Paeds Flashcards
1
Q
name 5 conditions tested for by the guthrie test?
A
sickle cell hypothyroidism CF maple syrup urine disease phenylketonuria
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
3
Q
what are some complications of premature birth?
A
NEC RDS- surfactant deficiency retinopathy of prematurity PDA jaudince- liver immaturity intraventricular haemorrhage
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
5
Q
causes of pathological jaundice?
A
rhesus d incompatibility/ABO
G6PD-deficiency
Infection - congenital (CMV, syphilis, rubella, toxoplasmosis, herpes)
Spherocytosis
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.
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
8
Q
management of incompatbility ABO or rhesus?
A
transfusion with group O negative blood
anti-D immunoglobulin
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)
10
Q
mode of inheritance of G6PD deficiency?
A
X-linked recessive
11
Q
pathophysiology of G6PD deficiency?
A
reduced G6PD leads to reduction in glutathione which causes increased susceptibility of RBC to oxidative stress
12
Q
management of G6PD deficiency in neonates?
A
exchange transfusion
phototherapy
13
Q
causes of physiological jaundice in neonate?
A
immature hepatic bilirubin conjugation
infection: sepsis/UTI
haemolytic disorders
breast milk jaundice
14
Q
management of neonatal jaundice?
A
blue light phototherapy
exchange transfusion if very high
15
Q
investigations of neonatal jaundice?
A
serum bilirubin to monitor
16
Q
causes of prolonged neonatal jaundice?
A
unconjugated:
-infection
-breast milk
-haemolytic anaemia
-hypothyroidism
conjugated:
-bile duct obstruction - biliary atresia
neonatal hepatitis
17
Q
what is biliary atresia?
A
complete or partial obstruction of the extrahepatic biliary tree within the first 3 months of life
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
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
20
Q
management of biliary atresia?
A
surgical intervention
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.
22
Q
RF for RDS?
A
premature birth
C-section delivery
maternal diabetes
past hx
23
Q
presentation of RDS?
A
nasal flaring grunting tachypnoea tracheal tug intercostal recession
24
Q
investigations and findings in RDS?
A
CXR: bilateral diffuse ground glass appearance, reduced lung volume
25
management of RDS?
```
surfactant administration (intra-thecal)
oxygen via nasal cannula (CPAP)
```
26
prevention of RDS?
corticosteroids (betamethasone/dexamethasone) 1-7 days before birth
27
presentation of PDA?
if large- poor growth, difficulty feeding and breathing
continous machinery murmur at upper L sternal border radiating to the back
28
investigations of PDA?
CXR- cardiomegaly
| ECHO
29
management of PDA?
indomethacin - to close
| surgical closure if fails
30
likely diagnosis in neonate who is vomiting and has distended abdomen with fresh blood in stool?
NEC
31
pathophysiology of NEC?
bacterial invasion of ischaemic bowel wall typically seen in premature infants
32
symptoms of NEC?
```
vomiting - may become billous
poor feeding
distended abdomen
fresh blood in stools
shock
```
33
investigations of NEC?
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
34
management of NEC?
stop oral feed
broad spec abx IV
total parenteral nutrition
surgery if necrotic or perforation
35
what is retinopathy of prematurity?
hyperoxic insult (i.e. O2 therapy in premature infant), causes neovascularization -> retinal haemorrhage, fibrosis and reintal detachment, ultimately leading to blidness
36
genetics of downs syndrome?
```
chr 21 trisomy
due to:
meiotic non-disjunction
translocation
mosaicism
```
37
what some non-physical features of downs syndrome?
```
hirschsprungs
duodenal atresia
septal defect (VSD)
alzheimers
ALL
tetralogy of fallot
PDA
```
38
what are some physical features of downs syndrome?
```
epicanthial fold
simian crease/single palmar crease
low set ears
flat nasal bridge
protruding tongue
sandal gap
short stature
flat occiput
hypotonia when born
```
39
diagnosis of down syndrome?
combined test at 10-14 weeks
Quadruple test at 15-20 weeks
Amniocentesis from 20 weeks
40
what does the combined test look for?
nuchal translucency
B-HCG
PAPPA
41
what does the quadruple test test for?
alpha fetoprotein
oestriol
B-HCG
Inhibin A
42
what are the risks of amniocentesis?
miscarriage
chorioamnionitis
amniotic fluid embolism
injury to foetus
43
what is the genetic defect in patau syndrome and how does it present?
trisomy 13
small eyes
cleft lip
rocker bottom feet
polydactyly
44
what is the genetic defect in edwards syndrome and how does it present?
Trisomy 18
small mouth and chin
rocker bottom feet
overlapping fingers
45
what is genetic defect in turners syndrome and features?
45, XO
short stature
webbed neck
infertility
absence of secondary sex characteristics
bicuspid aortic valve -> ejection systolic murmur
46
what is the definition of cerebral palsy?
permanent non-progressive cerebral insult
47
causes of cerebral palsy?
```
TORCH infections
hypoxic-ischaemia injury
kernicterus
traumatic delivery
meningitis/encephality
hydrocephalus/head trauma
```
48
what are the types of cerebral palsy and some of their defining features?
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)
49
key features of ASD?
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)
50
features of foetal alcohol syndrome?
```
thin upper lip
epithcanthic folds
microcephaly
short nose
short palpabral fissure
```
51
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?
measles
52
causes of measles
paramyoxovirus
53
feautres of measles?
prodrome: coryza, conjunctivitis, cough
koplik spots: white spots on buccal mucosa
maculopapular rash that starts behind the ears
54
complications of measles?
```
encephalitis
febrile seizures
DEAFNESS
hemiplegia
learning difficulties
```
55
likely diagnosis in child aged 5-9 with fever, malaise and large swelling of parotids?
mumps
56
complications of mumps?
orchitis + infertility
pancreatitis
meningitis/encephalitis
deafness
57
how does rubella present?
maculopapular rash that starts on face
| suboccipital and postauricular lymphadenompathy
58
what is the presentation of chicken pox?
rash- starts as macules, then papules appear as crops, then vesicles that start on head and trunk and progress to peripheries, then crusts over
59
what medication should be avoided in chicken pox?
NSAID!
| increases risk of necrotising disease
60
what virus causes shingles?
VZV
61
management of shingles?
aciclovir
62
presentation of infecitous mononucleosis?
```
tonsillitis
cervical lymphadenopathy
fever
malaise
petechiae on soft palate
```
63
likely diagnosis in child with fever and malaise, who a week later develops a erythematous rash on the face?
Parvovirus B19 (slapped cheek)
64
what are the features of slapped cheek?
viraemic phase- fever, headache, malaise
| 1 week later- erythematous maculopapular (often described as lace) rash on face which spreads to extremities and trunk
65
likely diagnosis in child with honey crusted plaques on chin?
impetigo
66
what is impetigo?
staph aureus or strep pyogenes infection (very infectious)
67
management of impetigo?
topical fusidic acid
| systemic flucoloxacillin if severe
68
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?
scarlet fever
69
what is scarlet fever
infection with group A strep- strep pyogenes
70
features of scarlet fever?
```
sore throat
vomiting
headache
sand paper like rash
strawberry tongue
enlarged tonsils
```
71
management of scarlet fever?
phenoxymethylpenicillin for 7 days
self isolate for 24 hours after starting antibiotics (can return to work after that)
notify public health england
72
likely diagnosis in patient with purpura on back of legs and buttocks?
Henoch-schonlein purpura (HSP)
73
what is HSP?
autoimmune IgA mediated small vessel vasculitis
74
presentation of HSP
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
75
investigations of HSP?
check renal function - U+E
serum IgA level
skin biopsy - small vessel vasculitis
urinalysis (should always be performed)- haematuria if renal involvement
76
management of HSP?
self limiting
| paracetamol
77
management of bacterial meningitis?
IM benzylpenicillin in GP
| IV ceftriaxone
78
organisms that cause bacterial meningitis in children?
```
GBS
E.coli
listeria monocytogenes
Neisseria meningitidis
HiB
strep pneumoniae
```
79
what are the cyanotic congenital cardiac conditions?
tetralogy of fallot
| transposition of the great vessels
80
what are the non-cyanotic cardiac conditions?
PDA
VSD
ASD
81
pansystolic murmur best heard at the left lower sternal edge?
VSD
82
feautres of VSD?
```
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
```
83
complications of VSD?
eisenmengers syndrome
| heart failure
84
management of VSD?
usually self limiting
diuretics with captopril (ACE-I) - if symptoms of heart failure
if symptomatic - surgery
85
machinery murmur best heard over left clavicle?
PDA
86
when does the PDA usually close?
3-4 days after birth
87
features of PDA?
```
poor feeding
failure to thrive
continous machinery murmur in left pulmonary/sub clavicular area
wide pulse pressure
bounding peripheral pulse
```
88
management of PDA?
self-limiting
NSAID treatment (indomethacin) - inhibits prostaglandins
closure with a catheter at 1yr
89
systolic ejection murmur in the pulmonary area?
ASD (A+E-> ejection)
90
pathophysiology of ASD?
patent foramen ovale
91
feautres of ASD?
systolic ejection murmur in pulmonary area
| mostly asymptomatic
92
what is eisenmengers syndrome?
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
features of eisenmenger syndrome?
cyanosis on excersise/exertion
94
management of eisenmengers sydrome?
heart-lung transplant
95
radial-radial delay and systolic murmur?
coarctation of the aorta
96
what are the two types of coarctation of the aorta and how does coarctation present?
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
signs specific to coarctation of the descending aorta?
radio-femoral delay
absent femoral pulses
systolic murmur
98
signs specific to coarctation of the ascending aorta?
radial radial delay
99
management of coarctation of the aorta?
resus and early surgical intervention
100
diagnosis in infant not cyanosed at birth, but develops cyanosis and tachypnoea?
tetralogy of fallot
101
4 cardinal features of tetralogy of fallot?
largeVSD
overriding aorta
RVH
pulmonary stenosis
102
investigations of tetralogy of fallot?
CXR- boot shaped heart
| ECHO
103
management of tetralogy of fallot?
IV prostaglandin E infusion to keep DA open
| surgery
104
diagnosis in baby born severely cyanosed and tacypnoeic?
transposition of the great arteries
105
what is transposition of the great arteries?
aorta and pulmonary artery are the wrong way round therefore RV goes into the aorta, creating two closed parallel circuits = medical emergency
106
management of transposition of the great arteries?
maintain PDA with IV prostaglandin infusion
| correction of metabolic acidosis and hypoglycaemia `
107
diagnosis in child with high grade fever who then develops strawberry tongue and peeling fingers and toes?
kawasaki disease
108
features of kawasaki?
```
MY HEART:
Mucosal involvement
Hands and feet desquamination
Eyes bilateral non-purulent conjunctivities
Adenopathy
Rash
Temperature - high and non-remitting
```
109
pathophysiology of kawaski disease?
systemic vasculitis
110
investigations of kawasaki disease?
```
FBC
ECHO- look for aneurysms
leucocytosis
ESR increased
LFTS increased
```
111
management of kawasaki disease?
IV immunoglobulin 2g/kg over 12hrs as single infusion to lower aneurysm risk
aspirin to lower thrombosis risk
112
criteria for rheumatic rever?
```
JONES-
joints
O- heart
nodules subcutaneous
erythema marginatum
sydenham chorea
```
113
management of rheumatic fever?
aspirin
ACE-I and diuretics if heart failure
anti-inflammatory agents
114
likely diagnosis in 6 months- 6 year old child with coryza that is followed by a barking cough and stridor?
croup (laryngotracheobronchitis)
115
which organism causes croup?
parainfluenza virus
116
features of croup?
coryzal symptoms followed by
barking cough
stridor - worse at night
hoarseness
117
investigations of croup?
O2 sats
| AVOID THROAT EXAM
118
management of croup?
corticosteroids - PO dexamethasone or neb budesonide
O2 therapy
intubation if airway obstruction
neb adrenaline if necessary
119
likely diagnosis in 6 month old child with breathing difficulties and coryzal symptoms?
bronchiolitis
120
which organism causes bronchiolitis?
RSV -> most common
can be para-influenza
adenovirus
rhinovirus
121
Ix of bronchiolitis?
RSV swab- nasopharyngeal swab for imunofluroescent rapid antigen testing
O2 sats
122
management of bronchiolitis?
supportive
123
vaccinations for bronchiolitis?
palivizumab - monoclonal antibody given to preterm and oxygen dependent infants at high risk
124
likely diagnosis in child 1-6 year old who has a high grade fever and soft stidor- sitting upright to optimise airway?
epiglottitis
125
what is the organism responsible for epiglottitis?
HiB
126
management of epiglottitis?
intubation under GA
cultures
antitbiotics-> cefotaxime + ampicillin
127
likely diagnosis in child <4months with week of coryzal symptoms followed by paroxysmal coughing and whooping?
whooping cough (pertussis)
128
organism responsible for whooping cough?
bordatella pertussis
129
investigations of whooping cough?
nasal swab
130
management of whooping cough?
erythromycin
isolation
close monitoring as risk of seizures, encephalopathy and death
131
features of whooping cough?
1-2 weeks: mild fever, cough, coryza
| 2-6 weeks: severe paroxysmal cough with inspiratory whoop
132
features of bronchiolitis?
coryza
inspiratory distress: tracheal tug, intercostal recession, nasal flaring, grunting
hyperinflation of chest
fine-end inspiratory crackles expiratory wheeze
133
indications for hospital referral in bronchiolitis?
```
< 50% normal feed
Hx of apnoea
increased resp effort
cyanosis
RR >70
sats < 94%
```
134
organisms that cause pneumonia in neonates, infants, and school age children?
neonates: GBS, e.coli, staph aureus
infants: strep pneu., chlamydia
school: strep penu., staph aureus, mycoplasma
135
likely diagnosis in 3 month old male infant with progressively worsening non-billous projectile vomiting after feeds + weight loss?
pyloric stenosis
136
what is pyloric stenosis?
pylorus is normal at birth but then undergoes progressive hypertrophy of the muscle surrounding the pylorus causing gastric outlet obstruction
137
features of pyloric stenosis?
```
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
investigations of pyloric stenosis?
ABG: hypochloraemic hyokalaemic metabolic alkalosis + hyponatraemia
USS: olive shaped mass in RUQ
139
management of pyloric stenosis?
stabilise with fluids (saline + dextrose)
stop oral feeds
surgery- pyloromyotomy (Ramstedts procedure)
140
likely diagnosis in baby that has recurrent regurgitation following meals, failure to thrive and holds neck extended?
GORD
141
pathophysiology of GORD in infants?
inappropriate relaxation of LOS due to immaturity and reduced peristalsis leads to increased flow of gastric contents into oesophagus
142
investigations of GORD?
24 hr pH study
| imagining of upper GIT
143
management of GORD?
```
reassure
resolves usually by 12 months
smaller more frequent feeds
thickened feeds
PPI
```
144
likely diagnosis in child (<1yr) who has screaming episodes of pain with legs drawn up, and passing redcurrent jelly stool?
intersussception
145
which part of the bowel does intersussception most commonly occur?
ileum passing into the caecum through the ileocaecal valve
146
sign of intersussception on examination?
palpable sausage shaped mass in RUQ
147
investigations of intersussception?
USS: target sign/doughnut sign
AXR: distended bowel and absence of gas distal to colon/rectum
contrast enema: GOLD STANDARD -> sausage shaped mass
148
management of intersussception?
IV fluids
NG tube
rectal air insufflation
149
clinical features of malrotation?
bilious vomiting
scaphoid abdomen
abdominal pain/tenderness
150
investigations of malrotation/volvulus?
urgent upper GI contrast study
abdo XR/CT= whirl sign
barium enema = birds beak sign
151
management of malrotations?
IV fluids
| Ladd procedure -> laparotomy and detorsion of volvulus
152
what is a volvulus?
loop of intestine twists around itself and the mesentery that supports it, resulting in bowel obstruction and ischaemia
153
definition of failure to thrive?
child falls in height or weight by one or more centiles, or is below the 5th centile for height or weight
154
causes of failure to thrive?
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
investigations in failure to thrive?
```
FBC
U+E
LFT
thyroid function
immunoglobulins
IgA tissue transglutaminase- coeliac disease
```
156
likely diagnosis in child that has failued to pass meconium in first 48hrs, and then a large amount is passed on DRE?
hirschsprungs disease
157
pathophysiology of hirschsprungs?
absence of parasympathetic ganglion cells from myenteric and submucosal plexus -> leads to a narrow and abnormal portion of large bowel
158
features of hirschprungs?
abdominal distention
PR= tight anal sphincter
explosive discharge of stools and gas
failure to thrive
159
investigations of hirschsprungs?
rectal biopsy
160
management of hirschsprungs?
surgical excision of aganglionic segment
IV fluids + antibiotic prophylaxis
cessation of feeding
NG tube
161
management of constipation?
osmotic laxative- movicol
| stimulant laxative- senna
162
most likely diagnosis in infant with colicky abdominal pain, bloating and chronic diarrhoea?
CMPA
163
what is the pathophysiology of CMPA?
IgE mediated hypersensitivty to casein
164
investigations of CMPA?
challenge test
| IgA tissue transglutaminase (in case coeliac)
165
management of CMPA?
hydrolysed protein only or soy based feeds
166
presentation of coeliac disease in paeds?
```
poor growth
foul smelling stools multiple times a day
abdominal distension
buttock wasting
irritability
anaemia - B12 and folate
growth failure
```
167
investigations of coeliac?
endomysial antibodies
tTG bodies
jejenul biopsy-> villous atrophy, crypt hyperplasia, increased inflammatory cells
test for HLA-DQ2
168
what derm condition is coeliac associated with and how does it present?
dermatitis herpetiformis:
| erythematous macules on extensor surfaces, servere pruritis
169
most likely diagnosis in child with periorbital and scrotal oedema and protein in urine?
nephrotic syndrome
170
most common cause of nephrotic syndrome in paeds?
minimal change disease
171
management of nephrotic syndrome?
prednisolone
fluid balance
penicillin prophylaxis
172
what is a wilms tuour and what does it contain?
most common renal malignancy of early childhood
| contains embryonic glomerular structures
173
presentation of wilms tumour?
abdominal pain
large mass in flank
haematuria
chronic poor appetitie
174
what is developmental dysplasia of the hip?
ball and socket joint of hip does not form properly in babies and young children
175
RF for DDH?
```
breech position
female
FHx
oligohydramnios
low birth weight
```
176
Ix for DDH?
USS
barlow test: dislocates an articulated femoral head
ortalani: relocates a disloacted femoral head
177
management of DDH?
spontaenously stabilise 3-6 weeks
| if not- pavlik harness
178
features of septic arthritis?
```
refusing to walk
reduced ROM
red tender and hot joint
fever
raised inflammatory markers
usually holds limb still
```
179
most common organisms to cause septic arthritis in paeds?
staph aureus
180
investigations of septic arthritis?
blood cultures
| joint aspiration and culture
181
management of septic arthritis?
```
IV antibiotics (flucloxacillin)
drainage and lavage in theatre
```
182
features of osetomyelitis?
```
acute onset limb pain
acute febrile
swelling and tenderness
erythematous and warm
moving joint= severe pain
```
183
pathophysiology of osteomyelitis?
infection of the metaphysis of long bone
184
most common sites of osteomyelitis in peads
distal femur and proximal tibia
185
most common organisms of osteomyelitis?
staph aureus
strep
HiB
186
investigations of osteomyelitis?
blood cultures
XRAY- initially normal apart from soft tissue swelling, after 10 days can see new bone formation
MRI
USS
187
management of osteomyelitis?
surgery to remove necrotic bone
surgical drainage
antibiotics for weeks to prevent necrosis
188
features of reactive arthritis?
oligoarthritis
conjunctivitis
urethritis
189
causes of reactive arthritis?
salmonella
shigella
C. jejuni
Yersinia
190
features of JIA?
chronic anterior uveitis
poly or mono-arthritis
pain improves throughout the day
growth disturbance
191
management of JIA?
NSAID and local steroid injection or oral pred
DMARD: MTX
biologic: etanercept/infliximab
192
what is a osteosarcoma?
aggressive malignant neoplasm producing immature bone - exhibits osteoblastic differentiation and produces malignant osteoid
193
what is perthes disease?
temporary ischaemia of founded femoral head causing avascular necrosis
194
who gets perthes disease the most?
4-10 year old males
195
features of perthes disease/
```
hip pain
exacerbated by movement
limp
unable to weight bear
worse on internal rotation
```
196
investigation of perthes disease?
MRI
| as disease progresses can see on XRAY: flattened femoral head
197
management of perthes disease?
self limiting
| hip replacement common if hip damaged
198
complications of perthes disease?
osteoarthritis
| premature fusion of growth plates
199
what is Duchennes muscular dystrophy?
X-linked recessive disorder mutation in the gene for dystrophin -> found in muscle membrane
200
features of DMD?
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
diagnosis of DMD?
DNA testing
| muscle biopsy
202
management of DMD?
corticosteroids
physiotherapy
respiration assistance
203
emergency treatment of febrile seizure?
```
ABCDE
check BM
rectal diazepam, buccal midazolam
IV lorazepam
IV phenytoin
IV sodium valproate
GA intubation if no improvement within 30 mins
```
204
what advice is given to parents of children with febrile seizures?
what they are
how to treat at home: rectal diazepam, buccal midazolam
check for non-blanching rash, dehydration
first air
999>5mins
205
what is caput succadaneum and cephalohaematoma and where are they both found?
caput succedaneum- can cross suture lines
cephalohaematoma- haemorrhage between periosteum and skull-> cannot cross suture lines
