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Paeds Key Points Bank Flashcards

1
Q

Threadworms

A

Perianal itching at night

Mx
- single dose of mebendazole for whole family and hygeine advice

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2
Q

ASD

A

Fixed splitting of 2nd heart sound

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3
Q

VSD

A

Pansystolic murmur in lower left sternal edge

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4
Q

Coarctation of the aorta

A

Crescendo-decrescendo murmur in upper left sternal edge

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5
Q

PDA

A

Continuous machinery murmur in upper left sternal edge

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6
Q

Pulmonary stenosis

A

Ejection systolic murmur in upper left sternal edge

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7
Q

Venous hum (Innocent murmur)

A

Sounds like blowing through nose below both clavicles

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8
Q

Still’s murmur (Innocent murmur)

A

Low pitched heart sound at lower left sternal edge

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9
Q

Roseola infantum

A

HHV6
6 months - 2 years
High fever comes and then goes and then a maculopapular rash develops
Diarrhoea, cough
Associated with aseptic meningitis and hepatitis

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10
Q

Laryngomalacia

A

4 weeks old with stridor

Mx

  • self resolves by 2 years old
  • if failure to thrive or breathing problems then surgery
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11
Q

Commonest cause of headaches in children

A

Migraine without aura

Mx

  • ibuprofen, sumitriptan nasal spray
  • pizotifen and propranolol prophylaxis
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12
Q

Infantile spams (West syndrome)

A

4-8 month old boy
Flexion of head trunks and arms followed by extension of arms (salaam attack) and hypsarrythmia on EEG

Poor prognosis
Mx
- vigabatrin

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13
Q

CF + Hirschprung

A

Meconium ileus

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14
Q

Infantile colic

A

Inconsolable crying, drawing up knees, flatus

Crying starts and stops for no reason that lasts for >3 hrs a day for >3 days a week for >1 week

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15
Q

Congenital cataract

A

No red reflex at birth

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16
Q

Retinoblastoma

A

Red reflex present at birth but not at around 18 months

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17
Q

Seborrhoeic dermatitis

A

Scalp (cradle cap), nappy area, flexures
Mx
- mild - baby shampoo/oils
- severe - mild topical steroids (1% hydrocortisone)

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18
Q

Hand Foot and Mouth Disease

A

Coxsackie A16
Maculopapular rash in mouth, palms and soles, groin and buttocks
Sore throat and low-grade fever

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19
Q

Paediatric BLS

A

Patient not breathing –> 5 rescue breaths –> assess circulation –> not breathing + no pulse –> CPR at 15:2

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20
Q

Jaundice

A

<24 hours - always pathological - ABO/rhesus haemolytic disease, hereditary spherocytosis, G6POD deficiency
2-4 days - common - physiological
>14 days - biliary atresia (high conjugated bilirubin), hypothyroidism, galactosaemia, UTI, congenital infection, breast milk jaundice
Ix for >14 days - conjugated and unconjugated bilirubin, direct antiglobulin test, TFTs, FBC, blood film, urine for MC&S and reducing agents, U&Es and LFTs

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21
Q

Development dysplasia of hip

A

RFs - female, breech, firstborn, birth weight >5kg, family history

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22
Q

Measles

A

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

23
Q

Mumps

A

Fever, malaise, muscular pain

Parotitis - initially unilateral and becomes bilateral

24
Q

Rubella

A

Pink maculopapular rash, initially on face spreads to whole body and usually fades by the 3-5 day
suboccipital and postauricular lymphadenopathy

25
Congenital rubella
Sensorineural deafness, congenital cataracts, PDA, glaucoma
26
Congenital toxoplasmosis
Cerebral calcification, chorioretinitis, hydrocephalus
27
Congenital CMV
Growth retardation, purpuric skin lesions
28
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
29
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
30
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
31
Umbilical hernia
Common, no treatment required Usually resolve by 3 years Associated to Down's syndrome
32
Early onset neonatal sepsis (<48 hours)
GBS - bacteraemia, joint infections, meningitis --> benzylpenicillin E. coli - menigitis, UTI --> gentamycin Listeria --> ampicillin
33
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
34
Marfan's syndrome
Autosomal dominant | Tall, pectus excavatum, scoliosis, repeat pneumothoraces
35
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
36
Turner syndrome
45, XO Short, shield chest, widely spaced nipples, webbed neck, bicuspid aortic valve, coarctation of the aorta, primary amenorrhoea, cycstic hygroma, high arched palate, multiple pigmented naevi Increased risk of autoimmune disease Associated with haemophilia
37
Erythema infectiosum
Parvovirus B19 Slapped cheek rash spreading to proximal arms and extensor surfaces Lethargy, fever, headache, coryza
38
Scarlet fever
Group A Streptococcus Strawberry tongue, fever, malaise, tonsilitis Rough sandpaper rash (fine punctate erythema) sparing the face
39
Chickenpox
Initially fever Itchy papular rash starting on head/trunk before spreading and becoming vesicular --> pustular --> crust over Mild systemic upset
40
Respiratory distress syndrome
RFs - male, diabetic mother, C-section, second of premature twins, delivery at <34 wks CXR - ground glass appearance + indistinct heart border Mx - oxygen, assistend ventilation, exogenous surfactant via endotracheal tube Prophylaxis - maternal steroids (betamethasone) if in labour <34 wks
41
Patau syndrome
Trisomy 13 | Microcephaly, cleft palate, polydactyly, scalp lesions
42
Edward's syndrome
Trisomy 18 | Micrognathia, low set ears, rocker bottom feet, overlapping fingers
43
Fragile X syndrome
M>F, associated with MVP and autism | Macrocephaly, long face, large ears, learning difficulties
44
Noonan syndrome
Webbed neck, pectus excavatum, short, pulmonary stenosis
45
Pierre-Robin sequence
Micrognathia, cleft palate, posterior displacement of tongue
46
Prader-Willi syndrome
Hypotonia, hypogonadism, obesity
47
William's syndrome
Deletion on Chr 7 | Short, learning difficulties, friendly, transient neonatal hypercalcaemia, supravalvular aortic stenosis
48
Toddler's diarrhoea
Undigested food in stool
49
Caput succedaneum
Present at birth - due to prolonged/difficult deliveries Forms over vertex and crosses suture lines Resolves in days - managed conservatively
50
Cephalohaematoma
Develops a few hours after birth - due to prolonged/difficult delivery Commonly in parietal region and does not cross suture lines Resolves in months - managed conservatively
51
Febrile convulsion
6 months - 5 years Occur early in a viral infection Generalised tonic-clonic seizures lasting <5 minutes with complete recovery within an hour Is a risk factor for epilepsy Mx - first seizure or any complex features --> paediatrics - giving paracetamol is good but it does not affect the chances of a febrile convulsion
52
Epilepsy risk factors
Family history, having complex febrile seizures, a background of neurodevelopmental disorder
53
Omphalocele
AKA exomphalos | Intestines and liver extend out of the body in a sac through the umbilicus
54
Gastroschisis
Intestines extend out of the body through a hole next to the umbilicus No sac

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