Paeds mx Flashcards
Mx of Immune Thrombocytopenic Purpura?
Reassure, avoid NSAIDs and IM injections and vigorous physical activity
If platelet <30k, give IVIG + Anti-D Ig, steroids
Mx of Kawasaki?
Steroids + IVIG + Aspirin
2DTTE at diagnosis and 6weeks later
Mx of T1DM hypoglycemic episode?
Start 15g oral dextrose, re-check CBG every 15 mins until CBG >4-5 mmol
Mx of nephrotic syndrome?
Steroids, immunosuppressants
ACE-Is, ARBs for proteinuria
Nephrotic diary
Diuretics for edema
Salt restriction
Protein restriction
20% Albumin IV if symptomatic edema
Statins for hyperCRL
Vaxx
Aspirin for hypercoagulopathy
Mx of HSP?
Supportive care: fluid supp
Analgesia with NSAIDs, but not if got active BGIT or acute GN
Discontinue drugs suspected of inducing HSP
F/u with monitoring BP, dipstick, serology
Mx of Cerebral palsy?
Anti-epileptics for seizures
Intermittent cath for neurogenic bladder
Ortho for scoliosis and kyphosis
Release surgery for contractures
VP shunt for hydrocephalus
Ophthal and ENT for vision and hearing issues
PT/OT for weakness
Speech therapist for speech
Anti-parkinsonian meds for athetosis
Botulinum for spasticity
etcetc
Mx of haemophilia?
Regular F8 transfusions, or Hemlibra
Desmopressin
TXA
Genetic counselling
Mx of IBD?
Exclusive Enteral nutrition for 8-12 weeks
Vit B12, zinc and iron supplementation
Sulfasalazine, azathioprine, MTX, prednisolone
Nutritional supplementation, dietician referral
Symptomatic treatment!! - NSAIDs for joint pain, blood transfusion for anaemia etc
Mx of recurrent UTI?
Perineal hygiene
Cotton underwear
Prophylactic abx if VUR 3-5
Correct VUR / neurogenic bladder
Bladder diary
Frequent timed voiding
Surgical correction of anatomical defects
Mx of Epilepsy?
Avoid risky activities e.g. swimming, cooking etc.
Educate - how to handle seizure at home
Involve school
Sleep hygiene
Anti-epileptics: Keppra, phenytoin, valproate etc.
Start with monotherapy first.
Mx of Biliary atresia?
Liver transplant definitive.
Before that can give MCT oil and Vit ADEK
Monitor for complications, mainly cholangitis. Can give prophylactic abx Bactrim
Monitor LFTs
Mx for thalassemia?
Folate supplementation
Regular blood transfusions
Iron chelator therapy
Monitor for signs of iron overload - goitre, osteoporosis, DM, Bronze colour
Splenectomy offered if hypersplenism
Definitive is BM transplant
Mx of DM?
**Self-monitoring of glucose - hypocount diary!!
**Regular TCU for control check and complications e.g. HbA1c
Insulin therapy
Monitoring for complications of treatment - lipodystrophy, FTT, DRP obesity etc.
Active lifestyle and weight control, healthy diet
Return advice for complications
Mx of DKA?
- Fluid resus with isotonic saline
- Short-acting insulin 0.1unit/kg/hr
3. Potassium replacement - Correct acid-base imbalance
- Treat precipitating cause e.g. infection
Treat any cerebral edema with IV mannitol. Cerebral edema is a rare complication of DKA
Monitor for signs of cerebral edema
Mx of acute hypogly?
IV 10% dextrose 2ml/kg slow bolus
If child is fitting or vomiting,
Give IV Glucagon. Second line is D50 glucose
Mx of nephritic syndrome with post-strep GN?
Edema = Diuretics, Salt and fluid restriction
HTN = CCBs, BBs
Uremia = Protein restriction
HyperK = dietary K restriction, resonium, wtv as needed for hyperK
Mx of intussusception?
Keep NBM + insert flatus tube for decompression. 70% recover with bowel rest and decompression.
NGT insertion
IDC for IO monitoring
IV fluid rehydration
Correct abnormalitiess
Definitive mx is air/barium enema
Mx of HFMD?
isolate in single room
Symptomatic tx - focus on hydration
Close monitoring for complications - tachycardia, apnea, seizures, myoclonic jerks
IVIG for complicated disease
Mx of chickenpox?
Supportive, but give acyclovir if higher risk.
If immunocompromised but:
- sec contact in family
- above 12yo
- chronic skin or lung coniditons
- on steroids:
- Start acyclovir within 72hrs of rash onset.
if immunocompromised, IV acyclovir until all lesions crusted, then PO for 3d more
Isolation + vaxx!
Mx of Infectious Mononucleosis?
Return advice - excessive dehydration, fatigue, SOB
Avoid amoxicillin
Avoid crowded places to prevent infection
Avoid vigorous activity for splenic rupture
Mx of dengue?
- Supportive + monitoring
- I/O for hydration
- platelet, hematocrit - Treat volume / blood loss
- Give platelet if active bleeding
- FFP if consumptive coag
- Packed cells for bleeding - Avoid
- IM injections
- Brushing teeth - Notify MOH + pt education / counselling
Mx of neurogenic bladder?
Clean intermittent cath
Self-dipstick at home
Bladder diary
Monitor for kidney function
Avoid nephrotoxic drugs
Avoid constipation
Mx of IBD?
Exclusive enteral nutrition for 8-12 weeks
Vit B12, zinc and iron supplement
Immunosuppressant meds
Nutritional supplement, dietician referral
Symptomatic tx - NSAIDs for joint pain, blood transfusion for anaemia etc
Surgery if got strictures / IO
Lifelong f/u for cancer monitoring, monitor for extra-GI manifestations
Complications - small bowel strictures, anal fistulas
Mx of meningitis?
Abx Ceftriaxone + Vanco + ampi if IC
IV Dexamethasone
Droplet precaution
Notify MOH 24hrs
Prophylactic abx for close contacts
