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Definitions > Paeds > Flashcards

Paeds Flashcards

1
Q

exanthem

A

a widespread rash occurring on the outside of the body and usually occurring in children

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2
Q

whats usually used to Rx Neonatal withdrawal (abstinence) syndrome

A

morphine sulphate

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3
Q

what are the classification groups of Paediatric Dermatological Conditions

A 
infective
infestations
inflammatory
genetic
neoplastic
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4
Q

Primary Skin lesions

A

These are fundamental morphological changes that appear first on formerly unchanged skin

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5
Q

eg of Primary Skin lesions

A 
Macule
vesicle
Papule
Plaque		
Nodule
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6
Q

Secondary Skin Lesions

A

lesions that develop from the alteration of primary lesions not on uninvolved skin

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7
Q

eg of Secondary Skin Lesions

A 
Scale		
Keratosis
Fissure 		
Erosion
Excoriation
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8
Q

Macule

A

Circumscribed, flat area of skin different in colour or texture from the surrounding, normal skin
A macule does not exceed 1 cm in greatest diameter

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9
Q

patch

A

A large macule more than 1cm in diameter

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10
Q

cx of macules and patches

A

Deposition of endogenous (hemosiderin) or exogenous products (tatooing)
Extravasation of blood (petechiae, purpura, ecchymoses, hematoma)
Changes in melanin content of the epidermis or dermis ( hyper- and hypopigmentation or depigmentation, melanoderma and leukoderma)
Active erythaema and passive hyperaemia (cyanosis)
Deminished blood supply and vasoconstriction

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11
Q

what other features can macules and patches have

A

may be slightly depressed below the skin surface or

scaling

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12
Q

papule

A

A circumscribed solid elevation of the skin up to 1 cm in diameter

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13
Q

cx of papule

A

tissue proliferation

cell infiltration

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14
Q

types of papules

A

epidermal
dermal
Dermoepidermal

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15
Q

plaque

A

A circumscribed, superficial, solid elevation of the skin greater than 1 cm in diameter

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16
Q

do Plaques occur as secondary lesions

A

Plaques may occur as primary lesions but may also result from coalescence of papules and then strictly speaking represent secondary lesions.

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17
Q

nodule

A

A circumscribed solid lesion of the skin up to 1 cm in size with depth

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18
Q

diff btwn nodule and papule

A

nodules can always be palpated and have depth

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19
Q

tumour

A

A solid lesion of the skin greater than 1 cm in diameter with superficial height, palpable depth or both

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20
Q

how do Tumours differ from papules and nodules

A

by size
may be inflammatory or non-inflammatory
benign or malignant

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21
Q

wheal

A

Transient dermal oedema, varied in size disappearing within up to 24 hours and typically cause itching

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22
Q

what colours can wheals become

A

pale red if the capillaries are dilated

whitish if the dermal oedema is heavy enough to compress the blood vessels

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23
Q

vesicle (small blister)

A

a circumscribed elevation of the skin up to 1 cm in diameter and containing fluid

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24
Q

BULLA (large blister)

A

a circumscribed elevation of the skin greater than 1 cm in diameter containing a fluid

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25
Q

Types of vesicles and bullae

A

subcorneal
Intraepidermal
Subepidermal
dermal

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26
Q

what fluids may blisters may house

A

serum, blood, lymph or a mixture of these fluids

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27
Q

pustules

A

A circumscribed superficial elevation of the skin filled with pus

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28
Q

name the 9 Morphological characteristics of skin conditions

A 
size 
shape
colour
number
arrangement

margins
consistency
surface characteristics
contour

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29
Q

give 5 eg of shape

A 
guttate (drop shaped)
nummular (coin shaped)
annular (ring-like)
serpiginous (wavy, snake-like)
arcuate (arc-like)
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30
Q

Koebner phenomenon (isomorphic response)

A

an aspect of psoriasis that’s well-known but not completely understood. It describes the formation of psoriatic skin lesions on parts of the body that aren’t typically where a person with psoriasis experiences lesions

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31
Q

Psoriasis

A

a skin disorder that causes skin cells to multiply up to 10 times faster than normal. This makes the skin build up into bumpy red patches covered with white scales

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32
Q

psoriasis appears mostly on

A

scalp, elbows, knees, and lower back

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33
Q

nikolski

A

When exerting tangential pressure on apparently normal skin, particularly near vesicles, the epidermis or parts of it may be detached in certain bullous diseases eg toxic epidermal necrolysis or epidermolysis bullosa

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34
Q

dermographism/

dermatographism

A

exaggerated wealing tendency when the skin is stroked

A bright red non-raised line due to vasodilatation occurs after 3-15 seconds

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35
Q

what happens to Dermographism In patients with atopic dermatitis

A

the respons is para-doxically anaemic (white dermographism)

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36
Q

wha is dermographism the commonest form of

A

physical or chronic inducible urticaria

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37
Q

cutis marmorata

A

transient, benign, reticulate, mottled, bluish discolouration of the skin that may last minutes to hours typically when child is cold, usually completely disappears by two months of age

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38
Q

if Cutis marmorata is persistent what syndromes can it indicate

A

Cornelia de Lange syndrome
trisomy 13
trisomy 18

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39
Q

what is Cornelia de Lange syndrome characterized by

A

slow growth before and after birth
intellectual disability
abnormalities of bones in the arms, hands, and fingers

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40
Q

skin fragility

A

Weakened attachments be-tween epidermis & dermis that are easily severed by physical or chemical trauma

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41
Q

peeling skin

A

Desquamation of neonatal skin most pronounced in infants born 40-42 weeks gestation
Rx an aqueos cream is used No creams with perfume or additives

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42
Q

types of peeling and where they occur

A

Physiological peeling – hands, ankles and feet

Postmature peeling – extremities and trunk

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43
Q

epsteins pearls

A

Benign Epidermal inclusion cysts (contain desquamated keratin) occur along the median palatal raphe, most commonly at the junction of the hard & soft palate.

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44
Q

what other skin lesion is similar to epstein pearls

A

milia

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45
Q

milia

A

Tiny (1-2mm) globular epidermal inclusion cysts which are white, pearly & firm
Occur on the nose, cheeks, chin and foreheads and usually appear and disappear spontaneously during first month of life

46
Q

where can Larger milia solitary lesions can be seen on

A

foreskin, scrotum, areolae and labia majora.

47
Q

diff btwn pustule and milia

A

Pustule - more yellow

Milia – more white

48
Q

Sucking calluses

A

solitary, oval thickenings on vermilion on the lips and is more common in breast fed, black infants.
Sucking calluses involute spontaneously within a few days to weeks after birth or upon cessation of breastfeeding

49
Q

Sebaceous Gland Hyperplasia

A

Multiple, pinpoint, yellowish papules seen at the opening of each pilo-sebaceous follicle in areas where sebaceous glands are abundant, such as the nose that resolve spontaneously.

50
Q

Sebaceous Gland Hyperplasia Rx

A

you can use vaseline or an aqueous cream but the latter is preferred

51
Q

neonatal mastitis

A

Maternal and placental hormonal effects on the neonate

Secretion of colostrum like substance called “witches milk” late during first week of life

52
Q

Mongolian Spots

A

Brownish, blue-gray or blue-black patch usually located over the sacro-gluteal area
Most common of all birthmarks in pigmented races

53
Q

erythema toxicum facts

A

Common in term infants (not preterms)
Appear birth to 2 weeks
Erythematous macules, papules, pustules or wheals found on any body surface
Palms and soles rarely affected
Dissapears spontaneously (The rash usually clears within 2 weeks. It is usually completely gone by age 4 months)

54
Q

Transient Neonatal Pustular Melanosis

A

Benign condition
Term neonates
Present at birth and resolve within 48 hours
After healing – end up with freckles
Lesions include
vesicles, pustules, crusted lesions, ruptured pustules with scale & pigmented macules –singly or in combination

55
Q

Miliaria

A

obstructions of the eccrine duct resulting in rupture of the ducts and sweating into the skin
Fragile 1-2mm clear, non-inflammatory vesicles
Most common in 1st week of life

56
Q

miliaria types

A

Miliaria crystalline
Miliaria rubra
Miliaria profunda
Miliaria pustulosa

57
Q

Miliaria Rubra

A

secondary local inflammatory response is responsible for the erythema associated with the papules and vesicles
Common sites face neck and trunk

58
Q

Neonatal acne/Transient Neonatal Cephalic Pustulosis

A

Common on face, neck, chest & back

Resolves within first 6 months of life

59
Q

Epidermolysis Bullosa

A

Neonatal vesicles, bullae and denuded skin, with friction and trauma induced blistering
can cx bleeding and Skin infections
Give morphine

60
Q

Subtypes of Epidermolysis Bullosa

A

Simplex
Junctional
Dystrophic

61
Q

Subcutaneous Fat Necrosis facts

A 
Idiopathic necrosis of the panniculus (subcutaneous fat) Indurated (hardened) plaques or nodules below the skin
can become hypocalcaemic 
self limiting – week or two 
ass with trauma during labour
term babies
62
Q

aphtha

A

small ulcer of mucous membranes

63
Q

cyst

A

any closed cavity with an epidermal, endothelial or membranous lining containing fluid or soft material

64
Q

erythroderma

A

generalized redness associated with infiltra-tion and disquamation of the skin

65
Q

Gangrene

A

necrotizing process due to arterial occlusion or infection

66
Q

Lichenification

A

thickening of the skin with accentuation and coarsening of the skin markings

67
Q

milium

A

tiny white cyst containing keratin

68
Q

scab

A

devitalized portion of the skin due to necrosis

69
Q

impetigo

A

Round confluent superficial blisters which rupture early and form crusts

70
Q

impetgo

A

Round confluent superficial blisters which rupture early and form crusts

71
Q

erysipelas

A

Superficial form of cellulitis involving the dermis and upper subcutaneous tissue

72
Q

Staphylococcal Scalded Skin Syndrome

A

Cutaneous tenderness and superficial widespread blistering & desquamation

73
Q

Pityriasis Rosea

A

Acute self limited, papulo-squamous disorder. Rash is often preceded by a herald patch with collarette of scale

74
Q

herald patch

A

erythematous, scaly 2 to 10 centimeter, round to oval patch or plaque with a depressed center and raised border.

75
Q

Erythema Multiforme Simplex

A

Acute self-limiting (1-2 weeks) vesicobullous disease with erythematous macules and papules which evolve into “target” lesions
ass with HSV

76
Q

Stevens-Johnson syndrome

A

Sudden onset of tender erythematous eruption usually due to a reaction to a medication or an infection

77
Q

Stevens-Johnson syndrome cx

A

Antibiotics
Anticonvulsants
NSAIDS
Mycoplasma pneumoniae

78
Q

Toxic Epidermal Necrolysis

A

like sjs but faster onset more severe but less common

Early symptoms include fever and flu-like symptoms

79
Q

Erythema Nodosum

A

Abrupt onset of tender red subcutaneous nodules on extensor surfaces of lower legs

80
Q

Scabies

A

the release of toxic or antigenic secretions of the female mite Sarcoptes scabiei var hominis

81
Q

Scabies

A

the release of toxic or antigenic secretions of the female mite Sarcoptes scabiei var hominis
small 1-2mm itching papules with various degrees of crusting and scaling

82
Q

scabies Most common sites

A

Hands, palms, wrists, buttocks, feet

83
Q

Scabies extra facts

A

Females lay ± 3 eggs/day, requiring ± 4 days to hatch
Time from egg laying to adult mite is 10–14 days
Mites are not blood feeders, but are thought to feed on intercellular fluid
can be acute or chronic (Acute glomerulo-nephritis if infected with Group A Streptococcus)

84
Q

scabies Rx

A

Lindane or Quellada lotion (Gamma Benzene hexachloride 1%)
sulphur 2,5%
Tetmosol soap
Benzyl benzoate
Permethrin with 70-80% of ovicidal activity

85
Q

Cutaneous Larva Migrans (Sandworm)

A

A creeping erruption caused by Ancylostoma braziliense crawling btwn epidermis and dermis
cx intense pruritis, erythaematous, raised, serpigenous tracts

86
Q

Cutaneous Larva Migrans (Sandworm) extra facts

A

secondary infx is common
Topical thiabendazole 10-15%
Albendazole

87
Q

Major pathogens causing superficial fungal infections in children

A

Dermatophytes: Trichophyton
Microsporum
Epidermophyton

Yeasts: Candida
Malassezia

88
Q

Tinea corporis

A

Active circumscribed raised round or oval scaly margins which spread outwards

89
Q

Tinea corporis Rx

A

Imidazoles

Griseofulvin

90
Q

Pityriasis Versicolor

A

Caused by malassezia yeast

Lesions on the face are usually hypopigmented, faintly scaling & ovoid

91
Q

Pityriasis Versicolor Rx

A

fluconazole

ketoconazole

92
Q

Scaling skin

A

the loss of the outer layer of the epidermis in large, scale-like flakes

93
Q

Pediculosis Capitis facts

A

human head louse that Infests the scalp and sucks blood
Pruritis is common in long term infestation, but first time infestation may produce no symptoms whatsoever
nits adhering to the hair

94
Q

Pediculosis Capitis EXTRA FACTS

A

Infestation most common in children 3-11 yrs
More common in girls than boys
Likes CLEANLINESS – hair but on body – LIKES DIRT
Most head lice products kill the adult lice but not the nits. Thus all topical treatments should be applied twice, 1 week apart

95
Q

Pediculosis Capitis Rx

A

Gamma benzene hexachloride
Permethrin
Nitagon

96
Q

lymphadenopathy common causes

A

infections
autoimmune diseases
cancers

97
Q

medications that cause lymphadenopathy

A 
Allopurinol
Atenolol
Captopril 
penicillin
Quinidine (anti arrythmic)
98
Q

Epidemiologic Clues to the Diagnosis of Lymphadenopathy

A

Cat scratch - Cat-scratch disease, toxoplasmosis
Undercooked meat -Toxoplasmosis
Tick bite - Lyme disease, tularemia

99
Q

Pain in LN is usually the result of an inflammatory process or suppuration, but pain may also result from

A

hemorrhage into the necrotic center of a malignant node

100
Q

LN Consistency.

A

Stony-hard nodes are typically a sign of cancer, usually metastatic
Very firm, rubbery nodes suggest lymphoma. Softer nodes are the result of infections or inflammatory conditions
Suppurant nodes may be fluctuant

101
Q

dx which cx benign matted LN

A

TB
sarcoidosis
lymphogranuloma venereum

102
Q

where do cat scratch dz and infectious mononucleosis cause lymphadenopathy

A

Cat SD- cervical or axillary adenopathy

Infx M- cervical

103
Q

Diff diagnosis of lymphadenopathy in Mononucleosis-type syndromes, EBV, leukemia, serum sickness

A

Mononucleosis-type syndromes: fever, malaise, Fatigue, atypical lymphocytosis
EBV type: Splenomegaly in 50% of patients
Leukemia: Blood dyscrasias, bruising Blood smear, bone marrow
Serum sickness: Fever, malaise, arthralgia, urticaria

104
Q

Increased hydrostatic pressure cx

A

High venous pressure - Congestive cardiac failure
- Constrictive pericarditis

Sodium and fluid retention -Glomerulonephritis
-Acute renal failure

105
Q

Decreased oncotic pressure cx

A

Decreased protein intake
Impaired absorption
Impaired production
Protein loss

106
Q

besides Increased hydrostatic pressure

Decreased oncotic pressure what cx oedema

A

Impaired capillary permeability

• Sepsis/inflammation

107
Q

Microcytic RBCs cx

A

Iron deficiency
Sickle-cell disease
Thalassemia

108
Q

Iron deficiency presentations and Rx

A

Tired
Koilonychias
Splenomegaly

Rx: ferrous gluconate/sulphate @ 6 mg/kg elemental iron

109
Q

Thalassaemia facts

A

Hb rarely < 10g/dl
S Iron normal
HB A2 & HB F increased.

110
Q

Sickle cell disease facts

A

Splenomegaly
Hb S & Hb F Increased
Hb A decreased

Definitions (11 decks)

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