Paeds Flashcards
Causes of gross motor delay
- Cerebral palsy
- DMD
- Antenatal insult eg. stroke
- Part of developmental impairment
Causes of speech delay
- Familial
- Hearing impairment
- Poor social interaction/neglect
- ASD
- DMD
- Part of developmental impairment eg. Down’s
Dysmorphic features (Down’s)
Hypotonia (reduced muscle tone) Brachycephaly (small head with a flat back) Short neck Short stature Flattened face and nose Prominent epicanthic folds Upward sloping palpable fissures Single palmar crease
Epicanthic folds are folds of skin overing the medial portion of the eye and eyelid. The palpable fissures are the gaps between the lower and upper eyelid.
Presentation of cerebal palsy
HX: Ex-prem or problems at/following birth
- Developmental delay - MOTOR MILESTONES
- Shows preference for particular hand (weakness)
- Feeding difficulties (reflux, aspiration pneumonia)
Causes of nocturnal enuresis (with and without daytime symptoms)
With daytime:
- Overactive bladder
- Structural abnormalities eg. ectopic ureter
- Neurological disorders eg. neurogenic bladder
- Chronic constipation
- UTI
Without daytime:
- Lack of sleep arousal
- Polyuria
- Small capacity/overactive bladder
NB: primary means never achieved sustained continence
Causes of secondary:
- Diabetes, UTI, chronic constipation, inadequate fluids, behavioural/psychological/emotional problems
- Social/family problems, environment (toilet access)
MX: desmopressin
Conditions tested with heel prick test
- Phenylketonuria (PKU)
- Congenital hypothyroidism
- CF
- Sickle cell disease
- Medium chain acyl-CoA dehydrogenase deficiency (MCADD)
+ 4 rare metabolic conditions:
- Homocysteinuria, maple syrup urine disease, glutaric aciduria type 1, isovaleric aciduria
Gower’s sign
Classically occurs in DMD - uses hands to get up from floor due to thigh weakness
MSK HX symptoms
Pain stiffness swelling/mass warmth deformity loss of function developmental delay or regression of milestones
Describe features of benign and malignant leg pain
THINK TIM
Benign: nocturnal, awake from sleep with cramps, resolved with massage/analgesia, functionally normal next day, bilateral, changes site, related to exercise, primary school kids
Malignant: nocturnal but unable to sleep, unremitting, unresponsive to analgesia, loss of function/altered, unilateral, persists in daytime, teenagers
- causes: bone tumours, neuroblastoma and leukaemia
Malignant MSK features on examination
Pain/tenderness
Metaphyseal tenderness - marrow infiltration
Mass on examination
Postural shift - altered gait/sitting
Neurological features
Systemic: weight loss, fever, bruising, anaemia
- causes: bone tumours, neuroblastoma and leukaemia
Causes of neonatal jaundice
- Physiological
- Breastfeeding induced
- Haemolytic disease of the newborn
- Neonatal sepsis
- Congential hypothyroidism
Causes of neonatal respiratory distress
- Transient tachypnoea of the newborn
- Respiratory distress syndrome - surfactant deficiency
- Meconium aspiration
- Pneumothorax
- Respiratory infection / neonatal sepsis
Causes of neonatal cyanosis
- Respiratory distress
- Persistent pulmonary hypertension of the newborn
- Congenital cyanotic heart disease
- Trachea-oesophageal fistula
- Diaphragmatic hernia
Neonatal sepsis
Cause: GBS
IX: ABC, FBC, CRP, glucose, cultures, LP
ABX: benzylpenicillin and gentamicin
Causes of neonate intestinal obstruction
- Meconium plug / ileus
- Duodenal atresia
- Oseophageal atresia
- Malrotation with volvulus
- Hirschsprung disease
Causes of microcephaly
- Congenital varicella syndrome
- CMV
- Zika
- Foetal alcohol syndrome
Causes of bilious vomiting in neonates
- Malrotation until proven otherwise - emergency
1. Duodenal atresia
2. Malrotation w/volvulus
3. Meconium ileus / plug
4. NEC
5. Hirschprung’s disease
Facial features of down’s syndrome
- Prominent epicanthic folds
- Upwards slanting palpebral fissures
- Brushfield spots on iris (white spots)
- Macroglossia
- Small chin, flat nose, round face, small ears
Features of foetal alcohol syndrome
Facial: epicanthic folds, low nasal bridge, absent philtrum, thin upper lip, small chin
Cardiac: VSD and ASD
Growth retardation, behavioural problems
Causes of vomiting in a baby
- Overfeeding
- Posseting
- GORD
- Pyloric stenosis
- Obstruction
Top 5 causes of abdominal pain in children
- Acute appendicitis
- mesenteric adenitis
- constipation
- gastroenteritis
- UTI
Direct vs indirect inguinal hernias
Indirect: most common in infants. via deep inguinal ring
Direct: in old people. ‘directly’ via defect in posterior wall
Cause of bronchiolitis and MX
Cause = RSV
MX supportive eg. humidified oxygen
Nerve roots in Erb’s palsy
C5 and C6
Top 5 cyanosis
- Respiratory disease
- Neonatal - TGA, pulmonary atresia, persistent pulmonary HTN newborn, hypoplastic left heart
- During a seizure
- Stress
- CNS depression
Electrolyte disturbance in pyloric stenosis
Hypochloraemic Metabolic Alkalosis with Hypokalaemia
4 features of tetralogy of fallot
Pulmonary stenosis
Right ventricular hypertrophy
Overriding aorta
Ventricular septal defect
PROVe
CF deficiency in haemophilia A
factor VIII
CF deficiency in haemophilia B
factor IX
Paediatric fluid bolus
20ml/kg
Baby feeding requirements
150ml/kg/day
Nephrotic syndrome criteria
Proteinuria, oedema and hypoalbminuaemia
