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Medicine > Paeds (ENT, Derm, MSK, Rheum) > Flashcards

Paeds (ENT, Derm, MSK, Rheum) Flashcards

1
Q

Tonsillitis Cause + Sx

A

S. Pyogenes =>

Fever
Sore throat
Diff swallowing/talking
Drooling
SOB
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2
Q

Tonsillitis Scoring

A

CENTOR Criteria

Abence of Cough
Tender, Cerv LN’s
White Exudate on Tonsils
Temp > 38

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3
Q

Tonsillitis Mx

A

Analgesia, Rest, Fluids
Delay ABx (Likely Viral)
If Bact confirmed: (CENTOR > 3): PO Phenoxybenzylpenicillin V (10 days)

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4
Q

Tonsillectomy Indications

A

Recurrent Tonsillitis (> 7/yr in 1yr, > 5/yr in 2yrs, > 3/yr in 3yrs)
Recurrent Tonsillar episodes
Enlarged Tonsils => Diff breathing/swallowing/sleeping (snoring)

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5
Q

Scarlet Fever Cause + Sx

A

(Group A, beta-Haem S. Pyogenes):

Fever
Sore Throat (Tonsillitis)
Bright Red, Itchy rash over Face + Body (1wk) (+/- Strawberry Tongue)

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6
Q

Scarlet Fever Mx

A

Rest, Fluids, Analgesia
Abx: Penicillin (Can return to school 24hrs after starting Abx)
Anti-Histamine

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7
Q

Hearing loss (< 3yo) Ix:
SN
CN
Mixed

A

(Chlidren < 3yo): Audiometry
Basic Resp to Sound (w/ results plotted on Audiogram)

SN loss:
Reduced AC + BC (=> AC > BC)

CN loss:
Reduced AC w/ Normal BC (=> BC > AC)

Mixed:
Reduced AC + BC w/ difference btw AC + BC > 15dB (AC > BC)

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8
Q

Cleft Lip/Palate Mx

A

Cleft Lip:
Surg at 3mo

Cleft Palate:
Surg at 6-12mo

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9
Q 
Viral Examthemas:
Chickenpox
Measles
Scarlet Fever
Rubella
Slapped Cheek D
A

Chickenpox (VZV):
Red, Painful, Itchy Vesicles

Measles:
Flat, Red, widespread (w/ Koplik spots - White, Inside of mouth)

Scarlet Fever (S. Pyogenes):
Flushed cheeks, Strawberry tongue, Red, Rough vesicles (Sandpaper)

Rubella:
Mild, Erythematous rash

Slapped Cheek D (Parvovirus B19):
Diffuse, Bright red rash on cheeks,
Raised, Reticular (net-like), Itchy rash

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10
Q

Roseola Infantum Patho + Sx

A

Human Herpes V 6/7 =>

Sudden, High-fever (+/- Febrile Convulsions)
Mild, Erythematous, Non-Itchy rash

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11
Q

Hand, Foot + Mouth D Sx + Warning

A

Red Blistering spots on Hands/Feet
Small, painful mouth Ulcers

Avoid close-contacts (Highly Contagious)

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12
Q

Impetigo Patho + Sx

A

Highly contagious Superficial Bact Inf

=> Bullous: Large, Flaccid Bullae/Blisters => Burst leaving Crusty, Golden Patches (Systemic Sx)
=> Non-Bullous (No Systemic Sx)

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13
Q

Impetigo Mx

A

Self-isolate (Until lesions healed)

Non-bullous:
Antiseptic cream, Top Fusidic Acid
PO Flucloxacillin

Bullous:
PO/IV Flucloxacillin

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14
Q

Pityriasis Rosea Features

A 
Herald patch (Circle/Oval) =>
Red, Itchy rash (Christmas tree distribution)
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15
Q

Scabies Sx + Mx

A

Sx:
Extreme Itching (esp at night)
Burrows along palm/soles
Close contact

Mx:
Permethrin cream
PO Ivermectin

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16
Q

Salter-Harris #’s Classification

A
  1. Straight Across
  2. Above
  3. Below
  4. Through Everything
  5. Crush
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17
Q

Limp Referral Criteria - 9

A 
Child < 3yo 
Duration > 6 months
Child > 9yo w/ restricted/painful Hip 
Unable to weight-bear
Severe Pain/Agitation 
Neurovascular compromise 
Red Flags (Fever, Fatigue, Weight loss, Night Sweats, Inflamm or Persistent Pain) 
Suspicion of Abuse
Deformity
18
Q

DDH Patho + Sx

A

Abnormal development of Fetal (Hip) bones in Preg => Instability (+/- Subluxation/Dislocation)

Asymmetry (Hips, Leg length, Knee Height, Skin folds, Movements), 
Restricted Hip Abduct, 
Clicking (No USS needed), 
Clunking (USS needed) 
(+) Ortolani: Ant dislocation
(+) Barlow: Post dislocation
19
Q

DDH Ix + Mx

A

USS,
(If > 6mo: X-ray)

Mx:
Pavlik Harness 6-8wks (Holds Fem head in Acetabulum w/ Hips Flex + Abd)
If > 6mo or Harness failed: Surg w/ Hip spica cast

20
Q

Transient Synovitis Patho + Sx

A

(3-10yo)
Temp Inflamm of synovium of Hip (Recent viral URTI) =>

Limp,
Groin/Hip Pain,
Refusal to weight-bear,
Mild low-grade Fever

21
Q

Transient Synovitis Ix + Mx

A

Joint Asp (Excl SA, If purulent: Tx as Sepsis)

Mx:
Analgesia + f/up w/in 48hrs,
Self-resolve w/in 1wk),
(If < 3yo: Admit, If > 3yo: Safetynet

22
Q

Perthes D Patho + Sx

A

(5-10yo): AVN of Fem Head => Deformity +/- Early OA:

Slow Onset Hip Pain (+/- Referred Pain to Groin/Knee)
w/ no Hx of Trauma
Limp, Restricted movement

23
Q

Perthes D Ix

A

X-ray (AVN of Fem head +/- Normal bone),
CRP/ESR (Excl SA, JIA),
Technetium Bone scan

24
Q

Perthes D Mx

A 
Maintain healthy position (Bed rest, Traction, Crutches) 
PT (Reduce stress on Bone/Joint, maintain ROM) 
Reg Xrays (Assess healing) 
(If Severe/Non-healing/Older: Surg)
25
Q

SUFE Eped, Patho, Sx

A

(Obese Male Adolescents undergoing growth spurt):
Fem head displaced from growth plate (Minor trauma) =>

Disproportionate Pain (+/- Limp) 
Restricted movement of Hip + Knee

O/E:
Hip held in Ext Rotat (Restricted Int Rotat)

26
Q

SUFE Ix + Mx

A

X-ray (SUFE),
CRP/ESR (Excl SA/JIA)

Mx:
Surg (Reduce + Fixate Fem head)

27
Q

Osteosarcoma Patho + Sx

A

(10-20yo, Cancer of Long Bones):

Persistent Bone Pain (esp at night => Waking)
Bone swelling (Palpable mass)
Reduced ROM

28
Q

Osteosarcoma Ix

A

Persistent Bone Pain/Swelling =>
Urgent X-ray w/in 48hrs:
Poorly-defined lesions
Fluffy appearance (Cortical destruction)
Sunburst (Periosteal React: Irritation of Periosteum)
(Raised ALP)

29
Q

Osteosarcoma Mx

A

(If X-ray (+): Urgent referral w/in 48hrs)
Surg resection (+/- Limb Amputation)
+/- Adj ChemoTx

30
Q

Osteopenia vs
Osteomalacia vs
Osteoporosis

A

Osteopenia: Reduced Bone mass (Radiolucent on Xray)

Osteomalacia: Reduced Bone minerals w/ normal matrix

Osteoporosis: Reduced Bone matrix w/ (normal) minerals (=> Reduced Bone Mass)
(Minerals can only bind to matrix that is there)

31
Q

Osgood-schlatters D Eped + Patho

A

(Adolescent males playing Sports):

Repeated stress + tension of patella tendon at tibial tuberosity whilst growing =>
Multiple small Avulsion #’s
Growth + Inflamm of Tibial tuberosity => Hard, painful Lump

32
Q

Osgood-schlatters D Sx

A

Gradual Hx of (Visible/Palpable) Hard, Tender lump at Tibial tuberosity
Ant Knee Pain (Exacerbated by Activity, Kneeling, Ext of Knee)

33
Q

Osgood-schlatters D Mx

A

Rest, Ice, Cool Compression, Elevation
NSAIDs,
(Stretching + PT),
If Full Avulsion #: Surg

34
Q

JIA Criteria

A

Auto-Immune Inflamm in Joints > 6wks

< 16yo

All other causes Excl (SA)

35
Q

HSP Patho + Sx

A

Henoch-Schönlein Purpura: (IgA Vasculitis triggered by URTI/Gastroenteritis) =>

Palpable purpura (Buttocks/LL -> Trunk + Arms) 
Diffuse Abdo Pain (GI Haem, Infarct, Intussusception)
Arthritis/Arthralgia (Knee/Ankle) 
IgA deposits (=> Haematuria/Proteinuria +/- Nephrotic Synd)
36
Q

Kawasaki D Patho + Sx

A

(Med V Vasculitis in Boys < 5yo)

Persistant High Fever > 5 days,
Rash,
Lymphadenopathy
Widespread Erythroderma (w/ peeling on soles of feet/hands)
(+/- Strawberry Tongue, Bilat conjunctivitis, Arthralgia)

37
Q

Kawasaki D Ix

A 
FBC (Anaemia, Raised WBC’s/Plt’s), 
Raised CRP/ESR, 
LFTs (Raised ALT/AST, Low Alb), 
Urinalysis (Raised WBC’s w/out Inf), 
Echo (Coronary A Aneurysm)
38
Q

Kawasaki D Mx

A

High-dose Aspirin (Reduce risk of VTE),
IVIg (Reduce risk of Coronary A Aneurysm),
Reg Echo monitoring

39
Q

Rheumatic Fever Patho + Sx

A

(Type 2 Hypersensitivity React 2-4wks Post-strep Tonsillitis) =>

Fever
SOB
Rash (Pink rings on torso)
Chorea
Migratory Arthritis (affects Large Joints)
Firm, Painless Nodules over Ext Surfaces
Carditis (+/- Mitral Valve D)
40
Q

Rheumatic Fever Ix + Scoring

A 
ASO titres
Jones Criteria (2 Maj, 1 Maj + 2 Min)
41
Q

Rheumatic Fever Mx + Monitoring

A

NSAIDs,
Aspirin + Steroids (Tx Carditis),
Prophylactic Abx (Prevent recurrence)

Monitor for:
(Rheum Fever),
Valvular HD (Mitral Stenosis), Chronic HF

Medicine (13 decks)

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