Paeds Key Points 2 Flashcards
Development dysplasia of hip
RFs - female, breech, firstborn, birth weight >5kg, family history
Measles
Prodrome - fever, conjunctivitis
Koplik spots (white spots on buccal mucosa)
Rash - starts behind ears then to whole body, discrete maculopapular rash becoming blotchy and confluent - initially blanching, becomes non-blanching later
Fever persists during the rash
Mumps
Fever, malaise, muscular pain
Parotitis - initially unilateral and becomes bilateral
Rubella
Pink maculopapular rash, initially on face spreads to whole body and usually fades by the 3-5 day
suboccipital and postauricular lymphadenopathy
Congenital rubella
Sensorineural deafness, congenital cataracts, PDA, glaucoma
Congenital toxoplasmosis
Cerebral calcification, chorioretinitis, hydrocephalus
Congenital CMV
Growth retardation, purpuric skin lesions
Nocturnal enuresis
Involuntary urination in a child aged 5 years or older, with no congenital or acquired defects of the nervous system or urinary tract
Mx
- look for underlying causes (constipation, diabetes mellitus, UTI if recent onset)
- advise on fluid intake, diet and toileting behaviour
- reward systems
- <7 - enuresis alarm
- >7 - desmopressin if needed in short term or alarm is not working
Pyloric stenosis
2-4 weeks old, M>F
Hypertrophy of the circular muscles of the pylorus
Projectile vomiting 30 minutes after feeding
May see a palpable mass in the upper abdomen or peristalsis in LUQ
Hypochloraemic, hypokalaemic alkalosis due to persistent vomiting
Diagnosis by USS
Mx
- Ramstedt pyloromyomotomy
ADHD
Characterised by extreme restlessness, poor concentration, uncontrolled activity and impulsiveness
M>F
Mx
- refer to CAMHS
- food diary to look for link between food and behaviour
- methylphenidate - monitor growth, psych symptoms and BP every 6 months
Umbilical hernia
Common, no treatment required
Usually resolve by 3 years
Associated to Down’s syndrome
Early onset neonatal sepsis (<48 hours)
GBS - bacteraemia, joint infections, meningitis –> benzylpenicillin
E. coli - menigitis, UTI –> gentamycin
Listeria –> ampicillin
Late onset neonatal sepsis (>48 hours)
Apnoea, poor feeding, respiratory distress, convulsions
GBS, e. coli, listeria, staph aureus, enterococci, citrobacter koseri, candida
Mx
- flucloxacillin + vancomycin –> piperacillin/tazobactam + vancomycin
- community acquired - cefotaxime + amoxicillin + gentamycin
Marfan’s syndrome
Autosomal dominant
Tall, pectus excavatum, scoliosis, repeat pneumothoraces
Down’s syndrome
Trisomy 21
Upslanting palpebral fissures, epicanthic folds, Brushfield spots in iris, protruding tongue, small ears, single palmar crease, hypotonia, congenital cardiaac abnormalities (tetralogy of fallot), duodenal atresia, Hirschsprung’s disease
