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Medicine > Paeds (Neonates, Development, Haem, Immuno, Inf) > Flashcards

Paeds (Neonates, Development, Haem, Immuno, Inf) Flashcards

1
Q

APGAR Scoring

A 
Act (M Tone)
PR
Grimace (Reflex)
Appearance (Colour)
RR
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2
Q

Hypoxic-Ischaemic Encephalopathy Mx

A

Neonatal ICU
Therapeutic Hypothermia: Cooled to 33-34
(Reduce Inflamm + N loss from Hypoxia)

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3
Q

Hypoxic-Ischaemic Encephalopathy Causes

A

Mat Shock,
Intrapartum Haem,
Prolapsed cord (+/- Nuchal cord)

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4
Q

Causes of Neonatal Jaundice
Physiological
Pathological

A

Physiological (2-7 days): Self-resolves w/in 10 days
(High conc of fragile Fetal RBCs, Immature Liver, Lack Placenta to excrete)

Pathological (w/in 24hrs):
Increased Prod:
HDN, ABO Incompatability, Haem, Sepsis/DIC

Decreased Clearance:
Prematurity, Neonatal Cholestasis, Biliary Atresia, HypoTh

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5
Q

Prolonged Jaundice Def + Mx

A

(Full-term: > 14 days, Pre-term: > 21 days):

Total BiliR monitoring (Tx threshold chart: X: Age, Y: BiliR)
PhotoTx (Converts unconjugated BiliR -> Harmless Isomers, Excreted in Urine/Bile)
Measure rebound BiliR 12-18hrs later

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6
Q

Faltering growth Def

A

Birthweight > 91st centile w/ drop of > 3 centile spaces

Birthweight: 9th + 91st centile w/ drop of > 2 centile spaces

Birthweight < 9th centile w/ drop of > 1 centile spaces

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7
Q

Gross Motor Milestones

A

9mo: Sit Unsupported (Red flag at 12mo)
12mo: Stand + Cruising (Walk w/ Aid)
18mo: Walk unaided (Red flag at 2yo), Squat + pick-up objects
2yo: Run + Kick

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8
Q

Fine Motor Milestones

A

12mo: Pincer grasp, Use crayons, Hand preference (Red flag < 12mo)
18mo: Use spoon

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9
Q

Express Language Milestones

A

1yo: Single words (Red flag at 18mo)
2yo: Combines 2 words

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10
Q

Receptive Language Milestones

A

6mo: Resp to Voice
9mo: Listens to speech
12mo: Follows simple instructions
18mo: Understands nouns (1 Keyword)
2yo: Understands Verbs (2 Keywords)
3yo: Understands Adjectives (3 Keywords)

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11
Q

Personal/Social Milestones

A

9mo: Cautious w/ strangers
12mo: Engages w/ others (Red flag at 18mo), Waves + Claps
18mo: Initiates Activities
2yo: Plays next to others, Dry throughout day
3yo: Seeks others for play (Red flag > 3yo), Bowel control

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12
Q

Developmental Red Flags

A 
Loss of milestone
Slowed/Absent Development 
Asymmetry (Hand preference < 12mo)
Unable to hold object at 6mo 
Unable to sit unsupported at 12mo 
Unable to stand independently at 18mo 
No words/interest in others at 18mo 
Unable to walk (w/out Aid) at 2yo 
Unable to run at 2.5yo
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13
Q

Sickle Cell Patho + Screening

A

(Auto-recess, beta-Hb Abnormality):

Screened for at Newborn Heelprick/Spot test (+ mother’s who are carriers/at increased risk)

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14
Q

Sickle Cell Anaemia Mx

A

Avoid dehydration (+ other triggers: NSAIDs)
Fully Vaccinate
Prophylactic Penicillin V
Hydroxycarbamide (Stim Prod of Fetal Hb)

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15
Q

Sickle Cell Crises

A

Vaso-occlusive
(Painful Occluion + Ischaemia)

Splenic sequestration
(Mx: Supp Fl +/- Splenectomy)

Aplastic
(Triggered by Parvoirus B19, Self-resolves w/in 1wk)

Acute Chest Synd
(Fever, SOB, Cough, New CXR Infiltrates)

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16
Q

Thalassaemia Patho + Sx

A

(Auto-recess, Hb chain Abnormality):

Excess Haemolysis = >
Jaundice,
Splenomegaly,
BM Expansion (+/- => #)

17
Q

Thalassaemia Mx

A

Monitor FBC,
Blood Transfusions,
(+/- Splenectomy, BM Transplant)

18
Q

Cause of Iron Overload

A

(Occurs w/ Thalassaemia):

Recurrent Haem + creation of new RBCs
Transfusions
Increased Fe Absorption in gut

19
Q

Iron Overload Mx

A

Monitor Ferritin + Transferrin saturation (Both Raised),

Limit Transfusions, (+/- Iron chelation)

20
Q

Hereditary Spherocytosis/Elliptocytosis Sx + Ix

A 
Sx:
Jaundice, 
Anaemia, 
Splenomegaly, 
Gallstones

Ix:
FBC (Raised Reticulocytes, MCHC - Mean Cell Hb Conc)
Blood film (Spherocytes/Elliptocytes)

21
Q

Hereditary Spherocytosis/Elliptocytosis Mx

A

Folate Supp,
Splenectomy (+/- Cholecystectomy),
(Acute crisis: Transfusions, BM Transplant)

22
Q

G6PDH Def Patho, Triggers

A

(X-linked Recess):
Lack of protection from Oxidative stress/ROS => Increased Haemolysis

Triggers:
Inf,
Drugs (Antimalarials, Sulfonylureas, Sulfasalazine, Trimethoprim, Nitrofurantoin, Cipro),
Broad/Fava beans

23
Q

G6PDH Def Features

A 
Neonatal Jaundice, 
Intermittent Jaundice (In Resp to Triggers), 
Anaemia, 
Gallstones, 
Splenomegaly
24
Q

G6PDH Def Ix + Mx

A

Blood Film (Heinz bodies: Denatured Hb w/in RBCs)

Mx:
Avoid Triggers,
Acute Crisis: Transfusions

25
Q

Classification of Allergies

A 
Type 1 (Immediate): IgE => Mast cells + Basophils
(Food Allergy, Allergic Rhinitis)

Type 2: IgG + IgM => Act Complement system:
(HDN, Transfusion React)

Type 3: Immune complexes accumulate:
(SLE, RA)

Type 4 (Cell-mediated): Inappropriate Act of T-cells
(Organ Transplant Rejection, Contact Dermatitis)
26
Q

Allergy Ix + Anaphylaxis Ix

A

Skin prick test: (Specific Allergens w/in solution => Sens react)
Patch test: (Allergens placed on skin for 2-3 days => Contact Dermatitis)
RAST: (Measure Total + Specific IgE levels w/in Blood: shows Sens)
Food challenge: (Monitor for Allergic react)

Anaphylaxis
Serum Mast cell Tryptase 6hrs Post Anaphylaxis
(Confirms Mast cell degranulation + Anaphylaxis)

27
Q

ITP Patho + Mx

A

Post-Inf Immune React targeting Plt’s => Thrombocytopaenia

Mx:
Steroids
If Plt < 0.5: Plt’s + IVIg

28
Q

IM Features

A

Rash
Lymphadenopathy
Fever
Splenomegaly

29
Q

IM Ix + Mx

A

Blood Cult
EBV Spot test

Mx: (Self-resolves w/in 2-3wks), 
Avoid: 
Alc (=> Liver Damage), 
Contact Sports (Exsanguination), 
Amox (Itchy, Maculopap Rash)
30
Q

Mumps Features

A

(Mumps V):

Fever
Parotid Gl swelling + Pain,
Myalgia
+/- Pancreatitis, Orchitis, Meningitis, SN Hearing Loss

31
Q

Mumps Ix+ Mx

A

Saliva/Throat Swab (w/ Viral PCR)

Mx: (Self-resolves w/in 1wk),
Supp (Rest, Analgesia, Fluids),
Notify Public Health,
Safetynet

32
Q

Hep B Viral Markers:

HbcAg (IgM, IgG)
HBsAg
HBeAg
HBV DNA
HBsAb
A

HbcAg:
IgM (High in Acute, Low in Chronic),
IgG (If HBsAg (-): Past Inf)

HBsAg: Act Inf (Given in Vaccine)

HBeAg: Acute-phase Inf (correlates w/ Inf Severity)

HBV DNA: Viral Load

HBsAb: Immune (Vaccinated, Past/Current Inf)

Medicine (13 decks)

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