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Endocrinology > Paeds COPY > Flashcards

Paeds COPY Flashcards

1
Q

Koplik’s spots

A

Measles

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2
Q

Slapped cheeks

A

Fifth disease aka erythema infectiosum (Parvovirus B19)

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3
Q

Strawberry tongue

A

Scarlet fever + Kawasacki disease

Scarlet fever has an incubation period of 2-4 days and typically presents with:
fever
malaise
tonsillitis
‘strawberry’ tongue
rash - fine punctate erythema (‘pinhead’) which generally appears first on the torso and spares the face although children often have a flushed appearance with perioral pallor. The rash often has a rough ‘sandpaper’ texture. Desquamination occurs later in the course of the illness, particularly around the fingers and toes

Diagnostic features for Kawasaki disease requires a fever >5d with 4 of the following criteria: A) Conjunctival injection B) Mucous membrane changes (dry cracked lips, strawberry tongue) C) Cervical lymphadenopathy D) Polymorphous rash E) Red and oedematous palms/soles, peeling of fingers and toes.

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4
Q

Hypokalaemia, hypotension + alkalosis in a newborn

A

Bartter syndrome

Defect in the ascending limb of the loop of Henle

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5
Q

Most common cause of gastroenteritis in children

A

Rotavirus

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6
Q

1st line treatment for uncomplicated constipation

A

Movicol Paediatric Plain (Polyethylene glycol 3350 + electrolytes)

  • If movicol is not tolerated switch to osmotic laxative
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7
Q

Most common cause of nephrotic syndrome in children

A

Minimal change disease

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8
Q

1st sign of puberty in

  1. Boys
  2. Girls
A
  1. Testicular growth (around 12)

2. Breast development (then height spurt, then menarche)

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9
Q

Grey coating on tonsils + cervical lymphadenopathy in unvaccinated child

A

Diphtheria

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10
Q

Most common cause of croup

A

Parainfluenza

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11
Q

When is the Men B vaccine given? (All 3 dates)

A

2, 4, and 12-13 months

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12
Q

The only childhood congenital syndrome that presents with polydactyly (also with microcephaly, small eyes, clept lip)

A

Patau syndrome (3* 13)

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13
Q

Rocker bottom feet (+ low set ears and micrognathia)

A

Edwards (3* 18)

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14
Q

The only childhood congenital syndrome that presents with macrocephaly (+ macro-orchidism, learning difficulties, long face and large ears)

A

Fragile X

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15
Q

The only childhood congenital syndrome that presents with pectus excavatum (+ webbed neck, short stature + pulmonary stenosis)

A

Noonan Syndrome (aka the male Turners, however affects males and females equally)

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16
Q

The only childhood congenital syndrome that presents with posterior displacement of the tongue (+ micrognathia, cleft palate)

A

Pierre-Robin syndrome

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17
Q

The only childhood congenital syndrome that presents with friendly, extrovert personality (+ short stature, learning difficulties, transient neonatal hypercalcaemia, supravalvular aortic stenosis)

A

William’s syndrome

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18
Q

IM benzylpenicillin doses for suspected meningococcal septicaemia in the community at age…

A
  1. 300mg
  2. 600mg
  3. 1200mg

(always doubles)

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19
Q
  1. 1st line investigation for complications of Kawasaki’s

2. Management

A
  1. Echocardiogram (due to possible coronary artery aneurysms)
  2. High-dose aspirin (one of the very few indications for the use of aspirin in kids). + IV immunoglobulin
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20
Q

Definition of precocious puberty = ‘development of secondary sexual characteristics before the age of ‘____’

  1. Females
  2. Males
A
  1. 8 years

2. 9 years

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21
Q

What are the live attenuated vaccines? (3) + 2 less important ones

A

BCG
MMR
Oral polio

Yellow fever
Oral typhoid

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22
Q

Most common presentation of Wilms’ nephroblastoma

A

Abdominal mass

Also painless haematuria, flank pain, anorexia + fever.

Management - Nephrectomy + chemotherapy

Prognosis - Good, 80% cure rate

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23
Q

Most common complication of Roseola infantum?

A

Febrile Convulsions

Roseola infantum (also known as exanthem subitum, occasionally sixth disease) is a common disease of infancy caused by the human herpes virus 6 (HHV6). It has an incubation period of 5-15 days and typically affects children aged 6 months to 2 years.

Features
high fever: lasting a few days, followed by a
maculopapular rash
febrile convulsions occur in around 10-15%
diarrhoea and cough are also commonly seen

Other possible consequences of HHV6 infection
aseptic meningitis
hepatitis

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24
Q

A baby is born at 32 weeks gestation (i.e. 1 month early), what should happen regarding the normal first set of vaccines beginning at 2 months?

A

Give vaccines as per normal timetable (i.e. don’t account for premature)

25
Q

Most common cause of death in the first year of life?

A

SIDS

26
Q

Most common cause of Bronchiolitis

A

RSV (also mycoplasma, adenovirus)

27
Q

What are the 4 components of Tetralogy of Fallot?

*TOF generally presents at 1-2 months

A

ventricular septal defect (VSD)

right ventricular hypertrophy

right ventricular outflow tract obstruction, pulmonary stenosis

overriding aorta

28
Q

Most common cause of hypertension in children

A

Renal parenchymal disease

(+ renal vascular disease,
coarctation of the aorta,
phaeochromocytoma,
congenital adrenal hyperplasia)

29
Q

1st line management of minimal change glomerulonephritis?

A

Prednisolone

Good prognosis - full recovery however 80% will have recurrences

30
Q

Acyanotic congenital heart disease causes (5)

A

VSD - most common!

ASD

PDA

Coartation of aorta

aortic valve stenosis

31
Q

Cyanotic congenital heart disease causes (4)

A

Tetralogy of Fallot (most common)

Transposition of great arteries (TGA)

Tricuspid atresia

Pulmonary Valve Stenosis

32
Q

What is the most appropriate way to confirm a diagnosis of pertussis?

A

Nasal swab

Management - oral course of erythromycin to reduce spread. However does not alter course of illness

33
Q

What 5 criteria make up the APGAR score?

A

Pulse

Respiratory effort

Colour

Muscle tone

Reflex irritability

34
Q

Treatment for threadworms

A

Hygiene measures + single dose mebendazole for all the family

35
Q

1st line management for uncomplicated enuresis (bed wetting)

  1. Below the age of 5
  2. Below the age of 7
  3. Above the age of 7
A
  1. Reassure, bed wetting is common until age 5
  2. Enuresis alarm
  3. Desmopressin
36
Q

What is the causative agent of roseola infantum

A

HHV6

37
Q

When is the oral rotavirus vaccine given?

A

2 + 3 months

38
Q

1st line management of absence seizures

A

Sodium valproate + ethosuximide

(Good prognosis, 95% become seizure free in adolescence)

SE of Sodium valproate: Weight gain + hair loss

39
Q

Causative organism of hand, foot and mouth

A

Coxsackie A16 virus (occasionally enterovirus 71)

40
Q

Investigation to confirm DDH if clinically suspected

A

Ultrasound

41
Q

How long should a child with chickenpox be excluded from school?

A

Until 5 days after skin lesions have APPEARED

42
Q

Treatment for HSP

A

Analgesia for arthralgia

Treatment of nephropathy is generally supportive. There is inconsistent evidence for the use of steroids and immunosuppressants

43
Q

What is the investigation of choice to diagnose vesicoureteric reflux?

A

Micturating cystourethrogram

44
Q

Most appropriate initial investigation for suspected coeliac disease

A

IgA TTG antibodies

Coeliac
HLA-DQ2 association

Diagnosis:
jejunal biopsy showing subtotal villous atrophy

anti-endomysial and anti-gliadin antibodies are useful screening tests

45
Q

What birth weight = fetal macrosomia?

A

> 4kg

46
Q

Most common palsy due to shoulder dystocia?

A

Erb’s palsy

47
Q

Pink maculopapular rash, initially on face before spreading to the whole body

+ suboccipital and postauricular lymph nodes

A

Rubella

48
Q

Causative organism for Scarlet fever

A

Group A haemolytic streptococci

49
Q

What length of school exclusion is recommended for kids with head lice

A

None.

50
Q

At what age should a child be referred if they are not walking?

A

18 months

51
Q

‘Jittery’ newborn with absent philtrum + dysmorphic feathures

A

Fetal alcohol syndrome

52
Q

saddle-shaped nose

A

Fetal alcohol syndrome

53
Q

‘Onion skin-like’ appearance on X-ray

A

Ewing’s sarcoma

54
Q

Positive technetium-99m pertechnetate scan

A

Meckel’s diverticulum

55
Q

Anosmia + low LH / FSH / Testosterone in male adolescent

A

Kallman’s Syndrome

Kallman’s syndrome is a recognised cause of delayed puberty secondary to hypogonadotrophic hypogonadism. It is usually inherited as an X-linked recessive trait. Kallman’s syndrome is thought to be caused by failure of GnRH-secreting neurons to migrate to the hypothalamus.

The clue given in many questions is lack of smell (anosmia) in a boy with delayed puberty

Features
‘delayed puberty’
hypogonadism, cryptorchidism
anosmia
sex hormone levels are low
LH, FSH levels are inappropriately low/normal
patients are typically of normal or above average height

Cleft lip/palate and visual/hearing defects are also seen in some patients

56
Q

1st test to perform on a child who presents with jaundice after 14 days

A

Split Bilirubin. Need to rule out biliary atresia

57
Q

Management of UTI in…

  1. 3 months
A
  1. Admit and treat with IV antibiotics

2. 3 day course of oral antibiotics (usually trimethoprim)

58
Q

Cyanotic heart defect with no murmur

A

Transposition of the great vessels

Endocrinology (27 decks)

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