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Y4 Paeds CCs > Paeds confusing stuff > Flashcards

Paeds confusing stuff Flashcards

1
Q

What are the school exclusion rules for chicken pox?

A

At least 5 days from onset of rash
OR
Until all lesions have crusted over

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2
Q

What are the school exclusion rules for hand, foot + mouth / coxsackie?

A

None

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3
Q

What are the school exclusion rules for measles?

A

4 days from onset of rash (and if well enough)

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4
Q

What are the school exclusion rules for mumps?

A

5 days from onset of swelling

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5
Q

What are the school exclusion rules for rubella?

A

5 days from onset of rash

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6
Q

What are the school exclusion rules for scabies?

A

After 1st treatment

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7
Q

What are the school exclusion rules for scarlet fever?

A

24h after starting antibiotics
OR
Until resolution of symptoms if not taking abx

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8
Q

What are the school exclusion rules for parvovirus B19?

A

None

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9
Q

What are the school exclusion rules for TB?

A

At least 2 weeks after effective abx treatment has started (none needed for latent or non-pulmonary TB)

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10
Q

What are the school exclusion rules for whooping cough?

A

2 days after starting abx
OR
21 days after onset of symptoms

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11
Q

How does pyloric stenosis typically present and how can it be managed?

A

-Non-bilious, projectile vomiting increasing in intensity
-Dehydration and weight loss
MANAGEMENT
-Hydration and pyloromyotomy

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12
Q

How does mesenteric adenitis typically present and how can it be managed?

A

-Viral symptoms
-May mimic appendicitis but no guarding or peritonism
MANAGEMENT
-Observation to rule out appendicitis
-Simple analgesia

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13
Q

How does intussusception typically present and how can it be managed?

A

-Knees to chest, colic pain
-Red currant jelly stools
MANAGEMENT
-USS (target sign)
-Air insufflation OR laparotomy if shocked / perforated

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14
Q

How does biliary atresia typically present and how can it be managed?

A

-Persistent jaundice, clay-coloured stools
MANAGEMENT
-Kasai procedure

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15
Q

How does Hirschsprung’s disease typically present and how can it be managed?

A

-Constipation, delayed passage of meconium
-Abdominal distension
MANAGEMENT
-Diagnosed on rectal biopsy (absence of ganglion cells)
-Pull-through procedure

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16
Q

How does malrotation (with volvulus) typically present and how can it be managed?

A

-Bilious vomiting
-Crying, knees drain to chest
-Abdominal distension
MANAGEMENT
-Upper-GI contrast study –> corkscrew appearance
-Ladd’s procedure

17
Q

How does NEC typically present and how can it be managed?

A

-Bilious vomiting, abdominal distension
-RFx include prematurity, asphyxia, maternal drug abuse
MANAGEMENT
-AXR –> air under diaphragm + pneumatosis intestinalis
-Bowel rest so feed by IV fluids + abx

18
Q

What is considered a red flag by NICE in terms of Activity?

A
  1. No response to social cues
  2. Appears unwell to a HCP
  3. Does not wake / remain awake if roused
  4. Weak, high-pitched or continuous cry
19
Q

What is considered a red flag by NICE in terms of Breathing?

A
  1. Grunting
  2. RR >60
  3. Moderate/severe chest indrawing / recession
20
Q

What is considered a red flag by NICE in terms of Circulation?

A
  1. Reduced skin turgor
21
Q

What is considered a red flag by NICE in terms of Colour + Other?

A
  1. Pale / mottled / ashen colour
  2. Aged <3 months + temperature >38
  3. Non-blanching rash
  4. Neck stiffness
  5. Status epilepticus
  6. Focal neurological signs / seizures
22
Q

What are the school exclusion rules for impetigo?

A

Until all lesions are crusted and healed
OR
48h after starting treatment

23
Q

How is a focal seizure defined?

A

-Originates within a network limited to one cerebral hemisphere
-Most commonly frontal and temporal lobes

24
Q

How is a generalised seizure defined?

A

-Originates within / rapidly engages bilaterally distributed networks with loss of consciousness
-Eg include tonic-clonic, myoclonic, absence

25
Q

What 3 features are used to diagnose childhood epilepsy syndromes?

A

-Specific age of onset
-Specific type of seizure
-Specific findings on EEG

26
Q

How is status epilepticus / prolonged seizures managed after trial of Benzos?

A

-After 2x doses of Benzos and no response
-Give levetiracetam (given over 5 mins)
-If no response, call anaesthetist and plan for rapid sequence induction
-Can give phenytoin whilst awaiting

27
Q

When do febrile convulsions most commonly occur?

A

-Between ages 6 months - 6 years
-Often a family history present

28
Q

What characteristics differentiate between a complex and simple febrile convulsion?

A

COMPLEX
->15 mins
-Recurrence within the same illness
-Focal seizure / focal neurological deficits present

29
Q

What features does childhood absence epilepsy syndrome have?

A

-Onset around 3-12 years
-Frequent absence episodes lasting 5-20 seconds
-Some associated automatisms eg eyelid flickering
-Otherwise normal, often a FHx
-Resolve without treatment by adolescence
-Carbamazepine increases frequency

30
Q

What features does juvenile myoclonic epilepsy have?

A

-Onset around 8-26 years, more common in girls
-Tonic-clonic seizures, provoked by sleep deprivation, alcohol, flashing lights
-Can have absence seizures, early morning myoclonic jerks of upper limbs
-Can be well-controlled with anti-epileptics

31
Q

What features does benign rolandic epilepsy have?

A

-Onset around 2-12 years
-Nocturnal, benign seizures involving paraesthesia of the face with ipsilateral facial motor seizure
-No LOC but unable to speak, often salivation
-Last around 1-2 mins
-Usually self-resolving

32
Q

What features does West syndrome have?

A

-Triad of:
1. Infantile spasm
2. Developmental delay
3. Typical EEG pattern (high amplitude, chaotic spike wave patterns)
-Poor prognosis, 5% mortality
-Developmental delay and persistent seizures, spasms helped by vigabatrin, steroids, ACTH

Y4 Paeds CCs (25 decks)

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