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Year 4 (Specialties) > Paeds general > Flashcards

Paeds general Flashcards

1
Q

Tetralogy of Fallot

  • Presentation
  • Auscultation findings
A

Presents 1-2 months of life.

Auscultation: ejection systolic murmur at the left sternal border secondary to pulmonary stenosis.

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2
Q

Transposition of the great arteries (TGA)

A

Loud S2
Cyanosis within first 24 hours of life
Common in infants of diabetic mothers

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3
Q

Henoch schonlein purpura

A
  • small vessel vasculitis
  • Triad of purpura, abdominal pain, arthritis (check urine dip for haematuria/proteinuria)
  • Supportive Mx
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4
Q

DKA

A
  • hyperglycaemia, acidosis and ketonaemia

- presents with drowsiness, abdominal pain, nausea

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5
Q

Name some dysmorphic features of Down syndrome

A

Upward slant of the eyes
Prominent epicanthic folds
Flat nasal bridge
Short neck

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6
Q

Features of Foetal alcohol syndrome

A 
Small palpebral fissures
Absent philtrum
Thin upper lip
Growth retardation
Developmental delay
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7
Q

Febrile seizures

A

Associated with fever >38.5 C
Reassure
Manage fever
Treat source of infection
Stop fit (buccal midazolam, rectal diazepam)
Increased risk of epilepsy only if prolonged fit, family history of epilepsy, onset <1 year, > 1 febrile seizure during an illness

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8
Q

DDx. chronic diarrhoea

A

Functional (Toddler diarrhoea)

Infectious (Gastroenteritis) - oral rehydration + ondansetron

IBS

Coeliac

IBD

CF

Others e.g HIV

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9
Q

DDx. bloody diarrhoea

A

Infectious colitis - Infectious salmonella/campylobacter

Allergic colitis – CMPI

Inflammatory bowel disease (usually > 2yo)

Meckel’s diverticulum

HUS

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10
Q

DDx constipation

A

Functional - dietary change, coercive potty training, emotional/behavioural factors

Organic
Hirshprungs disease
Metabolic - Ca2+++
Hypothyroidism
Neuro- developmental 
Anal stenosis
Anal fissure

Ask about ? Delayed meconium passage or ribbon
Early bowel habit

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11
Q

Mx of constipation

A

Laxatives

In children over 1 year of age with faecal impaction, an oral preparation containing a macrogol (movicol is a common brand name) is used to clear faecal mass
Osmotic (e.g. lactulose /Movicol)
Stimulant (senna/picolax/docusate) - If disimpaction does not occur after 2 weeks, a stimulant laxative should be added.

Clear out

Impaction regime
Enema’s / suppositories
Lavage (Klean-prep / Movicol)

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12
Q

Achondroplasia

A 
Disproportionate
-Short limbs
Autosomal dominant
FGFR3 mutation
Normal IQ
Respiratory & CNS complications
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13
Q

Turners Syndrome

A 
45 XO
Short Stature
Gonadal failure
Webbing of neck
Cubitus valgus
Coarctation of aorta
Horse shoe kidneys
Lymphedema
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14
Q

Young child presenting with drowsiness, abdominal pain, nausea

A

DKA

Cautious fluid replacement
Insulin infusion
Frequent obs
HDU if unwell 
Discuss with senior and diabetic team

Complications

  • Hypokalaemia - Consider temporarily stopping the insulin infusion
  • Cerebral oedema treat with mannitol or hypertonic sodium chloride
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15
Q

Enuresis

A 
Day-time
- delayed bladder maturity 
Increase drinks – usually ++!
Regular voiding / reminding
(Possible treatment Oxybutinin)

Nocturnal enuresis
Increase drinks but limit pre-bed
Lifting / alarms
(possible treatment Desmopressin)

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16
Q

Haemolytic uraemia syndrome (HUS)

A

Triad

  • microangiopathic hemolytic anemia/
  • thrombocytopenia
  • acute kidney injury

Complication of E.coli
This should be considered in any child coming with diarrhoea and developing pallor and jaundice

Ix

  • Stool specimens for culture
  • A full FBC
  • Blood film
  • Renal function with serum electrolytes
17
Q

Nephrotic syndrome - Triad of features

A

Proteinuria
Hypoalbuminaemia
Generalised oedema

18
Q

Emily is eleven. She presents to her GP with two days of dark, Coca-cola coloured urine. She has had a recent sore throat but is otherwise well.

A

Check urine dip, BP

Post strep GN

Penicillin 10 days

19
Q

Glomerulonephritis

A

Triad of:

Haematuria
Hypertension
Oedema

20
Q

Acute renal failure

A

Pre-renal

Dehydration / sepsis
Post op hypoperfusion
Ischaemia (eg perinatal asphyxia)
Renal

Drug toxicity
Haemolysis/ Myoglobinuria
Glomerulonephritis
Haemolytic Uraemic Syndrome
Acute on background of chronic impairment
Post-renal

Stones

21
Q

Ventricular septal defect

A
  • pan-systolic murmur

- failure to thrive

22
Q

Intussusception

A

< 2years
Features of bowel obstruction, pale, irritable, draws legs up, short hx of colicky abdo pain, RUQ mass

Blood stained redcurrent jelly

Ix

  • air contrast enema + abdo USS
  • PR
  • AXR

Mx

  • fluids, NG tube, referral to surgeons
  • reduction using air or barium enema
  • bowel resection
  • rectal air insufflation with fluoroscopy guidance
23
Q

Complications of minimal change disease [3]

A

increased risk of thrombosis e.g. DVT
Infections
Hypercholesteremia

24
Q

Neonatal resuscitation [9]

A
  1. Dry the baby
  2. Assess the tone, BR, HR
  3. If gasping or not breathing = give 5 rescue breaths
  4. Reassess
  5. If chest is not moving = consider 2-person airway control and repeat inflation breaths
  6. If chest is moving but HR is <60 bpm = ventilate for 30 seconds
  7. Reassess = if HR is <60 bpm = start chest compressions with ventilation breaths (3:1)
  8. Reassess every 30 seconds
  9. If HR remains <60 bpm = consider venous access and drugs (atropine)
25
Q

Necrotizing enterocolitis

A

Vomiting, feeding intolerance, abdominal distension.

Watery stools with specks of blood present within the nappy.

Abdo X-ray: gas cysts in the bowel wall

26
Q

Basic clotting screen

A

APTT, blood film, FBC, INR

27
Q

Haemophilia A

A

Elevated APTT, normal INR, bleeding time, FBC and platelet count

  • Haemarthrosis of the knee
28
Q

Perthes’ disease

A
  • avascular necrosis of the head of the femur
29
Q

Complications of haemophilia A

A
  • chronic arthropathy
  • compartment syndrome
  • haematuria
  • Hepatitis B

Year 4 (Specialties) (15 decks)

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