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2020 phase 3a newer > paeds > Flashcards

paeds Flashcards

1
Q

how might cmpa present?

A

vomiting
diarrhoea with blood
eczema

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2
Q

how do you test for lactose intolerance?

A

lactose hydrogen test

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3
Q

what are histological findings of coeliac disease?

A

jejunum is sampled
villous atrophy
crypt hyperplasia

t cell reaction! type 4!!!!

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4
Q

what isnt absorbed in coeliac disease?

A

iron
folate
b12

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5
Q

causes of pathological jaundice?

A

haemolytic

sepsis

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6
Q

what are the haemolytic causes of jaundice

A 
rhesus incompatibility
ABO incompatibiluty
spherocytosis
G6PD
pyruvate kinase
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7
Q

what are the torch infections

A 
toxoplasmosis
others - syphilis
rubella 
cmv 
herpes
hepatits
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8
Q

is haemolytic jaundice conjugated?

A

no

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9
Q

criggler najjar

A

glucoronyl transferase deficient

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10
Q

what is galactosaemia

A

deficiency of galactose breakdown enzyme

cataracts and speech deficit and ataxia

remove dairy from mum and child
and continue breastfeeding

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11
Q

what is a coombs test used for?

A

check for ABO haemolysis

checks for antibodies on surface of RBCs

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12
Q

what investigations would yo do for neonatal jaundice?

A

coombs
bilirubin
FBC - anaemia. haemolysis
blood film - g6pd, spherocytosis

blood typing of mum and baby

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13
Q

how do you manage haemolytic disease of newborn?

A

phototherapy and check the threshold for the phototherapy and the plasma exchange transfusions

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14
Q

if phototherapy doesnt work what do you give?

A

ivig

exchange transfusion

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15
Q

how often is bilirubin monitored?

A

every 4-6 hours after phototherapy

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16
Q

when to stop phototherapy?

A

when bilirubin is 50 micromol/L below threshold

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17
Q

what is kernicterus?

A

deposition of unconjugated bilirubin in basal ganglia and brainstem nuclei

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18
Q

how does kernicterus present?

A

increased muscle tone
seizures
coma
death

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19
Q

complications of kernicterus?

A

choreoathetoid cerebral palsy

learning difficulties
sensorineural deafness

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20
Q

how does g6pd present?

A

neonatal jaunduce triggered by infections
intravascular haemolysis
splenomegaly
gallstones

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21
Q

how is g6pd diagnose?

A

g6pd enzyme assay
blood film: heinz bodies
bite and blister cells

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22
Q

what does bite and blister cells mean?

A

g6pd

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23
Q

what does heinz bodies indicate?

A

g6pd

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24
Q

what antibiotics are contraindicated in g6pd?

A

ciprofloxacin
sulphonamides (all sulphs)
antimalarials

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25
Q

what can trigger aplastic crisis?

A

parvovirus can trigger in spherocytosis/sickle cell

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26
Q

what investigations for spherocytosis?

A

high MHCH and reticulocytes
blood film - spherocytes
coombs test = positive
electrophoresis?

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27
Q

how is spherocytosis managed?

A

oral folate replacement
splenectomy
oral penicillin prophylaxis
vaccination

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28
Q

how is aplastic crisis managed in spherocytosis?

A

blood transfusion

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29
Q

what is the difference between breastfeeding jaundice?

A

breastfeeding - not enough milk to lower bilirubin levels presents in first week of life

breastmilk jaundice - second week - substance in milk inhibits breakdown of bilirubin presents in 2nd week of life

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30
Q

lifespan of fetal hb?

A

70 days

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31
Q

lifespan of fetal hb?

A

70 days

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32
Q

what rash associated with conjunctivitis?

A

measles

cough
coryzal
conjunctivitis
cranky

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33
Q

what causes bilateral undescended T?

A

congenital adrenal hypoplasia

refer for paediatric endocrinologist

if excluded and still undescended by 3m, refer to surgeons by 6m

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34
Q

how is unilateral undescended T treated?

A

review at 6-8 weeks
review at 3
refer to surgeons

if retractile, review annually

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35
Q

what condition is oesophogeal atresia common in?

A

downs

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36
Q

how does bacterial tracheitis present?

A

similar to croup

  • barking cough
  • stridor

doesnt resolve
caused by staph aureus

treat with IV Abx/ intubation

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37
Q

what abx for uti in children

A

cephalexin

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38
Q

which rash associated with perioral sparing

A

parvovirus

also can cause aplastic crisis in those with spherocytosis? sickle cell???

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39
Q

what are the features of william’s syndrome

A 
star shaped iris
elfin facies
friendly
short
supravalvular aortic stenosis
neonatal hypercalcaemia
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40
Q

what is squint towards nose?

A

esotropia

41
Q

what is squint temporally?

A

exotropia

42
Q

what is squint to the bottom?

A

hypotropia

43
Q

what is the hirchberg test?

A

corneal light reflection test

asymmetrical if there is a squint

44
Q

what does eye deviation on cover test imply?

A

squint

45
Q

how is squint treated?

A

occlusive patch to prevent amblyopia (fails to correct even with glasses)

46
Q

how is meningitis treated in neonates?

A

cefotaxime and amoxicillin

47
Q

how to assess DDH in baby >4.5m?

A

xray

48
Q

how is epistaxis treated?

A

chlorhexidine and neomycin

49
Q

what murmur associated with transposition?

A

loud S2

palpable ventricular pulse

50
Q

where is affected in osgood schlatter?

A

tibial tuberosity

51
Q

what maternal disease can lead to surfactant deficiency in neonates?

A

maternal t1/2 diabetes (not gestational)

52
Q

what heart defects associated with turner’s

A

aortic coarctation

bicuspid valve

53
Q

what is ebstein’s anomaly?

A

atrialisation of the right ventricle

leaky tricuspid valve

54
Q

how long exclusion for impetigo?

A

48hrs from antibiotics/h2o2

55
Q

how is diaphragmatic hernia treated?

A

intubation and ventilation

ng tube to prevent distension of bowel??

56
Q

what causes ambiguous genitalia in newborn?

A

congenital adrenal hyperplasia

57
Q

what is bartter syndrome?

A

severe hypokalaemia, NORMOTENSION
polyuria polydipsia

caused by defective chloride absorption at nkcc2 in loop of henle

spironolactone, electrolyte replacement, acei to reduce glomerular filtration

58
Q

what are the features of neonatal CMV

A

blueberry muffin skin lesions
microcephaly
sensorineural deafness
hepatosplenomegaly

59
Q

what causes scarlet fever?

A

group a haemolytic strep (pyogenes)

60
Q

what are the complications of scarlet fever?

A

rheumatic fever
otitis media
glomerulonephritis

61
Q

what are the complications of measles?

A

otitis media
pneumonia
encephalitis
subacute sclerosing panencephalitis

62
Q

what are the complications of mumps?

A

pancreatitis

infertility

63
Q

what prophylactic for child exposed to measles?

A

mmr vaccine

64
Q

what is a complication of roseola infection?

A

febrile convulsions

65
Q

what causes prada willi at genetic level?

A

imprinting

part of father’s chromosome 15 missing

66
Q

how would hirschprung’s look on AXR?

A

fluid levels and dilated bowel

67
Q

how is SUFE treated?

A

internal fixation across the growth plate

68
Q

how is perthes’ treated?

A

if under 6, observe

over = surgical (plaster cast/osteotomy?)

69
Q

how is DDH treated?

A

pavlik harness
(aka dynamic flexion-abduction orthosis)

if older, surgery

breech - uss hip

70
Q

what investigation for pyloric stenosis?

A

uss abdo

71
Q

what does barlow test do?

A

dislocate

72
Q

what does ortolani test do?

A

relocate

73
Q

if umbilical hernia, when to fix?

A

after 5 years

74
Q

when is measles contagious?

A

4-5 days after resolution of rash

75
Q

how does gord present in children?

A

vomiting when laid flat after feeding

draws legs up and arch back

76
Q

what can rsv cause in children?

A

hyponatraemia and seizures

77
Q

when to do uss/mcug/dmsa?

A

if recurrent uti

uss within 6 weeks
dmsa within 4-6 months

only do mcug if less than 6m

78
Q

paediatric maintenance fluids!

A

100ml/kg first 10
50ml/kg next 10
20ml/kg remainder

over 24 hours

79
Q

how is fluid deficit calculated?

A

percentage dehydration * weight * 10

over 24/48 hours?

80
Q

stepwise acute asthma treatment

A 
inhaled salb
neb salb
neb ipratropium
oral prednisolone
iv hydrocortisone
magsulf
aminophylline
salbutamol IV
81
Q

how is all treated?

A

chemo

82
Q

how would ependymoma present?

A

3rd ventricles

surgery and radiotherapy

83
Q

how would astrocytoma be treated?

A

surgery

84
Q

how would medulloblastoma be treated?

A

resection

radio and chemo?

85
Q

how would osteosarcoma be treated?

A

chemo and surgery

86
Q

how would ewing’s be treated?

A

radio

87
Q

symptoms of nephrotic?

A

proteinuria
hypoalbuminaemia
oedema

88
Q

commonest cause of nephrotic?

A

minimal change disease

89
Q

how is nephrotic managed?

A 
pred 
diuretics
penicillin prophylaxis
flu vaccine??
albumin infusion
levomisole
cephalosporin
90
Q

how is retinopathy of prematurity treated?

A

laser therapy

91
Q

intraventricular haemorrhages/periventricular leukomalacia associated with?

A

cerebral palsy

92
Q

what is chronic lung disease defined as?

A

o2 requirement after 28 days?

recurrent infections

93
Q

how is nec treated?

A

abx and surgery

94
Q

what is otitis media caused by?

A

pneumococcus

95
Q

how is otitis media treated?

A

treat with pain relief
if no response in 4 days - abx
amoxicillin/erythromycin

96
Q

what are complications of otitis media?

A

perforation - discharge and then pain relief
glue ear - effusion causes conductive hearing loss
mastoiditis
meningitis

97
Q

what are the symptoms of mastoiditis

A 
swelling behind ear
fever
headache
hearing loss
ear discharge
98
Q

how is mastoiditis managed?

A

ct head
IV Abx
myringotomy

2020 phase 3a newer (11 decks)

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