Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 3a > paeds brief > Flashcards

paeds brief Flashcards

1
Q

wheeze is associated with ______

A

viral induced wheeze, asthma and bronchiolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is apnoea

A

cessation of breathing for at least 10 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what commonly causes sore throat

A
  • normally viral in children under 3
  • could also be caused by strep pyogenes (beta haemolytic strep)
  • epstein barr is a common cause of exudative tonsilitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which criteria indicate the likelihood of a sore throat being caused by a bacrterial infection and what does it include

A
  • Centor criteria
    • tender lymphadenopathy
    • tonsilar exudate
    • fever
    • absence of cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the treatment if strep throat is suspected

A

10 days of penicillin V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is croup

A

acute laryngotracheobronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what causes croup most commonly

A

parainfluenza virus

could also be RSV or bacterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what age is croup most common

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

management of croup

A
  • most get better at home within 24 hours
  • children may require hospitalisation due to
    • more severe illness
    • being under 12 months old
    • signs of fatigue or resp failure
  • managemnet
    • single dose dex or nebulised budesonide
    • nebulised adrenaline if need to get to ITU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what organism causes acute epiglottitis

A

haemophilus influenzae type B

rare to HiB vaccination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

age of acute eppiglotitis

A

1-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

management of acute eppiglottitis

A
  • do not
    • lie child down
    • examine throat
    • upset child (no bloods)
  • managed in resus room
  • examination of throat under anaesthetic
    • cherry red, swollen epiglottis on laryngoscopy
  • intubate
  • blood cultures
  • IV cefuroxime
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is bacterial tracheitis

A
  • rare but more common than epiglottitis
  • often seen as an acute deterioration after a vira infection
  • children systemically very unwell
  • no drooling
  • hoarse voice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what organisms commonly cause bacterial tracheitis

A

staphylococcus aureus

H. influenzae

strep spp.

neisseria spp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

management of bacterial tracheitis

A
  • secure airway
  • blood cultures
  • IV cefuroxime
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

distinguish croup, acute epiglottitis and bacterial tracheitis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

organism for whooping cough

A

bordatella pertussis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how long can whooping cough last

A

3 months

(100 day cough)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the management of whooping cough

A

erythromycin given early reduces infectivity and complications but does not reduce duration of illness

managment is largely supportive but 1% will need hospital admission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the two types of LRTIs

A

bronchiolitis

pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what causes bronchiolitis

A
  • viruses rather than bacteria
  • most commonly RSV
  • less commonly
    • adenovirus
    • influenza
    • parainfluenza
  • rarely: mycoplasma pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what would an X ray of bronchiolitis show

A

hyperinflation and patchy consolidation bilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the management of bronchiolitis

A

supportive

oxygen

some may be ill enough to need ng feeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what does pneumonia mean

A

inflammation of the lung parenchyma with consolidation within the alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what organisms cause pneumonia

A
  • viruses (more common in children <2)
    • RSV
    • influenza
    • parainfluenza
    • adenovirus
  • bacteria
    • strep pneumoniae (most common)
    • s. aureus (common in CF)
    • pseudomonas (common in CF)
    • HiB (in unvaccinated)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the classic signs of consolidation on the lungs (pneumonia)

A

decreased breath sounds

dullness to percussion

crackles

bronchial breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what three features suggest bacterial pneumonia

A

polymorphoneuclear leucocytosis

lobar consolidation

pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

first line antibiotic for bacterial pneumonia

A

oral amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are the aims of asthma treatment

A

no daytime symptoms or waking in the night due to symptoms

no exacerbations

no need for reliever therapy

no limitations on activity

normal lung function

minimal side effects of therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what’s the difference between brown and blue inhalers

A
  • brown - preventors
    • ICS
  • blue - relievers
    • salbutamol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

describe the steps of asthma therapy

A
  1. regular preventor
    • very low dose ICS
  2. initial add on preventor
    • inhaled LABA
  3. additional add on therapies
    • if no response to LABA stop it and increase ICS to low dose
    • if benefit from LABA but not enough then keep LABA AND increase ICS to low dose
    • if still inadequate add LTRA
  4. high dose therapy
    • increase ICS to medium dose
    • addition of theophyline
    • refer to specialist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the carrier rate of CF

A

1:25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

incidence of CF

A

1:2500 live births

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the most common CF mutation

A

three base pair deletion at F508

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Common pathogens in CF chest infection

A
  • S.aureus
  • H.influenzae
  • Pseudomonas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the gold standard of CF diagnosis

A

pilocarpine ionotophoresis sweat test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are the cornerstones of CF management

A

prevention of colonisation and infection of the lungs

effective mucocillary clearance

nutritional support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

ear ache is usually caused by:

A

infection of the middle ear

otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is acute otitis media usually caused by

A
  • can follow viral URTI
  • can also be bacterial
    • s.pneumoniae
    • pneumococcus spp.
    • h. influenzae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

management of otitis media

A

symptomatic treatment is usually sufficient

abx can reduce symptoms but not complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is conductive hearing loss usually due to

A

OME: otitis media with effusion aka glue ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

down’s syndrome is associated with which congenital heart disease

A

ASD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

turner’s syndrome is associated with which congenital heart disease

A

coarctation of the aorta

bicuspid aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

noonan syndrome is associated with which congenital heart disease

A

pulmonary stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

fetal alcohol syndrome is associated with which congenital heart disease

A

atrial septal defect

ventricular septal defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

describe the different types of cyanosis and what they mean

A
  • central cyanosis
    • blue lips, blue tongue
    • always pathological
  • peripheral cyanosis
    • blueness of hands and feet
    • can be normal in first 24hrs of life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

hallmarks of innocent murmurs

A

an asymptomatic child

a normal cardiovascular examination

systolic or continuous

no radiation

variation with posture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what kind of murmur is always pathological and needs investigation

A

diastolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

clinical features of heart failure in infants

A

poor feeding and breathlessness

faltering growth

excessive sweating

recurrent chest infections

CVS signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

initial investigations for suspected heart failure

A
  • ecg
  • chest x ray
  • diagnosis normally needs echo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

cxr finding of teratology of fallot

A

boot shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

cxr finding of transposition of great arteries

A

egg on side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what are the two cyanotic congenital heart conditions

A

teratology of fallot

transposition of great arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is the most commonn congenital heart disease

A

vsd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

complications of a left to right shunt

A

permanent irreversable pulmonary HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

compare the three severities of VSD

A
  • small vsd
    • pansystolic murmur
    • no symptoms
    • may close spontaneously but if murmer persists to 12 months do echo to look for complications
  • medium vsd
    • has symptoms
    • treated with diuretics and ACE inhibitors
    • spontenous improvement often occurs and surgery can often be avoided
  • large
    • presents early with cardiac failure
    • medical management
    • then surgical correction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

management of ASD

A

many close spontaneously before school age

management is to prevent heart failure and arrhythmias

transcatheter closure at age of 3-5

if very large might need surgical closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

when should the ductus arteriosus close

A

within hours of delivery

PDA diagnosed if duct doesn’t close in 1 month following birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what are the clinical features of a PDA

A

bounding pulses

wide pulse pressure

continuous machinery hum murmer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

management of PDA

A

ibuprofen to inhibit prostaglandin and encourage closure

can also be closed in first few months of life by cardiac catheterisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

clinical fetures of teratology of fallot

A

cyanosis

loud single S2

clubbing in older children if uncorrected

loud ejection systolic murmer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what are tet spells

A
  • in teratology of fallot when peripheral vascular resistance falls
  • increases right to left shunt
  • can be triggered by exertion, emotion, dehydration or illness
  • includes
    • worsenning cyanosis and pallor
    • distress/agitation
    • hypotonia
    • children squat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

managmenet of TOF

A
  • treat ‘tet’ or hypercyanotic events with:
    • high flow oxygen
    • morphine
    • IV fluids
    • bicarbonate for acidosis
    • intubation and ventilation in severe cases
  • definitive treatment is surgical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

managment of transposition of great arteries

A
  • initial aim is to promote mixing of blood
    • infusion of prostaglandin E1 to newborn
      • maintains patency of DA
    • emergency cardiac catheterisation and atrial septostomy
      • life saving procedures
  • definitive repair achieved with arterial switch surgery at a few weeks of age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

rheumatic fever is a complication of what and how frequently does it occur

A

group A beta haemolytic strep

a sore throat

occurs in <1% of cases of strep throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what age does rheumatic fever affect

A

5-15

use of antibiotics for bacterial throat infection have made it rare in UK

but is most common cause of cardiac valvular disease worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what are the jones criteria and how can they be used

A
  • used to diagnose rheumatic fever
  • for diagnosis patient needs to meet required criteria AND have either of:
    • two major
    • one major and two minor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what are the required criteria of jones criteria

A
  • evidence of streptococcal infection. either:
    • positive bacterial throat swab
    • raised antistreptolysin O titre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

what are the major criteria of the jones criteria

A
  • polyarthritis (can be fleeting)
  • erythema marginatum
  • subcutaneous nodules
  • carditis
  • chorea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

minor criteria of jones criteria

A
  • fever
  • arthralgia
  • raised ESR, CRP or WCC
  • previous rheumatic fever
  • prolonged PR on ECG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

ecg finding in rheumatic fever

A

prolonged PR

they may not have this

it is one of the minor criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

acute management of rheumatic fever

A
  • bed rest
  • high dose aspirin
  • steroids for severe carditis
  • diuretics and ace inhibitors for heart failure
  • Abx for acute illness and for prophylaxis of endocarditis
    • for 5-10yrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is the most common complication of rheumatic fever

A

rheumatic valvular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

any child with fever and a murmer what should you expect

A

endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

what is the most common causative organism in endocarditis

A

strep viridans

this is alpha haemolytic streptococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

diagnosis of endocarditis

A

cross sectional echocardiography can confirm diagnosis but cannot exclude

three blood cultures taken in first 24hrs of admission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

treatment for infective endocarditis

A

4-6 weeks of IV abx

e.g. high dose ampicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

investigations in a child presenting with abdominal pain

A
  • urinalysis
    • dipstick
    • mcs if indicated
  • bloods
    • fbc
    • crp
    • lfts if jaundiced
  • imaging
    • abdo x ray rarely useful
    • USS
      • can diagnose intussusception
      • can sometimes see appendicitis but cannot rule out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

organic causes of recurrent abdo pain

A

recurrent UTI

renal calculi

Helicobacter pylori gastritis

IBD

malrotation with intermittent volvolus

gallstones

recurrent pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

compare dehydration and shock with the following features

Sunken eyes and depressed fontanelle

Mucous membranes

Skin turgor

Alertness

HR and RR

Urine output

Skin colour

Extremities

Cap refill

Blood pressure

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

7 red flags with vomiting

A

bilious vomiting

localised abdo pain

persistent fever

altered consciousness/bulging fontanelle

meningism

petechial rash

respiratory distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

vomiting blood in first few days of life could be

A

swallowing maternal blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

acute diarrhoea is most commonly caused by

A

gastroenteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

what is a positive rovsing sign and what does it mean

A

palpation of the left iliac fossa causes pain in the right

appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

bloody diarrhoea should raise suspicion of

A

Bacterial gastritis particularly HUS (e.coli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

constipation red flags (6)

A

starts in first few weeks of life

meconium passed >24 hours

abdo distension or bilious vomiting

faltering growth

delayed walking or lower limb neurology

child protection concerns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what age does colic most commonly occur

A

2 weeks until about 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

7 differentials for inconsolable crying in an infant

A

colic

GORD

cows milk protein allergy

incarcerated hernia

intussusception

otitis media

UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

infantile colic managment

A

benign and has a good prognosis

sympathetic explanation of the condition is helpful but there is no evidence for medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

infants at risk of severe GORD

A

preterm infants

infants with congenital oesophageal anomalies

infants with cerebral palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

complications of GORD in infants and how many develop complications

A
  • 10% infants with symptomatic reflux develop complications
  • bronchospasm and wheeze
  • recurrent aspiration pneumonia
  • oesophagitis
    • could lead to haematemasis and anaemia
  • faltering growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

investigation of GORD

A
  • Diagnosed clinically
    • posseting
    • vomiting
    • crying after feeds
    • worse when lying down
  • sometimes to confirm diagnosis/assess severity
    • 24hr oesophageal pH monitoring in older kids
    • endoscopy if suspected oesophagitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

management of GORD

A
  • majority will resolve spontaneously by 18 months
  • following drugs can be used in severe reflux
    • H2 antagonists: ranitidine
    • proton pump inhibitors: omeprazole
    • prokinetic drugs: domperidone
      • reduce lower oesophageal sphincter pressure
  • surgery very rarely
    • nissen fundoplication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

pyloric stenosis is due to

A

hypertrophy of the smooth muscle of the pyloric sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

complications of pyloric stenosis

A

weight loss

constipation

dehydration

mild jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

what is the characteristic electrolyte disturbance in pyloric stenosis

why

A

hypochloraemic hypokalaemic metabolic alkalosis

due to loss of gastric acid contents

then kidneys retain H ions at expense of potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

managment of pyloric stenosis

A

correction of fluid and electrolyte abnormalities

difinitive treatment is ramstedt pyloromyotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

what is the most common surgical emergency

A

appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

common associated symptoms with appendicitis other than the pain

A

anorexia

nausea

vomiting

diarrhoea

constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

diagnosis and investigations of appendicitis

A
  • usually clinical
  • FBC
  • CRP
  • abdo US may confirm but cannot exclude
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

management of appendicitis

A

appendicectomy

if there is diagnostic uncertainty, a period of observation may be indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

what is mesenteric adenitis

A
  • inflammation of the intraabdominal lymph nodes that can mimic appendicitis
  • commonly follows viral infection
    • URTI
    • gastroenteritis
  • obs in hospital since diagnosis difficult
  • management is conservative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

peak age of incidence of intussusception

A

5-10 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

commonest site of intussusception

A

ileum into caecum

108
Q

classical presenting triad of intussusception

A
  • paroxysmal abdo pain
    • screaming, becomes pale, draws legs to chest
  • abdo mass
    • sausage shaped
  • redcurrent jelly stool
    • late sign
    • compromise in blood supply to bowel causes blood and mucus to be mixed in
109
Q

what will the vomiting be like in intussusception if there is some

110
Q

US finding in intussusception

A

doughnut or target sign

111
Q

management of intussusception

A

air or barrium enemas

if this fails aroscopy or laparotomy will be needed

112
Q

what is hirschprung’s

A
  • aka congenital aganglionic megacolon
  • aganglionic segment between bowel and colon is contracted
  • more common in males and children with down’s syndrome
113
Q

hirschprung’s presentation

A
  • infants in neonatal period
    • delayed passage of meconium >48hrs
    • intestinal obstruction with bilious vomiting
  • older children
    • chronic severe constipation from birth
    • absence of faeces in narrow rectum
    • abdo distension
114
Q

diagnosis hirschprungs

A

confirmation is by absence of ganglion cells on suction biopsy of rectum

115
Q

management of hirschprungs

A

surgical resection of involved area of colon

anastamoses normally innervated bowel with anus

ladd’s procedure

116
Q

causes of small bowel obstruction

A

duodenal atresia (associated with downs)

malrotaion with volvolus

strangulated inguinal hernia

meconium ileus

118
Q

causes of large bowel obstruction

A

hirschprung’s disease

imperforate anus

rectal atresia

119
Q

what is the most causative virus of gastroenteritis

120
Q

how to calculate maintenance fluids

A

100mL/kg/24hrs for first 10kg

50ml/kg/24hrs for second 10kg

20ml/kg/24 hrs after that

121
Q

what proportion of IBD have their first presentation in childhood

122
Q

in the paediatric settin is crohns or UC more common

A

crohns is twice as common as UC

123
Q

compare crohns to UC

A
  • crohns
    • occurs anywhere from mouth to anus
    • transmural inflammation
    • granulomatous inflammation
  • ulcerative colitis
    • colon only
    • mucosa only involved
    • nongranulomatous inflammation
124
Q

complications of CD and UC

A
  • crohns
    • strictures
    • abscesses
    • fistulae
    • 5-6x increased risk of colon cancer
  • UC
    • toxic megacolon
    • risk of PSC
    • 20-30x increased risk of colon cancer
125
Q

diagnosis of IBD

A

colonoscopy and biopsy

126
Q

faecal calprotectin is a marker of what

A

inflammation of the gut

127
Q

chrons management

A
  • steroids to induce remission
  • immunosuppressive agents for maintenance
    • mesalazine
    • azithioprine
  • antitumour mabs
    • infliximab
  • surgery if medical treatment fails
128
Q

UC management

A

steroids

immunosuppressive agents needed

surgery when medical treatment fails - subtotal colectomy and ileostomy can be curative

129
Q

which HLA type is associated with coeliac and how close is the association

A

HLA-DQ2 is found in 95% of affected individuals

130
Q

investigations in coeliac

A
  • IgA tissue transglutaminase with total IgA
    • there may be IgA deficiency where IgG can be measured instead
  • definitive diagnosis is by duodenal/jejunal biopsy
    • villous atrophy
131
Q

jaundice with pallor indicates

A

a haemolytic episode e.g. G6PD deficiency

132
Q

what is marasmus

A

undernourishment causing a child’s weight to be significantly low for their age.

133
Q

causes of jaundice in first 24 hrs of life

A
  • excess haemolysis
    • immune
      • rhesus incompatibility
      • ABO incompatibility
    • non-immune (intrinsic red cell defects)
      • G6PD deficiency
      • Spherocytosis
  • congenital infections
    • TORCH, hepatitis and syphilis
134
Q

causes of jaundice between 24hrs and 2 weeks

A
  • most common cause is physiological jaundice
  • breast milk jaundice
  • infection
  • bruising
  • excess haemolysis
    • ABO incompatibiltiy
    • G6PD deficiency
    • spherocytosis
135
Q

causes of jaundice after two weeks of life

A
  • breast milk jaundice
  • infections
  • haemolysis
    • ABO incompatibility
    • Rh incompatibility
    • G6PD deficiency
    • Spherocytosis
  • biliary atresia
  • neonatal hepitits
  • hypothyroidism (should have been screened as newborn)
136
Q

treatment of biliary atresia

A

kasai procedure but many still require a liver transplant by the age of 20

137
Q

investigations for babies presenting with prolonged jaundice (more than 2 weeks)

138
Q

what is potter’s syndrome

A

bilateral renal agenesis

oligohydramnios due to lack of foetal urine

death

139
Q

vesicoureteric reflux is a major cause of

A

CKD in children

140
Q

what is the most common causative agent in UTI in children and what are some others

A
  • most common is e.coli
  • proteus
  • klebsiella
  • pseudomonas
  • enterococcus
141
Q

causes of acute nephritis

A
  • most commonly post-streptococcal glomerulonephritis
    • 10-14 days after a throat or skin infection
  • henoch schonlein purpura
  • IgA nephropathy
  • SLE
  • haemolytic uraemic syndrome
142
Q

acute nephritis is characterised by

A

haematuria

reduced renal function

hypertension

(there may be oedema and proteinuria but these are less common than in nephrotic syndrome)

143
Q

compare acute nephritis and nephrotic syndrome using

Aetiology

Gross haematuria

Hypertension

Oedema

Urinalysis

Serum C3 and C4

Anti-DNase B / antistreptolysin O titre

Treatment

144
Q

what is the triad for nephrotic syndrome

A

proteinuria

hypoalbuminaemia

oedema

145
Q

causes of nephrotic syndrome

A
  • minimal change disease (most common)
  • focal segmental glomerulosclerosis
  • membranous glomerulonephritis
146
Q

treatment for minimal change disease

A

4 weeks of high dose prednisolone

147
Q

what is the most common cause of AKI in a previously healthy child

A

haemolytic uraemic syndrome

148
Q

what is haemolytic uraemic syndrome

A

shiga toxin producing E.coli leads to red blood cell fragmentation in the kidney and thrombocytopenia

ABX ARE CONTRAINDICATED AS THEY INDUCE SHIGA TOXIN PRODUCTION

149
Q

management of undescended testis

A

carry an increased risk of malignancy, subfertility and torsion

treatment is by orchidopexy if they have not descended by 6 months

150
Q

distinguishing a hydrocoele from an inguinal hernia on examination

A

hydrocoele it is possible to get above it and it cannot be reduced

it transilluminates

151
Q

treatment for hydrocoele

A

usually no treatment needed as it will resolve spontaneously

152
Q

management of inguinal hernias

A

surgery promptly - the risk is strangulation

153
Q

differential diagnoses of an acute scrotum

A

epididymo orchitis

idiopathic scrotal oedema

torsion of the testicular appendix

154
Q

most common cause of ambiguous genitalia

A

congenital adrenal hyperplasia of an XX individual

155
Q

what is the commonest vasculitis in children

A

henoch schonlein purpura

156
Q

how does HSP affect the skin, joints, GI system and kidneys?

A
  • skin
    • purpuric rash on extensor surfaces and buttocks
  • GI tract
    • abdo pain
    • GI bleeding
    • intussusception
  • Joints
    • arthralgia
    • swelling of large joints
  • Kidneys
    • glomerulonephritis
      • hypertension
      • microscopic haematuria
      • proteinuria
157
Q

what ig is responsible for HSP

158
Q

diagnosis of HSP

A
  • clinical diagnosis
  • normal platelet count and coagulation exclude other causes of purpura
159
Q

management of HSP

A

HSP is usually self limiting

treatment usually supportive with pain relief

steroids only if severe

160
Q

what is the most common cause of thrombocytopenia in childhood?

A

Idiopathic thrombocytopaenic purpura

161
Q

what’s the difference between IgE mediated allergies and non IgE mediated allergy

A
  • IgE mediated
    • asthma
    • acute allergy
    • alaphylaxis
  • non-IgE
    • cows milk protein allergy
    • eczema
  • IgE –> mast cell and basophil degranulation. classically have biphasic response with early and late component
  • non IgE –> less well understood
162
Q

investigating suspected allergies

A
  • there is no test for non IgE mediated allergies - just trial elimination and re-introduction
  • IgE allergy testing
    • Skin prick testing
      • wheal more than 3mm larger than negative control is a positive result
    • negative predictive value better than positive predictive value
      • so history important
163
Q

management of anaphylaxis

A
  • remove allergen
  • IM adrenaline (epinephrine) 1µg/kg 1:1000
  • if out of hospital an epi pen should be used
  • IV hydrocortisone
  • IV antihistamine (chlorphenamine)
  • back to back salbutamol nebs
164
Q

what does a maculopapular rash look like

A

has both macules and papules

i.e. areas that are flat and non-palpable as well as lesions that are fluid filled and raised

165
Q

examples of vesicular rashes

166
Q

examples of maculopapular rashes

A

viral exanthems like rubella, measles, roseola infantum

any viral infection

scarlet fever

kawasakis

167
Q

examples of haemorrhagic rashes

A

meningococcal sepsis

acute leukaemia

idiopathic thrombocytopenic purpura

Henoch-Schonlein purpura (usually legs and buttocks)

bleeding disorders

168
Q

three different varieties of eczema

A

atopic eczema

infantile seborrhoeic eczema

napkin dermatitis

169
Q

% of children affected by eczema

170
Q

management of eczema

A
  • step wise approach
    1. regular use of emollients
    2. topical steroids of appropriate potency
    3. topical tacrolimus and pimecrolimus
171
Q

what are the topical steroids in order of increasing potency

A
  • help every budding dermatologist
    1. hydrocortisone (least potent)
    2. eumovate
    3. betnovate
    4. dermovate (most potent)
172
Q

what is eczema herpeticum and what is the managment

A
  • secondary infection of eczema with HSV
  • potentially very serious
  • treatment with aciclovir
173
Q

what is infantile seborrhoeic eczema, where does it normally occur on the body, what age and what is the treatment

A
  • mild eczema
  • common in first 2 months of life
  • scaly and non itchy
  • initially on scalp - cradle cap
  • may spread to involve face, flexures and nappy area
  • treatments is with emollients and mild topical steroids
174
Q

rashes in the nappy areas can be due to

A

candidiasis

irritant contact dermatitis (nappy rash)

seborrhoeic dermatitis

175
Q

distinguishing true nappy rash from candidiasis

A
  • in true nappy rash the inguinal folds are spared since it’s the contact with urea that causes it
  • candidias will involve the skin folds
176
Q

management of nappy rash

A

frequent nappy changes

barrier creams

exposure to air can hasten recovery

177
Q

management of candidiasis

A

topical and oral antifungals such as nystatin

178
Q

bacteria for acne

A

propionibacterium acnes

179
Q

acne treatment

A
  • keratolytic agents
    • benzoyl peroxide
  • topical antibiotics
    • clindamycin
  • low dose oral antibiotics
    • doxycycline
  • vitamin A analogues
    • 13 cis retinoic acid
    • only prescribed by specialists
180
Q

what’s an important consideration with roaccutane

A

it’s teratogenic so councel teenage girls about this

181
Q

what is erythema multiforme

A

target lesions possibly with macules, papules and bullae

if there is mucous membrane involvement it’s called stevens-johnson syndrome

most commonly caused by HSV or EBV

self limiting and idiopathic

182
Q

erythema nodosum is caused by what

A

IBD

tuberculosis

strep infections

183
Q

what is the virus that causes molloscum and is it infectious

A

molloscipoxvirus

low infectivity

184
Q

management of molloscum

A

usually resolves spontaneously within 6 months to two years

185
Q

what is tinea capitis

A

scalp ringworm

itchy alopecia

occasional boggy inflammatory masses called kerion

186
Q

what is tinea corporis

A

body ringworm

187
Q

what is tinea pedis

A

athletes foot

188
Q

what are the tineas treated with

A
  • mild infections: treated with topical antifungal preparations such as clotrimazole or miconazole
  • severe infections: require systemic treatment with oral griseofulvin for several weeks
189
Q

how is scabies diagnosed

A

identification of mites or ova in scrapings from burrows or vesicles

190
Q

what is the treatment of scabies

A

permathrin cream 5% applied to whole body

two treatments 1 week apart

can take several weeks for the pruritis to subside after successful treatment as hypersensitivity persists - this can be treated with oral antihistamines

191
Q

what is pediculosis capitis

192
Q

summarise glasgow coma scale

193
Q

what is the difference between general and focal seizures

A

general - abnormal electrical activity originates from both hemispheres

focal - abnormal electrical activity originates from one hemisphere

194
Q

features of tonic clonic seizures and are they generalised or not

A
  • tonic phase
  • clonic phase
  • loss of consciousness
  • postictal drowsiness

can be febrile seizures

they are generalised

195
Q

features of absence seizures and are they generalised or focal

A

brief unawareness lasting a few seconds

no loss of posture

immediate recovery

may be very frequent

associated with automatisms - blinking and lip smacking

196
Q

what is the peak age of onset of childhood absence epilepsy

A

peak onset 6-7 years

197
Q

describe childhood absence epilepsy

A

absence seizures typically lasting 5-15 seconds but there may be up to several 100 a day

episodes induced by hyperventilation

198
Q

what do you see on an EEG in childhood absence epilepsy

A

generalised bilaterally synchronous three per second spike wave discharges

199
Q

what is the management and prognosis of childhood absence epilepsy

A

prognosis is good with spontaneous remission in adolescence

sodium valproate and ethosuximide are first line but medication is not required for infrequent absences

200
Q

what is another name for infantile spasms

A

west syndrome

201
Q

what is the peak onset of west syndrome

A

4-6 months

202
Q

describe the seizures in west syndrome

A

sudden flexor spasms of the head, trunk and limbs

followed by abduction and adduction of the limbs

remember that this will be happening in a baby under 6 months age

203
Q

what will the EEG show in west syndrome?

A

hysparrhythmia

204
Q

what is the management and prognosis of west syndrome

A

prognosis poor

seizures often intractable

often learning difficulties

treatment is with adrenocorticotrophic hormone or vigabatrin

205
Q

what age do febrile convulsions occur

A

6 months to 6 years of age

206
Q

what is the most common cause of seizures in childood

A

febrile convulsions

207
Q

what are the clinical features of febrile convulsions

A

1-2 minutes typically

generalised, tonic clonic

208
Q

what three things would make a febrile convulsion ‘complex’ rather than ‘simple’

A
  • any three of the following make it complex:
    • longer than 15 minutes
    • focal
    • recurring within 24hrs
209
Q

management of febrile convulsions

A

identification and treatment of underlying infection

regular anti-pyretics

prolonged convulsions treated as per status

210
Q

prognosis following febrile convulsion

A
  • in simple prognosis is good
  • child may have another febrile convulsion in their life but generally grow out of this by 6
  • slightly higher risk of developing epilepsy than the rest of the population
    • even more so if it was a complex seizure
211
Q

what is the insulin dose when managing DKA in children

A

0.1 units/kh/hr

212
Q

what is the treatment of kawasakis

A

IV Ig and high dose PO aspirin

213
Q

causative organism in osteomyelitis in children

A

staph aureus

214
Q

what is the management of oteomyelitis

A

IV cefuroxime or IV flucloxacillin

6 weeks of treatment - switch to PO once improving

215
Q

OGTT result in a) diabetes b) impaired glucose tolerance

A

diabetes: >11.1mmol/l

impaired glucose tolerance: 7.8-11mmol/l

216
Q

criteria for diagnosis of JIA

A

more than 6 weeks of pain and stiffness in a joint with no other cause found and they are under 16 years of age

217
Q

what is CAH

A

AR disease - most common cause of insufficient cortisol and mineralocorticoid secretion

218
Q

why do you give aspirin to children with kawasakis

A

they have high platelets - thrombocytosis - so they are at risk of thrombosis

219
Q

management of pneumonia

A

IB ben pen if acutely unwell

PO amoxicillin if stable

220
Q

fasting plasma glucose in a) diabetes b) impaired glucose tolerance c)euglycaemia

A
  • a) diabetes >7mmol/l
  • b) impaired glucose tolerance: 5.7-7mmol/l
  • c) euglycaemia 3.5-5.6mmol/l
221
Q

characteristic electrolyte finding in congenital adrenal hyperplasia

A

salt losing adrenal crisis

hyponatraemic hyperkalaemic metabolic acidosis

no aldosterone so losing salt and retaining potassium

222
Q

name a condition of hypogonadotropic hypogonadism with total anosmia

A

kallman syndrome

223
Q

what is the cause of kallman syndrome

A

failure in the correct production or activity of gonadotropin-releasing hormone by the hypothalamus. This results in low levels of the sex hormones testosterone in males or oestrogen and progesterone in females.

224
Q

glood goes through what to reach the baby from the placenta

blood goes through what to reach the placenta from baby

A

placenta –> umbilical vein –> baby

baby –> umbilical artery –> placenta

225
Q

what are the bacterial prophylaxis drugs

A

rifampicin

ciprofloxacin

226
Q

treatment for ESBL e.coli

227
Q

treatment of precocious puberty

A

GnRH superagonists suppress the pulsatility of GnRH action

228
Q

HbA1c in a) diabetes b) impaired glucose tolerance c) euglycaemia

A
  • diabetes: >6.5%
  • impaired glucose tolerance 5.7-6.4%
  • euglycaemia 4-5.6%
229
Q

biochemical diagnosis of CAH

A
  • raised lecvels of 17-alpha-hydroxy-progesterone
  • biochemical abnormalities:
    • hyponatraemic hyperkalaemic metabolic acidosis with hypoglycaemia
230
Q

how do you treat mycoplasma pneumoniae pneumonia

A

erythromycin

clindamycin

231
Q

managmenet of conductive hearing loss

A

wait - it normally goes away

grommett insertion

232
Q

what do you see in the bloods of kawasaki

A

high: crp, esr, wcc and platelets

233
Q

croup treatment

A

beclamethasone

234
Q

what mode of inheritance is osteogenesis imperfecta

235
Q

where is the defect in osteogenesis imperfecta

A

in the genes for type 1 collagen

236
Q

two genes involved in type 1 diabetes

A

HLADR3

HLADR4

237
Q

what is the inheritance pattern for spherocytosis

A

autosomal dominant

238
Q

treatment for UTI in children

A

IV cefuroxime

PO trimethoprim if stable

239
Q

when is the brainstem myelinated and what can this do to prems

A

32/34 weeks gestation

can cause apnoea of prematurity

240
Q

treatment for apnoea of prematurity

A

nasal cpap

caffeine to stimulate

241
Q

acute otitis media organisms

A

s. pneumoniae
h. influenzae

242
Q

meningitis organisms by age and antibiotic therapy

243
Q

why are prem babies at greater risk of infection

A

IgG transfer happens in the last 3 months of pregnancy

244
Q

what syndrome is associated with biliary atresia

A

down’s syndrome

245
Q

what is first line treatment for retinoblastoma

A

laser therapy

246
Q

what chromosomw is the rb1 gene on

247
Q

first line for focal seizures

A

carbamazepine

248
Q

criteria for tonsillectomy

A

>7 episodes of acute tonsilitis in a year

OSA or sleep deprived breathing

249
Q

common causes of diarrhoea

A

adenovirus

rotavirus

giardia

250
Q

what test for lactose intollerance

A

hydrogen breath test

251
Q

what is lactose hydrolysed into

A

glucose and galactose

252
Q

skin change from coeliac

A

dermatitis herpeteformis

253
Q

treatment of giardiasis

A

three days high dose metronidazole

254
Q

analgesia for paediatric fracture

A

paracetamol

oromorph

255
Q

coeliac HLA

A

DQ2 and DQ8.

256
Q

what is hypospadias

A

When the urethral opening is on the under side of the penis.

257
Q

which abx to reduce risk of neonatal infections in a pre-term baby

A

Benzylpenicillin (50mg/kg BD).
Gentamicin (5mg/Kg OD).

258
Q

when can you start feeding a prem baby

A

35 weeks - this is when suckling reflex develops

259
Q

medication for general seizures

A

Ethosuxamide or Sodium Valporate.

260
Q

ethosuxamide side effects

A

rash

nausea

d&v

261
Q

sodium valproate side effects

A

weight gain

hair loss

teratogenic

262
Q

what can absence seizures evolve into

263
Q

signs of JME

A

Clumsiness and GTCS that occur shortly after waking and are often provoked by sleep deprivation.

264
Q

demographics of students affected by ADHD

A

4 - 7 % of school age children

Male : Female = 4:1

265
Q

name an ADHD med

A

methylphenidate - it’s a stimulant

Phase 3a (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions