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3A > Paeds - Misc > Flashcards

Paeds - Misc Flashcards

1
Q

Recurrent otitis media

A

Common at 2-7 years

Conductive hearing loss

  • Speech difficulties
  • Learning problems
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2
Q

JIA aetiology and clinical features

A

Arthritis in under 16s
Lasting > 3 months

Arthritis

  • Stiffness after periods of rest
  • Morning joint stiffness

Systemic - FLAAAPy SALMON

  • Fever
  • Lymphadenopathy
  • Anterior uveitis
  • Anorexia
  • Arthritis
  • Pink rash - SALMON
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3
Q

JIA investigations

A

FBC

  • Anaemia
  • WCC ^
  • ESR ^
  • Ferritin ^

ANA +ve
Rh can be -ve

LFT ^

Albumin - LOW

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4
Q

JIA management

A

NSAIDS
Prednisolone
Mehotrexate

Tocilizumab - IL-6
Anakinra - IL-1

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5
Q

JIA complications

A 
Chronic anterior uveitis
Anaemia of chronic disease
Osteoporosis 
Growth failure 
Valgus deformity
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6
Q

Perthe’s disease aetiology and presentation

A

Chronic - Boys aged 4-10

  • Short stature
  • LBW
  • Passive smoking
  • Low SE status

Clinical features

  • Unilateral
  • Hip and knee pain
  • Limited ROM
  • Roll test - Guarding and spasm
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7
Q

Perthe’s disease investigations / management / complications

A

XR

  • Flattening and fragmentation of epiphysis
  • Sclerosis
  • Widening of joint

MRI
Bone scan

Management

  • Bed rest and traction
  • Surgery < 6 years

Complications - Premature fusion of growth plates

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8
Q

DDH aetiology and presentation

A 
Breech 
Birth weight < 5kg 
Family Hx
Female 
First born 
C-section

8 week check

  • Asymmetrical skin creases
  • Unequal length
  • Limited abduction
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9
Q

DDH investigations and management

A

Barlow’s - Dislocates
Ortolani’s - Relocates

Management

  • 60% resolve spontaneously - 3-6 weeks
  • Pavlik cast < 4/5 months
  • Surgery in older children
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10
Q

Transient synovitis presentation

A

3-10 years
Not weight bearing
Look well

Unilateral pain on walking and extreme ranges
No pain at rest

Previous respiratory infection
Mild fever

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11
Q

Transient synovitis investigations / management / complications

A

ESR - NORMAL
XR - NORMAL
USS - Fluid in joint

Rest
Analgesia

Complications - Perthe’s 3%

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12
Q

NAI

A

History doesn’t match presentation
Delayed presentation

Torn frenulum
Retinal haemorrhage

Cheek, neck, buttocks and forearms

Skull fracture
Rib fracture

Non-ambulatory child - Cerebral palsy?

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13
Q

Osteogenesis imperfecta aetiology and presentation

A

Autosomal dominant
Type 1 collagen

Multiple fractures
Scoliosis

Triangle face
Blue sclera
Dental deformity
Deafness - Due to otosclerosis

Hernia and valve prolapse

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14
Q

Osteogenesis imperfecta investigations and management

A

DEXA
Skeletal survey
Biopsy - Skin/bone
ALP ^

Management

  • Alendronic acid
  • Synthetic calcitonin
  • PT
  • Analgesia
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15
Q

Bone neoplasm types and presentation

A

Osteosarcoma
Ewing’s
Chondrosarcoma

Painful
Rapid growing limb

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16
Q

Rickets aetiology

A

Lack of vitamin D / calcium

Decreased intake

  • Oily fish
  • Eggs
  • Fortified cereal

Lack of sunlight
Liver disease
Renal disease
Decreased calcium absorption - GI disease

17
Q

Rickets presentation

A

Bowed legs
Painful limbs
Fractures

Motor delay
Hypotonia

Hypocalcaemia features

  • Tetany
  • Arrhythmias
18
Q

Rickets investigations and management

A 
Calcium - LOW 
PTH ^ 
Phosphate - LOW 
Vit D - LOW 
ALP ^

Management - Vit D

19
Q

Osgood schlatters

A

Pain better on rest
Worse on movement - Running and jumping
Inflammation of the tibial tuberosity
Athletic adolescents

Management - Physio

20
Q

Chondromalacia

A

Adolescent female
Pain on standing from sitting and walking up stairs

Management - Physio

21
Q

Neuroblastoma aetiology and presentation

A

Arises from…

  • Neural crest tissue of adrenal medulla
  • Sympathetic nervous system
Abdominal mass 
Pallor 
Weight loss 
Bone pain and limp
Hepatomegaly

RACCOON EYES

22
Q

Neuroblastoma investigations

A

Urinary…

  • Catecholamines ^
  • Vanillylmandelic acid ^
  • Homovanillic acid ^

AXR - Calcification

CT
Biopsy

23
Q

Retinoblastoma pathophysiology

A

Autosomal dominant

Loss of function
- Retinoblastoma tumour suppressor gene on chromsome 13

10% hereditary

24
Q

Retinoblastoma presentation

A

18 months

Absence of red-reflex
Replaced by white pupil - Leukocoria

Pain/redness around the eye

Strabismus
Visual problems

25
Q

Retinoblastoma management and prognosis

A

Enucleation
+ Radiotherapy
+ Chemotherapy

Photocoagulation

90% survival

26
Q

Hepatoblastoma presentation

A

Asymptomatic?

Abdominal mass
Ascites
Itchy skin
Jaundice

B symptoms

27
Q

Hepatoblastoma investigations / management / prognosis

A

CT/MRI
AFP ^

Surgical resection
Liver transplant

5 year survival = 15%

28
Q

Wilm’s tumour aetiology and presentation

A

Embryonic renal tissue
Loss of WT1 gene

Abdo mass
Painless haematuria
HTN

Flank pain
Anaemia - Haemorrhage into tumour

29
Q

Wilm’s tumour investigations and management

A

CT
USS
MRI

Nephrectomy
± Chemo
± Radio

30
Q

CNS tumour

A

^ ICP

  • Headache
  • Papilloedema
  • N/V

FND
Ataxia
Nystagmus
Squint

Infants

  • Developmental delay/regression
  • Head circumference ^

MRI
Surgery ± Chemo/Radio

31
Q

Effects of cancer treatment

A

Subfertility
Secondary cancers
Psychosocial
Growth retardation

Effects of chemo

  • N/V
  • Hair loss

3A (31 decks)

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