Paeds confusing stuff Flashcards
What are the school exclusion rules for chicken pox?
At least 5 days from onset of rash
OR
Until all lesions have crusted over
What are the school exclusion rules for hand, foot + mouth / coxsackie?
None
What are the school exclusion rules for measles?
4 days from onset of rash (and if well enough)
What are the school exclusion rules for mumps?
5 days from onset of swelling
What are the school exclusion rules for rubella?
5 days from onset of rash
What are the school exclusion rules for scabies?
After 1st treatment
What are the school exclusion rules for scarlet fever?
24h after starting antibiotics
OR
Until resolution of symptoms if not taking abx
What are the school exclusion rules for parvovirus B19?
None
What are the school exclusion rules for TB?
At least 2 weeks after effective abx treatment has started (none needed for latent or non-pulmonary TB)
What are the school exclusion rules for whooping cough?
2 days after starting abx
OR
21 days after onset of symptoms
How does pyloric stenosis typically present and how can it be managed?
-Non-bilious, projectile vomiting increasing in intensity
-Dehydration and weight loss
MANAGEMENT
-Hydration and pyloromyotomy
How does mesenteric adenitis typically present and how can it be managed?
-Viral symptoms
-May mimic appendicitis but no guarding or peritonism
MANAGEMENT
-Observation to rule out appendicitis
-Simple analgesia
How does intussusception typically present and how can it be managed?
-Knees to chest, colic pain
-Red currant jelly stools
MANAGEMENT
-USS (target sign)
-Air insufflation OR laparotomy if shocked / perforated
How does biliary atresia typically present and how can it be managed?
-Persistent jaundice, clay-coloured stools
MANAGEMENT
-Kasai procedure
How does Hirschsprung’s disease typically present and how can it be managed?
-Constipation, delayed passage of meconium
-Abdominal distension
MANAGEMENT
-Diagnosed on rectal biopsy (absence of ganglion cells)
-Pull-through procedure
How does malrotation (with volvulus) typically present and how can it be managed?
-Bilious vomiting
-Crying, knees drain to chest
-Abdominal distension
MANAGEMENT
-Upper-GI contrast study –> corkscrew appearance
-Ladd’s procedure
How does NEC typically present and how can it be managed?
-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
What is considered a red flag by NICE in terms of Activity?
- No response to social cues
- Appears unwell to a HCP
- Does not wake / remain awake if roused
- Weak, high-pitched or continuous cry
What is considered a red flag by NICE in terms of Breathing?
- Grunting
- RR >60
- Moderate/severe chest indrawing / recession
What is considered a red flag by NICE in terms of Circulation?
- Reduced skin turgor
What is considered a red flag by NICE in terms of Colour + Other?
- Pale / mottled / ashen colour
- Aged <3 months + temperature >38
- Non-blanching rash
- Neck stiffness
- Status epilepticus
- Focal neurological signs / seizures
What are the school exclusion rules for impetigo?
Until all lesions are crusted and healed
OR
48h after starting treatment
How is a focal seizure defined?
-Originates within a network limited to one cerebral hemisphere
-Most commonly frontal and temporal lobes
How is a generalised seizure defined?
-Originates within / rapidly engages bilaterally distributed networks with loss of consciousness
-Eg include tonic-clonic, myoclonic, absence
