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C TO REVISE - PHASE 3A > PAEDS - INFECTION/ALLERGY, MSK/DERM AND EXTRA CONDITIONS > Flashcards

PAEDS - INFECTION/ALLERGY, MSK/DERM AND EXTRA CONDITIONS Flashcards

1
Q

MENINGITIS
What are the most common causes of bacterial meningitis?

A
  • Neonates = GBS or listeria monocytogenes
  • 1m–6y = N. meningitidis (gram -ve diplococci), S. pneumoniae (gram + ve cocci chain), H. influenzae
  • > 6y = meningococcus + pneumococcus, rarely TB
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2
Q

MENINGITIS
What is the difference between Kernig’s and Brudzinski signs?

A
  • Kernig = pain/unable to extend leg at knee when it’s bent
  • Brudzinski = involuntary flexion of hips/knees when neck flexed
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3
Q

MENINGITIS
What are some complications of meningitis?

A
  • Hearing (sensorineural) loss is key complication
  • Seizures + epilepsy, cerebral abscess, encephalitis + hydrocephalus
  • Cognitive impairment, cerebral palsy + LD
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4
Q

MENINGITIS
What is the management of bacterial meningitis?

A
  • Supportive = correct shock with fluids, oxygen if needed
  • <3m = IV cefotaxime + amoxicillin (cover listeria from ?pregnancy)
  • > 3m = IV ceftriaxone + IV dexamethasone to reduce frequency + severity of hearing loss + neuro damage (NOT before 3m)
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5
Q

SEPTICAEMIA
What are the causes of septicaemia?

A
  • Most common = N. meningitidis
  • Neonates = GBS or gram -ve organisms from birth canal
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6
Q

MEASLES
What is measles?

A
  • Infection with measles virus (Morbillivirus) via droplets (highly contagious)
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7
Q

RUBELLA
What is the clinical presentation of rubella?

A
  • Mild prodrome (low-grade fever, sore throat, coryza)
  • Pink maculopapular rash starts on face then spreads down to cover whole body
  • Rash not itchy in children but is in adults
  • Suboccipital + postauricular lymphadenopathy
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8
Q

RUBELLA
What are some complications of rubella?
How can it be reduced?

A
  • Rare but > encephalitis, arthritis, myocarditis + thrombocytopenia
  • Congenital rubella syndrome > cataracts, CHD + sensorineural deafness
  • Avoid pregnant women, school exclusion 4d from rash, ensure vaccinated
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9
Q

MUMPS
What is mumps?
How does it occur?

A
  • RNA paramyxovirus, occurs in winter + spring, spreads via resp droplets where virus replicates in epithelial cells
  • Virus accesses parotid glands before further dissemination
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10
Q

MUMPS
What are some complications of mumps?

A
  • Viral meningitis + encephalitis
  • Orchitis (usually unilateral, may reduce sperm count + lead to infertility)
  • Pancreatitis
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11
Q

SLAPPED CHEEK
What are some complications of slapped cheek syndrome?

A
  • Aplastic crisis (most serious) more common in chronic haemolytic anaemias like sickle cell, thalassaemia + in immunocompromised
  • Vertical transmission can lead to foetal hydrops + death due to severe anaemia
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12
Q

TOXIC SHOCK SYNDROME
Give some examples of multi-organ dysfunction in toxic shock syndrome

A
  • GI = D+V
  • CNS = confusion
  • Thrombocytopenia
  • Renal failure
  • Hepatitis
  • Clotting abnormalities
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13
Q

HIV
When should HIV be suspected?

A
  • Persistent lymphadenopathy
  • Hepatosplenomegaly
  • Recurrent fever
  • Parotitis
  • Serious, persistent, unusual, recurrent (SPUR) infections
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14
Q

HIV
How should HIV be managed?

A
  • Antiretrovirals based on viral load + CD4 count
  • Co-trimoxazole prophylaxis (PCP)
  • ?Additional vaccines but not BCG as live
  • Regular follow up, check development, psychological support
  • Safe sex education when older
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15
Q

TUBERCULOSIS
What is the pathophysiology of tuberculosis (TB)?

A
  • Lung lesion + (mediastinal) lymph nodes = Ghon or primary complex
  • Primary infection > caseating granulomas followed by period of dormancy with ?reactivation (secondary TB)
  • If immune system unable to cope it disseminates > miliary TB
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16
Q

VACCINATIONS
What vaccines are attenuated?

A
  • MMR, BCG, nasal flu, rotavirus + Men B
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17
Q

ALLERGY
What is an allergy?
Give examples

A
  • Hypersensitivity reaction initiated by specific immunoglobulins
  • Food allergy, eczema, allergic rhinitis, asthma, urticaria, insect sting, drugs, latex + anaphylaxis
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18
Q

ALLERGY
Define hypersensitivity

A

Objectively reproducible symptoms/signs following a defined stimulus at a dose tolerated by a normal person

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19
Q

ALLERGY
Give an example of a type 1hypersensitivity reaction

A
  • acute anaphylaxis,
  • hayfever
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20
Q

ALLERGIC RHINITIS
What are the different types of antihistamines that can be taken for allergic rhinitis?

A
  • Non-sedating = cetirizine, loratadine
  • Sedating = chlorphenamine (Piriton) + promethazine
  • Nasal may be good option for rapid onset Sx in response to trigger
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21
Q

ANAPHYLAXIS
What investigation confirms anaphylaxis?

A
  • Serum mast cell tryptase within 6h of event = mast cell degranulation
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22
Q

IMMUNE DEFICIENCY
What are the 6 types of immune deficiency?

A
  • T-cell defects
  • B-cell defects
  • Combined B- + T-cell defects
  • Neutrophil defect
  • Leucocyte function defect
  • Complement defects
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23
Q

IMMUNE DEFICIENCY
What are some investigations for immune deficiency?

A
  • FBC (WCC, lymphocytes, neutrophils)
  • Blood film
  • Complement
  • Immunoglobulins
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24
Q

IMMUNE DEFICIENCY
What prophylaxis should be given in immune deficiency?

A
  • T-cell + neutrophil = co-trimoxazole for PCP, fluconazole for fungal
  • B-cell = azithromycin for recurrent bacterial infections
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25
IMMUNE DEFICIENCY What is the management of immune deficiency?
- Prompt, appropriate + longer Abx courses - Screen for end-organ disease (CT scan) - Ig replacement therapy if antibody deficient - Bone marrow transplantation for SCID, chronic granulomatous disease
26
WHOOPING COUGH What are some complications of pertussis?
- Pneumonia - Convulsions - Bronchiectasis
27
POLIO what is the pathophysiology?
- transmitted via faecal-oral route - incubation period is 3-30 days + can be excreted for up to 6 weeks - replicates in nasopharynx + GI tract and can spread to CNS where it can affect anterior horn cells, motor neurons and the brainstem
28
POLIO what is the clinical presentation?
90-95% of cases are asymptomatic fatigue fever nausea and vomiting diarrhoea sore throat headache photophobia
29
POLIO what are the clinical features of a more serious polio infection?
acute flaccid paralysis (AFP) - initially fatigue, fever N+V - asymmetrical lower limb weakness and flaccidity can progress to life-threatening bulbar paralysis and respiratory compromise
30
POLIO what are the investigations?
- virus culture from stool, CSF or pharynx - CSF analysis - serum antibodies to poliovirus - MRI of spinal cord - EMG of affected limb(s)
31
POLIO what is the management?
- supportive care with rehydration and neurological monitoring - physiotherapy - intubation and ventilation for respiratory paralysis
32
POLIO what are the complications?
post-poliomyelitis syndrome (PPS) - this usually occurs years after the initial infection - demonstrates the same features as polio infection - treated in the same way as polio
33
DIPHTHERIA what is the cause?
Corynebacterium diphtheriae
34
DIPHTHERIA what is the clinical presentation?
- sore throat - low grade fever - dysphagia, dysphonia, dyspnoea and croupy cough can occur in serious illness
35
DIPHTHERIA what is the management?
- hospitalisation, isolation - diphtheria anti-toxin - antibiotic (procaine benzylpenicillin)
36
DIPHTHERIA what is the management for close-contacts?
prophylactic antibiotics - erythromycin diphtheria toxoid immunisation
37
CHICKEN POX How long is it contagious for?
Contagious 4d before rash + until lesions crusted (often 5d)
38
GLANDULAR FEVER What are the complications of glandular fever?
- Splenic rupture, - haemolytic anaemia, - chronic fatigue, - EBV associated with Burkitt's lymphoma
39
TUBERCULOSIS When diagnosing TB, what would you see on sputum MC&S?
Acid fast bacilli stain red with Ziehl-Neelson stain on Lowenstein-Jenson culture medium
40
TUBERCULOSIS When diagnosing TB, what would you see on CXR?
- Patchy consolidation, - pleural effusions, - hilar lymphadenopathy
41
ALLERGY Define atopy
Personal/familial tendency to produce IgE in response to ordinary exposures to allergens (triad = eczema, asthma + rhinitis)
42
ALLERGY Give an example of a type 2 hypersensitivity reaction
- autoimmune disease, - haemolytic disease of newborn, - transfusion reaction
43
ALLERGY Give an example of a type 3 hypersensitivity reaction
- SLE, - RA, - HSP, - post-strep glomerulonephritis
44
ALLERGY Give an example for of a type 4 hypersensitivity reaction
- TB, - contact dermatitis
45
OSTEOMYELITIS What are some investigations for osteomyelitis?
- FBC (Raised WCC), raised ESR/CRP, blood cultures, bone marrow aspiration MC&S - XR can be normal - MRI is best imaging to establish Dx
46
OSTEOMYELITIS What is the management of osteomyelitis?
- IV empirical Abx (flucloxacillin or clindamycin if allergy) until sensitivities back - Amoxicillin, cefotaxime or ceftriaxone if <4y + suspect H. influenzae - ?Surgical drainage or debridement of infected bone
47
JIA What is the criteria for a clinical diagnosis of JIA?
- Onset before 16y with no underlying cause - Joint swelling/stiffness - >6w in duration to exclude other causes (i.e. reactive)
48
JIA How does systemic JIA (Still's disease) present?
- Subtle salmon-pink rash - High swinging fevers - Lymphadenopathy, weight loss, muscle pain, splenomegaly - Pleuritis, pericarditis + uveitis
49
JIA What are the investigations for systemic JIA?
- Antinuclear antibodies (ANA) + rheumatoid factor = NEGATIVE - Raised inflammatory markers = CRP/ESR, platelets + serum ferritin
50
JIA How might enthesitis-related arthritis present?
- Sx of psoriasis (psoriatic plaques, nail pitting, dactylitis) or IBD
51
JIA What are some complications from JIA?
- Chronic anterior uveitis > severe visual impairment - Flexion contractures of joints - Growth failure + constitutional problems like delayed puberty - Osteoporosis
52
OSTEOPOROSIS What are the causes of osteoporosis?
- Inherited = osteogenesis imperfecta, haematological issues - Acquired: – Drug induced (Steroids) – Endocrinopathies (hypoparathyroidism) – Malabsorption – Immobilisation (disabilities) – Inflammatory disorders
53
OSTEOGENESIS IMPERFECTA What are some associations with osteogenesis imperfecta?
- Conductive hearing loss (otosclerosis) - Blue/grey tinted sclera due to scleral thinness - Valvular prolapse, aortic dissection > aortic incompetence - Hernias - 'Wormian bones' = skull feels like bubble wrap (wiggly black lines on skull XR)
54
RICKETS What are some risk factors for rickets?
- Darker skin (need more sunlight) - Lack of exposure to sun - Poor diet or malabsorption - CKD as kidneys metabolise vitamin D to active form
55
RICKETS What are the symptoms of rickets?
- Bone pain, swelling + deformities - Muscle weakness + poor growth (gross motor delay) - Pathological or abnormal # - May have hypocalcaemic convulsions or carpopedal spasm
56
RICKETS What are some bone deformities seen in rickets?
- Bowing of legs, knock knees - Harrison sulcus = indentation of softened lower ribcage at site of attachment of diaphragm - Rachitic rosary = ends of ribs expand at costochondral junctions causing lumps along chest - Craniotabes = soft skull with delayed closure of sutures + frontal bossing - Expansion of metaphyses (esp. wrist)
57
RICKETS What are some investigations for rickets?
- Serum biochemistry - FBC + ferritin (Fe anaemia), inflammatory markers - Kidney, liver + TFTs, malabsorption screen (anti-TTG) - Autoimmune + rheumatoid tests - XR required to diagnose
58
RICKETS What would serum biochemistry show in rickets?
- Low = calcium + phosphate - High = ALP + PTH - 25-hydroxyvitamin D levels deficient (<25nmol/L)
59
RICKETS What might an XR show in rickets?
- Osteopenia (radiolucent bones) - Cupping - Fraying of metaphyses - Widened epiphyseal plate
60
PSORIASIS What is the pathophysiology of psoriasis?
- Chronic autoimmune condition where abnormal T-cell activation > hyperproliferation of keratinocytes + so psoriatic skin lesions
61
PSORIASIS What is the clinical presentation of psoarisis?
- Koebner phenomenon = new plaques of psoriasis at sites of skin trauma - Residual pigmentation of skin after lesions resolve - Auspitz sign = small points of bleeding when plaques scraped off - Nail changes (pitting + onycholysis)
62
PSORIASIS What is the management of psoriasis?
- 1st line = topical steroids, topical vitamin d analogues (calcipotriol) - 2nd line = UV phototherapy - 3rd line = immunosuppression with methotrexate or biologics
63
NAPPY RASH What is the management of nappy rash?
- Highly absorbent nappies - Maximise time not wearing + ensure dry before replacing nappy - Change nappy + clean skin ASAP - Water or gentle alcohol-free products to clean - Topical imidazole if candida
64
SCOLIOSIS what are the causes?
- idiopathic = most common - congenital = usually from congenital structural defect of the spine e.g. spina bifida - secondary = neuromuscular imbalance (cerebral palsy, muscular dystrophy), disorders of bone or connective tissues
65
SCOLIOSIS what conditions can cause scoliosis?
cerebral palsy muscular dystrophy birth defects infections tumours marfan syndrome down syndrome
66
TORTICOLLIS what are the causes of congenital torticollis?
- congenital muscular torticollis (CMT) = usually noticed in 1st month after birth. It causes shortening + fibrosis of sternocleidomastoid (can have palpable mass) - malformed cervical spine - spina bifida
67
TORTICOLLIS what are the causes of acquired torticollis?
- MSK = muscle spasm - infection = URTI, otitis media, dental infection, pharyngeal infection - atlantoaxial rotatory fixation - inflammation = juvenile idiopathic arthritis - neoplasm = CNS tumours
68
OSGOOD SCHLATTERS what are the risk factors?
- male gender - age - 12-15 in boys, 8-12 in girls - sudden skeletal growth - repetitive activities such as jumping and sprinting
69
SEPTIC ARTHRITIS what is the criteria for diagnosing septic arthritis?
Kocher's modified criteria /5, ≥3 is likely –Temp>38.5 – Raised CRP/ESR/WCC – Non-weight bearing
70
JIA What is the immunology of polyarticular JIA?
If rheumatoid factor +ve = seropositive (tend to be older children)
71
JIA what is the immunology of oligoarticular JIA?
ANA +ve but RF -ve
72
JIA What is it associated with?
- HLA-B27 gene - Prone to anterior uveitis = ophthalmology referral
73
JIA What causes reactive arthritis?
Post STI (chlamydia) in older children or Salmonella, Campylobacter
74
OSTEOGENESIS IMPERFECTA What is the pathophysiology?
Defects in type 1 collagen protein which is essential for the structure + function of bone, as well as skin, tendons + other connective tissues
75
RICKETS What are some sources of vitamin D?
Sunlight, fortified cereals, eggs, oily fish
76
PSORIASIS What are the causes?
- HLA-B13, - environmental triggers (alcohol, stress, group A strep)
77
JIA How does macrophage activation syndrome present?
- Acutely unwell with DIC, - febrile, - anaemia, - thrombocytopenia, - bleeding, - non-blanching rash, - low ESR
78
JIA What is the management of macrophage activation syndrome?
Life-threatening = supportive + steroids
79
TONSILLITIS | What criteria can be used to distinguish if tonsillitis is bacterial or viral?
CENTOR – - Tonsillar exudate, tender ant. cervical lymphadenopathy, fever, absence of cough (≥3 ?strep) FeverPAIN score – - Fever, Purulence, Attend rapidly (3d after Sx), severely Inflamed tonsils, No cough/coryza (2–3 consider delayed, ≥4 consider Abx)
80
TONSILLITIS | What is the main complication of tonsillitis?
- Quinsy (peritonsillar abscess)
81
TONSILLITIS | What is the management of tonsillitis?
- 1st line = Phenoxymethylpenicillin - if penicillin allergic = erythromycin | - Tonsillectomy last resort if quinsy (in 6w), recurrent severe (≥5/year) or OSA
82
TONSILLITIS | How does quinsy present?
Severe sore throat (unilateral), uvula deviation, lockjaw
83
TONSILLITIS | What is the management for quinsy?
Incision + drainage + IV Abx
84
INTESTINAL MALROTATION What can contribute to the obstruction in intestinal malrotation? How may it present?
- Ladd bands may cross the duodenum | - Obstruction or obstruction with compromised blood supply
85
INTESTINAL MALROTATION | What is the investigation + management of intestinal malrotation?
- Urgent upper GI contrast study is Dx, abdo USS | - Urgent surgical correction = Ladd's procedure rotates bowel anti-clockwise
86
ABDOMINAL MIGRAINE What is the acute management of abdominal migraine? What is the prophylaxis? What is a caution?
- Sumatriptan + paracetamol ± NSAID (ibuprofen) - Pizotifen (serotonin receptor antagonist) or propranolol - Withdraw pizotifen slowly as can cause depression, anxiety, poor sleep + tremor
87
FUNCTIONAL DYSPEPSIA | What is functional dyspepsia?
- Epigastric pain, early satiety, bloating + postprandial vomiting
88
FUNCTIONAL DYSPEPSIA | What is the management of functional dyspepsia?
- C-13 Urea breath test for H. pylori + upper GI endoscopy if Sx recur, if normal = Dx - Hypoallergenic diet - Eradicate H. pylori if suspected with triple therapy > omeprazole, amoxicillin + metronidazole or clarithromycin
89
NEPHRITIC SYNDROME What antibodies would you screen for? What would renal biopsy show in IgA nephropathy?
- Anti-dsDNA if SLE, ANCA in vasculitides | - IgA deposits + glomerular mesangial proliferation
90
VARICOCELE What is a varicocele? Which side is most likely? How does it present?
- Abnormal dilatation of the testicular veins - L sided due to angle of L testicular vein entering the L renal vein - 'Bag of worms', dragging or aching sensation, associated with subfertility
91
VARICOCELE | What is the management of varicocele?
- Confirm with USS + Doppler studies | - Conservative unless pain
92
DIABETES MELLITUS | What is the physiology of insulin?
- Lowers blood glucose by stimulating uptake from blood into muscle, kidney + fat cells as well as targeting the liver to convert glucose to glycogen
93
DIABETES MELLITUS | What are some negatives about insulin therapy in general?
- Lipohypertrophy (rotate site) - Risk of hypoglycaemia - Weight gain
94
DIABETIC KETOACIDOSIS | How does the body respond to ketoacidosis?
- Initially, kidney produces bicarbonate to counteract but this is used up > acidotic - Hyperglycaemia overwhelms the kidneys + glucose starts being filtered into the urine + draws water out with it in the process (osmotic diuresis) leading to polyuria + severe dehydration, stimulating thirst centre (polydipsia)
95
DIABETIC KETOACIDOSIS | What is the effect on potassium in DKA?
- Kidneys excrete K+ in urine so overall body K+ is low so when treatment with insulin starts can develop severe hypokalaemia as insulin drives K+ into cells
96
DIABETIC KETOACIDOSIS | What is the clinical presentation of DKA?
- Smell of acetone on breath (pear drops) - Vomiting, dehydration, abdominal pain - Hyperventilation due to acidosis (Kussmaul's breathing) - Drowsiness, coma + hypovolaemic shock
97
DIABETIC KETOACIDOSIS | What are some investigations for DKA?
Diagnosis – - Glucose >11mmol/L - Blood ketones >3mmol/L - Blood gas pH <7.3 or bicarb <15mmol/L (metabolic acidosis) ECG = signs of hypokalaemia (U waves, small/absent T, long PR, ST depression) - U+Es + creatinine show dehydration, hypokalaemia
98
DIABETIC KETOACIDOSIS | What are some complications of DKA?
- Cerebral oedema (neuro obs) - VTE - Hypokalaemia > arrhythmias - AKI
99
DIABETIC KETOACIDOSIS | How do you calculate how dehydrated someone is in DKA?
- 5% if pH 7.2–7.29 or bicarbonate <15 (mild) - 7% if ph 7.1–7.19 or bicarbonate <10 (mod) - 10% if pH <7.1 or bicarbonate <5 (severe)
100
DIABETIC KETOACIDOSIS What fluids do you give in DKA for... i) shock? ii) not shocked but needs fluids? iii) maintenance?
i) 1st bolus = 0.9% NaCl 20ml/kg, subsequent 10ml/kg, do NOT subtract bolus from deficit ii) 0.9% NaCl 10ml/kg over 1 hour, DO subtract bolus from deficit iii) 0.9% NaCl with 40mmol/L KCl (20mmol in 500ml bag)
101
HYPOGLYCAEMIA | What are some hypo phenomena?
- Hypo unawareness - Reactive hypoglycaemia (after meal) - Somogyi = post-hypoglycaemic hyperglycaemia - Dawn phenomena = morning rise in blood sugar
102
APNOEA OF PREMATURITY | What is apnoea of prematurity?
- Periods where breathing stops spontaneously for >20s (or shorter periods with oxygen desaturation or bradycardia - Common, esp <28w
103
APNOEA OF PREMATURITY | What is the management of apnoea of prematurity?
- Gentle tactile stimulation when alerted by apnoea monitors - Resp stimulant like IV caffeine - May need CPAP if frequent
104
IV HAEMORRHAGE | What is the management of intraventricular haemorrhage?
- Cranial USS - Sx relief with removal of CSF by LP or ventricular tap - Ventriculoperitoneal shunt may be needed for hydrocephalus
105
RETINOPATHY What is the pathophysiology of retinopathy of prematurity? What may this lead to?
- Affects developing blood vessels at junction of the vascular + non-vascularised retina - Retinal blood vessel formation is stimulated by hypoxia so hyperoxic insult can prevent this - Retina responds with vascular proliferation which may progress to retinal detachment, fibrosis + blindness
106
RETINOPATHY What are some risk factors for retinopathy of prematurity? What is the clinical presentation?
- Use of high oxygen conc, very LBW (<1.5kg), premature babies <32w - Plus disease describes other findings like tortuous vessels + hazy vitreous humour
107
RETINOPATHY | What is the management of retinopathy of prematurity?
- Regular eye screening by ophthalmologist for susceptible preterm infants (<1.5kg or <32w), must visualise all retinal areas - Transpupillary laser photocoagulation to halt + reverse neovascularisation
108
NEONATAL CONJUNCTIVITIS What is neonatal conjunctivitis? What is the management?
- Common starting day 3–4 - Usually just cleaning with water or saline - More troublesome discharge or redness of eye may be staph/strep so topical Abx eye ointment like neomycin
109
NEONATAL CONJUNCTIVITIS In terms of neonatal conjunctivitis, how would... i) gonococcal infection ii) chlamydia infection present and what is the management of both?
i) Purulent discharge, conjunctival injection, eyelid swelling, within 48h – Gram stain, IV ceftriaxone + cleanse frequently (can lose vision) ii) Purulent discharge, eyelid swelling, 1-2w – Immunofluorescent staining, PO erythromycin for 2w
110
SIDS | What are some major risk factors for SIDS?
- Baby sleeping prone - Parental smoking (during pregnancy or in same room) - LBW + prematurity - Sharing a bed - Hyperthermia (over wrapping) or head covering (blanket moving)
111
SIDS | What are some other risk factors for SIDS?
- M>F - Low socioeconomic status - Infant pillow use - Maternal drug use
112
SIDS | What are some protective factors from SIDS?
- Breastfeeding - Room (NOT bed) sharing - Use of dummies
113
SIDS | What is the management of SIDS?
- Following cot death screen siblings for sepsis + inborn errors of metabolism - Infants sleep on backs, 'feet-to-foot' position - Do not smoke near them - Bedroom for first 6m
114
NUTRITION | What are the advantages of breastfeeding?
- Free - Helps bonding - Lactational amenorrhoea - Reduces risk of NEC in preterm infants + SIDS - Antibodies to protect neonate against infection - Reduced maternal risk of breast + ovarian cancer
115
NUTRITION | What are the disadvantages of breastfeeding?
- Breast milk jaundice - Unknown intake so ?eating adequately - Discomfort for mother - Transmission of drugs or infections to baby - Insufficient vitamin D + K (reason for vitamin K IM injection at birth)
116
ROSEOLA INFANTUM What is roseola infantum? How is it spread?
- Caused by human herpes virus 6+7 | - Classically most children infected by age 2, often from oral secretions of a family member
117
COMMON KNEE ISSUES What is chondromalacia patellae? How does it present? What is the management
- Softening of the cartilage of the patellar, common in teenage girls - Anterior knee pain on walking up/downstairs + rising from prolonged sitting - Usually responds to physiotherapy
118
COMMON KNEE ISSUES What is... i) osteochondritis dissecans? ii) patellar subluxation?
i) Pain after exercise with intermittent swelling | ii) Medial knee pain due to lateral subluxation of the patellar, knee may give way
119
ACHONDROPLASIA | What is the clinical presentation of achondroplasia?
- Short stature from marked shortening of limbs + fingers - Large head with frontal bossing + depression of nasal bridge - 'Trident' hands + marked lumbar lordosis
120
ACHONDROPLASIA | What are some complications of achondroplasia?
- Foramen magnum stenosis > cervical cord compression + hydrocephalus - Recurrent otitis media (cranial abnormalities) - Obstructive sleep apnoea - Obesity
121
HEAD LICE | What is the management of headlice?
- Dimeticone 4% or malathion 0.5% lotions, leave overnight then wash off (repeat 7d later to kill any head lice hatched since) - Special fine combs + wet combing (bug-busting) every 3–4d for 2w
122
SCABIES | What is scabies?
- Infestation of mites (Sarcoptes scabiei) that burrow under skin + lay eggs - Can take 8w for Sx (delayed type 4 hypersensitivity reaction)
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SCABIES What is the clinical presentation of scabies? Classic location? When would you suspect it?
- Very itchy burrows, papules + vesicles (may be track marks from mites) - Classic location between finger webs, can spread to whole body - Suspect if child + family itching
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HYPERTHYROIDISM | What is the management of hyperthyroidism?
- 1st line = carbimazole or propylthiouracil (either dose titration or block + replace with thyroxine) - Radioiodine can be used too - May need subtotal thyroidectomy to give permanent remission - Beta-blockers for symptomatic relief
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THREADWORMS What causes threadworms?
Enterobius vermicularis
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THREADWORMS How is it treated?
Single dose mebendazole + hygiene measures for WHOLE family

C TO REVISE - PHASE 3A (11 decks)

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