Paeds Flashcards
Umbilical granuloma features
Small red growth in belly button
Wet
Leaks fluid
Treatment of umbilical granuloma
Bit of salt on the wound regularly
When you ask about milestones, what should you also ask about?
Vaccinations
Instead of ‘do you smoke’ for children, what do you ask?
Does anyone smoke in the house
Important social questions to ask in paeds history
How is everything at home?
Is the child known to social services
A three day old Caucasian infant becomes jaundiced. Past medical history and birth history are both unremarkable. The infant is breast fed and appears well. What is the most likely diagnosis?
Breast milk jaundice
Caused by increased bilirubin uptake from the gut
Presents in the first 2 weeks
If a child is diagnosed with meningitis, what should everyone else in the household receive?
All household or close contacts should receive rifampicin as post-exposure prophylaxis
Features of meningitis
HEADACHE Nausea Vomiting Photophobia Withdrawn and unwell
What is the genetic reason for Prader-Wili and how does it present?
Prada has no father The paternal gene is silenced Present with hyperphagia Weight gain Learning difficulties
What are the pyramidal tracts?
They are the tracts of voluntary movement!
The corticospinal tract
What is the pathophysiology of spastic cerebral palsy?
This is the most common form of cerebral palsy
It presents with damage to the pyramidal pathways
How might spastic cerebral palsy present?
Damage to pyramidal pathways ( pyramidal weakness)
General features: clasp knife, flexed hip and elbow, ankle plantar flexion. In babies, may present with stiff legs and no attempt to weight bear
Spastic hemiplegia: Arm>leg, early hand preference
Spastic quadriplegia: Most severe, Associated with seizures, leg>arm
Spastic monoplegia: paralysis of 1 limb, usually an arm
Scissor walking
Features of roseola infantum
High fever
Fever subsides
Rash appears
Cervical lymphadenopathy
What causes roseola infantum?
HHV6
Common complication of roseola infantum?
Febrile convulsions
How do you ‘diagnose’ delayed puberty simply due to late bloom?
X-ray of hands to assess the age of the growth plates
Treatment of biliary atresia?
Kasai procedure
How might biliary atresia present?
Jaundice at a couple of weeks old
How might a young child with UTI present?
Off their feeds
Pyrexia
Abdominal pain
What can you use to collect a urine sample in young babies?
Urine collection pad
A 13-year-old Afro-Caribbean boy presents to A&E with his parents as they are concerned that he has been complaining of pain in his chest and back. The pain started overnight and has progressively gotten worse
He is now struggling to breathe as the pain is worse on deep inspiration. He has a known diagnosis of sickle cell disease
Respiratory examination reveals bronchial breathing and crackles in the bases bilaterally
What is the most likely diagnosis?
Acute chest crisis
Strep throat -> nephritic syndrome a few DAYS later =>
IgA nephropathy
Strep throat -> nephritic syndrome a few WEEKS later =>
Post-streptococcal glomerulonephritis
Management of IgA nephropathy
Supportive measures and an ACE inhibitor
Fish oil containing omega-3
Corticosteroids
Patients with severe progressive glomerulonephritis may require immunosuppression
If a young child has a UTI what should you attempt to rule out?
Sexual abuse
Vesicouretic reflux
How do you test for vesicouretic reflux?
Micturating cystourethrogram
How do you investigate for scarring of the ureters?
DMSA scan
Causes of proximal myopathy (also think paediatrics)
Duchenne muscular dystrophy Polymyositis Endocrine = hypo/hyperthyroid Alcohol Cancer HIV Steroids (remember to do an oral dexamethasone test)
Symptoms of rubella infection
Mild fever Generalised rash Lymphadenopathy Conjunctivitis Arthralgias or arthritis
When should you perform an APGAR assessment in a newborn?
1 minute and 5 minutes
Features of parvovirus infection
Slapped, warm cheeks rash Lace-like rash over body Fever Diarrhoea Coryzal symptoms
What type of hypersensitivity reaction is asthma?
Type 1
Features of caput succundeam
Cap on the babies head
CROSSES SUTURE LINES
It’s all good
Boggy swelling
Features of a cephalohaematoma
Haemorrhage but doesn’t cross suture lines and isn’t pathological
Features of measles
KOPLIK spots
Fever
URTI
Maculopapular rash spreading from the face
Features of Scarlet Fever
S’s of Scarlet fever
Scarlet, strep, sandpaper, sore throat, strawberry tongue
Features of osteosarcoma aswell as x-ray features
Features = bone pain and swelling
NIGHT PAIN
FLAWS
x-ray features = sunburst appearance of periosteum
Hypsarrthymia
Fleshy nodules on torso
Seizure
Likely Dx
Tuberous sclerosis
Management of necrotising enterocolitis
IV antibiotics
TPN
?surgery
What type of seizure happens in children, often witnessed, at night and improves by puberty?
Benign rolandic epilepsy
Screening blood level for acromegaly
IGF-1 levels
Itchy round lesions all over the body, asymmetrical distribution, very itcy, DDx?
Discoid eczema Guttate psoriasis (not usually itchy) Tinea corporis (ringworm) (usually just one lesion)
Cause of lyme disease
Boreilla
