

A

IV fluids

Ladd procedure -> laparotomy and detorsion of volvulus

152
Q

what is a volvulus?

A

loop of intestine twists around itself and the mesentery that supports it, resulting in bowel obstruction and ischaemia

153
Q

definition of failure to thrive?

A

child falls in height or weight by one or more centiles, or is below the 5th centile for height or weight

154
Q

causes of failure to thrive?

A

non-organic: feeding problem, inadequate intake, low socioeconomic status, neglect
organic: cleft palate, chronic illness (coelaic, CF, crohns)
chromosomal disorders: downs
congenital heart disease

155
Q

investigations in failure to thrive?

A 
FBC
U+E
LFT
thyroid function 
immunoglobulins 
IgA tissue transglutaminase- coeliac disease
156
Q

likely diagnosis in child that has failued to pass meconium in first 48hrs, and then a large amount is passed on DRE?

A

hirschsprungs disease

157
Q

pathophysiology of hirschsprungs?

A

absence of parasympathetic ganglion cells from myenteric and submucosal plexus -> leads to a narrow and abnormal portion of large bowel

158
Q

features of hirschprungs?

A

abdominal distention
PR= tight anal sphincter
explosive discharge of stools and gas
failure to thrive

159
Q

investigations of hirschsprungs?

A

rectal biopsy

160
Q

management of hirschsprungs?

A

surgical excision of aganglionic segment
IV fluids + antibiotic prophylaxis
cessation of feeding
NG tube

161
Q

management of constipation?

A

osmotic laxative- movicol

stimulant laxative- senna

162
Q

most likely diagnosis in infant with colicky abdominal pain, bloating and chronic diarrhoea?

A

CMPA

163
Q

what is the pathophysiology of CMPA?

A

IgE mediated hypersensitivty to casein

164
Q

investigations of CMPA?

A

challenge test

IgA tissue transglutaminase (in case coeliac)

165
Q

management of CMPA?

A

hydrolysed protein only or soy based feeds

166
Q

presentation of coeliac disease in paeds?

A 
poor growth
foul smelling stools multiple times a day 
abdominal distension 
buttock wasting 
irritability
anaemia - B12 and folate 
growth failure
167
Q

investigations of coeliac?

A

endomysial antibodies
tTG bodies
jejenul biopsy-> villous atrophy, crypt hyperplasia, increased inflammatory cells
test for HLA-DQ2

168
Q

what derm condition is coeliac associated with and how does it present?

A

dermatitis herpetiformis:

erythematous macules on extensor surfaces, servere pruritis

169
Q

most likely diagnosis in child with periorbital and scrotal oedema and protein in urine?

A

nephrotic syndrome

170
Q

most common cause of nephrotic syndrome in paeds?

A

minimal change disease

171
Q

management of nephrotic syndrome?

A

prednisolone
fluid balance
penicillin prophylaxis

172
Q

what is a wilms tuour and what does it contain?

A

most common renal malignancy of early childhood

contains embryonic glomerular structures

173
Q

presentation of wilms tumour?

A

abdominal pain
large mass in flank
haematuria
chronic poor appetitie

174
Q

what is developmental dysplasia of the hip?

A

ball and socket joint of hip does not form properly in babies and young children

175
Q

RF for DDH?

A 
breech position
female
FHx
oligohydramnios 
low birth weight
176
Q

Ix for DDH?

A

USS
barlow test: dislocates an articulated femoral head
ortalani: relocates a disloacted femoral head

177
Q

management of DDH?

A

spontaenously stabilise 3-6 weeks

if not- pavlik harness

178
Q

features of septic arthritis?

A 
refusing to walk 
reduced ROM
red tender and hot joint 
fever
raised inflammatory markers
usually holds limb still
179
Q

most common organisms to cause septic arthritis in paeds?

A

staph aureus

180
Q

investigations of septic arthritis?

A

blood cultures

joint aspiration and culture

181
Q

management of septic arthritis?

A 
IV antibiotics (flucloxacillin)
drainage and lavage in theatre
182
Q

features of osetomyelitis?

A 
acute onset limb pain
acute febrile 
swelling and tenderness
erythematous and warm 
moving joint= severe pain
183
Q

pathophysiology of osteomyelitis?

A

infection of the metaphysis of long bone

184
Q

most common sites of osteomyelitis in peads

A

distal femur and proximal tibia

185
Q

most common organisms of osteomyelitis?

A

staph aureus
strep
HiB

186
Q

investigations of osteomyelitis?

A

blood cultures
XRAY- initially normal apart from soft tissue swelling, after 10 days can see new bone formation
MRI
USS

187
Q

management of osteomyelitis?

A

surgery to remove necrotic bone
surgical drainage
antibiotics for weeks to prevent necrosis

188
Q

features of reactive arthritis?

A

oligoarthritis
conjunctivitis
urethritis

189
Q

causes of reactive arthritis?

A

salmonella
shigella
C. jejuni
Yersinia

190
Q

features of JIA?

A

chronic anterior uveitis
poly or mono-arthritis
pain improves throughout the day
growth disturbance

191
Q

management of JIA?

A

NSAID and local steroid injection or oral pred
DMARD: MTX
biologic: etanercept/infliximab

192
Q

what is a osteosarcoma?

A

aggressive malignant neoplasm producing immature bone - exhibits osteoblastic differentiation and produces malignant osteoid

193
Q

what is perthes disease?

A

temporary ischaemia of founded femoral head causing avascular necrosis

194
Q

who gets perthes disease the most?

A

4-10 year old males

195
Q

features of perthes disease/

A 
hip pain
exacerbated by movement
limp
unable to weight bear
worse on internal rotation
196
Q

investigation of perthes disease?

A

MRI

as disease progresses can see on XRAY: flattened femoral head

197
Q

management of perthes disease?

A

self limiting

hip replacement common if hip damaged

198
Q

complications of perthes disease?

A

osteoarthritis

premature fusion of growth plates

199
Q

what is Duchennes muscular dystrophy?

A

X-linked recessive disorder mutation in the gene for dystrophin -> found in muscle membrane

200
Q

features of DMD?

A

weakness and atrophy of muscle starting in proximal upper limbs
weak reflexes
waddling gait
gower manouvere- walking up legs to standing position
dilated cardiomyopathy

201
Q

diagnosis of DMD?

A

DNA testing

muscle biopsy

202
Q

management of DMD?

A

corticosteroids
physiotherapy
respiration assistance

203
Q

emergency treatment of febrile seizure?

A 
ABCDE
check BM
rectal diazepam, buccal midazolam 
IV lorazepam 
IV phenytoin 
IV sodium valproate
GA intubation if no improvement within 30 mins
204
Q

what advice is given to parents of children with febrile seizures?

A

what they are
how to treat at home: rectal diazepam, buccal midazolam
check for non-blanching rash, dehydration
first air
999>5mins

205
Q

what is caput succadaneum and cephalohaematoma and where are they both found?

A

caput succedaneum- can cross suture lines

cephalohaematoma- haemorrhage between periosteum and skull-> cannot cross suture lines

Phase 3a (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions